PL-15-150 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-230076 Permit Number: PL-1-15-150
Scheduled Inspection Date: July 08, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: HERBITS, STEPHEN Work Classification: Septic
Job Address:246 NE 101 Street
Miami Shores, FL Phone Number (305)962-5552
Parcel Number 1132060134630
Project: <NONE>
Contractor: MR C'S PLUMBING &SEPTIC INC Phone: (305)651-7859
Building Department Comments
REPLACE SEPTIC TANK AND DRAIN FIELD. Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-226935. HRS ON FILE
sod required
sidewalk ok
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 07,2015 For Inspections please call: (305)762-4949 Page 8 of 52
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DIVISION of
Em Mamentai Health
Florida Health
Miami-Dade County N
OSTDS/Well Divbioa
11805 SW 260 S&W-Miami.FL 33175
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Miami Shores Village11"_1 75
Building DepartmentJAN2 0I5
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY.
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 2010
BUILDING Master Permit N�� � — 5
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: A114 NAr 101"r-
City:
06,rCity: Miami Shores County: Miami Dade Zip: 3 I S
Folio/Parcel#: &3,20w,— D/3--{%3o Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): 5-TEetWIJ 6-. A4e-RC3rrS Phone#: 3OS— 176,2' 5Y32
Address: /000 (/6'Nt T/fMJ t.J h-y 4U-- (?01f
City: /Y7/A-m i State: FF. zip:
Tenant/Lessee Name: "Cl AJ a Phone#:
Email: S #-eRQ IT'S y i 6-'►1. tmw.
CONTRACTOR:Company Name: Phone#: 77155
Address: 1*3), NW 2"- Y QQ �M
City: Meu... State: lL Zip: /1/b �I
Qualifier Name: E*wC4- Phone#: St. =—�tv
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: A/0 Ndr Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 't ,Square/Linear Footage of Work:
Type of Work: ❑ Addition Alt ation ( ❑ New Repair/Re lace
p ❑ Demolition
Pt^
Description of Work: [ Q-p/*co 5ed-071L 7a'4-,4L hlv.A A fidz D
Specify color of color thru tile: o,✓(!(
Submittal Fee$ �� Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
t
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature �,., � �$ Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Zc day of 20 by _day of 20 ) by
who' personally knownt0 t- WCL who is personally known to
me or who has produced as me or who has produced
SHERYI A M
identification and who did take an oath. identification and who tl r row.S"of Florida
NOTARY PUBLI¢: / NOTARY PUBLIC: MY Co".ExOUes Oct 23,2018
_ Commission#FF 138597
lllrough National Notary q«
Sign: �- C;t Sign:
Print: (iiY\Cw Yah 13 Print: L �
Seal t ! Cin*Kohn•Cybul ;,e Seal:
�• 2COmmini0n#FFO80513
J &Pires:UN.02,2018
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************************************************************************************************************
APPROVED BY a /; 22 fS Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Nk
STATE OF FLORIDA PERMIT #:.13-SC-1579492
DEPARTMENT OF HEALTH APPLICATION #: AP1171223
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
'D wit DOCUMENT #: PR960363
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Stephen Herblts
PROPERTY ADDRESS: 246 NE 101 St Miami, FL 33138
LOT: 7,8 BLOCK: 34 SUBDIVISION: Miami Shores Sec 1 Amd
PROPERTY ID #: 11-3206-013-4630 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S. , AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD new septic tank CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 300 ] SQUARE FEET new bed confiq. drainfield SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED ( ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 12.0' NGVD
N E I FT ABOVE BENCHMARK REFERENCE POINT
I ELEVATION OF PROPOSED SYSTEM SITE [ 26.40 ] [ INCHES ] [ BELOW BENCHMARK/
REFERENCE
BOTTOM OF DRAINFIELD TO BE [ 76.44 ] I INCHES FT ] [ ABOVE HELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.00 ] INCHES
O 1.-Install a 900 gal min. septic tank with an approved filter.
2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
T with s.64E-6.013(3)(0, FAC.
H 3.-Install 300 sf of drainfield in bed configuration.
4.-Install 12"of slightly limited soil at the bottom of the drainfield.
E 5.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
R (Comments Continued on Page 2.)
SPECIFICATIONS BY: Mr C' 's Plumbing TITLE:
APPROVED BY: TITLE: Engineering Specialist II 5R7e CHD
Yu eisy Martin
\ate; 10901a
DATE ISSUED: 01/12/2015 EXPIRAT
aNe S
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC F� 0 S Page 1 of 3
AP1171223 SE9474E4
DOCUMENT #: PR960363
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6.-Invert elevation of drainfield to be no less than 6.13'NGVD.
7.-Bottom of drainfield elevation to be no less than 5.63' NGVD.
8.-This permit includes the abandonment of the existing septic tank.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of
300 gpd.THIS PERMIT IS NOT FOR ANY ADDITIONS.
s
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN#A02, Tallahassee, Florida 32399-1703. The
Agency Clerk's facsimile number is 850-410-1448.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order
will constitute a waiver of your right to an administrative hearing, and this order shall become
a 'final order'.
Should this order become a final order, a party who is adversely affected by it is
entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings
are governed by the Florida Rules of Appellate Procedure. Such proceedings may be
commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the
Department of Health and a second copy, accompanied by the filing fees required by law,
with the Court of Appeal in the appropriate District Court. The notice must be filed within 30
days of rendition of the final order.