PL-15-1527 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-237329 Permit Number: PL-6-15-1527
Scheduled Inspection Date: July 14, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: YAGODA,JAY A Work Classification: Drainfield
Job Address:70 NE 99 Street
Miami Shores, FL 33138- Phone Number (954)401-6233
Parcel Number 1132060131050
Project: <NONE>
Contractor: MR C'S PLUMBING &SEPTIC INC Phone: (305)651-7859
Building Department Comments
SEPTIC TANK AND DRAINFIELD INATALLATION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS APPROVAL IN FILE
aC�
Failed
Correction
Needed ZL
Re-Inspection
Fee �
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 13, 2015 For Inspections please call: (305)762-4949 Page 22 of 41
DIVISION Of
I EWMnmentat Health
Florida Health .��
Miami-Dade County~, �jp�
RR.' OSTDSIWell DIVisiax ��
11805 SW 26i°Street•Miami,FL 33175
d� Date
Inspector
OSTDS#
Address
Comments:
I
Signature
&
n
: 'emelt .- -�' J- �
y
�eHb1 S L,�
Miami Shores Village11t
!(7wyrJ6 Pl�r li �gsid$tt�I -
10050 N.E.2nd Avenue NE Cris D [dr.
" Miami Shores,FL 33138 0000
Phone: (305)795-2204
PpR{ �1 D
FLORIOp' '
Expiration: 12120/2015
Project Address Parcel Number Applicant
70 NE 99 Street 1132060131050
j Miami Shores, FL 33138- Block: Lot: JAY A YAGODA
Owner Information Address Phone Cell
E
JAY A YAGODA 70 NE 99 Street (954)401-6233
MIAMI SHORES FL 33138-
70 NE 99 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: �$ 2,300.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
Total Sq Feet: 300
Type of Work:SEPTIC TANK AND DRAINFIELD INATALLA Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:
HRS Approval
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
Invoice# PL-6-15-56047
CCF $1.80 06/23/2015 Check#: 1129 $500.00 $168.30
DBPR Fee $2.25
DCA Fee $2.25 06/22/2015 Credit Card $50.00 $118.30
Education Surcharge $0.60 06/23/2015 Credit Card $ 118.30 $0.00
Permit Fee $150.00 Bond#:2759
Scanning Fee $9.00
Technology Fee $2.40
Total: $668.30
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS 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. Fuer orize the above-named contractor to do the work stated.
June 23, 2015
authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 23, 2015 1
Miami Shores Village �J-uf.4 N—Tv,!
Building Department 3u 2 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax: (305)756-8972INSPECTION LINE LINE PHONE NUMBER:(305)762-4949
FBC 24`13
BUILDING Master Permit N!02.�
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
M '�i� �}��nn CONTRACTOR DRAWINGS
I�J
JOB ADDRESS: 70 b S t �,t
City: Miami Shores ppCounty: Miami Dade Zip: J 30655
Folio/Parcel#: — 3ab6 -' tlC 3 l os-d Is the Building Historically Designated:Yes NO +�
Occupancy Type: Load: Construction Type: Flood Zone:
Phn�e:: BFE: FFE:
OWNER: Name(Fee Simpl Titleholder): 70 � L.f-
E V NTA& C, l" 1 r ne#:(4 ��`�/ -i3
Address: C�u UR 1t
City: Y�k-1'+.-t State: t Zip: 3,3 131
Tenant/Lessee Name: Phone#:
Email: r r
CONTRACTOR:Company Name: ` Vv Phone#:d � c ` D
Address: � 1 �W �!`111'�
City: µY]N"^� State: C Zip: 6
Qualifier Name: � 1 Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: 2 City: State: ZiD:
Value of Work for this Permit:$ a30 X b Square/Linear
�?Repair/Replace
Footage of Work: 0
Type of Work: El Addition ❑ Alteration El New El Demolition
Description of Work: a+4 rL �( %�� 4 I,d / �J
Specify color of colpr tile:
Submittal Fee$ Permit Fee$ /sU. y 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)
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.
kA�Signature Signature
WNER rAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
ncc�, day of , 006 20 1 Ste, by PX day of 0A)C-7 20 s , by
361 %hOAA who is personally known tof who is person_ ally known to
me or who has produced as me or who has produced .�— as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: - ")A Sign:
SHER
Print: L TRICK Print: � � .`P blit-State of Florida
Notary Public- ar Expires Oc
Seal: =?: ;� My Comm.Expires Sep 19,2017 Seal: C0
'�` �pMMISsion # FF 136597
' # FF 055732 ?N,
s,y `or Commission 901�dMr'r:ar al Notary Assn.
P° h National Notary Assn. ,�:1�.1;.•���
Bonded Through
************************************************************************************************************
APPROVED BY �,u�5 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
CFN: 20150355609 BOOK 29642 PAGE 440
DATE:06/04/2015 09:53:38 AM
DEED DOC 3,393.00
HARVEY RUVIN,CLERK OF COURT,MIA-DADE CTY
prepared by and return to:
Federico E.Fernandez
DiFalco&Fernandez,LLLP
777 Brickell Ave Suite 630
Miami,FL 33131
305-569-9800
File Number: 15-0006
Will Call No.:
[space Abovc This Line For Recording Datal
Warranty Deed
This Warranty Deed made this 29th day of May, 2015 between 70 RE Venture LLC, a Florida limited liability
company whose post office address is 1450 Brickell Ave, Miami, FL 33131, grantor, and Jay A. Yagoda,a single man
whose post office address is 55 SE 6 Street,#4202,Miami,FL 33131,grantee:
(Whenever used hereat die terms"grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives,and assigns of
Individuals,and the successors and assigns of corporations,trusts mid trustees)
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND N01100 DOLLARS($10,00)and other
good and valuable considerations to said grantor in hand paid by said grantee,the receipt whereof is hereby acknowledged, j
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate,lying and being in Miami-Dade County,Florida to-wit:
LOTS 3 AND 4, BLOCK 8, AMENDED PLAT OF MIAMI ShIORES SECTION NO. 1.
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10, PAGE 70, OF
THE PUBLIC RECORDS OF DADE COUNTY,FLORIDA.
Parcel Identification Number: 11-3206-013-1050
Subject to taxes for 2015 and subsequent years; covenants, conditions, restrictions, easements,
reservations and limitations of record,if any.
i
Together with all the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold,the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said [and in fee simple; that the
grantor has good right and lawful authority to sell and convey said land;that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful clauns of all persons whomsoever; and that said land is free of all
encumbrances,except taxes accruing subsequent to December 31,2014.
In Witness Whereof,grantor has hereunto set grantoes hand and seal the day and year first above written.
DoubleTinies
ti
CFN: 20150355609 BOOK 29642 PAGE 441
Signed,sealed and delivered in our presence:
70 RE VENTURE LLC
Witness Name: YICO a Florida limited liability company
By:DIFALCO&FERNANDEZ,LLLP
a Florida limited liability ited partnership
its Manager
it ess Name. y}0--
By. ,.
C e L.DiFalco,Partner
State of Florida
County of Miami-Dade
The foregoing instrument was acknowledged before me thisc —day of May,2015 by Christophe L. DiFalco, Partner of
DiFalco&Fernandez, LLLP, a Florida limited liability linuted partner up and Manager of 70 Re Venture LLC, a Florida
limited liability company, on behalf of the company. He/she tj is personally known to me or L]has produced
as identification.
[Notary Seal] Nota Public
JAN AVENDANO
Printed Name: Qh(r
rl�A MY COMMISSION NFFt 12931 My Commission Expires: -�r-i ) 5, ';)b ]
ptplRE3 April 18,2018
�nOwrtietvlCe•e
An 90e.Dtee RloddeNtri '
1
;
Warranty Deed-Page 2 DoubleTimse
PERMIT #: 13-SC-1612512
MOM
APPLICATION #:AP1 9 2787
1
STATE OF FLORIDA
DATEPAID:
A
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
�0-60'TF DOCUMENT #: PR978358
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: (70 RE Venture LLC)
PROPERTY ADDRESS: 70 NE 99 St Miami, FL 33138
IAT: 3 4 BLOCK: 8 SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3206-013-1050 [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 j GALLONS / GPD new septic tank ✓ CAPACIT`j
A I 0 1 GALLONS / GPD CAPACITY
N [ 0 J GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ) GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ )
D [ 300 1 SQUARE FEET new bed confiq.drainfield SYSTEM
R [ 0 j SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ 1 MOUND ( 1
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCIOJARK: FFE 13.1'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE ( 22.8011 INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE ( 72.841 [ INCHES FT 1 [kBODVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: ( 0.001 INCHES EXCAVATION REQUIRED: ( 62.001 INCHES
1.-Install a 900 gai min.septic tank with an approved filter.
O 2.-The licensed contractor installing the system is responsible for installing the mi .mum category of tank in accordance
I
T with s.64E-6.013i3;(f), FAC.
3.-Install 300 sf of drainfield in bed configuration.
H 4.-Install 12"of slightly limited sol at the bottom of the drainfield.
E 5.-Perimeter of excavationar a shall be at least 2 ft wider and longer than the pr; used absorption bed or drain trench.
(Comments Continrd n Page 2.)
R
SPECIFICATIONS BY: 's P1b Sept TITLE:
APPROVED BY: ! r' TITLE: Engineering Spec:,.alist 11 Dade CHD
e2sY Martin
DATE ISSUED: 617/2015 EXPIRATION DATE: 09115/2015
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Page 1 of 3
Incorporated: 64E-6.003, FAC
6/20/2015 CCF06152015_000OO.jpg
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
----------- PART II-SITEPLAN---------------------------
:t
Scale: Each block represents 10 feet and 1 inch=40 feet.
S
.- t r�
-T 14.
>;e
I
all
-7a i
&A I'
I ell
L
There are no pertinent features on adjacent properties and or across the street that may affect the New Septic system installation.
Notes:
Site Plan submitted by: '
Plan Approved Not Approved Date
By County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015,10!96(Replaces HR S-H Form 4016 which may be used) Page 2 of 4
(Stock Number: 574:-002-4015-6)
https://drive.google.com/drive/folders/0F13SYVJLEW i RfWYMFU 1 aU 5xQ1 U 1/1