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PL-15-982 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233291 Permit Number: PL-4-15-982 Scheduled Inspection Date: July 30, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: MENDEZ, BENIGNO Work Classification: Septic Job Address:551 NE 105 Street Miami Shores, FL 33138-2044 Phone Number Parcel Number 1122310140280 Project: <NONE> Contractor: CHAPMAN SEPTIC SERVICE, INC. Phone: (305)815-9901 Building Department Comments ABANDON SEPTIC TANK 900 GAL AND 300 DRAINFIELD infractio Passed Comments INSPECTOR COMMENTS False TO REPLACE PERMIT PL14-513 Inspector Comments Passed rough ok HRS PICKED UP SOD REQUIRED SIDE WALK REPAIR REQUIRED Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 29, 2015 For Inspections please call: (305)762-4949 Page 12 of 40 Permit 1U3. �"�- -'I - � Miami Shores Village Psl3hit Type. P1tlmbin0,,- 10050 N.E.2nd Avenue NE � WO!%<`Eja55tCc�f1Dt8:S@1t(C Miami Shores, FL 33138-00001 'V= Phone: (305)795-2204 Pelt`$1a11JS_ 'PRO W '��oRioA tss Date:F�-22/111115 Expiration: 01/1812016 Project Address Parcel Number Applicant 551 NE 105 Street 1122310140280 Miami Shores, FL 33138-2044 Block: Lot: BENIGNO MENDEZ Owner Information Address Phone Cell BENIGNO MENDEZ � 551 NE 105 Street � .. MIAMI SHORES FL 33138-2044 551 NE 105 Street MIAMI SHORES FL 33138-2044 Contractor(s) Phone Cell Phone Valuation: $ 3,450.00 CHAPMAN SEPTIC SERVICE, INC. (305)815-9901 Total Sq Feet: 300 Type of Work:ABANDON SEPTIC TANK 900 GAL AND 300 Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return : Final Classification:Residential Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# PL-4-15-55319 DBPR Fee DCA Fee $4.50 07/22/2015 $4.50 Credit Card $318.40 $0.00 Education Surcharge $0.80 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $318.40 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:11 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. Futhermore, I authorize the above-named contractor to do the work stated. July 22, 2015 Authorized Sig a ure:Owner / Applicant / Contractor / Agent Date Building De ar Ment Copy July 22, 2015 1 Miami Shores Village Building Department APR 15 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 to BUILDING Master Permit No. � �"— 98 2 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP ❑ ❑ CONTRACTOR ❑ ❑ DRAWINGS JOB ADDRESS: / (�►1- I O s S� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: l ° 2 2-3 i 0) OZf O Is the Building Historically Designated:Yes NO � Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): VA'k a Q Me ) Phone#: C- Address: �C-5 [ c)C 1"� City: S' f�rV­p_� State: � � Zip: 3 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: C"[�-fy yj ' ► I C Phone#: Address: �0 O JC �� �► City: 7 Y�1(A Vyl k _ State: L— Zip: 5 Qualifier Name: C�� HA(v Phone#: � �j� _ O 1 State Certification or Registration#: �� 1 Certificate of Competency#: > DESIGNER:Architect/Engineer: Phone#: S rl Ci Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: 3�x=" Type of Work: ❑ Addition ❑ Alteration ❑ lyew ] Repair/Replace ❑ Demolition Description of Work: kk Ct v` SPpC h k" C c Ct� ✓�CCS G4 q �� l Specify color of color thru tile: Submittal Fee$ "5-v CU Permit Fee$ ' � U CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ U• ` _�J (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. Signature Signature &/a, WNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _day of F(920 --'?0I5, by -3 day of FC 6 , 20 �)e)I',>, by Bi Y)i)to fY\1;'ri A if Z_ ,who is personally known to who is personally 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. ADA1N'r'u NOT4PUBL P..•.'�' MY COMMSPSIEONt�FRFO165583NOTARY PUBLI ro`"•••:��% AIDAPEGUERO EXPIRES:October 5,2018 ,� * MY COMMISSIONt FF 1855&4 °A �Oe Bonded Thru Budget Notary Senka ` EXPIRES:October 5,2018 rFpFFly RdBonded Thru Budget Notary Smim Sign: Sign: PrintPrint: Seal: Seal: APPROVED BY (C ���"�S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) i s Miami Shores e Villa g C Building Departmentc� f 10050 N.E.2nd Avenue,Miami Shores,Florida 33138S20 AR 172014 3` Tel:(305)795.2204 Far.(305)756.8972 INSPECTION'S PHONE NUMBER:(3o5)762.494 BUILDING Permit No. PERMIT APPLICATION Master Permit No.P/ i Permit Type: PLUMBING aoB ADDREss: S�1 12e, /95 city: Miami Shores County: Miami Dade Zip: 3 13 0 Folio/Parce*. Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): ;Bsa,A N O_Mir. phone#• Address SS'1 n - 1®�6fi �_ City• m1a lk) State: ivy zip: Tenant/Lessec Name: Phone#: Email: CONTRACTOR:Company Name: qmuwL���� Phone#; Address: h city: State: zip:-3 32gs Qualifier Name: Phone#:c3 State Certification or Registration#: (07 Certificate of Competency#: S A 6 all B S Contact Phone#:13 96A 1 Email Address: 06quaA f4j4 DESIGNER:Architect/Engineer: Phone#: Value of Work-for.this Permit:$ SquatWUnear F'Oobvaf Work: c3 of brk: O,A ONew 44air/Roplace UDemolition Type: �Y ddrees DAltcration Description of Work: ,? i ,r*,kap►w�e�t*ttww*«,rwwt� +*maw«�,k�wwF��r*,r�rsir,r«w*ew,rwaa+nrrr+�►�rw�**+rwwir*,err Submittal Fee S,312100 Permit Fee$ �. �+ CCF$ CO/CC$ i Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Tralaing/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ _pyo TOTAL FEE NOW DUE$,�� •CY i 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 EMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMNVIENCEMENT." 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 O or Agent Contractor The foregoing instrument was acknowledged before me this L7— The foregoing iastrament was aclmowl ged before me this] day of ll�,20 A by Y Alm.&—eAiAAyL , day of P110rek J 20 W,by who is personally known to me or who has*duced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: g111ulilyty,� xs, . Sign: f/ .•••.. /.••.• Ste: S ••.....:K Print 7 r� a:'• 90.PD •'•. • � • Print- • My Commission Expires: •• *s My Commission Expires: iOFFOUe� •SOslo ?e • Prwtlee •04 � ti�rmas •• O� *«** *eye ka rya*«**,e,ae, ,t*,rw**nr*yew �,r,raw«w r,k,k�r*w**,►,k,r,rw�e,►w*rww w. w,r+r w*w+r+r* ql •'91,'' ,►«,eew ��ptlHu�p���� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Rmi9ed3/12t2012XRrAsed 07/10/07)(1trAsod 06/10/=9XRrA9ed 3/15/09) r Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax:(305)756-8972 Inspection Number: INSP-209089 Permit Number: PL-3-14513 Scheduled Inspection Date:March 25,2014 Permit Type: Plumbing - Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: MENDEZ, BENIGNO Work Classification: Drainfield Job Address:551 NEI 05 Street Miami Shores,FL 33138- Phone Number Parcel Number 1122310140280 Project <NONE> Contractor: CHAPMAN SEPTIC SERVICE,INC. Phone: (305)815-9901 Building Department Comments ABANDON EXISTING TANK INSTALL 900 GALLON AND Infractio Passed Comments 300SQ. FT DRAIN FIELD INSPECTOR COMMENTS False Inspector Comments Passed Failed kA Correction Needed Re-Inspection Fee �- ' e No Additional Inspections can be scheduled until / re-inspection fee is paid March 24,2014 For Inspections please call: (305)762-4949 Page 19 of 35 i i i I i I I i I � Master Septic Tank Contractor CHAMES J CHAPMAN 471 BIG PINE ROAD KEY LARGO FL 33037- CHAPMAN SEPTIC SERVICE,INC. Business Authoritatbn. SA0910574 SM0941167 Registration Expires on September 30,2014 i i PERMIT #:13-SC-1520382 STATE OF FLORIDA APPLICATION tl:AN 135308 DEPARTMENT OF HEALTH DATE PAID ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT (I: }, DOCUMENT a:PR929687 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Benign Mendez PROPERTY ADDRESS: 551 NE 105 St Miami,FL 33138 LOT: 19 BLOCK: 10 SUBDIVISION: amd pl miiami shores PROPERTY ID 9: 11-2231-0140280 [SECTION, TONNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 361.0065, P.O., 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 I A)MW K CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS II ]DOSES PER 24 HRS $Pumps [ ] D [ 300 ] SQUARE FEET bed configuration drainflel SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [xl STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: Top of bottom floor,12.30'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 18.00] INCHES FT IIABOVE BELOOP BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 58.00] niaHEs FT ][ABOVE BSNcHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] ITCHES EXCAVATION REQUIRED: [ 52.00] INCHES This repair permit was wranted based on building information provided in the application by the contractor of 3 bedroom O SFR with 1,542 sq.ft.of building area. T New sewer line shall be permitted and inspected by the pertinent plumbing dept. H Inspector to verify the existing septic tank is properly abandoned before final approval. *Invert elevation of dreinfield to be no less than 7.96'NGVD. E 'Bottom of drainfield elevation to be no less than 7.48'NGVD. "Install 12'of slightly limited soil under the bottom of dreinfeld. R SPECIFICATIONS BY: Charles J Chapman TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Dade CHD Carlos M Ioasa DATE ISSUED: 02/122014 EXPIRATION DATE: 05/132014 DH 4016, 08/09 (&fi(M ISI ��;,� fi r { ��erQr z �y not be used) Incorporated: 6�0�r9�p+' j ad"F1 c�"rain9ielTexcava;% Incorporated: �t� time ui iulY inspectico.',ior t.,Final Approval,title-DOFI Page 1 of 3 inspector shall wi[es '�ia°soil borina ans±Corr"*woe 58919610 results to the original siie evaluation submitted.A reinspection tee will be assessA if the contractor is no` at the jrjlosite ai ttie arranged:+me ■■rrrrrrrrrrrrrrrrrrrrrrrrrr■ ■rrrr■ MMMMMrrii�■rrrrr■ ■rrl��ti�ilrrrir�������rrr�itrr�RlORB ■rr�c%r■�rrri�r����r■■rl t■iii r��Mt1r■ ■rrrrrrl�rrrrrhh�rrrrrl�r�lr..��r■ ■rrrr■■�lr■r■r�► rr■■rrr,■/■rrrrr ■rrrrr ri`rr■■Irrr�rr rrrirN�rrMEIN ■rrrrr ORE■rrrwrt.arr■r u�.r r wml rrrr ■r rr►I■rrrrAMEMAP! rr■ . rrrrrr■r��rrrrrr■■rrl a.�rrr rrrrr■ ■ rr�; r rr��■rrrrrrr��Arrr■rrrrr■ r� rrr■■r��■rrrrr�rr�■rrrrr��rrr■ ■r rrr■■NW rrrrMrorrr rrrrr■r�nrr■ rrrrrr r��■■r�r��:?rrr rrrrr■rr.rrrr■ ■rrrrr r�r�■�.rrrr��r■■��r�■ ;rrr■ ■rrrrrr ?,: NMI Mom ■rrrrr��i■��;irr�/rrrrr rrrrr r�rrr■ ■r+���r�r�E�wrr�rrrr■■rrrrrirrr■ rOMA.wSLOW r; rrMINE NOON rrrrrr■ ■r�+��r■®r��rr�r■■■r■rrrrr rrrrr■ ONO ON rrr/�!!!"!�*'� T�''�"' �'r err■rrrrr,err . ...� .�,�1..'_L_.. -� ,1�r_!�1'�'%�►A' L. ��'`�-�... rI' ■ " .. 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