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PL-15-1105 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234409 Permit Number: PL-5-15-1105 Scheduled Inspection Date:August 20,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: WESTHORP,BRENDA Work Classification: Drainfield Job Address:1184 NE 91 Terrace Miami Shores, FL Phone Number (305)798-7113 Parcel Number 1132050010460 Project: <NONE> Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859 Building Department Comments DRAIN FILED INSTALLATION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed hrs in file Ui `G Failed Correction Needed S4 C�1c Re-Inspection s Fee No Additional Inspections can be scheduled until re-inspection fee is paid August 19,2015 For Inspections please call: (305)762-4949 Page 8 of 41 Permit NO. PL-rJ'-1 J- �ggortEs�,� Miami Shores Village Permit Type:Plumbing-R8$Ede s� . 10050 N.E.2nd Avenue NE � � FFI" Work Classiftcatipw,©rainfiel� Miami Shores,FL 33138-0000 Per7rlitat&1U3:, }�P : Phone: (305)795-2204 FtoRI'D issue Date: 5/15/2015 Expiration: 11/1V2015 Project Address Parcel Number Applicant 1184 NE 91 Terrace '- _ 1132050010460 Miami Shores, FL Block: Lot: BRENDA WESTHORP Owner Information Address Phone Cell BRENDA WESTHORP 1184 NE 91 Terrace (305)798-7113 MIAMI SHORES FL 33138- 4 -�: �-..A.a,f$hi�,..'.C.7iA'. A�'&3 � •.. sr.. .�..-.'. '^. SJv.S„o- _„��- 1184 NE 91 Terrace MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone 1 $ 6,000.00 MR C'S PLUMBING&SEPTIC INC (305)651-7859 I Valuation: _ - Total Sq Feet: 200 Type of Work: DRAIN FILED INSTALLATION Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return Final Classification:Residential Scanning:3 Review Pl ambing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# PL-5-15-55505 CCF $3.60 DBPR Fee $2.25 05/15/2015 Check#:2781 S E23,10 $ 50.00 DCA Fee $2.25 05/11/2015 Credit Card $ 90.00 $0.00 Education Surcharge $1.20 Bond#:2717 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $673.10 In consideration of the issuance to me of this perm t, I agree to perform the work covered hereunder in compl ince with all ordinances and regulations pertaining thereto and in strict conformity with the plar:s,drawings, statements or specifications submitted to the prol er authorities of Miami Shores Village. In accepting this permit I assume responsibility for all cork der._ either ^yself _:_ _ ., . . :cy - I understand that separate permits are required for ELECTRICAL,PLUMBING, MECHANICA-,WINDOWS, DOORS,ROOFING an(I SWIMMING POOL wort. OWNERS AFFIDAVIT: I certify t t all the foregoing information is accurate and that a!I work will be done in com iliance with all applicable laws regulating construction and zonin more, I a rize the Fbove-named contractor to do the work stated. Ma115, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent )ate Building Department Copy May 15, 2015 - ---- ------------ 1 Miami Shores Village RECRWED Building Department MAY 11.2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 �BS �eS— i✓A�7�Q FBC 20 1� BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP AL CONTRACTOR DRAWINGS JOB ADDRESS: 'I b L NU 4 I reftne City: Miami Shores County: Miami Dade Zip: 3'XTr Folio/Parcel#: 1( SUS W D(&64 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 3e. , U.�_4&save Phone#: 70S -1 iY 7113 Address: I(CK4 NE� I y'Ur- City: State: rL Zip: 3?I39' Tenant/Lessee Name: Phone#: Email: / / ,.5�/�, /� / CONTRACTOR:Company Name:��/' d At �iZ Phone#: 3,08 mfr Address: /f9y kw �V i City: lkw' // State: /� Zip: V/0 Qualifier Name: Kt4e &iak Phone#: X757 i90 State Certification or Registration#: 6w 5-76 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ t/2 Square/Linear Footage of Work: ;2.OV J Type of Work: ❑ Addition ❑ Alteration / ❑ New Repair/Replace ❑ Demolition Description of Work: � � Jk Specify co/oof color`thru tile: Submittal Fee$ Permit Fee$ �'� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ .0,--) -t— 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 O N R or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 6 day ofc� 20 / by day of 20 S by who is personally known to who is personally known to me or who has produced D6P&-A ISce a\c_ 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: 5�;e k ) 641&— Sign: Sign: Print: LJ Print: OR •tPpY PUB, KEMBLE ETTRICK ??o , Notary NN -SWIG 001 Seal: ;'_°, .`mss Notary Public- State of Florida Seal: - _my Comm.Expires Oct 23,2018 My Comm. Expires Sep 19,2017 "�� �� p��Cyommmi(s�ssiionp�# FF 135597 Commission # FF 055732 „ocr� xy Notary Assn. Bonded Through National Notary Assn. ********* * **************************************************************** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) •r;' ` • : :. Mtt- �Cpl+ ' PERMIT #:13-SC-1 601140 UNV APPLICATION #:AP1185361 STATE OF FLORIDA DATE PAID: DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT # •�� DOCUMENT #:PR972137 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Brenda Westhorp PROPERTY ADDRESS: 1184 NE 91 Ter Miami,l=L• 33138 LOT: BLOCK: SUBDIVISION: Watersedge PROPERTY ID #: -11-3205-001-0460 ISECTI6*, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TA-,'ID NUMBER] I , SYSTEM MUST BE CONSTRUCTED IN ACtGORDANCE : VTiTH , SPEC,IF CATIONS AND STANDARDS OF SECTION 381.Q065, F.S. , AND CHAPTER 643-6, F,�A.C.;' DEPARTMENT rAYRROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIODOF TIM?. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUA1tC8. OF:' JHIS:...PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS. MAY RESULT fN 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 existing septic tank CAPACITY A I ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 225 ] GALLONS DOSING TANK CAPACITY 150.00 ]GALLONS @I 6 ]DOSES PER 24 HRS #Pumps [ 1 ] D [ 216 ] SQUARE FEET bed configuration=i]ralnfiel ••SYSTZM' ` . R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ]T,FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED "E I N F LOCATION OF BENCHMARK: FFE 6.1' NGVD I ELEVATION OF PROPOSED SYSTEM SITE 1 16.8011 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 30.8011 INCHES FT IEABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 4.00] INCHES. "'��4EXCkVA'TIO13j.2tE�QUIRED:' I 26.00] INCHES "Performing Lift Dosing with 225 gal min tank. **Pumps must be certified as suitable for distribut'p sewage efflugn'#. �S4,�9� VE .. T l.-Existing 900 gal.septic tank,certified by Mr..C' '.hPlumbing 9•Sept1on 64/20120,15,to remain. 2.-The licensed contractor installing the system is'i:esponsiblef&installing the min'mum category of tank in accordance H with s.64E-6.013(3)(f),FAC. ' E 3.-Install 216 sf of grainfield in bed configuration. (Comments Continued on Page 2.) R SPECIFICATIONS BY: Kemble Ettrick TITLE: APPROVED BY: TITLE: Engineering Spec.'.alist II Dade CHD Erlande Omlaca DATE ISSUED: 05/04/2015 EXPIRATION DATE: 07/21/2015 DH 4016, 08/09 (Obsoletes all previous edt-tions Evhich.may not be used) ��,(ir]` �}!A�•■. Incorporated: 64t:-6.00$, FAC v 1.1.4 AP1185361 SE ONTRACTOR..• 1LBrnING The contractor(or des'gned)is required to perform a soil boring adiacent to the dra',nl:e:d excavation at the time of final inspect?on. Friar to Pir.al Approval, the FDOH inspector shall witness the sort boring and compare the results to the original site evaluation.scbrni ted. A reinspection fee will be assessed d the contrac for Is not at the jobshe at the arranged time. �1 � � s ad_ . � o � �� � ,� � � I ,. .. ���, _ __ � ��: y r ry, •� �� v -; 3