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PL-15-1739 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-238894 Permit Number: PL-7-15-1739 Scheduled Inspection Date:August 20,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: LUCA, CORNELIU Work Classification: Drainfield Job Address: 1065 NE 97 Street Miami Shores, FL Phone Number (305)321-3919 Parcel Number 1132050170090 Project: <NONE> Contractor: MR C'S PLUMBING &SEPTIC INC Phone: (305)651-7859 Building Department Comments DRAINFIELD INSTALL Infractio Passed Comments INSPECTOR COMMENTS False Spector Comments Passed ED� HRS APPROVAL WILL BE ON MAIL BOX Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 19, 2015 For Inspections please call: (305)762-4949 Page 15 of 41 DIVISION OF Environmental Health Florida Health Miami-Dade County �D OSTDS/Well Division 401 11805 SW 26th Street•Miami,FL 33175 O Inspector N�C12 UVV4ej-< Date Address— 10(0 S Ny q� — OSTDS#��J q r1 11 1 t Comments: Signature - Permit No. PL-7-15-1739 „�,S Miami Shores Village Permit Type: Plumbing-Residential 10050 N.E.2nd Avenue NE td Permolt Work Classification:Drainfi0 '• "' Miami Shores,FL 33138-0000 Permit Status:APPROV Phone: (305)795-2204 issue Date:Date:7/15/2015 Expiration: 01/11/2016 Project Address Parcel Number Applicant 1065 NE 97 Street 1132050170090 CORNELIU LOCA Miami Shores, FL Block: Lot: Owner Information Address Phone Cell CORNELIU LUCA 1065 97 Street (305)321-3919 MIAMI SHORES FL 33138- 1065 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 2,100.00 Valuation: MR C'S PLUMBING&SEPTIC INC (305)651-7859 Total Sq Feet: 300 Type of Work:DRAINFIELD INSTALL Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Y Type Date Pa T e Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# PL-7-15-56312 CCF $1.80 07/15/2015 Credit Card $ 118.30 $550.00 DBPR Fee $2.25 DCA Fee $2.25 07/13/2015 Credit Card $50.00 $500.00 Education Surcharge $0.60 07/15/2015 Credit Card $500.00 $0.00 Permit Fee $150.00 Bond#:2790 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. Fut�thorize the above-named contractor to do the work stated. July 15, 2015 orized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 15, 2015 1 Miami Shores Village $� ��"�� '�°��'I g , �u� i 20115 !, Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 _ - Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20l`� BUILDING Master Permit No.PL PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL F—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1065 NE 97th street City' Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Buildinj Historically Designated:Yes NO Occupancy Type: Load: Construction Type: _Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): ('4'0'Pz u ZA4 64— Phone#: Address: �mos— City: os— City: l�W 2y( S�/'' "Z State: �L Zip: l/�3 Tenant/Lessee Name: _Phone#: Email: ry, C / CONTRACTOR:Company Name: Mr C4 PI��I�, � J�Z Phone#:(/3\1 t7f)-71- Address: k613 d, KU �Ik Af(_ ?? City: VV,k..I State: Zip: 7 Qualifier Name: K",e stn ck Phone#: State Certification or Registration#: ��06 �i� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ i Iy1 G'd Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: 1�n1 Specify color �o/f�color thru tile: ` Submittal Fee$ c�J •� Permit Fee$ 1JG• '-W CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPIR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ gn•00 —?i-F& 8� TOTAL FEE NOW DUE$ •�� 1 � (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address _ City State 0 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 a ov d 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 r 3 day of sV�� 20 , by day of 20 by Lp4�N€Lry LU6R who is personally known to who is personally known to me or who has produced 7 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: Sign: a Print: Print: L ,Y Notary Public State of Florida Seal: .<r�°Po'o SHERYL A MENOES Seal: �',`. ( e`My Comm. Expires Sep 19,2017 ,o e, NotaryPublic-State of Florida Commission#FF 055732 * My Comm.Expires Oct 23,2018 Bonded Through National Not Assn. cCommission#FF 1 5q oo?:. ary Assn. APPROVED BY r jS Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) e i PERMIT #: 13-SC-1 616143 ' PP=r; oN #:AP 1195197 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DOCUMENT #: PR980251 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Corneilu Luca PROPERTY ADDRESS: 1065 NE 97 St Miami, FL 33138 LOT: 9 BLOCK: 180 SUBDIVISION: Miami Sho''es Sec 8 Rev PROPERTY ID #: 11-3205-017-0090 [SECTIC:1, 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 TIYE. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, P.EQUIRE 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 existinq septic tank to remain CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALIONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 300 XISQUARE FEET new bed confiq drainfie STEM 0000 • R [ 0 ] SQUARE FEET SYSTEM ,, • • •••• •••••• • • • • A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND ( ] •• . � I CONFIGURATION: [ ] TRENCH [x] 'BED [ ] •••••• ••••� �•��• •••••• F LOCATION OF BENCHMARK: FFE 11.3'NGVD •.•• . • • • I ELEVATION OF PROPOSED SYSTEM SITE [ 20.40 ] ( INCHES FT ] [ F,BOVE BELOW BEN(WK/REFHRF.NCE POINT•••• E BOTTOM OF DRAINFIELD TO BE [ 70.44 ] [ INCHES FT ] [ ABOVE BELOW BE4Gt4M/REFrbAENcE:POINT•••• •• •• •• •• •••••• L .. • D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.00 ] INCHES • • • • 2.-Install 300 sf of dra septic nnk, certified y"Mr.C's Plumbing"on 7/2/2015 to remain. :••••• . •. 9 9 P Y" 9" ••• •• T 3.-Install 12"of slightly limited soil at the bottom of,the drainfield. • • • 4.-Perimeter of excavation area shall be at least 2 ft wider and loriger than the prcposed absorption bed or drain trench. H (Comments Continued on Page 2.) E R ... I t SPECIFICATIONS BY: r C' P�b Sept TITLE: APPROVED BY: MR TITLE: Engineering Specialist II Dade CHP tin DATE ISSUED: 'ZA/2 15 EXPIRATION DATE: 10/05/2015 DH 4016, 08/09 (Obsoletes all previous editions which ritay not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1..7..A 97 SE965397 7/1312015 CCF07022015 00000-jpg r s STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number ---------------------------PART II -SITEPLAN----------------------_- N Scale: Each block represents 10 feet and 1 inch=40 feet. O � o rr 44— SY1 I� t lir q5e vill, 3 o ivy 11 3 11 r S � � • • • ••• • • ago*. • • • •• 6 09066• • 9 *0 0 • • •1�74 • 0 •• •• There are no pertinent features on adjacent properties and or across the street that may affect the New&"(;gystem installation. + o es: • • -1)r0 hof t-e-.R�Site Plan submitted by: C6 v- r cafe Plan Approved Not Approved Date 1 2 _ By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY ALTH DP-PARTMENT DH 4015,10/96(Replaces HRS-11 Form 4016 which may be used) PLUMPM PLAM Page 2 of 4 (Stock Number: 5744-002-4015-6) Approvfr��i w7. ___Date �•� '/ https://drive.google.com/drive/folders/OB3SYVJuZW i RfV214Y2N BY2l pOEU 1/1