PL-15-875 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232483 Permit Number: PL-4-15-875
Scheduled Inspection Date:August 18,2015 Permit Type: Plumbing- Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: ARENAS,JORGE Work Classification: Drainfield
Job Address:286 NE 99 Street
Miami Shores, FL 33138-2435 Phone Number
Project: <NONE> Parcel Number 1132060134310
Contractor: G&L PLUMBING SERVICE Phone: 305-551-5090
Building Department Comments
DRAIN FIELD REPAIR Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS IN FILE
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 17, 2015 For Inspections please call: (305)762-4949 Page 9 of 38
o: DIVISION OF
Environmental He i
Florida Health
pQ�O Miami-Dade County �0
OSTDS/Well Division
11805 SW 26th Street•Miami,FL 33175 O
Inspector O ,� A —^- Date L�
0
Address i�1�p N�. OSTDS#
Comments:
6
Signature
Miami Shores Village, ,
Building Department APR 1 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax: (305)756-8972 BY: --
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20(() �-
BUILDING Master Permit No.�d
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:_ L—Iz�)
City: — Miami Shores County: Miami Dade Zip: ';::5z->k-5t9
Folio/ParcelM-J([U��q �6-Wrt j Is the Building Historically Designated:Yes N4 : _
Occupancy Type: TrS Load: Construction Type: Flood Zone: BFE: FFE: g
�'
OWNER: Name(Fee Simple Titleholder): G r--*NiZG�,3 A.�, Phone#:
Address: aS �Q,
City: Cf 44 State: Zip:
Tenant/Lessee Name: Phone#:
Email:
I J / -.z, S r7/7
CONTRACTOR:Company Name: ��l Utt �)) r Pd%!• 7 �D C� �(y hon :
Address:
City: Al 'V --bl State: �� Zip:
Qualifier Name: /9 ,r p,✓% G Phone#-
State Certification r Registration#: G ��G�� 10 7S Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work: / b
Type of Work: ❑ Ad ition ❑ Alteratio ❑ New 5Zepair/Replace ❑ Demolition
/
Description of.Work: O y
Specify"&q,r, it thrL4 ti e:
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)
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."
building permit with an estimated value exceeding 2500 the Notice to Applicant: As a condition to the issuance of a b g p g S 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 i pection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wil not be oppr ed a a reinspection fee will be charged.
Signature Signature:t—�'_ � �
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_day of lD ?qq / 20 1, , by 1 day of 20.2,9 , by
��d/L11� ff�P/ f who is personally known told( who is personally known to
me or who has produced/�-� y�Z �� �s ine 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:
Ubllc State of FlOfida p��� ��4 I G'
Pr t: 0 cYq Notary F Prin . ,.t►s,Y P"°'••,,
v g * s
a �,iy,Commission FF X82753 ` ,.
Se Seal: My Comm.Expires Feb 22,2016
'� •:r,aa ExpiresQ1lt._/1D98 %r
Commission#EE 168632
,P�yr•,,d�,s'a,•t+•ne°,r' �r���ma
APPROVED BY �� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
i REPAV
1MIAw1-wr comes 11FJtt"€Itomfflow PERMIT #: 13-SC-1597850
APPLICATION #:AP1183273
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #: PR970345
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: ,Jorge Arenas
PROPERTY ADDRESS: 286 NE 99 St Miami, FL 33138
LOT: 2 BLOCK: 32 SUBDIVISION: Miami Shores Sec 1 Amd
PROPERTY ID #: 11-3206-013-4310 [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, <V.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 1 GALLONS / GPD Septic CAPACITY
A [ 0 J 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 [ < 22G 11 SQUARE rTET Trench configuration drain SYSTEM
R [ `�U , SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ l FILLED [ J MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 12.29'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 17.801 [ INCHES FT l [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 47.881 [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
L 2t =
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 30.001 INCHES
1.-Install a 900 gal min. septic tank with an approved filter.
O 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 225 sf of drainfield in trench configuration.
4.-Invert elevation of drainfield to be no less than 8.8'NGVD.
E 5.-Bottom of drainfield elevation to be no less than 8.3' NGVD.
6.-This permit includes the abandonment of the existing septic tank.
R
SPECIFICATIONS BY: E TITLE:
APPROVED BY: - TITLE: Engineering Specialist II Dade CHD
t e-01mino i
DATE ISSUED: 04/07/2015 EXPIRATION DATE: 07/06/2015
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FACa r -ms sn a T Page of 3
v 1.1.4 AP1183273 TySE956691
Thv- ) e C.' SD'sr
if the cO1S8Clof IS no'L
' J IH I C Vt- rLUNIUH
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
--- - - --- - --- - - -- -- - -- - - --- PARTII -SITEPLAN ----0p RECIF
��� APR �: 5 015
Scale: Each block represents 10 feet and 1 inch = 40 feet.
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Notes: Q�� ( *ry1 S 1'q v1 4( t f C7�� � (5 ,e •• •
Of 4d - ,--
D( G r V ri-P 16ba,, �. &4 J-0 E' P G l Pct
Site Plan submitted by:
Plan Approved ✓ Not Approv Date
By, County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015,08/09(Obsoletes previous editions which may not be used) Incorporated: 64E-6.001,FAC _ �, 1 z.e Stt)"e5 V iII;1Cje Page 2„l
(Stock Number: 5744-002-4015-6)
I
APPROVED I 173 DATE
_, --DEP,l •� T-/
.
ull.li ("Il i�� �,n`:v 'I W',JT wnH ALL I t DFRAI_
'
!`;Intl "vii) ;I1lllilvliul-f=sAND (at llAIIONS 1
i
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795 2204
N1E6 N ��
FCORLD>} A
ke 3
Expiration: 10/24/2015
Project Address Parcel Number Applicant
286 NE 99 Street 1132060134310
JORGE ARENAS
Miami Shores, FL 33138-2435 Block: Lot:
Owner Information Address Phone Cell
JORGE ARENAS 826 NE 99 Street
MIAMI SHORES FL 33138-
826 NE 99 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 4,500.00 Mm..
G&L PLUMBING SERVICE 305-551-5090 (786)225-3648
Total Sq Feet: 300
Type of Work:DRAIN FIELD REPAIR 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-4-15-55197
CCF $3.00 04/15/2015 Cash $ 50.00 $621.50
DBPR Fee $2.25
DCA Fee $2.25 04/27/2015 Cash $ 121.50 $500.00
Education Surcharge $1.00 04/23/2015 Cash $500.00 $0.00
Permit Fee $150.00 Bond#:2685
Scanning Fee $9.00
Technology Fee $4.00
Total: $671.50
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: Y certify that all!Pe foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a o Futhermo , I orize he above-named contractor to do the work stated.
April 27, 2015
Authorized Signature: r / Applicant / Contractor / Agent Date
Building Department Copy
April 27, 2015 1