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PL-15-2753 t q A I Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246793 Permit Number: PL-10-15-2753 Scheduled Inspection Date: November 23,2015 Permit Type: Plumbing -Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: DEVINE, MICHAEL&CLAUDIA Work Classification: Septic Job Address:54 NE 102 Street Miami Shores,FL 33138- Phone Number 305.759.4883 Parcel Number 1132060131470 Project: <NONE> Contractor: MR C'S PLUMBING B SEPTIC INC Phone:(305)651-7859 Building Department Comments INSTALL 900 GAL SEPTIC TANK&300 SQUARE FOOT Infra'ctio Passed Comments DRAINFIELD AND PIPING INSPECTOR COMMENTS False Inspector Comments Passed '-- i 1 f 2_S)' S Failed Correction Needed Re-Inspection ( � Fee No Additional Inspections can be scheduled until re-inspection fee is paid November 20,2015 For Inspections please call: (305)762.4949 Page 11 of 41 Y DIVISION OF Environmental Health R10 Florida Health ��© Miami-Dade County ,O OSTDS/Well Division 11805 SW 26th Street•Miami,FL 33175 ,- Inspector d1`r'�" r zio n e © Date Address OSTDS omments: g nat ur e m Miami Shores Village Building Department OCT zoos Miami Shores, Florida 33138 10050 N.E.2nd Avenue, ' Tel: (305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201q BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP S/,- CONTRACTOR DRAWINGS i JOB ADDRESS: (, 16d City: Miami Shores County: Miami Dade Zip: '52/�0 Folio/Parcel#: Is the Buillfing Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 14, tiL 1)(411%2C Phone#: Address: � /V� Id-); -r 773 b "a City: R1&t� , State: /9?1 Zip: YrlL7e Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Com any Name: �jJ _ f W-k 7 � Phone#: Address: / � /� L"r-A-"C City: / ^��^ __ Stater Zip: 3��6 Qualifier Name: K6144- (-41&C1 Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$_ o 6 Square/Linear Footage of Work: f ur) Type of Work: ❑ Addition ❑ Alteration ❑ New [Repair/Replace F1 Demolition Description of Work: .,zy' Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$1d5""() Co TOTAL FEE NOW DUE$ C� (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. Signatu4 �� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was//acknowledged before me this The foregoing instrument was before me this day of k'J e-- 20 lr , by 2? yC day of bc- 0 20 by %/%dLlr`u (2i✓�r who is personally known to K�l/YI/� 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. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: 2��PR�PGB,, ETTRICK `�o%'y P., y HERYL A MENDES Seal: :°? Notary Public -State of Florida Seal cio; NotarPublic-State of Florida N* My Comm. Expires Sep 19,2017 w� •: '•�My Comm.Expires Oct 23,201#E 8 or P Commission #FF 055732 =;�, P�= Commission FF 136597 rou Nat .,,or c tom.• Bonded Through National Notary Assn. °j%°;;;°4° Bonded Thional Not Assn. ******************** ** * * ******************** ************ APPROVED BY -Z r 3 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) aM PERMIT #:13—SC-1637759 AP "CAT #: AP1209349 C .. P..nr . STATE OF FLORIDA ;DATE PAID: DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: ocicummT #:PR991915 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Claudia Devine PROPERTY ADDRESS: 54 NE 102 St Miami, FL 33138 LOT: 5 g,6 BLOCK: 11 SUBDIVISION: Miami Shores Section 1 [SECTION, TOWNSHIP RANGE, PARCEL NUMBER] PROPERTY ID #: 11-3206-013-1470 [OR TAX ID NUMBER] IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION SYSTEM MUST BE CONSTRUCTED 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 I?7 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 T [ 900 1 GALLONS / GPD new septic tank CAPACITY A [ 0 1 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 [ l D [ 300 1 SQUARE ET new bed confia.drainfield SYSTEM, "" FE R C 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: Ex] STANDARD [ ] FILLED [ ] [ ] I CONFIGURATION: [ ] TRENCH Ex) BED [ ] N F LOCATION OF BENCHMARK: FFE 13-4'NGVD I ELEVATION OF PROPOSED SYSTEM SITE E 27.601[ INCHBS FT ] [ABOVE BE BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE E 77.r,4 ][f INCHES FT ] [ABOVE BELOFk BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: E 62.001 INC S 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)(f), FAC. 3.-Install 300 sf of drainfield in bed configuration. H 4.-Install 12"of slightly limited soil at the bottom of the drainfield. E 5.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorptiion bed or drain trench. (Comments Continued on Page 2.) R • • s • • • SPECIFICATIONS BY: C"s •++ ••i •+ • d2 • F 1 APPROVED BY: TITLE: Engineering Specialist II Dade CBD Lffy Martin ••• ••• +-+ • •s• •i• EXPIRATION DATE: 01/21/2016 DATE ISSUED: 0/2 (201500 • • • • • • • • DH 4016, 08/09 (Obsoletes all previous editia;rs wh1P21 > y nob-be used) Page 1 of 3 Incorporated: 64E-6.003, FAC V 1.1.4 AP1209349 9E974979 • • IN not ray Miami Shores Village )✓" � � � , 10050 N.E.2nd Avenue NES Miami Shores, FL 33138-0000 s ' 'bFk � Phone: (305)795-2204 1mw' Expiration: 05/10/201 Project Address Parcel Number Applicant 54 NE 102 Street 1132060131470 MICHAEL&CLAUDIA!DEV!INE Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell MICHAEL&CLAUDIA DEVINE 54 NE 102 Street 305-759-4883 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 9,200.00 MR C'S PLUMBING &SEPTIC INC (305)651-7859 Total Sq Feet: 300 Type of Work: INSTALL 900 GAL SEPTIC TANK&300 S Available Inspections: Type of Piping: Inspection Type: Additional Info: Bond Return: HRS Approval 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-10-15-57588 CCF $6.00 DBPR Fee $4.50 10/28/2015 Credit Card $50.00 $784.00 DCA Fee $4.50 11/12/2015 Credit Card $ 500.00 $284.00 Education Surcharge $2.00 11/12/2015 Credit Card $284.00 $0.00 Permit Fee $300.00 Bond#:2903 Scanning Fee $9.00 Technology Fee $8.00 Total: $834.00 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. Futhermore e t ve-named contractor to do the work stated. November 12, 2015 AuthoriiWTIgnature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 12, 2015 1