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PL-15-2889 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)756-8972 Inspection Number. INSP-247871 Permit Number. PL-11-15-2889 Scheduled Inspection Date: December 08,2015 Permit Type: Plumbing -Residential Inspector. Diaz,Osvaldo Inspection Type: Final Owner. WEISMANTLE,LOIS Work Classification: Septic Job Address:640 NE 101 Street Miami Shores,FL 33138-2468 Phone Number (305)467-5342 Parcel Number 1132060172090 Project cNONE> Contractor. STATEWIDE SEPTIC CONNECTIONS Phone:(954)963-0082 Building Department Comments REPLACE BROKEN TANK DRAIN FIELD Infractic Passed Comments INSPECTOR COMMENTS Fad TO REPLACED PERMIT PL15-155 nspector Comments Passed ` Failed �s Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee Is paid. December 07,2015 For Inspections please call: (305)762.4949 Page 22 of 44 O FloYl ,, �ali -- - 1a111t at4��` Q � x TDS w It sign ,y ` 118h5 �+'26thfrecf• ;an€i,FL 331'75 NN- -DW n v. 'd olg: 6k 1E �6d 1 Coju s. 7� 7 , ur Signate 1 - Nod.` 'I -2 Miami Shores Village Pei71i/f 7-� Plu�crb eid 10050 N.E.2nd Avenue NE �' t hesn Miami Shores,FL 33138 0000 Orl Phone: (305)79-r-2204 .• , 7 � xpir I n. E at'o06116/201 3 Project Address Parcel Number Applicant 640 NE 101 Street 1132060172090 Miami Shores, FL 33138-2468 Block: Lot: LOIS WEISMANTLE Owner Information Address Phone Cell LOIS WEISMANTLE 640 NE 101 Street (305)467-5342 MIAMI SHORES FL 33138- 640 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 8,500.00 STATEWIDE SEPTIC CONNECTIONS (954)963-0082 �.---- W ._-------- --- Total Sq Feet: 225 Type of Work:REPLACE BROKEN TANK DRAIN FIELD Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40Invoice# PL-11-15-57773 DBPR Fee $4.50 11/18/2015 Check#:4940 $287.40 $50.00 DCA Fee $4.50 Education Surcharge $1.80 11/16/2015 Check* 1038 $50.00 $0.00 Notary Fee $5.00 Permit Fee $300.00 Scanning Fee $8.00 Technology Fee $7.20 Total: $337.40 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: 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 zon' Futhermore,I auth 'ze th bove named contractor to do the work stated. November 18, 2015 Tu-thod S ature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 18,2015 1 Miami Shores Village . Building Department 11, 11111, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 '. Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 5�K FBC 201q BUILDING Master Permit No. TL. `S— Z PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ,, ''11`V CONTRACTOR DRAWINGS cc JOB ADDRESS: TO F, I 0 C� 1 City: Mia�mi Shores County: Miami Dade zip: 136 Folio/Parcel#:l tt1- r2-0 -01-1 '-'2-09 0 Is the Building Historically Designated:Yes NO V Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ®16 we) Phone#: 70 L?SI - 2-90Z Address: (0 40 kk-: 1.0 1 City: A&&(noo vr-5 State: 11- Zip: 1�� Tenant/Lessee Name: Phone#: Email: r CONTRACTOR:Company Name: ®�f�Ca.D1 phone#: Address: I,(," City: -, State: l`� Zip: tT Qualifier Name: � SoLeine n Phone#: State Certification or Registration#: OCl'I I '� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 01 S Square/Linear Footage of Work: Z2.1' T W Type of Work: F-1Addition [-IAlteration ❑ New [�Repair/Replace ❑ Demolition Description of Work: 2L, 4m Specify color of color thru tile: Submittal Fee$ Permit Fee$ �a �`7' 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 A 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. � S Signatur Signature 1 10 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this i® day of 20 1 S by day of4�&E�' ,20 15 by _ In i S We rSmQ,A k-who is personally known to who is personally knowno me or who has produced as me or who has produced F M UCk K--`as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUB Sign g Sign Print: &Zj t or, Print: L,,§, Seal: +►ag4 Se a�;•••., o TERES JsI . AMON po, ro r: d� Ncsr �t�F�todaa * • W CONSSION#FF 518161 � z EXPIRES November 8,2019 •Q np�y GRe e6e0 B Th APPROVED BY ��'/���Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) I yPERMIT #:13-SC-1580560 � STATE OF FLORIDA � Lti mRTYHATH PAP'S cATION #:AP1171899 DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: wo DOCUMENT #:PR961013 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: John Grndhauser PROPERTY ADDRESS: 640 NE 101 St Miami, FL 33138 LOT: 3 5 BLOCK: 103 SUBDIVISION: PROPERTY ID #: 11-3206-017-2090 [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, 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 [ 1,200 ] GALLONS / GPD new septic tankn CAPACITY A [ 0 ] 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 [ 225 ] SQUARE FEET new trench confiq.drainfie SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: FFE 14.5'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 69.60 ] [ iNCHEs FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 117.601 [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 48.00 ] INCHES 1.-Install a 1200 gal min.septic tank with an approved filter. 0 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.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench. E 5.-Invert elevation of drainfield to be no less than 5.20'NGVD. 6.-Bottom of drainfield elevation to be no less than 4.70'NGVD. R SPECIFICATIONS BY: er�,sa Solomon TITLE: Master Septic Tank Contractor APPROVED BY: Imux TITLE: Engineering Specialist II Dade CHD d Martin DATE ISSUED: 16/ 015 EXPIRATION DATE: 04/16/2015 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 V 1.1.4 AP1171899 SE948068 DOCUMENT #: PR961013 7.-This permit includes the abandonment of the existing septic tank. THIS PERMIT IS NOT FOR ANY ADDITIONS. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of 460 gpd. ,g}st ,��'': I A t- �!° 1_ OF 1 LOt itf1 J-`: DEPARTMENT OF HEALTH {` = APPLiCATI�i`d FOR ONSITESEWAGE DISPOSAL SYSTEM CONSTP JGI fOP! PERMIT Permit Applicat`ort E`lur�#� 'r'' yrAl — _— — — PART II -SITE PLAN!-- Scz;e: Each block represents 5 feet and 1 inch =50 feet. - - S. T,}. • -� ✓ �: e C 717 T. 3 ,Y ' - 3 l z L' z - i fig r _ 4r(0C - = - ot, _nr UZ 100 Ci Site Plan submitted by: A � It OT, -4a? w `' Sign re ride — Plao Ap r F och; Not Approved Date --- County Health Departm- ALL CHANGES MUST BE APPROVED BY T14E COUNTY.HEALT14 DEPARTMENT OH 40S.E0MU{Reptl�As H11S41 Foim W 15.which mal be WW) torr FNx 574 c.