PL-15-1832 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-249478 Permit Number: PL-7-15-1832
Scheduled Inspection Date: December22,2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: JOUBERT,JEAN-PIERRE LOUIS& Work Classification' Septic
iCeclrw UC%DAI ec
Job Address:77 NW 96 Street
Miami Shores, FL 33150- Phone Number (305)401-7778
Parcel Number 1131010330390
Project: <NONE>
Contractor: MR C'S PLUMBING$SEPTIC INC Phone: (305)651-7859
Building Department Comments
SEPTIC TANK AND DRAIN FIELD INSTALLATION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-239598. HRS IN FILE
NO PERMIT ON SITE
Failed
Correction ❑ V-�c��- o.� u,l
Needed
Re-Inspection
Fee r z S
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 21,2015 For Inspections please call: (305)762-4949 Page 22 of 33
R
a s�
V
"E
v
Y 3
e
�,�," � /r�•jx;, \ t 3 'may i �� �a � /// �,,, �� �I
�; E `�• /l'� ! ;"/'/ r is /i
s, 1 �✓ s
r
E`
Y �3
::.,...: .�;?.a\ ,. ...cid',' +.... ,�• ":.
Permit No. P .-7-15-X832..
Miami Shores Village Pelt t
TY0'q:'Plur>I�rinc -:Rosictentiai
10050 N.E.2nd Avenue NW
WorkCta lficaffon.Sept10
Miami Shores,FL 33138-0000 � � �
yrs¢ Phone: (305)795-2204
Permit Statute APPROVEli
Issu40ate:7/2412.015 Expiration: 01/2012016
Project Address Parcel Number Applicant
77 NW 96 Street 1131010330390
Miami Shores, FL 33150- Block: Lot: JEAN-PIERRE LOUIS 8 JESSICA
Owner information Address Phone Celt
JEAN-PIERRE LOUIS&JESSICA 77 NW 96 Street (305)401-7778
---- -- - ---- MIAMI SHORES FL 33150-
77 NW 96 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone Valuation: $ 2,400.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
., Total Sq Feet: 200
Type of Work:SEPTIC TANK AND DRAIN FIELD 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 Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF Invoice# PL-7-15-56427
$1.80 07/24/2015 Credit Card $272.80 $550.00
DBPR Fee $4.50
DCA Fee $4.50 07/24/2015 Check#:59 $500.00 $50.00
Education Surcharge $0.60 07/22/2015 Credit Card $50.00 $0.00
Permit Fee $300.00 Bond#:2797
Scanning Fee $9.00
Technology Fee $2.40
Total: $822.80
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. >eMore,Ijgy0wMze the above-named contractor to do the work stated.
July 24, 2015
ce"'
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 24,2015 1
a Miami Shores Village cFT .0
Building Department JUL 22 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 By:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 —
ji
FB,pC 200Y
BUILDING Master Permit No. // /"5-® // 92—
PERMIT APPLICATION Sub Permit No.
F_JBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: 11�yi O�10 See?-_
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ` 10 1 ®33 0 3q D Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): \em' fa�_ HOYa&&S _AuJ t- Phone#:_�>Li®I—}��
Address: —1 :)- N Lr) Ll 6� ST
City: Miami S�j®re S State: T Zip: 33
Tenant/Lessee Name: V\Iv-- Phone#: V1
Email: 5013 EQ---T 1-A e CTHP,ZL_, C®�-A
CONTRACTOR:Company Name: 11r. C'Sy ium6y'a Sufi L, Phone#:Ops) Est--565Z
Address: 019 32 2 nk Ave,
City: �_kiayvMt State: !— Zip: 33)(0 1
Qualifier Name: K2w61e Phone#: f 651 Z SS3
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip: _
Value of Work for this Permit:$ Square/Linear Footage of Work: 2000
Type of Work: ❑ Addition ❑ Alteration ll ❑ New
�j � Repair/Replace [:1 's
Demolition
Description of Work: MreftIA- AAL P dlm�
Specify color of color thru tile:
Submittal Fee$4L,0 -6tn d Permit Fee$ 11�>' CCF$ CQ/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 lu I 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to th
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at th ob
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted no
inspection will not be approved and a reinspection fee will be charged. 1a
Signature Signature
g g
WNER or AGENT CONTRACTOR J
fit
The foregoing instrument was acknowledged before me this The for oing instrument was acknowledged before me is
c2( day of 5101-•`7 ,20 IS— ,by �day of Tu 1. 20
' 5oy}� 3'�UBEf�T ,who is personally known to Kft6 LE who is personally kno
me or who has produced as me or who has produced
identification and who did take an oath. identification and who did take anl atho,siP,,��,
NOTARY PUBLIC: NOTARY PUBLIC: t'=j.' s,�= NI�bIY `r Florida
,� ••E my�.r X3,2018
:597
i 'ry Assn.
Sign: Sign: __
Print: KEMBLE ETTRICK Print:
Notary Public-State of Florida RYL A 118ENOES
Seal: -•. :• My Comm.Expires Sep 19,2017 Seal: �?°,. ublic-Stale of F
�• _
%N� �`� Commission #FF 055732 =•" `rn•Exp Oct 23,
Bonded Through National Notary Assn. ;�- iss(pp N FF 13 E 5 a
�4uU•
RIPMR
�,
aottplly/ Notar
���***waawaaw*awwawwwaa*awwa***wawaawaw*+a*��**�x�►�****x��xx��x+rr��xr� �i.*�xx��**�*��x�**+rix
APPROVED BY LZ, ?s Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
PERMIT #:13-$C-1618534
AppmcATIoN #:AP1196670
STATE OF FWRIDA DATE PAID
DEPARTMENT OF HEALTH FEE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTM
CONSTRUCTION PERMIT RECEIPT #:
<m DOCUMENT #:PR981584
>°;,`�4 vi�(!= ^L'c:�iy'f4°''l�:F•.'i_�i'��'-�rt'!4R�HD�^��
CONSTRUCTION PE:RMT FOR: OSTDS Repair
APPLICANT: Gregory Wilkins
PROPERTY ADDRESS: 77 NW 96 St Miami,FL 33150
Lox: 1718 BLOCK: 130 SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3101-033-0390 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
AND CHAPTER 64E-6, F.A.C. DEPARTMXNT APPROVAL OF SYSTEM DOES NOT GUARANTEE
381.0065, F.S.,
ANY CHANGE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. E IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY
VOID.
IMODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS PAY RESULT IN THIS PERMIT BEING MADE NULL A
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 Septic(New Tank) CAPACITY
A [ 0 ] GALLONS / GPD CAP. ::ITY
N [ 0 1 GALLONS GREASE INTERCEPTOR CAPACITY [MAXn an, CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK I [
]GALLONS .a[ ]DOSES PER 24 HRS #Pumps
CAPAC [ ]
D [ 200 ] SQUARE FEET Bed Drainfield SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: IK] STANDARD I ] FILLED I ] MOUND I ]
I CONFIGURATION: I ] TRENCH Ix] BED I ]
N
F LOCATION OF BENCHMARK: FFE12.7
I ELEVATION OF PROPOSED SYSTEM SITE [ 26.40] INCHES FT ] IriBOVE A BE7TCWj BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE 176.40] [ INCHES I FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: 10.00] INCHES EXCANATIOR-REQUIRED: I 62.00 l INCHES
"**THIS PERMIT IS NOT FOR ADDITIONS—
* 1.-Install a 900 gal min.septic tank with an approved filter.
T 2.-The licensed contractor installing the system is responsible for installing the m:r imum Category of tank in accordance
with s.64E-6.013(3)(f),FAC,
H 3.-Install 200 sf of drainfield in bed configuration.
E 4.-Install 12"of slightly limited soil a the bottom of the drainfield.
5.-Perimeter of excavation area at ast 2 ft wider and longer than the pro-*sed absorption ted.
R
SPECIFICATIONS BY: 1 G 1! TITLE:
APPROVED BY: IT . Enginee3r�.ng Specialist II Dade CSD
x EXPIRATION DATE: 10/15/2015
DATE ISSUED: 07/17
DH 4016, 08/09 (Obsoletes all previous editions which may not be used) page 1 of 3
Incorporated: 64E-6.003, FAC svys6�-a
v ll.d FP2:'�55?4
e
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
--------------------------- PART II -SITEPLAN ---------------------------
Scale: Each block re resents 10 feet and 1 inch =40 feet.
Sq
i
Zes:
re are no pertinent features on adjacent properties and or across the street that may affect the New Septic system installation.
77 N LJ 96 5+ Aia e.i Sk."s f L 33150
"2f&t&
Site Plan submitted by: KoQ
Plan Approved Not Approved Date
BY County He 4th 6epartment
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015,10/96(Replaces HRS-H Form 4016 which may be used) Page 2 of 4
(Stock Number: 5744-002-4015-6)
CFN: 20150449800 BOOK 29694 PAGE 4538
DATE:07/14/2015 08:33:10 AM
DEED DOC 2,298.00
HARVEY RWIN,CLERK OF COURT,MIA-DADE CTY
Prepared by and return to:
Albert Naon,Jr.
Attorney at Law
Law Office of Albert Naon Jr.,P.A.
3785 N.W.82 Avenue,Suite 107
Miami,FL 33166
305-577-9409
File Number. 314-Joubert-01
Will Call No.:
Parcel Identification No. 11-3101-033-0390
(Space Above This Line For Recording Data] ,_,
Warranty Deed
(STATUTORY FORM-SECTION 689.02,F.S.)
This Indenture made this 9th day of July,2015 between Gregory T.Wilkins whose post office address is 133 Ichabod
Lane, Mankato, MN 56001 of the County of Blue Earth, State of Minnesota, and Nestor A. Chardon whose post office
address is 605 W. Flagler Street, #1008, Miami, FL 33128 of the County of Miami Dade, State of Florida, grantor*, and
Jean-Pierre Louis Joubert and Jessica Morales Joubert, husband and wife whose post office address is 77 N.W. %
Street,Miami Shores,FL 33150 of the County of Miami Dade,State of Florida,grantee*,
Witnesseth,that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS ($10.00)and other
good and valuable considerations to said grantor in hand paid by said grantee,the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee,and grantee's heirs and assigns forever, the following described land,
situate,lying and being in Miami-Dade County,Florida,to-wit:
Lot 17 and the West 1/2 of Lot 18, Block 130, Miami Shores Section No. 6, according to the plat
thereof as recorded in Plat Book 10,Page 39,Public Records of Miami-Dade County,Florida.
Subject to taxes for 2015 and subsequent years; covenants, conditions, restrlctions, easements,
reservations and limitations of record,if any.
and said grantor does hereby fully warrant the title to said land,and will defend the same against lawful claims of all persons
whomsoever.
"Grantor"and"Grants"are used for singular or plural,as context requires.
In Witness Whereof,grantor has hereunto set grantor's hand and seal the day and year fust above written.
Signed,sealed and delivered in our presence:
(Seal)
Witness
Witness Name: .411,`..T N4 +n Gregory T. tlkins
Witness Name: Mw,,a- "oak-A 4L0^
�-- (seal)
Witn�esssl Name: AAC,&& 615 o n Nesror A.Chardon
Witness ame:
State of Florida
County of Miami-Dade
The foregoing instrument was acknowledged before me this 9th day of July, 2015 by Gregory T. Wilkins and Nestor A.
Chardon,who[J are personally known or[X]have produced a driver's license as identification.
[Notary Seal] Notary Public
Printed Name:
a u k
i"',
/t-t v�uOU( -�..�Q�n' My Commission Expires: d a0(7
�° MMIW.AARo1dV6TAttlGuur
DoubleTlaW