PL-15-3188 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250056 PermitNumber: PL-12-15-3188
Scheduled Inspection Date: January 21,2016 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: MORALES,YURI Work Classification: Drainfield
Job Address:302 NE 92 Street
Miami Shores, FL 33138-
Phone Number (305)790-3849
Parcel Number 1132060136480
Project: <NONE>
Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859
Building Department Comments
DRAINFIELD INSTALL Infractio Passed Comments
INSPECTOR COMMENTS False
nspector Comments
Passed hrs in file
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 20,2016 For Inspections please call: (305)762-4949 Page 18 of 32
94�
��� DIVISION OF
Environmental Health
Florida Health
0Miami-Dade County �O
OSTDS/Well Division
11805 SW 26th Street•Miami,FL 33175
O
t Mr p���r Date
Inspector
Address OSTDS#
Comments:
Signature
J
P it No. PL-12-15-318,81 �,.
Miami Shores Village PBrmif Type:Pitumbinj -ResidentfillM'
10050 N.E.2nd Avenue NE Work Cla'socafifon:Drainfleld
Miami Shores,FL 33138-0000
Phone: (305)79x2204
F@Ctr; �t -= PP C}t ED
is rte:12130/201S Expiration: 06/27/2016
Project Address Parcel Number Applicant
302 NE 92 Street 1132060136480
Miami Shores, FL 33138- Block: Lot: YURI MORALES
Owner Information Address Phone Cell
YURI MORALES 302 NE 92 Street (305)790-3849
MIAMI SHORES FL 33138-3134
Contractor(s) Phone Cell Phone Valuation: $ 2,400.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
Total Sq Feet: 400
Type of Work:DRAINFIELD INSTALL Available Inspections:
Type of Piping:
Inspection Type:
Additional Info: HRS Approval
Bond Return: Final
Classification:Residential Scanning:2 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF $1 60 Invoice# PL-1 2-15-58167
DBPR Fee $2.25 12/28/2015 Credit Card $50.00 $615.30
DCA Fee $2.25 12/30/2015 Credit Card $500.00 $115.30
Education Surcharge $0.60 12/30/2015 Credit Card $ 115.30 $0.00
Permit Fee $150.00 Bond#:2939
Scanning Fee $6.00
Technology Fee $2.40
Total: $665.30
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 fore inf rmation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I au a th ove-named contractor to do the work stated.
December 30, 2015
Authorized Signa :Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 30,2015 1
Miami Shores Village --
Building Department DU 28 2015
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 201H
BUILDING Master Permit No. pll i5 —3
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 32 Ii�G C-(-
City: Miami Shores County: Miami Dade Zip: 3,3/ ✓Zd
Folio/Parcel#: 3)d&- (3(3- �4,M Is the Building Historically Designated:Yes NO
Occupancy Type: Load: �Construction�/T�ype: Flood Zone: BFE: FFE:
f
OWNER: Name(Fee Simple Titleholder): / 09'1 �'"��41;LC ' Phone#: 3c)- WLZ2 J
Address: 202- A16 Cf Z _5 T
City: M f 4 19 State: F(_ Zip: '�S
Tenant/Lessee Name: Phone#:
Email: i yj 2 4C-0 1 Ce
CONTRACTOR:Company Name: �^ t / k �1 //c. Phone#: ( 3���� 7,P;
Address:
�3 N
City: Ates I. II // �(��®4 State: 8% zip:
Qualifier Name: Onk6 6Phone#:
State Certification or Registration#: Certificate of Competency#:
DES113NER:Architect/Engineer: Phone#:
Address: _ City: State: Zip:
Value of Work for this Permit:$ S ° Square/Linear Footage of Work: 40
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work4
Specify color of color thru tile:
Submittal Fee$ "� Permit Fee$ �U� '`y 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."
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.
g
Si nature Signature
g
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The fore oing instrument was acknowledged before me this
de day of D66 6M®F—& 20 1 C by 2 day of :9;C�A4 J5;4 20 1 $7 by
who is personally known to �Cwho 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:
a Pie,,,,'
EMB LE 7Sep
print: �.—
Print:
My Comm.Expir9,2017 Seal:
1116
Seal: = •oP; "" SHERYL A MENDES
= Commission 732 ���Pa�°OB'•Bonded Through NaryAssn. ,• �•*� Notary Public-State of Florida
My Comm.Expires Oct 23,2018
Commission#FF 136597
"B'bw"arAafi'6r'la1`I44arysn
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)
/ «= r
6� fs'
Y ...
mtAmi-DAoE CoaJt�(HEALTH; PERMIT #: -SC-1646027
} STATE OF FLORIDA APPLICATION #:AP1215016
DEPARTMENT OF HEALTH
DATE PAID:
ONSITE SEVI GE TRtJM4ENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRIICTION PERMIT
•�� RECEIPT fi:
DOCUMENT #:PR996776
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Yuri Morales
PROPERTY ADDRESS: 302 NE 92 St Miami, FL 33138
LOT: 11, 12 BLOCK: 48 SUBDIVISION: Miami Shores Section 1
PROPERTY ID ti: 11-3206-013-6480 [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 [ 1,050 l GALLONS / GPD existing septic tank CAPACITY
A [ 7 GALLONS / GPD CAPACITY
N L I GALLONS GREASE INTERCEPTOR CAPACITY [M103MOM CAPACITY SINGLE TANK:1250 GALLONS]
K I 7 GALLONS DOSING TANK CAPACITY I IGALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 400 I QUARE FEET bed confiquration drainfiel SYSTEM
R L .._ SQIIARE FEET SYSTEM
A TYPE SYSTEM: Ixl STANDARD [ 7 FILLED [ I MOUND L l
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 12.0'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE L 26.401[ INCHES FT ] [ABOVEBELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE 176.407E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ 62.001 INCHES
"THIS REPAIR PERMIT IS NOT FOR ANY ADDITIONS"
O 1-Existing 1050 gal.septic tank,certified by Mr.C's Plumbing and Septic on 12P1/2015,to remain.
T 2.Install 400 sf of drainfield in bed configuration.
H 3.-Install 12"of slightly limited soil at the bottom of the drainfield.
4.-Perimeter of excavation area shall be at least 2 It wider and longer than the proposed absorption bed or drain trench.
E (Comments Continued on Page 2.)
R
SPECIFICATIONS BY: Kemble Ettrick TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Erlaade omisca
DATE ISSUED: 1210712015 EXPIRATION DATE: 03/06/2016
DH 4016, 08/09 (Obsoletes all previous editions which may not be used),
Incorporated: 64E-6.003, FAC
v AP1215016
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