PL-16-267 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number. INSP-252004 Permit Number: PL-2-16-267
Scheduled Inspection Date: February 08,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez,Rafael
Inspection Type: Final
Owner: PING,ALEJANDRO Work Classification: Septic
Job Address:9105 NE 5 Avenue
Miami Shores, FL 33138- Phone Number (305)302-5770
Parcel Number 1132060141210
Project <NONE>
Contractor: A.B.T.SEPTIC SERVICE LLC Phone: (305)218-8907
Building Department Comments
RENEWAL OF EXPIRED PERMIT PL15-1071 IPassed Comments
INSPECTOR COMMENTS False
900 GALLON SEPTIC TANK WITH A 375 SF DRAIN FIELD
IN TRENCH CONFIGURATION
Inspector Comments
Passed H1 HRS APPROVAL IN FILE
Failed a
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 05,2016 For Inspections please call: (305)762-4949 Page 26 of 45
7 77
l��ft1?f Ivt : 'L� - 6-267
�s$ME iMiami Shores Village Pwmlt T*,e:Fllu!r tng-R )dlential
10050 N.E.2nd Avenue NE vl t l �860`h Septic
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Miami Shores,FL 33138-0000 Permlt$tetus.APPROVED
•,` � � Phone: (305)795-2204
Haim
Expiration: 0 /03/2016
. t�sue Date:21512016
Project Address Parcel Number Applicant
9105 NE 5 Avenue 1132060141210 ALEJANDRO PINO �
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ALEJANDRO PINO 9105 NE 5 Avenue (305)302-5770
MIAMI SHORES FL 33138-
9105 NE 5 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
A.B.T.SEPTIC SERVICE LLC (305)218-8907
_ Total Sq Feet: 375
Type of Work:RENEWAL OF EXPIRED PERMIT PI-1 5-1071 Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
HRS Approval
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Fees Due jAnPay Date Pay Type Amt Paid Amt Due
CCF Invoice# PL-2-16-58515
DBPR Fee 02/05/2016 Credit Card $313.60 $0.00
DCA Fee
Education Surcharge Permit Fee Scanning Fee Technology Fee Total:
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 foregreabloeZ-ned
rmation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize t coTtrto do he work stated.
February 05, 2016
Authorized Signature:Owner / Appli / Contractor / Agent Date
Building Department Copy
February 05,2016 1
�• .• DIVISION OF
• Environmental Health
�Q Florida Department of Health qA
®� Miami-Dade County Health Department j
OSTDS/Well Division �I�►0
�j 11805 SW 26 St.•Miami,FL 33175
�N1
Inspector &)a-& 1�jCS_1 Dated
Address Le J.5 4q« OSTDS# )
Comments: 1 as-Em
Signature
,7
Miami Shores Village ���
FEB 01 281
Building Department 1
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ' f�
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No.;F/ /6 6 -1
PERMIT APPLICATION Sub Permit No. PL151071
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9105 NE 5 Ave
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1132060141210 Is the Building Historically Designated:Yes NO X
Occupancy Type: SFR Load: Construction Type: CBS Flood Zone: X BFE: FFE: 11.20
OWNER:Name(Fee Simple Titleholder):Alejandro Pino Phone#:
Address:4957 SW 71 Place
City: Miami State: FL Zip: 33155
Tenant/Lessee Name: Phone#:305 302 5770
Email: ALEJANDROGPINO@GMAIL.COM
CONTRACTOR:Company Name: A.B.T Septic Service LLC Phone#: 305 218 8097
Address: 14100 SW 256 St
City: Homestead state: FL Zip: 33032
Qualifier Name: Raul Miranda Phone#: 305 218 8097
State Certification or Registration#: SR0141736 Certificate of Competency#:
DESIGNER:Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 0 000. ') Square/Linear Footage of Work: 7-
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Extension of a permit for a new 900 gallon septic tank with a 375 SF Drain field in trench configuration
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ c CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ 1
TOTAL FEE NOW DUE$ :313 • j
(Revised02/24/2014)
c
Bonding Company's Name(if applicable) NONE
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) NONE
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whicccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv d a reinspection fee will be charged.
Signatur_ Signature �Y
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of RA 20 l G ,by 1 day of c° L' 20 ` ( by
't -'Pwho is personally known to 'T who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
O930PNSeal: Seal: OURDES SANUM
MSMY CMSEES40
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16,2016
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APPROVED BY C ( l ,fie®� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
REGISTERED SEPTIC TANK CONTRACTOR
,f RAUL R. MIRANDA
- 15870 S.W.250 STREET
MIAMI, FL 33031-
C AB.T.SEPTIC SERVICE LLC
Business Authorization: SA0041185
SR0141736
Registration Expires can September 30,2016
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j STATE OF FLORIDA PERMIT #: 13-$C-1594207
DEPARTMENT OF HEALTH APPLICATION #: AP 1180868
`' ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
s DOCUMENT #: PR972935
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Alejandro Pinp
PROPERTY ADDRESS: 9105 NE 5 Ave Miami, FL 33138
LOT: 7 BLOCK: 58 SUBDIVISION:
PROPERTY ID #: 11-3206-014-1210 [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 [ 900 ] GALLONS / GPD Septic(New Tank) CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ] ON3 @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 375 ] SQUARE FEET Trench Confiquration STEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: N. C/L NE 5 AVE: 8.78'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.84 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 33.84 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES
O 1.-Install a 900 gal min.septic tank with an approved filter.
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.
H 3.-Install 375 sf of drainfield in trench configuration.
4.-Install 42"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 absorption bed.
R 6.-Invert elevation of drainfield to be no less than 7.10'NGVD.
(Comments Continued on Page 2.)
SPECIFICATIONS BY: Jorge M Millan Jr. TITLE: t1
'rJ
APPROVED BY: TITLE: Engineering Specialist I , I ", aCl CHD
ico e e
DATE ISSUED: 04/29/2015 10/29/2016
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.d AP1180 868
DOCUMENT #: PR972935
7.-Bottom of drainfield elevation to be no less than 6.60'NGVD.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of
300 gpd.
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21)days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN#A02, Tallahassee, Florida 32399-1703. The
Agency Clerk's facsimile number is 850-410-1448.
Mediation is not available as an alternative remedy.
Your failure to submit a petition.for hearing within 21 days from receipt of this order
will constitute a waiver of your right to an administrative hearing, and this order shall become
a 'final order'.
Should this order become a final order, a party who is adversely affected by it is
entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings
are governed by the Florida Rules of Appellate Procedure. Such proceedings may be
commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the
Department of Health and a second copy, accompanied by the filing fees required by law,
with the Court of Appeal in the appropriate District Court. The notice must be filed within 30
days of rendition of the final order.