PL-15-3020 f
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)796-2204 Fax:(306)756.8972
Inspection Number: INSP-248777 Permit Number. PL-12-15-3020
Scheduled Inspection Date:April 14,2016 Permit Type: Plumbing -Residential
Inspector. Hernandez,Rafael
Inspection Type: final
Owner. CONTESSA,MICHELE Work Classification: Drainfield
Job Address:9220 NE 2 Avenue
Miami Shores,FL Phone Number
(305)761-5243
Parcel Number 1132060133060
Project <NONE>
Contractor. MR C'S PLUMBING&SEPTIC INC Phone:(305)6514869
Building Department Comments
DRAINFIEL INSTALLATION Infractio Passed omrents
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS APPROVAL IN FILE
Failed El
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee Is pald.
VL _ -3020 .
r� IQs DIVISION OF
Environmental Health
`Q Florida`Health 91�
Miami .Dade County*01
OSTDS/Well Division �`i
11805 SW 26th Street•Miami,FL 33175 �O
Inspector r ''7�- / d Date
Address OSTDS#
Comments:-
Signature AiL
z
Miami Shores Village ,
10050 N.E.2nd Avenue NE .
Miami Shores,FL 33138-0000
Phone: (305)795-2204
�? s
Expiration: 06/0612016
Project Address Parcel Number Applicant
9220 NE 2 Avenue 1132060133060
MICHELE CONTESSA
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
MICHELE CONTESSA 9220 NE 2 Avenue (305)761-5243
MIAMI SHORES FL 33138-
9220 NE 2 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,400.00
MR C'S PLUMBING S SEPTIC INC (305)651-7859 Total Sq Feet: 500
Type of Work:DRAINFIEL INSTALLATION 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
CCF $1.80 Invoice# PL-12-15-57944
DBPR Fee $2'25 12/03/2015 Credit Card $50.00 $118.30
DCA Fee $2.25
Education Surcharge $0,80 12/09/2015 Credit Card $118.30 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $168.30
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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore I miAhorize the above-named contractor to do the work stated.
December 09,2015
orized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 09,2015 1
Miami Shores Village D C 03 2015
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 l
FBC 2014:'
BUILDING Master Permit Nd'Pi 15- 302-0
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: IR D VE O1 Aue
City: Miami Shores County: Miami Dade zip: :3-3`3 r
Folio/Parcel#: It" 3dD6 - 0(3—306 O Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): AMC (0otiefsx Phone#: '3®5 761 Q4 7
Address: q0do NC i- AV-C
City: N 1'gr,wat State: Zip: 3 39
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Ir A/ 1 Phone#: �it7 p,�//�r7
Address: Aw k
City: / _State: . Zip:
Qualifier Name: T� � L'`. Phone#:
State Certification or Registration#: T 06,4s-31, Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: `Zip:
Value of Work for this Permit:$ uare/Linear Footage of Work: ,VX-)V1
Type of Work: ❑ Addition ❑ Alteration New Repair/Replace ❑ Demolition
Description of Work: J,
�1
f,[ l:::'! ./r.e•p?r;Ui 7'e4i,c° i,y r` �`OaS
Spectie�."i!,or croW thri:i p,
a.
'�•. fits'!iI7,i..tr..g,r.li'1 ......
Submittal',
e$ 7Perme$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double-Feeee$$ ,
Structural Reviews$ Bond$ �..a.:�!J -
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)
3
Mortgage Lenderts 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 e p oved and a reinspection fee will be charged.
Signature .' V Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
.�i day of PLPh. .20 1 r .by day of Du"Iffl .20 's .by
m1U1�t2 l iJi� e�Shn .who is personally known to K ms ( - .who is personally known to
me or who has cedaD '(',X3-2-Sit o-b�'(-1 rpP or who has produced as
identification and who did take an oath. identification and who.oid take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
*Jr
Sign Sign: JA�
Print: Print:
lPRV PUB . ♦ ,
Seal' ,'2�+ •��': Notary Public-S7Florida Seal: Ptd Slee of FI"a
My Comm.ExpireC011nn.ER�teBOct23.2018
Commission# CQmmhmftn#FF 198597
Bonded Through Nati
APPROVED BY 12A, f 5 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
A PERMIT #:1340-1643360
APPLICATION #:AP1213189
STATE OF FLORIDA DATE PAID:
DBPARTMBNT OF HEALTH
01P. ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID.
CONSTRUCTION PERMIT RECEIPT 4:
DST •:PR996341
CONsTADCTION PERMIT FOA: OSTDS Repair
APPLICANT: Michele Contessa
PROPERTY ADDRESS: 9220 NE 2 Ave Miand,FL 33138
LOT: 3,4 BLOCK: 23 SUBDIVISION: Miami Stores Seo 1 Amd
[SECTION, TOWNSHIP, RANGE, PARCEL NUMMMI
PROPERTY ID 9: 11-3206-013-3060 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCCODANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 648-6, 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 PDDR 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 CCMPISANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DBVELOMM OF THIS PROPERTY,
SYSTEM DESIGN AND SPECIFICATICNS
I,
T E 1,050 1 GALLONS ! GPD existing septic tRnk to remain �A
Y
T
A E 0 1 GALIANB / GPO
N [ 0 ] GALLOWS GpEAW nrfZPCSPTOR CAPACITY [ CAPACITY SINGLE TANK:1250 GALLCINSI
K [ I GALLONS DOSING TANK CAPACITY E ]GALLONS 6E ]DOSES PER 24 HRS "umps [ I
D E 500 I agamm FEET neve trench config.drainfie SYSTEM
R E 0 1 SQUARE FEET SYSTEM
A TYPE SYSTEM: Ia] STANDARD I I FILLED 13 MOUND I I
I CONFIGURATION: Is] TRS I ] BED [ I
N
F LOCATION OF BENCHMARK: FFE 10.W NGVD
I ELEVATION OF PROPOSED SYSTEM SITS E 9.60 I IIdCHEB FT II ABOVE BELQW POINT
E BOTTOM OF DRAINFIBLD TO BE t 59.64 I INCHES FT I E ABOVE BELOW HERK/ POINT
L
D FILL REQUIRED: 10.001 INCHES EXCAVATION REQUIRED: E 86.001 INCHES
1.-Existing 1050 fat.septic tank,certified by-Was PlurnbW on 11/1712015 to remain.
2.4nstall 500 sf of drainfiei d in trench configuration.
T 3.4nstall 36"of slightly limited soil at the bOWm of the drsinfk0d.
4:Perimeter of excavation area shau be at West 2 ft wader and longer than the proposed absorption bed or drain trench.
H (Comments Continued on Page 2.)
E
R
SPECIFICATIONS BY: C s tic TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHIP
Y Marr+�
DATE ISSUED: 15 EXPIRATION DATE: 0310212016
DH 4016, 08/09 (Cbsoletes all previous editions which may not be used) Page i of 3
Inoarporated: 64E-6.003, FAC
v 1.k.4 Ap1213189 SE978504