PL-15-2919 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)755-2204 Fax:(305)756.8972
inspection Number. INSP-248076 Permit Number: PL-11-15-2919
Scheduled inspection Date:April 20,2016 Permit Type: Plumbing - Residential
Inspector. Hernandez,Rafael
Inspection Type: Final
Owner. ALVARADO,EDDIE Work Classification: Drainiield
Job Address:93 NW 96 Street
Miami Shores,FL Phone Number 3051674-7105
Parcel Number 1131010330380
Project: <NONE>
Contractor. STATEWIDE SEPTIC CONNECTIONS Phone: (954)963-0082
Building Department Comments
INSTALL NEW DRAIN FIELD SYSTEM FOR EXISTING Infractio Passed meat
SEPTIC SYSTEM INSPECTOR COMMENTS False
TO CLOSE PERMIT#PL15-40
01-2215 I. Naranjo
Need to obtain permit to replace damage sidewalks and
Inspector Comments
Passed 0 1
Failed El
Correction ❑
Needed
Re-Inspection
Fee
No Additional Irapedions can be scheduled until
re-inspection fee Is paid
April 19,2016 For Inspections please calk(305)762-4949
Page 9 of 46
.. ri� r �i as
Miami Shores Village ` v
10050 N.E.2nd Avenue NW a3 ,
Miami Shores,FL 33138-0000
Phone: (305)795-2204
£
Expiration: 06117/2016
Project Address Parcel Number Applicant
93 NW 96 Street 1131010330380
EDDIE ALVARADO
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
EDDIE ALVARADO 93 NW 96 ST 3051674-7105 (305)751-0275
MIAMI SHORES FL 33150
Contractor(s) Phone Cell Phone Valuation: $ 3,000.00
STATEWIDE SEPTIC CONNECTIONS (954)963-0082 Total Sq Feet: 300
Type of Work:INSTALL NEW DRAIN FIELD SYSTEM FOR Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Final
Bond Retum: HRS Approval
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# PL-11-15-57812
DBPR Fee $2.25 11/19/2015 Check*1014 $173.30 $0.00
DCA Fee $2.25
Education Surcharge $0.60
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $173.30
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 z ning. Futhermore,I ho' the above-named contractor to do the work stated.
- C November 19,2015
Auth VrIzednature:Owner / Applicant / Contractor / Agent a e
Buildinpartment Copy
November 19,2015 1
Miami Shores Village `
•
M ' ' Building Department 18 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 T
INSPECTION LINE PHONE NUMBER:(305)762-4949 l
FBC 20
BUILDING Master Permit No. ` U 5-a 9 19
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ea KW �) G &±
City: Miami Shores County: Miami Dade Zip: 331 SO
Folio/Parcel#: 11-3/0-033 -03W Is the Building Historically Designated:Yes NO v
Occupancy Type: Load: Construction Type: Flood Zone:_/ BFE: FFE:
OWNER:Name(Fee Simple Titleholder):f >n1P- h-NA!6L4f;y Eu ZABEN S.01eo Phone#: -784,37(6-)Z3?
Address: -s Q w f-'T
City: `M)kt i t SkICXLE State: �L Zip:
Tenant/Lessee Name: Phone#:
Email: �'l�hL�lla (�i-(b 1C. corl
CONTRACTOR:Company Name: S'Cb L LJ 1Df— .SL9'' %C d..-4JVFl-A.0Ld>, (a-.Phone#:
Address: 13c qo O•w `1 16- 1 Lx, 06. )S
City: Lo�j4Z State: -Ik— Zip: 3 30"
Qualifier Name: Phone#:
State Certification or Registration#: St-1 Qq Z(:P2Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ my- Square/Unear Footage of Work: :3 O-D
Type of Work: ❑ Addition ❑ Alteration ❑ New E Repair/Replace ❑ Demolition
Description of Work: I PS-r LC A £w I JUREL8 .4?'S?Fr1 ror- Fk1571Au6 �,>?t7rf C
S7szE�l cv s ern _ t1/16ti 1 -'!55fC;0-J 16"19 Wf e-CL4j`ry LH9 S A60ri17's
Specify color of color thru tile:
Submittal Fee Permit Fee$ CCF$ CO/CC$ t
Scanning Fee$ Radon Fee$ DBPR$ Notary$ - 'Q6
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 1 13 •3
(Revlsed02/24/2014)
Bonding Company's Name(if applicable) s 1
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
or ENT CONTRACTOR
The foregoing instrumen was acknowledged before me this The foregoing instrument was acknowledged before me this
G day of 1`2 y ,20 V ,by �`' day of NhUFN ,.120 � .by
AW G-ra t6,who is personally known to CIES U N O N S: w�fio i dr�onally known to
me or who has produced as me or who has produced Eubz wp— ii 61D as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign
Print: Print: P"gE-2
Seal: ��ar,q�, Seal:
* �s,�$ p� Notary Public State of Florida
Sindia Atvarraz
$� M My commission FF 158750
soft�***********************
APPROVED BY �`G�/� Plans Examiner Zoning
i
Structural Review Clerk
(Revisedo2/24/2014)
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Scanned by CarnScanner
PERMIT #:13-SC-1579002
«a
APPLICATION #:AP1170919
STATE OF FLORIDA
DATE PAID:
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #:PR959831
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Eddie Alvarado
PROPERTY ADDRESS: 93 NW 96 St Miami,FL 33150
LOT: 1516 BLOCK: 130 SUBDIVISION:
PROPERTY ID #: 11-3101-033-0380 [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 649-6, 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 I 900 ] GALLONS / GPD existing septic tank to remain CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY I ]GALLONS @I ]DOSES PER 24 HRS #Pumps [ ]
D [ C013
SQUARE FEET new bed confiq.drainfield SYSTEM
R I SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED I ]
N
F LOCATION OF BENCHMARK: FFE 13.2'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE 131.20][ INCHES FT ][ABOVE 89LOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 81.24 ] [rXNCHESq FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: 10.00] INCHES EXCAVATION REQUIRED: [ 50.001 INCHES
1.-Existing 900 gal.septic tank,certified by"Statewide Septic"on 01/05/2014 to remain.
0 2.-Install 300 sf of drainfield in bed configuration.
T 3.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
4.-Invert elevation of drainfield to be no less than 6.93'NGVD.
H 5.-Bottom of drainfield elevation to be no less than 6.43'NGVD.
E The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow
R of 300 gpd.THIS PERMIT I NOT FOR ANY ADDITIONS.
SPECIFICATIONS BY: re " J Solomon TITLE: Master Septic Tank Contractor
APPROVED BY: �. TITLE: Engineering Specialist II Dade CHD
tin
DATE ISSUED: /2015 EXPIRATION DATE: 04/06/2015
DH 4016, 08/09 (obsoletes all previous editions Which may not be used)
Incorporated: 649-6.003, FAC Page 1 of 3
v 1.1.4 AP1170919 SE947008
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'$TATE OF FLORIDA
DEPARTMENT OF HEALTH
•; ` • APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTPJGI"IOC! PERMIT
Permit A plical-on Num r I V.
Pf1RTII -SITE PLAN-------- I � �
Scare: Each lack represents 5 feet and 1 inch'= 50 feet.
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N.
Not:s: A) V-0 r 0 D N 0 G S des 3-3 IV)
. r30041, bed
Site Plag,submttteed y: r C-co—
T,t W. w _.
Plat r ved Not Approved Date
By _-.County Health Departm:;
4
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DR 40.5.TOM Mopkms 14F494fFwm4015wbich mwj boo.-W)
-57"-OW-4015-6P
IS-44D
liivissox of
Eawmawntat Heatth
Florida Health
Miami-Dade,County
Q� OSTDS/Well Division
0805 SW Sweet•Miami,FL 33175
AAr I nspecfor O : . ` ' ✓e r" Date
-TAA—�.--
Address._._Aa Aw `. osTDs# /7 j 4 I
Comments:
. signature
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