PL-16-709 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)766-8972
Inspection Number. INSP-255031 Permit Number: PL-3-16-708
Scheduled inspection Date: May 04,2016 Permit Type: Plumbing- Residential
Inspector. Hernandez,Rafael
Inspection Type: Final
Owner: DE LA ESPRIELLA,ALEXANDRA Work Classification: Drainfield
Job Address:1110 NE 100 Street
Miami Shores,FL 33138- Phone Number
Parcel Number 1132050190460
Project: <NONE>
Contractor MR C'S PLUMBING&SEPTIC INC Phone:(305)651-7869
Building Department Comments
INSTALLATION OF DRAINFIELD Iniracdo, Passed Commeros
INSPECTOR COMMENTS False
TO CLOSE PERMIT*PL01-1004
Inspector Comments
Passed HRS ON FILE
Failed
Correction
Needed ❑
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re4nspec tion The is pak.
rrs a
Miami Shores Village ,
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
� Phone 30 795-2204 ,y` P �I ' �,� � ,� C�'r, ,I,ti,� �, �t.,li 1•.�,';1r,
�x
Expiration: 09/1812016
Project Address Parcel Number Applicant
1110 NE 100 Street 1132050190460 ALEXANDRA DE LA ESPRIELLA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ALEXANDRA DE LA ESPRIELLA 1110 NE 100 ST
MIAMI SHORES FL 33138-2602
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
MR C'S PLUMBING 8 SEPTIC INC (305)651-7859 Total Sq Feet: 200
Type of Work:INSTALLATION OF DRAINFIELD Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
HRS Approval
Bond Retum: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 invoice# PL-3-16.59059
DBPR Fee $2.00 03/18/2016 Credit Card $50.00 $71.20
DCA Fee $2.00
Education Surcharge $0.40 03/22/2016 Credit Card $71.20 $0.00
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $121.20
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.
OWNER FIDAVIT: I cert' th II h fo oing information is accurate and that all work will be done in compliance with all applicable taws regulating
construct! z n ut 0 riz th above-named contractor to do the work stated.
March 22, 2016
\A Applicant / Contractor / Agent Date
Building Department Copy
March 22,2016 1
Y
Miami Shores VillageCFITVFIID
.. `% M 18 2016
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY^
Tel:(305)795-2204 Fax:(305)756-8972 �J
INSPECTION LINE PHONE NUMBER:(30S)762-4949 ��n
FBC 20 Iq
BUILDING Master Permit NOT, 0 ®�
PERMIT APPLICATION Sub Permit No.
r-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I l t O I 5t- -°�
City: Miami Shores County: Miami Dade Zip: J� J
Folio/Parcel#: -3-ol 05 1 61 d4 60 is the Building Historically Designated:Yes NO
Occupancy Type: 6v- $Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): vv C S sI e Pone#: _3D o-3�4 7: cD T
Address: 0`,0 S`�
City: l l a WL 1 1l� s , State: F- Zip: �J
Tenant/Lessee Name: Phone#:
Email: / �7 G
CONTRACTOR:Company Name: f 1.( V„+�,�ISNU Phone#: J�J� 15 17b �y
Address: Mw 'r An
City: State' Zip:
Qualifier Name: )64R CL Phone#:
State Certification or Registration#: Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$Z�� ' Square/Linear Footage of Work:
Type of Work: ❑ Addition ElAlteration ( F-1New �tepair/Replace ❑ Demolition
a
Description of Work: DRAAa. A 3 1 —TO �Q� lT -PLO I
Specify cplor o color thru tile:
Submittal Fee$' permit Fee CCF$ 9 - 90 CO/CC$
Scanning Fee$ e Radon Fee$ DBPR$ o'� Q�) Notary$ •�
Technology Fee$ Training/Education Fee$ t) Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Rev1sed02/24/2014)
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 hermit 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 rei p ion fee will be charged.
Signature Signature v
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of �� 20 t' ,by day of /I! ,20 1� ,by
'w '�onally known to �/Gw�+O'e7T��C� ,who is personally known to
me or who has produced L �� me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTA Y BUC: NOTARY PUBUQ
Sig f Sign:
Print�1 I Vy�i 1—\�Jv-4- 1�, Print
Seal: Seal: Notes►Pott-sta s at fie
a
Notary Public State of Florida • My Cow.Expires Oct 23.2018
Sindia Alvarez
My commission FF 156750 .y� Commisstort#Ff 138887
E*h'es 09l08J2018
**************** ****************************** **** ***e ** * ** ******s****
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
,
l q
�P
t7EMIT N: 13-SC-1664662
APPLICATION
:AP12277J9
STATE OF FLORIDA �
DATE PAID:
y DEPARTMENT OF HEALTH:: ,
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FSE PAID:
CONSTRUCTION PERMIT RECEIPT #:
M ,
DOCUMENT #: PR1009416
3
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Alexandra De la Dsprieila
PROPERTY ADDRESS: 1110 NE 100 St Mia3138
h{k
LOT: 14 BLOCK: 178
&,. ....,, �UHD=vISION: Miami Shores Sec 8 Rev
t (SECTION, TOWNSHIP, RANGE,' ERj
PROPERTY ID : 11-3205-019-0450Z _
[OR TAX ID 1•IUMBERJ
3
T
SYSTEM MUST BE CONSTRUCTED IN CORDANCE WITH SPECIFICATIONS, TANDARt7S OF"�;.
381.0065, F.S., AND CHAPTER 64E fir IA•LC DEPARTMENT APPROVAL 0 6TEM DOES NOT GUARANT
SATISFACTORY PERFORMANCE FOR ANY SPECXPIC 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,
ilk STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 750 ] GALLONS / GPD existing septic tank CAPACITY
A L ] GALLONS J GPD CAPACITY "
t .: Nz�
f ] GALLONS GREASE INTERCEPTOR CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLO2j ]'.:-
K ] GALLONS DOSING TANK CAPACITY { ]GALLONS @( ]DOSES PER 24 HRSPumg� ( j
1
D f 200 ] SQUARE FEET bed Confiquration drainfiel SYSTEM
R f ] SQUARE FEET SYSTEM
. A TYPE SYSTEM: [X] STANDARD [ ] FILLED ( ] MOUND
I CONFIGURATION: ( ] TRENCH txj BED [ ]
§\ v
F LOCATION OF BENCHMARK: FFE 10.9'NGVD
IELEVATION OF PROPOSED SYSTEM SITE > ��.
" 122.80 ] ( INCHES FT,] [ABQ ..,, BELOW BENCFifSARl'�fRE
E BOTTOM OF DRAINFIELD TO BE C 52,$0 ] CINCHES ` F`I` ] C AEi`}L�F BELOW BENCt�fARKJRE � �E��
L
D FILL REQUIRED: [ ] INCHES EXCASrATION REQUIRED: ( 4200 ] INCHES �� a3{
O 1.-Existing 750 gal.septic tank certified by Mr.O's Plumbing, Septic on 7"
12"
to remain,
2.-Install 200 sf of drainfield in bed configuration.
T 3-lnstali 12"of slightly limited soil at the bottom of the drat field { ;
4.-Perimeter of excavation area shall he at Least 2 ft wider and longer than the proposed absorption bed or drain trench.
H '
5_-Invert elevation of drainfield no less than 7.001 NGVD. 6.-Bottom of drainfield elevation no less than 6.50`NGVD. l•
E The system is sized for 2 bedrooms with a maximum occupancy of 4 persons(2 per bedroom),for a total estimated flaw
of 300 gpd. "THIS REPAIR PERMIT IS NOT FOR ANY SEASON'
R
SPECIFICATIONS BY: Kemble Ettrick
TITLE:
APPROVED BY: %l+/ t 'i TITLE: Engineering Specialist II
Eri,and� omi.aca Dade CHD
DATE ISSUED: 03!1512015
� EXPIRATION DATE: 06f13l2016
ZH 4016, 08/09 (Obsoletes ail previous +e+ tions which may not be used]
Incorporated: 64E-6.003,11 �
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DIVISION OF
Environmentat Health
Florida Health
Miami-Dade County
OSTDS/WeR D"iov,
-'Ilk 11805 sw 26th stceec•Mialol,FL M75
\ Inspector �C�y Date
EoI►tments:
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