PL-12-1060 .t
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972 rodaw
Inspection Number: INSP-174659 Permit Number: PL-6-12-1060
Scheduled Inspection Date: February 21,2013 Permit Type: Plumbing- Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: BUTLER,JACQUELINE Work Classification: Septic
Job Address:1461 NE 102 Street
Miami Shores, FL 33138-2621 Phone Number
Q)WOOOOO Parcel Number 1132050240140
Project: <NONE>
Contractor: G&L PLUMBING SERVICE Phone: 305-551-5090
Building Department Comments
SEPTIC 1200 GL AND 375 DOSING AND NEW
DRAINFIELD
Inspector Comments
Passed
A'*d S
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
February 20,2013 For Inspections please call: (305)762-4949 Page 3 of 23
Miami Shores Village PIFICE111 FID
Building Department JUN 112012
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:_ —
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
BU L ING Permit No.
PERMIT APPLICATION Master Permit No. E(,..,12 '09 `2aal
FBC 20 Cr-j--
Permit Type: PLUMBING
OWNER:Name(Fee Simple Titleholder): 9,UILU- Phone#:
Address: i q kj '\-*— %-/ L St'
City: %A4 l4 )i l smm_� State: -r'L- Zip: 2,2,J
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS:
City: Miami Shores County: Miami Dade
Folio/Parcel#• 9k —3205.— 07 01 q U
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: Vm 6-oveee,* ;We, phone#: +"31(6"50q,9
Address: 71-4 j J
City: r-41 a �' State: Zip:
Qualifier Name: !� Joq A(-la12.A Phone#: 3066'3«0' 1t)gg
State Certification or Registration#:: Certificate of Competency,#t.
Contact Phone#: .3 -!4101049 Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit: S
$ .,u .v
quare/Linear Footage of Wort:
Type of Work: UAddress DAlteration EJNew ORepair/Replac� ODemolition
Descriptio Work: 7
Submittal Fee$` Permit Fee$ . d " CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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 ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature`s � o' i.
Owner or Agent Contractor
The fore oing instrument was acknowledged before me this The fore ping instrument was acknowlec d before me this /
day of V I1 e, ,20 M,,by�x�.r✓.wA� day of ,20/ ,, y
who is personally known to me or who has produced who is personally known to me or w o as produced
As identification and who did take an oath. as identificatio who id take an oath.
NOTARY PUBLIC: �gp� NOTARY PUB ,:
WComM0M#DD9M
EWRE&M A 2M
Sign PaA" Sign:
Print _AJ V r=- 0 Print: wrwma
My Commission Expires: Jo � 30 1 ION My Co � n FxAt 9-1m s�EEo13426
?a poi Expires 10/0272014
skkkb8akksk8s$s�kkdkkksk8+k8ekkkffisgaRsk dk+kkRkbkk8eakkkkkskakd+skkskkAkkkakkakaAkfi8ak8akskkskkd+skk&kRdAkdade&dedekkdesk+k+kRkkkkkkRddakkkskkskskdsIak
APPROVED BY jea �-//,�L Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
A N I F W�Q�E Al
STATE OF MORTCA P�xM=T #: 13-5C-1286987
DEPART=Kr or xrALTH APPLYCATIom #: AP983999
ONSITE SEWAGE MMATMNT AM DISPOSAL DATE PAID:
SYSTEM YES PAID:
CONSTRUCTION PEPMT
RECEIPT• 0 M:
' DOCVXWT #: PM831325
CON3TRUCTION PERXXT FOR: OSMS Now
AMMTCANT: JaCgereline .8utier
MOV=T r ADDRESS: 1461 NE 102 St El Portal,FL 33138
LOT: 16-18 HLOCX; 1 SU7EDIVISI00! Miami Shores;
PROPERTY ID M: 11.3208 024 0140 (SECTION, TOW SOXV, RANGE, PARCEL WMINV 11
rOR 'TAX ID NUMURI
ssas s
SYSTEM MUST MUST BE CONSTRUCTED IN ACCORDANCE WITH SPxCIF%CATZONB AND STANDARDS OF SECTION
381.0065, F.S., AND C34PM $4E-6, F.A.C. DEPARTMUT APPRW4AL OF sXSTEM DOES NOT 0W%A-*4TEE
SATISFACTORY PERFO7PiE.NCZ FOR ANY SPECIFIC PERIOD OF TIME. ANY CXANGB IN NATERIA7, FACTS,
WR=Cil SERVED AS A BASIS FOR %$$VANCE Of TXXS PSRMST, REQUIRE THE APPLICANT TO MODIFY• THE
P7sMTT APPLICATION. SVCA moDIFICATIONS NXY RESULT IN THYS PERMTT BTcING MADE N= AND VOID.
ISSUANCS OF THIS PERMIT DOES NOT NX00? THE APPLXCANT VAOX CONPLZANCE WITH OTHER FEDERAL.
STATL°, OR LOCAL PBRMITTzW* RBQVSRBD FOR DEVELOPNZNT OF THIS PROPERTY.
SYSTAX DESIGN AND SBSCIFSCATIONS
T C 1.200 7 GALLOP$ I GPD` H-10 traffic rate setic tank CAPACITY
A ( J G?LLONS / GPD N/A CAPACITY
14 t 3 2"X4WS GRlyJ1SE ,IN'TERCEPTOR CAPACITY (14atXlbit7DG COACITY SINGLE TANK:1250 GALLONS]
K t 375 } GALLONS DOSING TANK CAPACITY ( 83.00 ]GALLONS a t 6 3DOSSS PEA 24 MRS fiPV�s t 1 l
D ( $25 1 SgJARE FEET Trench COnflotrrolon drain_SYSTaM
R ( ] $QUARE FEET N/A 8YSTXx
A TYPE SYSTEM: t ? STANDMW ;:l rxL%ED r l mom t 3
I CONFIGURATION: tx3 TUNCH
N
F LOCATION Or 27NCKKARK: CL NE 102 St.,4.67'NGVD
I ELEVATION OF PROPOSED SYSTEM Sz= t 7.56 1 t XNCMS FT I flgiP BnowIBENCHNAM/7i'JBnnuvCB POINT
E BOTTOM OF DRASKFZ=.TO 8E t 4.56 1 I SNc"u— rT 1 C�.SELOW 3 EENCHMARKIREFEBTKE POINT
D FILL REQUII=! 1115.003 rdCENG ZY4XVATION REQUIRED: t 45.60.1 INCHES
0 Invart elevation of drainfleld to be no less then 5.50 ft.NGVR.
'Bottom of drainfieid elevatlon to be no less than 5.00 ft.NGVD.
T •Install 42"of slightly lirrited soil under the bottom of the drainfield.
x -Perlmeter of excavatlon area shall be at least 2 ft wider and longer than the proposed abiorption or drain trench.
-The licensed contractor installing the system is responsible for installing the minimum category tank accordance
E with sec.645.6.013(3){f}. F.A.C. gn`
R gQ® `
SPECIFXCATIONS BY. Carlos M Icaaa TITLE: l
APPROVED BY: TITZB; ® ado CHD
as ee c�
aArs ZSSr>ED: 01,11/2011
DATE: 07/11/2012
ph 4016, OB/09 (Obeol.etes all psevicus editions WhiCh may not be U"d)
Page 1 of 3
?ssoorporated: 64E-6.003, FAC Y i.w.a 1.4993899 ata36a44