PL-15-2667 (2). Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-248996 Permit Number. PL-10-15-2667
Scheduled Inspection Date:April 25,2016 Permit Type: Plumbing -Residential
Inspector Hernandez,Rafael Inspection Type: Final
P� Ype.
Owner. SOUTO,PABLO F Work Classification: Dralnfield
Job Address:161 NE 107 Street
Miami Shores,FL Phone Number
Parcel Number 1121360070300
Project: <NONE>
Contractor STATEWIDE SEPTIC CONNECTIONS Phone:(954)963-0082
Building Department Comments
REPLACE DRAINFIELD Infroido, Passed me"ffi
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-246079. NO PERMIT NO SOD
Failed El
Correction
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
reinspection fee is paid
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a Miami Shores Village
Building Department °'��'�`'
OCT
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 2 p 2015
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2011
BUILDING Master Permit No. TL lS- 26(p?'
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
UMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
I r tt CONTRACTOR DRAWINGS
JOB ADDRESS: LQ I mC. t �� �-
City: Miami Shores ��,,��•�� County: Miami Dade zip:
Folio/Parcel#:`� c3 3�V�W�" Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: Q
OWNER:Name(Fee Simple Titleholder): `p IzA -� Phone#
Address: I �0 {l� I Is—)
City: �:A,( Q 3('� State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name:
4one#: 1— m
Address: ''Lo,..,�9,^vU�9.pa �
City: pDa —State: Zip:aa �j 7
Qualifier Name: C^ Phone#:
State Certification or Registration#: �"1 V`"l� j� l0 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: �v City: State: I`Zip:
Value of Work for this Permit:$ ss, .� l�� w Square/Linear Footage of Work: V
Type of Work: ❑ Addition ❑ Alteration ❑ New i Repair/Replace ❑ Demolition
Description of Work: �cir:c -�r u encE i dl
Specify color of color thru tile:
Submittal Fee$ Permit Fee$. CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
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)
Mortgage Lender's Address
City Stat 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
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of �� ,20� ,by day of ba ,20 15 .by
(L") who is personally known to 1��/e5� S0)Oirncarzwho is personally known to
me or who has produced as me or who has produced F—L Jq ::I�p as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: / NOTARY PUBLIC:
Sin \ Si n.
g g
Print: �f 'tel_ �P1 ta- �'.( X�)k S Print: r4e-e CA ( l S
Seal: Seal:
:P W*Stft a of Flopda
TmvdY CO-"WIM RF 988307
y q Us
APPROVED BY 6 f/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Piperty Search Application- Miami-Dade County Page 1 of 8
1 11091
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Address Owner Name Folio
SEARCH-
_7 Suite P�J
PROPERTY INFORMATION
Folio 11-1,36-007-0300
Sub-Divisior
r ",N11 ",HORES EXT NO 3
Property Address
161 NE 107 ST
li .7031
,:'%i ric r
PABLO FEP,NANDO SOUTO
7�ANIE!_A". ;TURBURU
.i': r'Wdr,�ss
NF ":C7 ST
FL 33161
Primary Zone
1000 SGL FAMILY-2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL-SINGLE FAMILY: 1 UNIT
BPds a Baths/Half 3/2/0
Floors 1
Livinn Units 1
hap:i;'1v v �,rfiiartiidade.gov/propertysearch/ 10/20/2015
` • 1 M
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REPAIR PERMIT #: 3-SC-1635299
OCT � 2015 MIAMI-LADE COUNTY bl'_=..1•:I_T 4-?A� �ON #: P 1207685
STA OF E'LOR
DEP TA�}NT OF HEALTH
DATE PAID:
ONSITE SEWAGE--TREATMENT AND DISPOSAL SYSTEM FEE PAID:
4
D
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #:PR991044
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Pablo Souto
PROPERTY ADDRESS: 161 NE 107 St Miami,FL 33161
LOT: 14 BLOCK: 209 SUBDIVISION:
PROPERTY ID #: 11-2136-007-0300 [SECTION, TOWNSHIP, RANGE, PAR EL 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 DOS 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 APPLICAM 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 WITR OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 650 ] GALLONS / GPD existing septic tank to remain CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GAL ONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 300 ] SQUARE FEET new bed config.drainfield SYSTEM
• R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ 7
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 11.9'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 19.20][ INCHE3 FT ] [ABOVE BELOW BENCHMARK/ FERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 64.20 ][ INCHES FT ] [ABOVE JBELOW BENCmXARK/PEFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 45.00 ] INCHES
1.-Existing 650 gal.septic tank,certified by"Statewide Septic"on 10/06/2015 to remain.
O 2.-Install 300 sf of drainfield in bed configuration.
T 3.-Perimeter of excavation area shall be at least 2 It wider and longer than the proposed absorption bed or drain trench.
H 4.-Invert elevation of drainfield to be no less than 7.05'NGVD.
5.-Bottom of drainfield elevation to be no less than 6.55'NGVD.
E THIS PERMIT IS NOT FOR ANY ADDITIONS.
The system is sized for 3 bedro ms with a maximum occLip R an"$f pprsors(9 pgr begoom),for a total estimated flow
• •• • • • • ••• •
SPECIFICATIONS BY: TT Solomon ••• ••i ••:T Msstdr Septic Tank Contractor
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Martin • •
DATE ISSUED: c1111/2'0q • • • • • • • • EXPIRATION DATE:
•• • • • • • • • • • 01/14/2016
DH 4016, 08/09 (Obsoletes all previous edit; 41ch M14 nV be used) i
Incorporated: 64E-6.003, FAC Page 1 of 3
%1.207685 SE974323
1'.
• •• •• • • • •• ••
STATE OF FLORIDA
DEPARTMENT OF HEALTH
•� APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PER � w
�,A •
Permit Application Number
------ ----- ------ PART 11 -SITE PLAN•--•-----�.�=--�-`—
Scale: E h block represents 5 feet and 1 inch;=50 feet.
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cotes: ONEI
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• •• • • • • ••• •
lite Plan submitted y: ® C
f' atutrp• • ••• • — Title
'Ian Appr a Not ove• • •
l4pRt 5 . . . . . D to
-�_ . . ••
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;y
L 1:11 : - : : 1 11:11 : Counly Health Department
ALL CHANGES MUST BE APPROVED P•lf•"�H�'�0� - AEALTH DEPARTMENT
14015,10M(Re*oes HRS-H Forth 4015 which may be used)
lock Number:5744-M-40156)
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