PL-16-197 & Z5
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone:(305)795-2204 Fax: (305)7564972
Inspection Number. INSP-251553 Permit Number. PL-1-16-197
Scheduled Inspection Date: May 16,2016 Permit Type: Plumbing-Residential
Inspector: Hernandez,Rafael Inspection Type: Final
Owner: TOVAR,JONATHAN A ANDREA Work Classification: Septic
Job Address:464 NE 92 Street
Miami Shores,FL Phone Number (78675.5533
Parcel Number 1132060140030
Project <NONE>
Contractor: MR C'S PLUMBING S SEPTIC INC Phone:(305)651-7859
Building Department Comments
NEW SYSTEM INSTALLATION. Infractio m
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS APPROVAL ON FIL
Failed El
Correction a
Needed
Re-Inspection
Fee
No Additlonal Inspections can be scheduled untli
re-inspecdon The Is paid
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
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T s➢ '. 3k �' �� 3 a_.
Phone: (305)795-2204
Expiration: 07/27/2016
Project Address Parcel Number Applicant
464 NE 92 Street 1132060140030
Miami Shores, FL Block: Lot: JONATHAN&ANDREA TOVAR
Owner information Address Phone Cell
JONATHAN&ANDREA TOVAR 464 NE 92 Street (786)375-5533 (305)610-0914
Miami Shores FL 33138-
464 NE 92 Street
Miami Shores FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 6,500.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
Total Sq Feet: 375
Type of Work:NEW SYSTEM INSTALLATION. 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 $4,20
DBPR Fee Invoice# PL-1-16.58440
$4.50 01/26/2016 Credit Card $50.00 $279.20
DCA Fee $4,50
Education Surcharge $1.40 01/29/2016 Credit Card $279.20 $0.00
Permit Fee $300.00
Scanning Fee $9.00
Technology Fee $5.60
Total: $329.20
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accura and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named o do the work stated.
January 29,2016
Authorized Signature:Owner / Ap nt / Contractor / Agent Date
Building Department Copy
January 29,2016 1
Miami Shores %tillage
3 N 26 015
Building Department
�f 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(30S)795-2204 Fax:(305)756-8972 _
RUPECTWU l T6Z
FBC20t4
BUILDING Master Permit NoCJ
PERMIT APPLICATION Sub Permit No.� &—1 Q-4
OMUBM 0 ELECMC OROMM 0 RFASIM 0
PLUMBING MECHANICAL []PUBLIC WORKS ED CHANGE OF 0 CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Cft Miaaaw shy Wiaml Dade 3?13
Folio/Parcels: ��,'" %L64 04 00 �O' K the Building Historically Designated:Yes NO
Occupancy Type: Load Construction Type: Flood Zone: BFE: FFE
OWNER:Name(Fee Simple Titleholder): Phone#:
Address:: kAA)JE 1 PV . '
City: mi State: Tip:' 4
Tenant/Lessee Name: Ot Phone#:
Email: c
CONTRACTOR:Company Name: / [! ( Phone#: Ififf/ wE-f
Address:
City: f � State• Zip•
Qualifier Name: Phone#•
State Certification or Registration .Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address- City: State: Zip:
75TypValue of Work for this Permit:$ Square/Linear Footage of Work:_175—
Type
e of Work: 0 Addition [] AlterationNew Repair/Replace ®Demolition
Description of Work:
Spec&color of color t m We:
.r^
Submittal Fee$ . Permit Fee$ _, ' . r`t,CCF$ ' CO/cc$ PL
Scanning Fee$ Radon Fee$ DBPR$_ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ _ Bond$ `
TOTAL FEE NOW DUE$
(Pwwseai02/24/2014)
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 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 Apprkant: As a condPtion to the issuance of a building permit with an estimated value exceeding$25017,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 re' spection fee will be charged
Signature Signature
OWNER CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of "� 20 1 by day of '`t. ..o.20 by
is personauy known to
me or who has produced Ae* as me or who has produced as
Identification and who did take an oath. identification and who did take an oath.
NOTARY PUBUC: NOTARY PUBLIC:
Sign: 2 i" Sign:
Print: dal Pri✓1 Print:
Seal: Seal: "'uu"''•, SHERYL A MENDES
RUTH A.PALMIERI Notary► n. licEx l Octof 3brida
>Y COMUSSIoN a"0420 e 'Cormn. ion# O23.2018
MMM �2D17 Cortaaisaba FF 158597
a+�e+satisas�rww� s�+r�s�es�e+�s�se+r�s�s+a�s+es +�sasxr
APPROVED BY )�- d r Plans Examiner Zoning
Structural Review Clerk
MeviseMV24/2014i
STATE OF FLORIDA PERMIT #: 13-SC-1609624
'
DEPARTMENT OF HEALTH APPLICATION #: AP1190956
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM FEE PAID:
CONSTRUCTION PERMIT
• « RECEIPT #•
DOCUMENT #: PR980712
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Andrea&Johnathan Tovar
PROPERTY ADDRESS: 464 NE 92 St Miami,FL 33138
LOT: 4 BLOCK: 49 SUBDIVISION: Miami Shores Sec 2
PROPERTY ID #: 11-3206-014-0030 [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 [ 900 ] GALLONS / GPD Septic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
R [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 375 ] SQUARE FEET Trench configuration drain SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: CL NE 92 st.,9.57'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 10.60 IFINCHES1 FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
9 BOTTOM OF DRAINFIELD TO BE [ 40.68 ] [ INCHES FT ] [ABOVE JBELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES
0 *Invert elevation of drainfield to be no less than 6.68'NGVD.
*Bottom of drainfield elevation to be no less than 6.18'NGVD.
T *Install 42°of slightly limited soil under the bottom of drainfield.
H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow
E of 300 gpd.
R The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s.64E-6.013(3)(0,FAC.
SPECIFICATIONS BY: Teresa J Solomon TITLE: Master Septic Tank Contractor
APPROVED BY: TITLE: Dade CHp
Carlo—s-K-T-Caza
DATE ISSUED: 07/10/2015 EXPIRATION DATE: 01/10/2017
DE 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1190956 SE965773
? DIVISION OF
#Xox • Environmental Health
Florida Health
QQ�Q� Miami-Dade County
OSTDS/Well Division �01j
�► 11805 SW 26t4 Street•Miami,FL 33175
n
' .. Inspector 1z t7 Date 1 j
� # Address �� �' �ff�r `, ? :`' OSTDS# '4 �� �� ./v
Comments:
Signature