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PL-16-2398 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-266207 PermitNumber: PL-8-16-2398 Scheduled Inspection Date:August 31,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: DEMIDUKE,ROBERT&AIMEE Work Classification: Drainfield Job Address:246 NE 105 Street Miami Shores,FL 33138- Phone Number (772)341-7158 Parcel Number 1121360130490 Project: <NONE> Contractor: A SUPER SEPTIC&DRAIN FIELD INC Building Department Comments DRAIN FIELD INSTALLATION Intractio Passed Comments INSPECTOR COMMENTS False TO REPLACE PERMIT#PL141907 Inspector Comments Passed HRS APPROVAL ON FILE Failed s r K Correction �� Needed ❑ Re-inspection Fee No Additional Inspections can be scheduled until reinspection fee is paid. x m' " IT nrO , - 398 z z Miami Shores Village 60 �@1fI 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 yv- o Phone: (305)795-2204 � � � 6 Expiration: Q?126117 Project Address Parcel Number Applicant 246 NE 105 Street 1121360130490 Miami Shores, FL 33138- Block: Lot: ROBERT&AIMEE DEMIDUKE Owner information Address Phone Cell ROBERT&AIMEE DEMIDUKE 246 NE 105 Street (772)341-7158 MIAMI SHORES FL 33138- 246 N E 105 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,300.00 A SUPER SEPTIC 8,DRAIN FIELD INC _. _ __.. _p ... _..... .... _.. Total Sq Feet: 225 Type of Work:DRAIN FIELD INSTALLATION Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: HRS Approval Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 DBPR Fee InVOiCe# PL-8-16-61128 $2.25 08/26/2016 Check#:0109 $50.00 $118.30 DCA Fee $2.25 Education Surcharge $0.60 08/30/2016 Check#:3796 $118.30 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 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 foregoininformation is accurate 8nd that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize a a ed ont actor to do the work stated. August 30,2016 Authorized Signature:Owner / Ap can ntr ctor gent Date Building Department Cop August 30,2016 1