PL-16-662 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)756-8972
Inspection Number. INSP-254648 PermitNumber. PL-3-16-662
Scheduled Inspection Date:August 24,2016 Permit Type: Plumbing -Residential
Inspector. Hernandez, Rafael
Inspection Type: Final
Owner. SABELLA,ANN Work Classification: Septic
Job Address:795 NE 94 Street
Miami Shores,FL Phone Number
Parcel Number 1132060142040
Project: <NONE>
Contractor: MR C'S PLUMBING A SEPTIC INC Phone:(305)651-7859
Building Department Comments
INSTALL SEPTIC TANK AND DRAINFIELD o menta
INSPECTOR COMMENTS False
Inspector Comments
Passed1;0 1 K
Failed El
Correction /OL1
Needed ❑ G'���( �
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection The is paid
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 z
Phone: (305)7952204
� Qs
Expiration: 0911612016
Project Address Parcel Number Applicant
795 NE 94 Street 1132060142040
Miami Shores, FL Block: Lot: ANN SABELLA
Owner Information Address Phone Cell
ANN SABELLA 795 NE 94 Street
MIAMI SHORES FL 33138-2914
Contractor(s) Phone Cell Phone Valuation: $ 4,000.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
--- - - - -� - -- Total Sq Feet: 200
Type of Work:INSTALL SEPTIC TANK AND DRAINFIELD Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Retum: Final
Classification:Residential Scanning:3 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# PL-3-16-59003
CCF $2.40 03/22/2016 Check#:8439 $500.00 $169.90
DBPR Fee $2.25
DCA Fee $2.25 03/22/2016 Credit Card $119.90 $50.00
Education Surcharge $0.80 03/14/2016 Credit Card $50.00 $0.00
Permit Fee $150.00 Bond#:3024
Scanning Fee $9.00
Technol§}Fee $3.20
Total%"� $669.90
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
pertaininjAereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
acceptinWAis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required WELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS-.,;AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construcNQri and zoning. Futhermore,I authorize the above-named r to do the work stated.
March 22,2016
Authorized Signature:Owner / Applicant krContmctor / Agent Date
Builcng Department Copy
March 22,2016 1
Miami Shores Village
Building Department
MAR i,4 2018
i
• ��` 1OOSO N.E.2nd Avenue,Miami Shores,Florida 33138
BY:
Tel:(305)795-2204 foot:(305)756-8972
INSPECTION LIME PINE NUMBER:(30S)762-4949
"\
FISC 2014-
k
BUILDING Permitter Permit No.
PERMIT APPLICATION Sub Permit No.
®BUILDING p ELECTRIC p ROOFING p REVISION p EXTENSION ❑RENEWAL
I M PLUMBING p MECHANICAL. ❑PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑SHOP
�JG j/� G�,r�.�.� CONTRACTOR DRAWINGS
JOB Ate: !-1 '"'" �_s 't 1
Clw Miami Shores County Miami Dade zip: I RFs
FoWParce7#: d 3 a 0 b 6 L L' 220 ZM Is 8dIng Historkall�/Designated:Yes NO
Otxu cy Type: Load• Construction Type:-Flood Zone: SFE: FFE•
OWNER:Name(Fee Simple TRiehoider):
Address: 22 5__
_ A Cr 1 �
City., OAT,. State: � Zip: 23 13D
Tenant/lessee Name: Phone#:
Email:
CONTRAcroR:Company dame: Mr C's Plumbing and Septic: Phone#: 305 6517859
Address: 19932 LVW 2 Ave
I may: Miami state: FL Zip: 33169
qualifier Name: Kemble Mick Phone#: 305 6517859
State Certlfwation or Registration#: SR061536 Certlfkate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State Zip:
Vake of Wont for dds Permit:$ a� ' ® square/Unear Footage of Work
Type of Warlo El Addition
❑ Alteration ❑ New 10 Repalr/Replace ❑ Demolition
Deurlption of Woric `
A
t
d
Sjwdfy color
o(f'color thru tile: `
Submi"Fee$ `-'�-'` Permift Fee$ Ire CCF COAL$ —
oScarFee$ Radon Fee$ a a`5 DBPR$. Notarry$
Tedtstology Fee
Training/Education Fee$ d 3 Double Fee$
Structural Review$ �_ Bond$ -
TOTAL FEE NOW DUE$ X
(Re 2/24/Zn4) Gf9 . 9
Bonding Company's Name(if applicable)
` Bonding Company's Address
city state Zip
Mortgage tender's Name(if applicable)
Mortgage tender's Address
r
,may 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 wail be done in compliance with all
applicable laws regulating construction and zoning.
1
"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
f� TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
r
Notice to AWkant. As a eondltion to the issuance of a building permit wish an estimated value exceeding$25Oq the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure wilt be delivered to the person
whose property is subject to ottachment Also,a cert*d copy of the recorded notice of commencement must be posted at the job site
for the first inspection whkh occurs seven (7)days after the building permit is issued. In the absence of such pasted notice, the
# inspection will not be approved and a reinspection fee will be charged.
i
Signatu Signature-
0,
NER or AGENT CONTRACTOR
The foregoing Instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this
W
day of &n 6 ,by day of M&&—EL ,20 by
f
who is personally known to who o is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTA"PUBLIC: NOTARY PUBlK:
3
Sign: Sign:
.. ����� KEMBLE ETTRICK
Pint
Print: :tPaY�'Ug�p O •No
« Seal • •ec My Comm.Expires Oct 23,2018
Seal: '•: : My Comm.Expires Sep 19,2017 Commission#FF 136597
o.
Commission#FF 055732 ��'�. „t:`°� hNWy
Bonded Through Natiorsd(fir Assn.
APPROVED BY .s Plans Examiner Zoning
Structural Review Clerk
(RwWdDV2412114)
REPAIR PERMIT #A"C-4665958
4,Qlfii�' IU�t cotes'.'j4F ]- F?"' 3' ABar.Ic�►TIa�r n:AP9228W
STATE OF FLORIDA
I RATS PAID:
DEPARTMENT OF HEALTH
ONSITE SEWAQE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION T RECEIPT #•
DocmmT #:PR1008614
t CONSTRUCTION PERMIT FOR.: OSTDS PApair
APPLICANT: Ann Sabel
PROPERTY ADDRESS: 795 NE 94 St Mland,FL 33138
LOT: 27,26 RLOCK- 67 IVISION: Miami Shores Sec 3
PROPERTY ID #: 11-3208-0142040 tSECTION, TOW1WRIP, RANGE, PARCEL NUMBER]
(OR TAX ID NUMBER]
I
�t
SYSTEM MUST BE COLJSTRUCTED IN ACCOFANCB WITH SPECIFICATIONS AND STANDARDS OF SECTION
391.0065, F.S., AND CHAPTER 645-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARJMZE
SATISFACTORY PERBORMANCE FGR 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 DOSS NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQunm FOR DEVELOPMENT! OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T I 900 ] GALLONS ! GPD septic tank CAPACITY
A I ] GALLONS / GPD CAPACITY
N ( ] GALLONS GREASE INTERCEPTOR CAPACITY JMXIMUM CAPACITY SINGLE TANS:1250 GALLONS]
f K ( IGALLONS DOSING TANK, CAPACITY GATJMS @t ]DOSES PER 24 HHS #Pumps ( ]
i
D I 200 ] SQUARE FEET bed txmttpuratiort drainfi®l SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: jst STANDARD I I FILLED t ] umnt ]
I CONFIGURATION: I ] TRENCH fx] BED t ]
N
F LOCATION OF BEKCffiNARK: FFE 12.01 IdGVD
I ELEVATION OF PROPOSED SYSTEM SITE t 22.801 INCHES FT IIABOVE BELOW POS'
E BOTTOM OF DRAINFIELD TO BE t 62.80] INCHES FT ]DOVE BELOW
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: 152.001 INCHES
0 1.-Install s googal min.septic tank with an appraved filter.
j
2.-The M*adOr installing the Wall=Is s99ponsible for� minimum min�ncategory of tank In acQon#soca
i T with s.64E-6.013(3)(f),FAC.
3.Install 200 sf of dfainfieki in bed configuration.
H 4.-Install IT Of Slightly Umited 8011 at the bottom Of the drAnilaid.
E 5.-Perimeter Of exon area shall be at least 2 it wider and mer than the proposed absorption bed Or drain bench.
(Comments Continued on Page 2.)
R
i
SPECIFICATIONS BY: Kemble Ettrick TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
lslaaft ouLaca
DATE ISSUED: 03!09/2016 EXPIRATION DATE: 06107)2016
DH 4016, 06/09 (Cbsoletes all previous editions which may not be used) =y
Incorporated: 64E-6.003, FAC aPi: r t :�„i U a s s
sE988149
AP1228484
v 1.1.4 i�te'-:>�i.`fF!'..._ .:i•,.�`.:�•.-f..,'.t 1.S 1:,'+�L'i?'.`,C�•'lCt'Pi�3 5C?:!�`J:li:..
;! $Cji �V':�Y i BXC3VitL'e: a� ti'G '"ilE of 1+r^
rail Anpw-Val, i':':
.�, iWftfL'�S ir:�Ste•Y:y:l.":tf� ^-t cvmp'a't) vie rns:rts to'.i-ie angina
i
sits-,evaluation 5::arr4tui. A reirtSp,_x.:;::tt fee vAl! be asse'&sec
if the contractor is not at tt e
jairsqe at the arranged tstne.
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