PL-16-1207 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)756.8972
Inspection Number. INSP-258175 Permit Number. PL-5-16-1207
Scheduled Inspection Date. September 19,2016 Permit Type: Plumbing -Residential
Inspector. Hernandez, Rafael
Inspection Type: Final
Owner. ENTIN, BRIAN Work Classification: Drainfield
Job Address:511 NE 101 Street
Miami Shores,FL 33138-
Phone Number (954)2245158
Parcel Number 1132060171090
Project <NONE>
Contractor. MR C'S PLUMBING&SEPTIC INC Phone:(305)651-7859
Building Department Comments
INSTALL DRAINFIELD AND SEPTIC TANK. 1nftcU° Pawed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS TAG IN FILE
Failed
Correction ❑
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re4nspecdon fee is paid
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>sx�;Fs << Miami Shores Village I73(P Pliil � ��IIt1�
10050 N.E.2nd Avenue NE ,:
Miami Shores,FL 33138-0000
tiPhone: (305)795-2204
41F-
Expiration: 11/02/2016
Project Address Parcel Number Applicant
511 NE 101 Street 1132060171090 BRIAN ENTIN
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
BRIAN ENTIN 511 NE 101 Street (954)224-5158
MIAMI SHORES FL 33138-
511 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,400.00
MR C'S PLUMBING S SEPTIC INC (305)651-7859
_. Total Sq Feet: 300
Type of Work:INSTALL DRAINFIELD AND SEPTIC TANK. Available Inspections:
Type of Piping: Inspection Type:
Additional Info: HRS Approval
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF $�6o Invoice# PL-5-16-59647
DBPR Fee $4.50 05/06/2016 Check*261 $500.00 $327.80
DCA Fee $4.50 05/06/2016 Check#: 1090 $277.80 $50.00
Education Surcharge $0.60 05/04/2016 Credit Card $50.00 $0.00
Notary Fee $5.00 Bond#:3076
Permit Fee $300.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $827.80
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 ELE ICA PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS#nd
T: certify all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructin . thermore,I authorize the above-named contractor to do the work stated.
May 06,2016
Tut razed Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 06,2016 1
Miami Shores Village =BY:
1 Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 \�
FBC 20 4�
BUILDING Master Permit No. � K, -
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION [:] EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
/ ,�V/� CONTRACTOR DRAWINGS
JOB ADDRESS: S�l Ol d I ,
City: Mi/ami Shoore�s County: Miami Dade zip: T313 6
Folio/Parcel#: / +-_�,3, /"� -017+ 169 g7t/ Is the Building Historically Designated:Yes NO
Occupancy Type: V'r Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder)-B?, ( (SIA e.- �I,L,, Phone#: TS Y'-0�;)y -rise?
Address: .5'1/ tv l0 _y -e.jLq__
City: State ��--- Zip: -331-3 t�
Tenant/Lessge Name: Phone#:
Email: Vo'vx&14t6
CONTRACTOR:Company Name: r �C � ' Phone#: 7 ( 7S.c
Address: l ✓� NA)
City: State: Zip:
,33/449
Qualifier Name: e m e, � / /GAG Phone#:
State Certification or Registration#: SR 0 61' m Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ �' Square/Linear Footage of Work: .36-4
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ,❑ Demolition
Description of Work:
1N51A-L L h1 -lel N rl Cl,� r"e C. t irk,
Specify color of color thru tile: �1
Submittal Fee$ Permit Fee$ ® � CCF$ l �yl� CO/CC$
Scanning Fee$ ':::T- CA2) Radon Fee$ ® DBPR$ Notary$
Technology Fee$ 0 Training/Education Fee$ a Double Fee$
Structural Reviews$ t-A Bond$ Es 00 r 03
TOTAL FEE NOW DUE$
(Revised02/24/2014) �� s
i
BonLJngOompan11L1Name(if applicable)
BonCing(bmpandEAMre®
City State Zip
Morigage LenEW Name(if applicable)
Mores LenDW❑Ame®
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.....
Oil NERSAFRDAVIT: 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.
"❑ARNING TO OD NffU YOUR FAILURE TO FEOOFU A N0110E OF OOM M ENCEM ENT 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 N0110EOF OOM M BVCEVI E"J"
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500,the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven m days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
L:—L
Signature Signature
OWNER or AGENT 011/1 v� CONTRACTOR
Theforeg oing instrume was acknowledged before me this The foregoing instrument was acknowledged before me this
day of --"t - ,20 1 CP by day of r'v`< 20 I� by
tuc—
who is personally known to �' Z1'Y" 1L ��,who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PU NOTARY PUBLIC:
Sign: .�o"" Y EMBLE ETTRICK Sign: `
:z°, „`� Notar Public-State of Florida p ;° M �yj • �S�e�
Print: ' OMFA. F86 Print: M$,' N
`� Commission#FF 055732 `�' °' - ME
Seal: "-'r� °P.•' Seal: �+ ® gzt r^=
°' Bonded Through National Not
Assn. ® otic
sv
*w*w*w*w*w***w*****w*www**w*w***w*www***ww//ww*wwwww*w*wwwww*ww****w*w**ww*wwww**ww**w******����•'�Ss.�ip��'���a
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
• PzHMrT #:13-SC-1678224
APPLICATION #:AP 1236905
STATE OF FLORIDA
p• DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT :
Docms= #TR1016225
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Cristina Pacheco
PROPERTY ADDRESS: 511 NE 101 St Miami,FL 33138
LOT: 15 BLOCK: 94 SUBDIVISION:
PROPERTY ID #: 11-3206-017-1090 [SECTION, TOWrTSHIP, 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 64E-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 [ 0 ] GALLONS / GPD CAPACITY
N [ 0 l GALLONS GREASE INTERCEPTOR CAPACITY [M)LXIMUM CAPACITY SINGLE TANK:1250 GALLONS] o1M 2
S 0
K [ ] GALLONS DOSING TANK CAPACITY [ l GALLONS @[ ]DOSES PER 24 HRS. ��'t0�:#n�� ]
D [ 200 ] SQUIRE FEET SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ l MOUND [
I CONFIGURATION: [ ] TRENCH [xl BBD [ I
N
F LOCATION OF BENCHMARK: FFE:11.9 NGVD tpSQ �G ,age 1t
I ELEVATION OF PROPOSED SYSTEM SITE [ 24.001 INCHES FT ][ABO t '6 M /REFERENCE POINT
E BOTTOM OF DRA32 FIlEM TOME [ 74.00] INCHES FT ][ABOVE •ffiOW BENCHMARK/REFERENCE POINT
L
D FILL REED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 62.00] INCHES
1:Existing septic tank certified by Mr.C'Plumbing on 4262016 to remain.
O 2.-Install 200 sf of drainfield in trench configuration.
T 3.-Install 12"of slightly limited soil at the bottom of the drainfield.
4.-Perimeter of excavation area shall be at least 2 It wider and longer than the proposed absorption bed or drat pq
H 5.4nvert elevation of drainfield to be no less than 6.23'NGVD. F
E 6.43ottom of drainfield elevation to be no less than 5.73'NGVD_ ' K=•t. ~
•, ;
****"—'*THIS PERMIT IS NOT FOR ADDI170NS""""*`
R r Vie.
SPECIFICATIONS BY: TITLE:
APPROVED BY; TITLE: Engineer Supervisor III Dade CED
Astrid v Edwards
DATE ISSUED: 04/29/2016 EXPIRATION DATE: 07/282016
DH 4016, 08/09 (obsoletes all previous editions whish may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1236905 SE994075
DST #: PR1016225
Required drainfield area based on rule 64E-6.015(6)(c)2.
Install a new drainfield to achieve Drainfield size requirement
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