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PL-16-1312 T Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-258890 Permit Number: PL-5-16-1312 Scheduled Inspection Date: September 06, 2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: WILKINSON,KENNETH Work Classification: Drainfield Job Address:390 NE 91 Street Miami Shores, FL 33138- Phone Number (973)632-2529 Parcel Number 1132060190190 project: <NONE> Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859 Building Department Comments TO INSTALL DRAINFIELD Infractlo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed HRS APPROVAL IN FILE Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid l Div 5 e yp zl ' qy rk 4 4 Sl� F .:• 'W►.., I 'TIl'�.. -`rrt' ,k V, 1 a x I 1 yt Miami Shores Village " �: � R 10050 N.E.2nd Avenue NE � lrai �eii Miami Shores,FL 33138-0000 � � Phone: (305)795-2204 �� E ' � 0 Expiration: 11/13/2016 E Project Address Parcel Number Applicant 390 NE 91 Street 1132060190190 Miami Shores, FL 33138- Block: Lot: KENNETH WILKINSON Owner Information Address Phone Cell KENNETH WILKINSON 225 NE 105 Street (973)632-2529 MIAMI SHORES FL 33138- 225 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,200.00 MR C'S PLUMBING&SEPTIC INC (305)651-7859 Total Sq Feet: 200 Type of Work:TO INSTALL DRAINFIELD 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 Invoice# PL-5-16-59778 $1.80 05/17/2016 Cash $500.00 $168.30 DBPR Fee $2.25 DCA Fee $2.25 05/17/2016 Credit Card $ 118.30 $50.00 Education Surcharge $0.60 05/16/2016 Check* 1092 $50.00 $0.00 Permit Fee $150.00 Bond#:3090 Scanning Fee $9.00 Technology Fee $2.40 Total: $668.30 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named cont or to do the work stated. May 17, 2016 Authorized Signature:Owner / Applicant Contractor / Agent Date Building Department Copy May 17,2016 1 Miami Shores Village aMA � � =4 BuildingDepartment s 016 p10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 2®1� BUILDING Master Permit iva:�(/a w PERMiT APPLICATION Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL 4 ®PLUMBING C]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS I !OB ADDRESS: Cites Miami Shores G A County: Miami Dade zip: -3 ( 39 Folio/Parcel#: �� ' I !`" is the Building HistoHcaft Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: 6FE: FFE: OWNER:Name(Fee Simple Titleholder): k4A U/( ` R)! 1 /tS Phone#: Address: 1) (�qN� O% 1 S� City: J 6YIA State: Fl— Zip: ( Tenant/Lessee Name: ° Email: fCONTRACTOR:Company Name: Mr C's Plumbing and Septic Phone#: 305 6517859 Address: 19932 NW 2 Ave rMiami state: FL Zip: 33169 City: Qualifier Name: Kemble Ettrick PhOn� 305 651 7859 1 ' State Certification or Registration# SR061536 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: _� Gty; State: Zip: j Address: c 2 C��i �� Value of Work far this Permit:$ Square/Linear Footage of Work. Type of Work: ❑ Addition ❑ Alteration ❑ New A Repair/Replace ❑ Demolition Description of Work Specify color of color thru tile: Submittal Fee S_ Permit Fee$ �� CCF$ Z. Ra Co/CC S Scanning Feee$ _Rasion Fee$ DBPR$ Notary S TechnoIM Fee$ Training/Education Fee$_�, Lion Double Fee$ Structural Revie $ Bond w TOTAL FEE NOW DUE$ 3Z (Revisedo2/24/2024) Bonding Company's Name(if applicable) Bonding Company's Address _ City State Zip Mortgage Lender's Blame(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. 1 understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OVVNER'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. i '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.,, t Notice to Applicant: As a condition to the issuance of a building permit with on estimated value exceeding$2.50"0, 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 s ch posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatur( Signature OWNER or AGENT CONTRACTOR The foregoing Instrum t was acknowledged bef r ,me this The foregoing instrument nwas acknowledged before me this ,© da of � 20�—,by _day of 1`--r`-�°ti� .20 ,by 11')5CV�Mo is personally known to �� SGS `�� C who is personally known to me or who has produced 4 as me or who has produced 1 &L as Identification and who did take an oath. identification and who did take an oath. NOTARY PU NOTARY PUBLIC: Sign: Sign: PrintPrint• - KE '�•�"ar Pei%�. Seal; , 1�u; Notary Public State of Florida Seal: =cry °= Notary Public-State of Florida My Comm.Expires Sep 19,2017 "P My Comm.Expires Jan 27,2017 `o`c Commission#FF 055732 "C), Commission#EE 868595 lost Bonded Through National Notary Assn. APPROVED BY Plans Examiner Zoning Structural Review Clerk (ReAsedo2/24/2014) �^ PERMIT #:13-SC-1680041 �G. STATE OF FLORIDA APPLICATION #:AP1238142 DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: WE DocummT #:PR1017200 CONSTRUCTION PERMIT FOR: OSTDS Repair.J APPLICANT: Kenneth Willanson PROPERTY ADDRESS: 390 NE 91 St Miami,FL 33138 LOT: 1 &2 BLOCK: 2 su IVISION: EI Portal PROPERTY ID #: 11-3206-019-0190 [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 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MAMTAL 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 [ 750 ] GALLONS / GPD Septic(E)istinq) CAPACITY A [ 0 1 GALLONS / GPD CAPACITY N [ 0 I GALLONS GREASE INTERCEPTOR CAPACITY [M?kX1MUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS #Pumps [ I D [ 200 I SQUARE FEET Bed Drainfield SYSTEM R ( 0 I SQUARE PUT SYSTEM A TYPE SYSTEM: [X) STANDARD [ I FILLED [ I MOUNO [ I I CONFIGURATION: [ ] TRENCH [XI BED [ ] N F LOCATION OF BENCHMARK: FFE 11.6 NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 30.00 J INCHES FT I[ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 80.00][ INCHES FT I [ABOVE��BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.001 INCHES "'THIS PERMIT IS NOT FOR ADDITIONS" O 'Install 12°of slightly li nisoil at the bottom of the drainf 1d. T 'Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed. H *Invert elevation of drainfield to be no less than 5.44'NGVD. `Bottom of drainfield elevation to be no less than 4.94'NGVD. E The system is sized for 2 bedrooms with a mardmum occupancy of 4 persons(2 per bedroom),for a total estimated flow of 300 gpd. R SPECIFICATIONS BY: TITLE: APPROVED BY; TITLE: Engineering Specialist II Dade CRD P s DATE ISSUED: 05106/2016 EXPIRATION DATE: 08/04/2016 DH 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 AP1238142 SE994893- A } . • « .• L) ■!■■■■■!■!■!!■i-i�i■�!■�■�wir��■i■ ��"�iM■�li■■■■llil■i� ■!!■■■■■■i■!�!■iris■■!■r!■!■■■■lli3 ■!■■■■■■■i■!■SII !■� lidl�■!■■■1■■ F:''��!!��'�t�� 1111;■r!!!■!!��!■SCi �� cam"o!!mar iil�li■!lliii!!!!!!1■■ i i r e