PL-16-1939 (2) r
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-263072 Permit Number: PL-7-16-1939
Scheduled Inspection Date: July 28,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael Inspection Type: Final
Owner: WARES, HUGO Work Classification: Septic
Job Address:395 NE 92 Street
Miami Shores, FL Phone Number (786)364-4675
Parcel Number 1132060136410
Project: <NONE>
Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859
Building Department Comments
SEPTIC TANK AND DRAIN FIELD REPLACEMENT. Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS IN FILE
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
July 27,2016 For Inspections please call: (305)762-4949 Page 14 of 35
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Miami Shores,FL 33138-0000 �- �t,
Phone: (305)795-2204Pl
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7= Expiration: 01/1612017
Project Address Parcel Number Applicant
395 NE 92 Street 1132060136410
Miami Shores, FL Block: Lot: HUGO WARES
Owner Information Address Phone Cell
HUGO WARES 3436 N MIAMI Avenue (786)364-4675 (786)899-1143
MIAMI FL 33127-
Contractor(s) Phone Cell Phone Valuation: $ 6,000.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
Total Sq Feet: 400
Type of Work:SEPTIC TANK AND DRAIN FIELD REPLACE 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-Contractors Bond $500.00 Invoice# PL-7-16-60567
CCF $3.60
DBPR Fee $4.50 07/20/2016 Check#:3352 $500.00 $327.60
DCA Fee $4.50 07/20/2016 Credit Card $277.60 $50.00
Education Surcharge $1.20 07/12/2016 Credit Card $50.00 $0.00
Permit Fee $300.00 Bond#:3150
Scanning Fee $9.00
Technology Fee $4.80
Total: $827.60
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 egoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore orize the above-named contractor to do the work stated.
July 20, 2016
Authorized Signatu :Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 20,2016 1
R
Miami Shores Village
Building Department J 2 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20�`�"��
BUILDING Master Permit No.T U
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
_J-4
I rLUMBING F-1MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION ❑ SHOP
T CONTRACTOR DRAWINGS
JOB ADDRESS: 395 NE 92nd Street
City: Miami Shores County: Miami Dade Zip: ����
Folio/Parcel#:11-3206-013-6410 Is thuilding Historically Designated:Yes V O
Occupancy Type: Load: Construction Type: �� Flood Zone: i BFE: 1�FFE: 10,00
OWNER:Name(Fee Simple Titleholder):Hugo C. Mljares Phone#:786-859-1143
Address:395 NE 92nd Street
City. Miami Shores state: FL ,Zip. 33138
Tenant/Lessee Name: Phone#;
Email: hugomijares@gmail.com
i � I
CONTRACTOR:Company Name: dr �•� 1, Phone#:I
Address: 1 411, AIg!
City: ice'"' State: Fz:- Zip:
Qualifier
Qualifier Name: f"l �-,e & Phone#: (mss D `u C
State Certification or Registration#: :ga6l 5 3 6 Certificate of Competency#:
DESIGNER:Architect/Engineer: Hugo C. Mljares Phone#:' 786-859-6365
Address:5582 NE 4th Court suite 7A city. Miami -Stat e: FL Zip: 33137
Value of Work for this Permit:$ Od Square/Linear Footage of Work: el
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ 50 Permit Fee$ e� CCF s--3, A® . 4CC$
Scanning Fee$ 6 6 Radon Fee$ DBPR$ --C-6 % hitary$
Technology Fee$ �� Training/Education Fee$ ®� 120 Double ee$
Structural Reviews$ Bond$,, ®yy
/7 '���
TOTAL FEE NOW DUE$aT.
(Revised02/24/2014)
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 Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochuri will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature 41AO Signature AzIl na�
O NER or AGENT ONTRA OR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ��� 20 Ifo by 12% day of _3J t-i 20 16 by
who is personally known to � 1� LIM-4 G!C ,Who is personally known to
me or who has produced Z as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLIC:
Sign. 'N •; LORENABRACHOAGJAM I I Sign.
00
Print: =� WIRES:Apr913,2020 Is Print:
��.a� v EJE
Seal: F Seal: .? Notary Public-State
• My Comm.Ekplres OCommtssl n#FF tened Nla<OW Nolmy
a�**a
APPROVED BY s �' Plans Examiner , Zoning
Structural Review Clerk
(Revised02/24/2014)
ClIeni
® RCT,tF aNT PERMIT #:13-SC-1692374
r*Al-®PDE co °� APPLICATION #:AP1246343
STATE OF FLORIDA
DEPARTMENT OF HEALTH D I$TE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #TRI
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Ulrich Koepf
PROPERTY ADDRESS: 395 NE 92 St Miami, FL 33138
LOT: 23,24 BLOCK: 47 SUBDIVISION: Miami Shores Sec 1 Amd
PROPERTY ID #: 11-3206-013-6410 [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 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 [ 1,050 ] GALLONS / GPD septictank CAPACITY
A [ ] GALLONS / GPD CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 400 ] SQUARE FEET bed configuration drainfiel SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 10.0'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 13.20 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 54.96 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ 54.001 INCHES
1.-Install a 1050 gal min.septic tank with an approved filter.
0 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
T with s.64E-6.013(3)(f), FAC.
H 3.-Install 400 sf of drainfield in bed configuration.
4.-Install 12"of slightly limited soil at the bottom of the drainfield.
E 5.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
(Comments Continued on Page 2.)
R
SPECIFICATIONS BY: Kemble Ettrick TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Erlande Omisca
DATE ISSUED: 07/01/2016 EXPIRATION DATE: 09/29/2016
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC CQ TR CTOR...
rt
AP1246343 S
The cont*--tor(nr Vie=gneel is required to perform a soil boring
acacent t; `ne dr<'^^eld excavation at the tune of final
icsrection, Pror to TaalAp
prova'. the FDOH ir.spec'or shall
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