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PL-16-2114 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone. (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-264254 Permit Number. PL-7-16-2114 Scheduled Inspection Date:August 08,2016 Permit Type: Plumbing - Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner: CHIDSEY,LARRY D Work Classification: Septic Job Address:9313 NW 2 Court Miami Shores,FL 33138- Phone Number (786)348-8907 Parcel Number 1131010150390 Project" <NONE> Contractor. MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859 i Building Department Comments INSTALL SEPTIC TANK AND DRAINFIELD Inftctio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed HRS IN FILE Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid • DIVISION OF 01yironmentai Health Florida Health Miami-Dade County eO � Q`eQ� 11soQSTDS/We ;bivbi6n ► ( SW 26th Sheet JVHjIM4 ITL 33175 Inspector _ /�+� '' ✓ '� Date �tE p Address= lot/4< '� OSTDS# O S-� Comments:• Signature J I �I 4 Miami Shores Village Pert r �� on i 3 ' 10050 N.E.2nd Avenue NW Ja$S C's Optic Miami Shores,FL 33138 0000 hF � Phone: (305)795-2204 Star :APPOOVED I Date: i Expiration: 01/2812017 Project Address Parcel Number Applicant 9313 NW 2 Court 1131010150390 LARRY D CHIDSEY Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell LARRY D CHIDSEY 9313 NW 2 CT (786)348-3907 MIAMI SHORES FL 33150-1204 Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 MR C'S PLUMBING&SEPTIC INC (305)651-7859 Total Sq Feet: 230 Type of Work:INSTALL SEPTIC TANK AND DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# PL-7-16-60770 CCF $4,P0 DBPR Fee $4.50 08/01/2016 Check*132 $500.00 $323.20 DCA Fee $4.50 08/01/2016 Credit Card $273.20 $50.00 Education Surcharge $1.40 07/27/2016 Credit Card $50.00 $0.00 Permit Fee $300.00 Bond*3180 Scanning Fee $3.00 Technology Fee $5.60 Total: $823.20 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 co ctor to do the work stated. August 01,2016 Authorized Signature:Owner / Applicant Contractor / Agent Date Building Department Copy August 01,2016 1 Miami Shores Village , 1101, JUL 2-4 2016 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY_ ==f Tel:(305)795-2204 Fax:(305)756-8972 'J INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.VLi(o --'Ok PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP R1 1 �1 CONTRACTOR DRAWINGS JOB ADDRESS: R1 J ,V w City: Miami Shores County: Miami Dade Zip: 35160 Folio/Parcel#: 11 3101 bl S 6-31D Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: ' OWNER:Name(Fee Simple Titleholder): LA lr! j i SeN Phone#: I%b 34 D 31DI Address: N 10 City: State: L zip: 3 3 lid Tenant/Lessee Name: Phone#: Email: p c CONTRACTOR:Company Name: r / i cJ 'C Phoe#:& 01, ?8✓t�l Address: mw Ar! r- `1 City: ML46 State: r` Zip: Qualifier Name: K*AjA & 6T&moi. / Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 60 Square/Linear Footage of Work: A 3 o Type of Work: ❑ Addition ❑ Alteration ❑ New 4R.epair/Replace ❑ Demolition Description of Work:�lls .SBs>, L ,- Q ( i Specify color o color thru tile: CCF$ -0 CO/CC$ Submittal Fey Permit Fee$ Scanning Fee$ Radon Fee$ DB R$ �® Notary$ Technology Fee$ � Training/Education Fee$ T) Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWWER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this l day of J"&ly .20 1 � , by 7 day of ru� 020 14- by �^wMl "id ief h&'We who is personally known to � 'We C;4r7%GJ. --,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 PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: ( Print: g& L C:� SHERYL A MENDES ?o� {�y a O60 of Florida + Notary Public- tate o Florida Seal: �qy§8i1?t8,18p1flf Oct 23,2018 Seal: �• My Comm.Expires Oct 23,2018 @®iiiHillifi0n it FF 138597 %�� , Commission B FF 136597 '•�;•F �Ondsd TWough NO"Notary Assn. NIIHar�l Assn. APPROVED BY t 2-dG Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) PERMIT #:13-SM-1695682 APPLICAlL'ION #:AQP 1248551 STATE OF FLORIDA DATE PAM: DEPARTMENT OF HEALTH ONSITE SETAAM TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT # DW*= #:PRI 026774 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Larry Chidsey PROPERTY ADDRESS: 9313 NW 2 Ct Miami,FL 33150 LOT: 15 BLOCS: 3 sUBDIVISION: Odell Manors [SECTION, TOWNSHIP, RANGE, PARCEL NIIMBER] PROPERTY ID #: 11-3101-015-0390 [OR TAX M NUMBER] SYSTEM MUST BE CONsTRUCfi= LN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 645-6, F.A.C. DSMU MJEN'1' APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY pERE,0HMApCg FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN XhTMtM FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH 1+ODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT MMMPT 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 NEW Septic TANK CAPACITY A [ 0 l GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY DoXnM CAPACITY SINGLE TANS 1250 GALLONS] S [ ] GALLONS DOSING TANS CAPACITY [ ]GALLONS @[ ]DOSES P 24 ARS D [ 230 ] SQUARE FEET DF IN BED CONRGURAT SYST� [ O ] SQUARE FEET SYST�2 :� ,�,. ,[ R A TYPE SYSTEM: [8] STANDARD [ ] FILLED [ ] M� I ] RCst I CONFIGURATION: [ ] TRENCH [X] BED N t FFE.. 13.ONGVD 4k;t; t �.;' F LOCATION OF BENCHMARS: ............ I ELEVATION OF PROPOSED SYSTEM SITE [ 13.20] niam FT ] [ABO�� ` ` /REFERENCE DINT E BOTTOM OF DRAINFIELD TO BE [ 63.20][�� FT l[ABOVE,�BSNCHMARS/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.001 INCHES 1.-Install a 900 gal.septic tank with an approved filter O 2.-The licensed contractor installing the system is responsible for installing the minimum category ofltank in accordance T with s.64E-6.013(3)(f)FAC. 3-Install 230 sf.of drahfield in bed configuration. H 4.-Install 12"of slightly limited soil at the bottom of the drainfield. than the proposed absorption bed or trench. g 5-Perimeter of excavation area shall be at least 2 ft carder and longerp posed rp (Comments Continued on Page 2.) R SPECIFICATIONS BY: Gerard L Philizaire TITLE: Engineering Sp4cialist II APPROVED BY: TITLE: Engineer Supervisor III Dade CHD I Astrid V Edwards DATE ISSUED: 07/22/2016 EXPIRATION DATE: 10/20/2016 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Sage 1 of 3 v 1.1.9 AP1248551 SEIO02756 7 1� O � k W+i t i i 71 •�I 'N0 � �4 W �