PL-13-166Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 184866
Permit Number: PL -1 -13 -166
Scheduled Inspection Date: February 21, 2013
Inspector: Hernandez, Rafael
Owner: VIRTUE, JASON
Job Address: 800 NE 98 Street
Miami Shores, FL
Project: <NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (786)202 -9698
Parcel Number 1132060142570
Phone: (954)963 -0082
Building Department Comments
REPLACE DRAINFIELD
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
hrsinfile
February 20, 2013
For Inspections please call: (305)762.4949
Page 13 of 23
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20 (CI
Permit No. FL `S 1 �O
Master Permit No.
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS: 00 R1 . 9e 1 Te e +
City:
Folio/Parcel #:
Miami Shores County:
JAN 2 9 20
l(-32_06 2510
Miami Dade Zip: 33 (7,8.
Is the Building Historically Designated: Yes NO
Flood Zone:
n ho G 5 OWNER: Name (Fee Sim p le Titleholder ) : �G, P-1 V r f P#-8 - Z- V 1
Address: SOO i re Q -1-
City: 1'1.1arr1tl SAO re State:
Tenant/Lessee Name: Phone#:
Zip: 'n,13 S
Email:
(V
CONTRACTOR: Company Name: S ��''^3i dpi — a `� 1 `''�t 1"( S Phone #: 6633
Address: c:0O (52 S1/43 ZS S %TLe+
City: M; f Gil State: FL, Zip: 330 215
Qualifier Name: T e f V-C (O ` l err 3—, Phone#:
State Certification or Registration #: CM O q 11 2 '6E2- Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Q-4-1:30 Square/Linear Footage of Work: 50
Type of Work: ❑Address ❑Alteration ❑New *Reepair/Replace
Description of Work: Ref (pct., d rr q I r ll -P ( d
(5ohS+)
❑Demolition
*** ,: m **** ******* **x:** ** ****** ********F *** ****m *********** ***** ********************
Submittal Fee $ Permit Fee $ ��� CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TO ALFEENOW IUE$ I i,E O
11 )1 60A.d Ca4
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 r ',ot be appto ''d and a reinspection fee will be charged.
Signature g Signature
Owner or Agent -{ Contractor
The foregoing ins ' meat was acknowledged before me this -T g h The foregoing instrument was acknowledged before me thisr-
day of eat . , 20 3 ., by l QSor , c
who is personally known to me or who has produced RAY ■W ,ma
• who is personally known to me or who has produced ` L t 1-D
clrj As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
4
day of J `( , 201, by -`6-12- 7 b 50LCm0‘)
Sign:
Print:
My Commissio
-1--sreC4. L -
**** * ** *****
APPROVED BY
TERESA J SOLOMON
•
rz- Mr COMMISSION # EE131935
EXPIRES November 08. 2015
,�,A�
Plans Examiner
Structural Review
(Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
`����‘0, I i i i i miir�r'ii
Aria
Sign: O O co Tr-
co Print: _ y �ig�� `41, �/8 a'
rn • //k;o °1/6':
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My Commission Expires:
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Jason Virtue
PROPERTY ADDRESS: 800 NE 98 St Miami, FL 33138
LOT: 9 -12
PERMIT #:13 -SC- 1452073
APPLICATION #: API 095391
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #:PR895545
BLOCK: 73 SUBDIVISION:
PROPERTY ID #: 11- 3206 - 014 -2570
[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 [ 650 ] GALLONS / GPD septic tank 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 [ 1
D [ 150 ] SQUARE FEET trench configuration drainf SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [8] TRENCH [ ] BED [ 1
N
F LOCATION OF BENCHMARK: FFE 11.86' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
[ 0.00 ] INCHES
[ 42.90 ] [I INCHES 1 FT ] [ ABOVE 4 BELOW 6 BENCHMARK /REFERENCE POINT
[ 78.90 1 [I INCHES r FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 36.003 INCHES
System #2 (SW System)
1.-Existing 650 gal. septic tank, certified by Statewide Septic on 1/24/2013 to remain.
2. -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s. 64E- 6.013(3)(f), FAC.
3.-Install 150 sf of drainfield in trench configuration.
(Comments Continued on Page 2.)
SPECIFICATIONS BY:
APPROVED BY
olo - TITLE: Master Septic Tank Contractor
DATE ISSUED: 01/28/2013
TITLE:
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E- 6.003, FAC
v 1.1.4 AP1095391
Dade CHD
EXPIRATION DATE: 04/28/2013
SE888508
Page 1 of 3
DOCUMENT #: PR895545
4. -Invert elevation of drainfield to be no Tess than 5.78' NGVD.
5.- Bottom of drainfield elevation to be no less than 5.28' NGVD.
The systems are sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated sewage
flow of 400 GPD.
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. .i.` TE-ut- FLORIDA • '
. • 1 • DEPA TMENT OF HEALTH •
. .
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION P
' .
'5& )pplication Numb
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- 77777 777
• • "! - 31- • ' •
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Scale: Each block repre ants 5 feet and inch 50 .
feet.
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