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PL-11-274Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156132 Permit Number: PL -2 -11 -274 Scheduled Inspection Date: January 27, 2012 Inspector: Hernandez, Rafael Owner: GUILLERMO CASTRO, JOSE Job Address: 9701 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: JOE LEWIS SPECIALTY SEPTIC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Septic Phone Number Parcel Number 1132060143320 Phone: (305)662 -7979 Building Department Comments INSTALL 1050 GAL SEPTIC TANK AND 225 DRAINFIELD IN TRENCH CONFIGURATION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments HRS FINAL IN FILE. January 26, 2012 For Inspections please call: (305)762 -4949 Page 2 of 17 Miami Shores Village REcEIVEI) Building Department JAN 2 5 012 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Permit No. P., Master Permit No. OWNER: Name (Fee Simple Titleholder): ��p, d' �� hone #: Address: �� ere-) City: State: Zip: Tenant/Lessee Name: Phone#: 2 r2. - ( ) 17 Email: JOB ADDRESS: 1-1 0 6 bl sccu -jt (-J (' J GI City: Miami Shores 'J County: Miami Dade Zip: 3 ➢ r3Es- Folio/Parcel#: 1 t •-- 3O 2 2- 6 - 01 4 - J0j'_- Is the Building Historically Designated: Yes _ NO Flood Zone: CONTRACTOR: Company Name: 3b( Le cry 1 S 6 0 141 7 Phone #: "1 RI G 2') 1 Z3 Address: /O1 S ��-vJ G, 1 Ave. City: M 1''r a ark a., State: Zip: -3,,t22--1 Qualifier Name: V--eke., Le)..11 S Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 2 o ' Square/Linear Footage of Work: 22- S Type of Work: Address ❑Alteration ❑New epair/Replace ❑Demolition D rat` r - l Of Description of Work: ****1 x�x�a�x�x�a�xx��x* ***a��x+x�x*****�n+x***wax * **** Fees** �xx�*************+ x�x* �x+�x� **** *�x�x****�•�x **** **** Submittal Fee ' Permit Fee $ . L , CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 t ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b ' appru ved and a reinsp ion fee will be charged. Signature Owner or A The foregoing instrument was ackn Signature Contractor ed before me this Z3 The foregoing instrument was acknowledged before me thi;2-3 day of 3 1 , 20 12 , by NM o. 6'4 to 9rl e(4l Ale arttflay of ro , 20 It-, by 3'o 1,-.60.11 S' , who is personally known to me or who has produced pin t' who is personally known to me or who has produced ®ra V. Uwe (PA.-) As identification and who did take an oath. LNenk C as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: / r, Sign: Print: l y�@ ®pp A Print: `_ " N � 4' ! ERESA J SOLOMOAI My Commission Expires: ,,;_ My Commission Exp : !'. ':• MY COMMISSION # EE131935 , . MY COMMISSION # EE131935 1.•V' EXPIRES November 08, 2015 :f o, EXPIRES November 08, 2015 8f,,,`` F a ervme.eom (407) 398-0153 FladdaNataryServiee.cam (407) 398 0153 ����. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 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 BUILDING PERMIT APPLICATION FBC 20 _Permit Type: PLUMBING ,�/ ? /� p OWNER: Name (Fee Simple Titleholder): 36 Li; 1 � (YID Phone#: JV O 01 -3951 Address: 9-* 0 `g/ sec,i 0-42 TR 1 vi%) City: 14-1 1 iron) State: Zip: l Tenant/Lessee Name: ,a ,� Phone #: Email: CPS4I 0 7, P"-' E T) a ILA). ®►Y`�il - Eb U Permit No. FEB 182011 - ii-e•-•""? Master Permit No. CaSi- f0 DA1a5 JOB ADDRESS: •c1 1l? City: Miami Shores County: Miami Dade Zip. Folio/Parcel #: I Building Historically Designated: Yes NO Flood Zone: /'e CONTRACTOR: Company Name: jC _ L v r S . St e C/4 �5 -r-if Phone #: Address: 30 7S sP• 6 ( /- P4- City: Al r`!L.AM4qq IC State: F f• Qualifier Name: c 1 Q (. C %/ LS c 1 i _.. State Certification or Registration #: .5/e 0 047 /S 9 /- Certificate of Competency #: Contact Phone #: 7�I6 -243 /7Z3 zip: 33o23 Phone #: 7y(- Z `) Email Address: krkj /✓ _k776-/10 // Ai 4,7 • `Ce, ,*� DESIGNER: Architect/Engineer: ° Phone#: Value of Work for this Permit: $ lat3oo Square/Linear Foo f Work: Type of Work: ❑Address DAlteration New /Replace ❑Demolition ■ Description of Work: + u+ x***+ x*** ************ **** ** *** * ******** Fees********************** ***********+x+•**** ***** 0 vJ Submittal Fee $ Permit Fee $ 36 6 ° CCF $ tO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) "' Bonding o npany'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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspgction fee will be charged. ,Signature . wner or Agent The foregoing instrument was acknowledged before me this The f day of Fe. b , 20 l 1 , by-31:6€ G. aC1 rD bQn 6 S , day of who is personally known to me or who has produced b' L• who is ersonally kno C 2 ° 4t1- (o 1` ' L entification and who did take an oath. LAC NOTAItM PUBLIC: Signaturee� -- Contractor I instrument was ackn• !edged be ,jre me tlyds ,_ 0 11 , by 4' i to me or who has producej d l 0-41Wiil- ' as identification and who did take an oath. Sign: Print: q us Lit RIDA Yusmila Alen My Commission Ex , Commission #DD686772 mr ,,.„,,,$ Expires: AUG. 06, 2011 BONDED MEW ATLANTIC BONDING CO, INC. NOT Sign: Print: PUBLIC: My Commission Expires: Nal 00V 4a ** ** * * ** *,k,k******* BNB+k*,A**** ***+k**+ ANA **** * * * ********+k*ga** kph***** ******+ k*****+ k* *+ k******+ K*********k,knk*skHaeN,kHb*** APPROVED BY 07--(P-// (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Plans Examiner Structural Review Zoning Clerk h JoLoQ� er ! tr--•I V S420. Z-' STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM! C0 NSTRuCTION PERMIT FOR: OSTDS Repair APPLICANT: Jose Guillermo (Castro) PERMIT 1:13 -SC- 1300963 APPLICATION # :AP993763 DATE PAID: FEB PAID: RECEIPT #: DOCUMENT #: PR835320 PROPERTY ADDRESS: 9701 Biscayne Blvd Miami, FL 33138 LOT: 1-4 BLOCK: 79 SUBDIVISION: Miami Shores PROPERTY ID #: 11 -3208- 0143320 (SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM )JUST BE CONSTRUCTED XS ACCORDANCE MITE SPECIFICATIONS AND SAS 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, ERICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT III THIS PERMIT HEING mama NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COIIPL?ANCE NITS OTHER FEDERAL, STATE, OR LOCAL PERICCEEDSG REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 1.050 ] GALLONS / GPD Septic CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLOWS SEBASE INTERCEPTOR CAPACITY [MAXI) CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSIMG TANK CAPACITY [ WALLOW @[ ]DOSES PER 24 SRS #Pumps [ ] D [ 225 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] =LED [ ] MOUND [ ] I CONFIGORAtION: [u] TRENCH 1 1 BED [ ] N F LOCATION OF BENCHMARK: F.F.E.: 12.127' NGVD. I =RATION OF PROPOSED SYSTEM SITE E BOTT034 OF DRAZNFXELD TO BE L [ 18.30 ] t 46.30] INCHES FT II ABOVE A BELOW haigNanamovinmEncE POINT FT ] [ ABOVE n BK/1►CE POINT D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: 1 28.00 ] INCHES 1- Install 1050 gal. category-3 septic tank equipped with an approved filter. 2-The licence contractor install ng the system • is responsible for installing the minimum seemly of tank in accordance with sec. 64E -6.013(3)(f). 3- Install 225 sf of T drainfield in trench configuration. 4- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed • absorption trench. 5 -Invert elevation of drainfield to be no less than 8.80' NGVD. 6. Bottom of drainfield elevation to be no less than 8.30' NGVD.. THIS PERMIT IS NOT FOR EPA1R SPECIFICATI DATE W Oer4 a 02/17/2011 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E- 6.003, FAC v1.1.4 AP993763 EXPIRATION DATE: SE836353 Page 1 of 3 • NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 - 410 -1448. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order.