Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PL-12-473
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 171269 Permit Number: PL- 3- 12-473 Scheduled Inspection Date: March 30, 2012 Inspector: Hernandez, Rafael Owner: HART, NEIL Job Address: 295 GRAND CONCOURSE Miami Shores, FL 33138- Project: <NONE> Contractor: ROTO ROOTER SERVICES COMPANY Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)962 -4547 Parcel Number 1132060133600 Phone: (786)464 -1080 Building Department Comments EXTENDING DRAINFIELD Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments hrs in file March 30, 2012 For Inspections please call: (305)762 -4949 Page 6 of 11 F FLORIDA I L kA,ENT O'� HEALTH aEW1lAG TR,'A� ENT AND DISPOSAL SYSTEI U 1"CON INSPECTION AND FINAL .APPROVAL PERMIT NO. DATE PAID. FEE PAID: RECEIPT #: 06 4744 AGENT: PROPERTY ADDRESS LOT :_ OCK: ': SUBDIVASION: PROPERTY ID ft 1132 O(zb+, I 3 CHECKED [Xj ITEMS ARE 001--. TAIUK INSTALLATION [01] TANK 54.[1] (02j TANI, ,I IATI • "b3J( „O 1 LET DE 164)r MULTI- CHAMBEAt [ ) [5j. bUTLET FILTER, [ l [96] LEGEND [ - -] ] [08] 00.5 WrTH STATUTE -.OR .RULE; AND MUST. BE COR'RE'CTED. • — .SETBACKS • [2T] . SURFACE WATER DRAINiI!BLt_ [10] A [111 DISTr` '[121 NDMIt [13] Dlt :) 414] [ ]. '[1,5] j , .. t 14'41 [ l (?] ] 414 1191 ] 120) ' 7fiG'GN ,AGfGIIEO'A1 ,,ahv6A'frIC1 [22] PILL AM [231 :'FILL (24] EXCAVATION ,DEPTH 3 a [251 AFiEA'fiEtAGE© {26j flEPLACEME VT MATERIAL EXP1(AtNq ION OF' uiIOLATf S' ',/ I iktMyANI•t l [ l' _ ENT, LOCAT,IION PONFORMS. WITH SITE PLAN 'FINAL SITE GRADING ONTRAOTOR - . - +'..- OTHER ABANDONMENT [4$1 TANK PIJ ''ED,' [50J TANK CRUSHED & FILLED FINAL SYSTEM ( R /DISAP;'['ROVEC P /DtSAPRROVEDj: DH 401,6 (Page 2), 10/97 (Previous Editions May Be Used) Stock Number: 57444)024016-4 CND DATE: l� iYfai.Y+A YUkd1Kr 5'.,, -.•. - OAS -Q •Ftt�^3 es" :�Aa2y+. = g ess •:.a,Z ": PT I :. Applicant • PT 2: installer /Contractor PT3's_ BuIEding Department 'PT-41„ I3ealth Department's Page of 3 63041l p- _`Sm -try BUILDING 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 Permit No.P Z-- 410 PERMIT APPLICATION FBC 20 MAR 1 9 252 Master Permit No. Permit Type: PLUMBING 1 OWNER: Name (Fee Simple Titleholder): NE- IL * G of f l 4 i f Address: Z Ct �('�.C1 C �� (-1(f City: CLe: ikti S\,1(j'C 'y State: Tenant/Lessee Name: Email: Cr S F CLT- k-- A c . , (en Cr JOB ADDRESS: 2 (c � , . % ' i'cLr Q C \ City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Phone#: C- 463 C Phone#: Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: Address: l 5 6. ® A u) city: 12,97''4 Qualifier Name: (--16 /- G 7 State Certification or Registration #: Contact Phone#: Ad-0 Re 0,441"-- 71 A-1,' States / ��r': dif Zip: 33/Z b ;;-, AC� ktde- Phone#: -44' ere ()57 . 6 Certificate of Competency #: J zn / leo alez 40 rrepe. a Eoief Flood Zone: Phone#: l '44°4 °4 Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ f!' Square/Linear Footage of Work: Type of Work: OAddress DAlteration New yifiZep /Replace Demolition Description of Work: ntie 01 rill Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ 'O® Technology Fee $ 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 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 Owner or Agent Contractor The f regoiing�innstrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of V��f►`-' ` , 201, by e.A Mos , day of \Ce-S(1 , 20a, by- t c r-Aer, who is personally known to me or who has produced c CCOC. who is personally known to me or who has produced eDewei S `cenT€As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: , NOTARY PUBLIC: Sign: Print: My Commission Expires: 4gti `anys Lopez c. ` My Commission EE017504 94 0 04. Expires 10/28/2014 Sign: Print: My Commissio \d *spspsksk> papgsgs*skspgsspgagagaxpoY******aa,k kph, kxeHr.& *******,k*skek***sk*ck* , ******** ***********ffi*** APPROVED BY Plans Examiner gaaa** Notary Public State of Florida Marilys Lopez My Commission EE017604 Expires 10/28/2014 * *0 Zoning Structural Review Clerk (Revised 07 /10/07)(Revised O6110/2009)(Revised 3/15/09) 03/16/2012 13:40 3052206729 OFFICEMAX STATE OF FLORIDA DEPARTMENT OF HEAZTE ONSITE SEWAGE TREATMENT AND DISPOSAL. SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Existing Modification APPLICANT: Joann Hart PROPE>:Lxx A1vngESS: 295 Grand Consourse Miami, FL 33138 LOT: 1 PAGE 02/02 PERMIT #: 13-SC-1397732 APPLICATION 0: AP1064744 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT tt : PR870058 BLOCK: 27 SUBDIVISION: PROPERTY ID #: 11- 3206 -013 -3600 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER) [OR ENE TO NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, P.S., AND CHAPTER 64E -•6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OP TIME. ANY CHANGE IN WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE TBE APPLICANT PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH STATE, OR LOCAL PERMITTING: REQUIRED FOR DEVELOPMENT OE THIS PROPERTY. MATERIAL FACTS, TO MODIFY THE NULL AND VOID. OTHER FEDERAL, SYSTEM DESIGN AND SPECIFI ATIONS T A N K D Ft A I N F I E L D O T H tL R 1,0880 ] GALLONS / GPD Septic existing CAPACITY ] GALLONS / GPO N/A CAPACITY ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM MUM CAPACITY SINGLE TANK :1250 G IL NS] ] GALLONS DOSING TANK CAPACITY [ ]GALLONS S[ ]DOSES PER 24 MRS #PUmpel [ ] 667 ] SQUARE FEET ] SQUARE FEET TYPE SYSTEM: [x] STANDARD CONFIGURATION: [ ] TRENCH Add 337 to pet 687 sq ft SYSTEM NIA SYSTEM [ ] FILLED [ ] MOUND Ix] RED [ ] LOCATION OF BENCHMARK: FFE : 11.50' NGVD ELEWATION OF PROPOSED SYSTEM SITE BOTTOM OF DRAINFIELD TO BE [ 16.80 ] II INCHES F' FT ] [ ABOVE A BELOW I] ELITC E /REFERENCE [ 46.80 ] [f INCHES I FP ] [ ABOVE BELOW IIHENCHMARK /REFERENCE FILL REQUIRED: 1 0.00] INCHES EXCAVATION - Modify (existing 300 sq ft) drainfield to get a 687 sq ft drainfield, - Elevation of bottom of drainfield to be no less than 7.80' NGVD, - Existing 1050 g septic tank. to remain. REQUIRED: [ 30.003 INCHES POINT POIN',F The contractor (or ciesignee) is required to perform a soli boring adjacent to the ctrajnfiold excavation at the time of final inspection. Prior to Final Approval, the DOH inspector shall witness the soil baring and compare the results to the original site evaluation submitted. A reinspection fee will be assessed If the contractor Is not at the jobsite at the arranged time. SPECIFICATIONS BY: APPROVED BY: OATH ISSUED: Teresa .T Sol ,Air Joa ph 03/16 TITLE' Master Septic Tank Contractor Engineer Specialist II Dade DH 4016, 08/09 (Obsolete 11 previous editions which may not be used) Incorporated: 64E-6.003, FAC v L.7..a 701064744 EXPIRATION DATE: 09/16/2013 a' a 65693 CHD Page 1 of 3 Miami-Dade My Home My Home Show Me: Rupert! initenmadion Search By: Select bern Text onli Property Appraiser Tax Estimator 111 Prokerty Appraiser Tax Comparison Portability S O.H. Calculator Summa Details: • ACTIVE TOOL: SELECT . HART MIST BEL p HART TRS GMND CONCOURSE MI SHORES PL 33-2E62 Information: ATM SHORES SEC 1 PB RIM LOT 1 • S OR 19E644337 Assessment Information: oar; 111H11 MHO =MIMI ALxY.:4•, 2=1111. Si6$02 31:ZM ALILL Exemption Information: =MI= 2811 2010 =MEMO= 1256E9 IF771 MESMER= =EMI VES Taxable Value Information: Sale Information: Bele: *Amount: ..„if,;11 • Aerial Photography - 2009 0 ----- 116 ft My Home 11Property Information I Property Taxes IMA_Neighborhood IPrpperty Appraiser Home jjUsing Our Site ilPhorle Directory 1Privaqy iDisciaimer N you ampanleace techmicad gab Poops* ilidonsalin moiNswfoa, strudel maid sre yaw ocatataWra, essmilleas or sispoillows Owes small siSsitVVebmaster. Web Site 2002 Miami-Dade County. All rights reserved. Page 1 of 2 Legend Property Boundary °4° Selected 6 Property Street re Highway Miami-Dade County Water w+a http://gisims2.miamidade.gov/myhome/propmap.asp 3/16/2012 frt ACRE® CERTIFICATE OF LIABILITY INSURANCE DATE 611 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernent(s). PRODUCER MARSH USA INC. 525 VINE STREET, SUITE 1600 CINCINNATI, OH 45202 AOn: ctnchma0.certrequ nalsh.com, Fax 212- 948 -0785 400408-RRSC-GAUW-11-12 00044 REACT PHA FAX E-MAL ADDRESS: PRODUSER CUSTOMER ID 4: INSURERS) AFFORDING COVERAGE NAIC S INSURED ROTO - ROOTER SERVICES COMPANY 1550 NORTHWEST 79TH AVENUE MIAMI, FL 33126 INSURER A : Zurich American Insurance Company 16535 INSURER B : WA WA INSURER C : NIA N/A INSURER D : 04101012 INSURER E : $ INSURER F : X COVERAGES CERTIFICATE NUMBER: CLE -x-20 REVISION NUMBER:1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LIR TYPE OF UISURANCE � WVDD POLICY NUMBER (MMIDDIYYY) f MIDDIJYYYYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY X I OCCUR GL09379365 -07 04/01/2011 04101012 EACH OCCURRENCE $ 2,000,000 X PREMISS occurrence) $ CLAIMS-MADE MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 6,000,000 GEN L AGGREGATE UNIT APPUES PER: � ^ I POLICY I1 P Cat 17 LOC PRODUCTS - COMP/OP AGG $ 5,0005,000,000 , $ A AUTOMOBILE LIABUITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAP9379363.07 (AOS) 04/01/2011 04/01/2012 COMBINED SINGLE UNIT (Ea accident) $ 300%000 X BODILY INJURY (Per person) $ BODILY INJURY (Per acddent) $ PROPERTY DAMAGE $ $ $ UMBRELLA L1AB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION lm AND PLOYERS LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE EXCLUDED? (yyry In NH) DESCRI OF OPERATIONS Y N N / A WC9379366 -07 (AOS) 04/012011 04/01/2012 X I WC TORY LIM STATU- ITS I 1OER EL EACH ACCIDENT $ 1,000,000 N EL DISEASE - EA EMPLOYEE $ 1 below EL DISEASE - POLICY LIMIT $ 1,000,E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B mom space Is re adred) CERTIFICATE HOLD TION MIAMI SHORES VILLAGE 10050 N.E SECOND AVENUE MIAMI SHORES, FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. John F. Schultz mac-- ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS IS NOT A-BILL - DO NOT PAY RENEWAL • RECEIPT NO. • 360943 -6 .STATE* CFC057653 345553 -2 BUSINESS NAME! LOCATION ROTO ROOTER SERVICES COMPANY 1550 NW 79 AVE 33126 DORAL FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER ROTO ROOTER SERVICES COMPANY iS Sec. Type of Business WORKER ER 196 PLUMBING CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO. VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR UCENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S OUAUFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 08/08 /2011 60000000123 000105.00 SEE OTHER SIDE DO NOT FORWARD ROTO ROOTER SERVICES COMPANY R L ARQUILLA PRES 1550 NW 79 AVE MIAMI FL 33126 111111111111111111111111311 ii14111til,f;l, III .,i 111 “111811