PL-13-2248F__
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-200469 Permit Number: PL-10-13-2248
Scheduled Inspection Date: October 16,2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: PEARSON, RONAL AND CARLY SILVER Work Classification: Drainfleld
Job Address:249 GRAND CONCOURSE
Miami Shores, FL Phone Number
Parcel Number 1132060133610
Project: <NONE>
Contractor: SR0061536 MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859
Building Department Comments
REPLACING DRAINFIELD Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed t'G ct,
Failed
��. 0 . A4&- --- -
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 15,2013 For Inspections please call: (305)762-4949 Page 26 of 48
Miami Shares Village
}
Building Department
JOUQ N.E.2nd Avenue,Miami Shores,Florida 33138 OCT 0 4 2013
Tel:(305)795.2204 Fax:(305)756.897$
INSPECTION'S PHONE NUMBER:(305)762.4949 B'Y-
FBC 20
BUILDING Permit No.
PERMIT AL< A Master Permit No� f �
Permit Type:PLUMBING �,
JtTB�YDII)I�ESS: Z 9 t� vZ 0 ue,S5-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: & 3a0
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): /-"� r r Phone#.
Address:
Zyq (Aow® 70
City: h'(AoU Slwj State:
Tenant/Lessee Name: Phone#:
Email: rOAN pc,ArJvn (� A-C • e4r, udw. P��
CONTRACTOR:Company Name: I"t W' `G`s SYr I � '� � '"�`"J l� Phone#:
Address: ✓l/?31Z &LV
City: 44 .- State: FZ- Zip: 3 l6 9
Qualifier Name: Phone#: T4S75-`
State Certification or Registration#- SP--1111W&6IX'U Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit,$ e dde.0-4 Square/Linear Footage of Work:
Type of Work: OAddress ❑Alltteration LINew ARepair/Replace ODemolition
Description of Work. PM-4/,!ay
Submittal Fee$ 00 Permit Fee$ X CCF$ CO/CC$
Sc unlit Yee$. Ram Fee$ DBPR$ 11oud$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee S 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 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
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this / The foregoing instrument was acknowledged before me this A
day of ,20 139 by hga U ?Qt r�af day of 0406C 20 r7 ,by K&A"➢a 9e-
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print -54W Yyl6coo 6 5 Print:
4'1 Pbta7y Publle smote of Fiolida
My Commissi Exe�: My Commissio A Agendas mry Public state Of Rorma saes eryl A M @ndte '+� MY Canift"1on 6s0iT5i3 Coen+rtlaobn LE017513 �i
n�Ile Facptroa 10/3 `2814 pku 1012=14�, ak�Nak=k��d¢�eAcN�eNBas k�kakdsnk�k�s�kHsek�ksk�N�Iaik�l s��k�nA�essffiN��k��kae�abHssbs��i+�kdaskeRaksRob�sk�daskskds�Is�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
: s
x
PERMIT #:13-SC-1497129
a p CATION #:AP1121488
STATE OF FLORIDA
DEPARTMENT OF HEALTH OCT 042013 TE PAID:
ONSITE SEWAGE TREATMENT AND DISP SAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT CEIPT #:
F ,
I .
k
CUMENT 343
F i �
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Ronald Pearson
PROPERTY ADDRESS: 249 Grand Concourse Miami, FL 33138
LOT: 2,3 BLOCK: 27 SUBDIVISION: Miami Shores Section 1
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3206-013-3610 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SEECTION
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 TIMES. 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 [ 900 ] GALLONS / GPD Existinq septic tank to remain. CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 300 ] SQUARE FEET bed configuration drainfiel SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: F.F.E., 11.90'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 22.80 ] [ INCHE3 FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 67.80 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 57.001 INCHES
"'Invert elevation of drainfield to be no less than 6.75'NGVD.
O 'Bottom of drainfield elevation to be no less than 6.25' NGVD.
T *Install 12"of slightly limited soil under the bottom of drainfield.
H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench.
THIS PERMIT IS NOT FOR"ADDITION(s)".
E The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow
of 400 gpd.
R
SPECIFICATIONS BY: Kembl ttrick fF TITLE:
APPROVED BY: TITLE: Dade CHD
arlo M I a
DATE ISSUED: 1 02/2 EXPIRATION DATE: 12/31/2013
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC ertorm a Page 1 of 3
v 1.1.4he cciltr3Ckc `T :e`i lift, is required;c p
soil boring adjacent fo%g tield excavation the DON 372
time of final inspection.Prior to Final Approval,
tor sti:itl witness the soil boring and compare the
inspec
results to the original site evalu"t'ar'submitted.A
reinspection fee will be assessea it the contractor is not
at ft jobsite at the arranged time.
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 governed 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.
i