PL-17-2453 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795.2204 Fax: (305)756-8972
Inspection Number: INSP-290524 Permit Number: PL-10-17-2453
Scheduled Inspection Date: March 21,2018 Permit Type: Plumbing -Residential
Inspector: Hernandez,Rafael Inspection Type: Final
Owner: ZULUAGA,JUAN Work Classification: Drainfield
Job Address:580 NE 106 Street
Miami Shores,FL 33138- Phone Number
Parcel Number 1122310140170
Project: <NONE>
Contractor: A AARON SUPER ROOTER Phone:305.944-8886
Building Department Comments
REPLACE SEPTIC TANK AND DRAINFIELD Infractio .. Passed _Comments
INSPECTOR COMMENTS False
i
Inspector Comments
Passed HRS APPROVAL ON FILE
Failed
Correction
Needed ❑
-Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 20,2018 For Inspections please calk(305)762-4949 Page 5 of 19
`
Permit NO. PL-1 0-17-2453
RE
Miami Shores Village Permit Type:Plumbing-Residential
1oosow.s.2nd Avenue mE
Miami Shores,FL 33138-0000 Per, 1 " t
Phone: (3057e5-220* Permit Status:APPROVED
issue Date: 10118/20 17 f Expiration: 04116/2018
Project Address
580 NE 106 Street 1122310140170
Miami Shores, FL 33138- Block: Lot: JUAN ZULUAGA
Owner Information Address Phone Cell
JUAN ZULUAGA 580 NE 106 Street
MIAMI SHORES FL 33138
580 NE1OGStreet
PL
Co6tractor(s) Phone Cell Phone Valuation: $ 6,500.00 -
A AARON SUPER ROOTER 305-944-8886
Total Sq Feet: 225
Type,of Work:'REPLACE SEPTIC TANK AND DRAINFIELD
Available Inspections:
Type of Piping: Inspection Type:
Additional Info: HRS Approval I
Bond Return Final
Classification:Residential Scanning:3 Review Plumbing
/
Fees Due Amount Pay Date Pay Type Annt Paid Annt Due
Bond Type-Owners Bond $500.00 Invoice# PL-10-17-65343
DBPR Fee $4.50 10/12/2017 Credit Card $.50.00 $777.70
Educ�tion Surcharge $1.40 Bond 3532
Permit Fee $300.00
Scanning Fee $9.00
. `
^ Technology Fee $5.60 /
Total: $827.70
`
In omvmeruoon of the issuance to mu of this permit, I oomm to no«onn the work covered hereunder in compliance with an ordinances and regulations
nwnoinmg thereto and in strict conformity with the plano,drawingo,statements o,specifications submitted to the proper authorities of Miami Sxvmm wnaga In
accepting this ponnu | assume responsibility for all work done by either myself, my agent, servants, or employes. | understand matoopamte'ponnno are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
Miami Shores Village
Building Department o r 12 017
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
.'i
INSPECTION LINE PHONE NUMBER:(305)762-4949 r�
FBC 20 �L4
BUILDING Master Permit No�,L��--
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL
(]PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
QCONTRACTOR DRAWINGS
JOB ADDRESS: Sy O NI�E Io G
City: Miami Shores County Miami Dade33 ) 6
Zip
Folio/Parcel#:_ _ ZZ 3 1-0 ( �- - ��� 1D.—Is the Building Historically Designated:Yes NO L---'
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): ,JUG z
C /� Phone#:
J
Address: &,0 jgjE IoG ST
i
City: �� 1L'�1\ �� State:
/
Zip: 33 (6�
Tenant/Lessee Name:
Email: Phone#:
` � ,
CONTRACTOR:Company Name: rT- rfA-hdrl �Csl phon#:
Address: 22 ) ?5 C f'
City: Mn r-G�-►-�GvSt �t
ate: Zipr3
Qualifier Name:
Phone#:
State Certification or Registration#: Certificate of Competency# (
DESIGNER:Architect/Engineer:
Phone#: .
Address:
City: State: Zip:
Value of Work for this Permit:$-16�`l7 Q Square/Linear Footage of Work:_ G Z
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace
❑ Demolition
Description of Work: VI G G6
n
¢' Y-ot l h
Specify color of color thru tile:
Submittal Fee$
Scanning Fee$ permit Fee$ 30 0-"*"
CCF$ 'x''
c CO/CC$
Radon Fee$ 3' � DBPR$ T•��
Notary$
Technology Fee$ Training/Education fee$
Double Fee$
Structural Reviews$
Bonds. �,�'\�
W
TOTAL FEE NOW DUE$
(Revised02/24/2014) ��
Bonding,Compa y's Namelif applicable)
Bonding Company's Address
City State Zip
Mortgage Lenders 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of comm ment must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I th absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
i o day`of O�if" 20 by 110 day of UC,-�P 20by
wGh ZU I,U ct F)CI who is personally known to J d �,n TMJ who is personally known to
me or who has produced as me or who has produced I h as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Si n: r�
g Sign: y
Print: Pwt$�w4.3y, 1JPrint: I Cil�1P Z 1p��3.
Seal: y r :et�`�n 1rFESJ Seal: ;+`"� Trq!! J.$040moN '
SRI RQAI � * "` CCh'it;fSION 'FF 424161
'p,
: c2T e 2014
'O .;
r6a; 1 ,ir:udaetN� ys
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revisedo2/24/2014)
i
STATE OF FLORIDA PERMIT #: 13-SC-1793815 '
m DEPARTMENT OF HEALTH APPLICATION #: AP 1309839
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: f
SYSTEM
= FEE PAID:
CONSTRUCTION PERMIT
RECEIPT V
• DOCUMENT #: PR1078067
0000••
• • • 0000••
CONSTRUCTION PERMIT FOR: OSTDS Repair •• • 0000 •
APPLICANT• ,Juan Zuluaqa 0000•• 0000 0000••
•
PROPERTY ADDRESS: 580 NE 106 St Miami, FL 33138 0900 • 0••••0
0000 • 0000•
LOT: 12 BLOCK: 110 SUBDIVISION: 000900 • • 00000
•• •• 1• •• 000000
[SECTION, TOWNSHIP, RANGE PARCEL NUMBER] •
•
PROPERTY ID V 11-2231-014-0170 ••••r.• •
[OR TAX ID NUMBER] • • %
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND 0•STANDARD!f••Ot SEICTION*
381.0065, F.S. , AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOV 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 [ 900 ] GALLONS / GPD NEW SEPTIC TANK TO INSTALL CAPACITY I
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 [ 225 ] SQUARE FEET NEW DF IN TRENCH CON SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FIFE..............15.10'NGVD
I, ELEVATION OF PROPOSED SYSTEM SITE [ 24.00 ]'[ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 72.00 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
L`
D FILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ 48.00 ] INCHES
0 1.-Install a 900 gal.septic tank with an approved filter
2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
T with s.64E-6.013(3)(f)FAC.
H 3.-Install 225 sf.of drainfield in .......TRENCH... configuration.
E 4.-Existing slightly limited soil at the bottom of the drain field to remain
5.-Invert elevation and Bottom of drainfield to be no less than 9.60'& 9.10' NGVD respectively
R THIS PERMIT IS NOT FOR ANY ADDITIONS.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of
SPECIFICATIONS BY: JOHN J TUFFY TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Gerard L P i izaire
DATE ISSUED: 10/09/2017 EXPIRATION DATE: 01/07/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1309839 SE1049528
DOCUMENT #: PR1078067
Required drainfield area based on rule 64E-6.015(6)(c)2.
Install a new drainfield to achieve Drainfield size requirement.
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. . •
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• • •••. •
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT A
a
Permit Application Number
--------------------------- PARTII I - S I'TE P LAN _ •
Scale: Each blockre rese is 10_feet and 1 inch =40 feet. t �•• 'i "
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Site Plan subrriitted y:
Plan Approved Not Approved
Date
By County Health Department
ALL CHA GES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015,08/09(Obsoletes previous editions which may not be used) Incorporated: 64E-6.001,FAC Page 2 of 4
(Stock Number: 5744-002-4016-6)
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777 N.W.72(0 AVENUE 2804 OEt PRA00 9LVD SOUTH
LP\ SUITE 3025 SUITE NO.292 UNIT I
.MIAMI.FLORIDA 33126 CAPE CORAL;VL'33904 .' RV
.-J-- PH: (306}262.0400 PH; (23.)640-2660 1.
fAX:(=!29)Z9Z 0.101 FAY-,(2.6'1)94C-26^4 r
MAP OF BOUNDARY SURVEY !�
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NF_ 906TH STREET
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0No.6778 Pi S RECORDS OFANAW-44DECOLW7Y,FLORDA
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STA +u 08/01/2014 o L �- ° c
FIE DATE: L! Li 0 C U
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,-,N L LANA_.•' SURVEY NO: 14-002674.1 0 �] z
SEAL SHEET: 2 OF 2 0-
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RECEIVED 1 �� ZuA 5
APPLICATION #:AP1309839
�q�,
STATE O RIDA PERMIT #:13-SC-1793815
DEPARTMENT OF HEALTH DOCUMENT #:FI 1147542
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:11/02/2017
we FEE PAID:100.00
RECEIPT #:13-PID-3428926
APPLICANT.': Juan Zuluaga
AGENT: A Aaron-Super Rooter
PROPERTY ADDRESS: 580 NE 106 St Miami, FL 33138
LOT: 12 BLOCK: 110
SUBDIVISION: ID#: 11-2231-014-0170
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ 1 [01] TANK SIZE (1] 1090.00 [2] [ ] [27] SURFACE WATER FT
[ ] [02] TANK MATERIAL Polyethylene [ ] [28] DITCHES FT
[ 1 [03] OUTLET DEVICE [ ] [29] PRIVATE WELLS FT
[ ] [04] MULTI-CHAMBERED [ Y N ] [ ] [30] PUBLIC WELLS FT
[ ] [05] OUTLET FILTER Polylok PL-68 [ ] [31] IRRIGATION WELLS 32 FT
[ ] [061 LEGEND 1. 70-143-11DC4 2. [ ] [32] POTABLE WATER 10 FT
[ 1 [07] WATERTIGHT [ 1 [33] BUILDING FOUNDATIONS 14 FT
[ 1 [08] LEVEL ` [ ] [34] PROPERTY LINES 3.6 FT
[ ] [091 DEPTH TO LID [ ] [35] OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ ] [10] AREA [1] 240 [21 SQFT [ ] [36] DRAINFIELD COVER a
[ ] [11] DISTRIBUTION BOX HEADER X [ ] [37] SHOULDERS
[ ]
1121 NUMBER OF DRAINLINES 1. 4.00 2. [ ] [38] SLOPES
[ ] [13] DRAINLINE SEPARATION [ ] [39] STABILIZATION
[ ] [14] DRAINLINE SLOPE
[ ] [15] DEPTH OF COVER ADDITIONAL INFORMATION
[ 1 [16] ELEVATION [ ABOVE / BELOW ]BM 60.36 [ 1 [40] UNOBSTRUCTED AREA
[ ] [171 SYSTEM LOCATION [ ] [41] STORMWATER RUNOFF
[ ] [18] DOSING PUMPS [ ] [421 ALARMS
[ ] [19] AGGREGATE SIZE [ ] [431 MAINTENANCE AGREEMENT
[ ] [20] AGGREGATE EXCESSIVE FINES [ ] [441 BUILDING AREA
[ j [21] AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH,SITE PLAN
FILL / EXCAVATION MATERIAL [ 1 [461 FINAL SITE GRADING
[ ] [221 FILL AMOUNT [ 1 [471 CONTRACTOR A Aaron S(A Aaron S ROOte
[ ] [23] FILL TEXTURE [ 1 [48] OTHER ADS ARC 24
[ 1 [24] EXCAVATION DEPTH ABANDONMENT
[ ] [251 AREA REPLACED [ ] [491 TANK PUMPED 11/01/2017
[ ] [26] REPLACEMENT MATERIAL [ ] [50] TANK CRUSHED & FILLED 11/01/2017
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED / Dade CHD DATE: 11/03/2017
_DISAPPROVED ]' Environmental Specialist II Heber Montero(Department of Health In Da
FINAL SYSTEM [ APPROVED / DISAPPROVED ] : Dade CHD DATE: 11/03/2017
Environmental Specialist II Heber Montero(Department of Health in D
(Explanation of Violations on following page)
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1309839 EID1793815
Y"t APPLICATION #:AP1309839
• 4
rti STATE OF FLORIDA PERMIT #:13-SC-1793815
DEPARTMENT OF HEALTH DOCUMENT #:F11,147542
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
' CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:11/02/2017
uvc�
FEE PAID:100.00
RECEIPT #:13-PID-3428926
Violation Number Comment
Comments
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of 300
gpd.
-16 chambers,4 drainlines(4 chambers each)
-trench configuration,existing sand
-ok to cover drainfield only,leave header expose.
r
i
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 AP1309839 EID1793815