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PL-12-2224Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 183811 Permit Number: PL -11 -12 -2224 Scheduled Inspection Date: January 09, 2013 Inspector: Hernandez, Rafael Owner: GARCIA, RICARDO Job Address: 436 NE 93 Street Miami Shores, FL Project: <NONE> Contractor: SMITH SEPTIC TANKS OF HOMESTEAD, INC. Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)756 -5301 Parcel Number 1132060140210 Phone: 305 - 245 -7220 Building Department Comments REPLACE DRAINFIELD Infractlo 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 January 08, 2013 For Inspections please call: (305)762 -4949 Page 31 of 40 APPLICANT: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Ci AGENT: LL., PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: S 7/ PROPERTY ADDRESS: • LOT: e BLOCK:,5 0 SUBDIVISION: Z_j_- t! / d___PROPERTY ID #: CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK [01] [02] [03] [04] [05] [06] [07] (08] INSTALLATION TANK SIZE [1] e cD (2]. TANK MATERIAL, /7' ,!nbEAZ_ . OUTLET DEVICE MULTI - CHAMBERED (/ N 1 OUTLET FILTER LEGEND % WATERTIGHT LEVEL [09] DEPTH TO LIp 4./X(3 PVC) DRAINFIELD INSTALLATION e® [10] AREA [1] [21=2 !0 SQFT [11] DISTRIBUTION BOX _ HEADER [12] NUMBER OF DRAINLINES 3/ (13] DRAINLINE SEPARATIONS [14] DRAINLINE SLOPE [15] [16] [17] [18] [19] [20] [21] FILL [22] [23] [24] [25] [26] DEPTH OF COVER /2 °j ELEVATION [ABOVE LOW BM SYSTEM LOCATION DOSING PUMPS A AGGREGATE SIZE Al://,04.09 AGGREGATE EXCESSTft FINES AGGREGATE DEPTH "" /- / EXCAVATION MATERIAL FILL AMOUNT - FILL TEXTURE EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: ( [ 1 [ ] ( 1 1 1 1 SETBACKS • [27] SURFACE WATER [28] DITCHES (29] PRIVATE WELLS [30] PUBLIC WELLS [31] IRRIGATION WELLS (321 POTABLE WATER LINES [33] BUILDING FOUNDATION (34] PROPERTY LINES [35] OTHER FILLED / MOUND SYSTEM J [36] DRAINFIELD COVER 1 (37) SHOULDERS ] (38] SLOPES ] [39] STABILIZATION FT FT FT FT FT FT FT FT FT ADDITIONAL INFORMATION (-1" [40] UNOBSTRUCTED AREA r-4- [41] STORMWATER RUNOFF [ 7] [42] [ / ] [43] [ l _ [44] { (451 [ a [46] t ._-J [471 [ 1 (48] 1 ALARMS MAINTENANCE AGREEMENT BUILDING'AREA LOCATION CONFORMS WITH SITE PLAN FINAL SITE GRADING ? / CONTRACTOR 4/./ .,,.t�'7��c- c�G OTHER ABANDONMENT J yQ ] [49] TANK PUMPED / / / ] [50] TANK CRUSHED & FILLED / / CONSTRUCTION {APPROVED ISAPPROVED] s( at - -A - FINAL SYSTEM APPROVE /DISAPPROVED] : GEC w4,+ _..Q- I J�ir -�. DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E- 6.003, FAC CHD DATE: //- 2 S -I CED DATE: 41--2S -/ Page 2 of 3 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 NOV 2 j2012 FBC 20 BUILDING Permit No. FL 1 '7.,-222:1 PERMIT APPLICATION Master Permit No. Permit Type: PLUMBING JOB ADDRESS: 4'13 t ,71- City: Miami Shores County: in Miami Dade Folio/Parcel#: / / o 'g a 0 4, Is the Beating Historically Designated: Yes NO Zip: 33/3 Flood Zone: OWNER: Name (Fee Simple Titleholder): n t (° 0 v at I' C i \ek Phone*: -315.- 9 a ) / 9 9' Address: ' G 91-3 ¶ City: J44 4, 4 State: Zip: Tenant/Lessee Name: Phone#: Finail• CONTRACTOR: Company Name: 5/// %all ..pn c -j ,t i O FiirtAt.50-4P, one#: � A Y � °' 7 720 Address: / 5/ 0 5- 5 w O 5 -FE l� City: IA c9v t ST�I State: Qualifier Name: GPI §� �1_L �p� 11-1-1 -1-,j State Certification or Registration #: Email Address: FL Zip: 3d 3 Phone#: SO 5- a to -6/ 416— S 5 D ! O Certificate of Competency S P O7 % A-A) 4G S �' Sivt 177-1 ?,#077c /�iuKS�Cs� DESIGNER: Architect/Engineer: Phone#: Contact Phone#: 7O aLf -- %%2 O Value of Work for this Permit: $ 2 ®- Square/Linear Footage Type of Work: DAddress Description of Work: OAlteration O■ew Work: a,0 0 r =' epair/Replacp UDemolition * * * * ** ** ** **** * * *** *** * * * *** *** **** * * *F ************* ****** * * *** * ***** * * * * * * * *** **** Submittal Fee $ b, l) „� n . ermit Fee $ /45-0 CCF $ CO/CC $ a,.. . 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 properly 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��' /��� Owner or Agent The forego' g instrument was r7edged before me this /544 day of / ' 20 , by who is personally known to me or who has produced Ft Lk. As identification and who did take an oath. Contractor The foregoing instrument was ackno ed before me this /51'6A day of 1/ , 20 /a , by 12 T' > who is prrsknsn to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: -15 3 -C3 NOTARY PUBLIC: Sign: :L ..�►!r' ?�P - an'�►- t_JI■�1 Print: 4.ii'1 \v iii w. 1/AL ite My Comnnss �. # LE 6242 emodulaish Nosy ma ***************** v*********************************************************** * * * * * * * * * * * * * * * * * * * * * *** * * * * * ** APPROVED BY Z& °-lam- Plans Examiner Structural Review (Revised3 /1212012)(Revised 07 /10 /070Revised 06/10/2009XRevised 3/15/09) Zoning Clerk PERMIT #: 13-SC-1438536 APPLICATION 4:API087771 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DOCUMENT #: PR889050 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Ricardo Garcia PROPERTY ADDRESS: 436 NE 93 St Miami, FL 33138 LOT: 8 BLOCK: 50 SUBDIVISION: Miami Shores Sec 2 PROPERTY ID #: 11-3206-014-0210 [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 [ 900 ] GALLONS / GPD Existing 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 [ 200 ] SQUARE FEET bed configuration drainfile 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., 10.51' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00 ] INCHES O T H E R [ 13.50 ] [I INCHES I FT ] [ ABOVE /) BELOW II BENCHMARK /REFERENCE POINT [ 43.50 ] [i INCHES I/ FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ 42.00] INCHES *Potable water line within 5 ft. of drainfield shall not be located at an elevation lower than the drainfield absorption surface. *Invert elevation of drainfield to be no less than 7.40 ft. NGVD. *Bottom of drainfield elevation to be no Tess than 6.90 ft. NGVD. V24 a`r.,.i *Install 12" of slightly limited soil under the bottom of the drainfield. - Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench. -The system is sized for 2 of bedrooms with a maximum occupancy of 4 of pe' s (2 per_ bedroom), fora total estimated SPECIFICATIONS BY: APPROVED BY: Carlos C Icaza TITLE: DATE ISSUED: 11/06/2.'L' DH 4016, OS /09Tf�b:so1 es all previous editions which may Incorporated S0d4E' -6y0g3 Bkd19nee) is required perform elrnr ar` ,u 1?- 6,1 i °J thejdraidfield ex avation 1oa7-/71 Insa, :urn„ s,�i ,; ;- ;Un. Prior to Final Approval, the r,, is o; t �,..3s the soil boring proval the DOH nnos the . original site evaluation, sub d compare .,,, :pe ttion ir'.e Sul be assessed if miffed. r is the ! �e c t re arranged time, the contractor is rqn_ not be used) Dade CHD EXPIRATION DATE: 02/04/2013 5E882547 Page 1 of 3 STATE QE FLORIDA DEPARTMENT OF HEALTH a APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PEFI T i Permit Application Number " \ - -- - - - - -- - PART II ITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. r 'BARE MOPERTINEN'FEATURES ONAOJACENT PR�[,'SA�ORRAACROSSSSTTHE STREcTTHATMAYBI otes: Si nafu Site Plan submitted by: �Q „ .,�� ...,: r,� , � ,�fi.DELL SM ! �y�� "`�°°� Title Plan Approved 9Not Approved Date 1. I 7 //. By County Health Department- ALL CHANGES MUST,BE APPROVED SY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4 )16 which may be itsed) (Stock Number. 5744- 002 - 40156)