PL-14-937Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number. INSP- 213505 Permit Number: PL -5 -14 -937
Scheduled Inspection Date: June 17, 2014
Inspector. Diaz, Osvaldo
Owner: NUNES, ALINA
Job Address: 775 NE 97 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: JASON'S SEPTIC INC
Permit Type: Plumbing - Residential
inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132060142330
Phone: 305 -252 -1080
Building Department Comments
NEW DRAIN FIELD
Infractio 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
HRS IN FILE
June 17, 2014
For Inspections please call: (305)762 -4949
Page 23 of 45
For: Building Department - Miami Shores
Fax number: 305 -756 -8972
From: Jason's Septic, Inc.
Fax number; 305- 252 -5765 /
Date: b/ 2,/ / c{
Regarding: Final Inspection
Number of pages: 4/
Comments: Please see attached DOH approval for final
inspection at the following property:
Atina Nunez
775 NE 97 St
Permit No.: PL -14 -937
Please let me know if this has been approved so I
can turn in the BOND paperwork.
305 -252 -1080
Thank you,
Lori
ck
■
J
4
STATE OF FLORIDA
DEPARTMENT OF WEALTH
ONSITE SEA TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: AIina Nunez
AGENT: Jason Septic
PROPERTY ADDRESS: 775 NE 97 St Miami, FL 33138
LOT:
SUBDIVISION:
Miami Shores Sec 3
APPLICATION 8: API 143200
wax= 8 :13- SG-1532742
DOCUMENT 8:F1955695
DATE RAID: 04/1 4/2 0 14
FEE mum :200.00
RECEIPT #:1 3 -P 1 D- 2373939
BLOCK: !A
IDB: 114208-014-2330
CHECKED [X] ITBME ARE NOT IN tOmPLIANCE WITH STATUTE OR ROLE AND MUST BE CORRECTED.
1
3
3
]
3
1
1
1
3
1
1
3
1
3
3
1
3
3
3
TANif INSTALLATION
[01]
[02]
(033
[043
[05]
(06]
[07]
[08]
[09]
TANK SIZE [1] 1050.00 [2]
TBBX MATERIAL
OUTLET DEVICE
MULTI- [ Y / N ]
OUTLET FILTER
Concrete
LED 1. 01- 01M1 -Q314
WATERTIGHT
LPL
DEPTH TO LTD
2.
DRAINFTELD INSTALLATION
[101 AREA [1] 228 [2] SQFT
DISTAIRUTION BOX HEADER X
NUMBER OF DRA/NLINES 1. 4.00 2.
[3.1]
[12]
[131
[143
[131
[16]
117]
[18]
[19]
[201
[21]
DRA1NL1NE SEPARATION
DRAINLINE SLOPS
DEPTH OF COVE
NATION [ RB0VE /
SYSTEM LOCATION
DOSUI4 PUMPS
AGGREGATE sxzE
AGGREGATE EXCESSIVE FINES
AGGREGATE DEPTE
BELOW
] B14 58.53
FILL / EXCAVATION MATERIAL
[22 ] FILL ANCUNT
[23] WILL RR•'XTURE
[24] EXCAVATION DEPTE
[25] AREA REPLACED
[26] REPLACEMENT MATERIAL
Counts: Comments are on page 2.
CONSTRUCTION [
FINAL $I$TH4
SETBACKS
[27] SURFACE WATER
[28] DITCHES
[29] PRIVATE WELLS
[30] PUBLIC WELLS
(313 IRRIGATION WELLS
[32] POTABLE RATER
[33] BUILDING FOUNDATIONS
[34] PROPERTY LINES
(35] OTHER
PILLB= / MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
[39] STABILIZATION
20
2
FT
FT
rT
FT
FT
FT
5 FT
FT
FT
ADDITIONAL maramerIcB
(40] UNOBSTRUCTED AREA
[41] STORMSATER RUNOFF
[421 ALARMS
[43] MAINTENANCE AGREEMENT
[441 BUILDING AREA
[43] LOCATIONT CONFORMS WITH SITE PLAN
[461 FINAL SITE GRADING
1471 CONTRACTOR Jason NBSBnman (Jason "s 8
[48] OTHER INFILTRATOR Quiok4 Standard ChB
ABANDONMENT
[49] TANK PtD
[30] TANK CRUSHED & FILLED
I mammal
�
APPROVED
(ana +gAtion of Violations on
/ DISAPPROVED 7;
folloriag page)
DE 4016, 08/09 (Obsoletes all previous editions
Incorporated: 64E- 6.003, FAC
EH Database v 1.0.1
001532742
Page 2 of 3
4
STATE OF FLORIDA
DEPARTMENT Or HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICATION #: AP1143290
mem 41:13- SC-1532742
Docut r #: F1955695
DATz RAID 04/14t2014
ENE pt :200.00
AZCZ=P2 #:13 -PID- 2373939
Violation Number
cannsat
Comments
19 Quick -4.
The system is sized for 3 bedrooms with a maxsnum occupancy of 6 persons (2 per bedroom), for a total emanated flow of 400
9pd•
Da 4016, 09/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E- 6.003, PAC
EH Database v1.0.1
AP1143200
81D1532742
Page 2 of 3
A\AO
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PRONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
MAY 0 8 2014
FBC2010
Permit No.
Master Permit No. I L — 013 ---
Permit Type: PLUMBING
JOB ADDRESS: 7 7 5 AI 9 7 Si'
City: Miami Shores County: Miami Dade
Folio/Parcel#: // 3a"D(p C') I U 2r 3 'DC7
Is the Building Historically Designated: Yes NO i. Flood Zone:
OWNER Name (Fee Simple Titleholder): 4/, /1 GL N U/It Phone#:
Address: -1 cj /`.1 F 2 7 5+
City: MtciLAi S l reA State: FL .
v, /38
Tenant/Lessee Name: —
Finail•
Zip:
Phone#:
CONTRACTOR: Company Name: /ci 3 ()t S Sep
Address: /3 / ,STAJ 8 0V--12_.
Phone#: 20,5 (( O
State Certification or Registration #:
O03f
Contact Phone#: :tpc Z5S'2s I 0 C' Email Address:
DESIGNER: Architect/Engineer:
Zip: 33 I q-Cto
Phone#:, / < ) Q
Certificate of Competency #:
Value of Work for this Permit: $ 9's CT Square/Linear Footage of Work: O S c 1)l-F
Type of Work: DAddress OAlteration
Description of Work:
/l./e CifrCu 11 C�•
ONew 7 :' /Replace ODemolition
x******* ** * * * *** * ** * *** * * * * * * * * * ** *wy,* Fees************* * * * * * * * *r ** * * * * * * * * ** * * * * * * * * **
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ l I �• j `
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 inspectio % , ccurs seven (7) days after the building permit is issued. In the absence of such posted ce, the
inspection will no a approved a reinspection fee will be charged.
Signature
Owner or Agent
The fore oing instrument was acknowledged be
day of
who is personal y known to me or
by
i ;iii
Mir 4iir r eir
, iO s : • rt -1
SF
ntractor
instrument was acknowledged before me this 7
20 , by Jf )/? �%e/e/I / /ZO(
ho 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:
** *+ k****+ F***************** M**M ******************************** ***+M**** **************** ** ******* *** ** ***P****
APPROVED BY C �S� el-7y_ Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07 /10/07XRevised 06/10O2009)(Revised 3/15/09)
RE
HEALTH DEPARTMENT
kAIAMbDADE cow l°
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT.
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Alina Nunez
PROPERTY ADDRESS: 775 NE 97 St Miami, FL 33138
LOT: 7
CI en+
PERMIT #: 13-SC-1532742
APPLICATION #:API 143200
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR938417
BLOCK: 70 SUBDIVISION: Miami Shores Sec 3
PROPERTY ID #: 11- 3206 -014 -2330
[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 [
A [
N [
K [
1,050 ] GALLONS / GPD
] GALLONS / GPD
] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY
existing septic tank
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ 225 ] SQUARE FEET trench configuration drainf SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD ( ] FILLED
I CONFIGURATION: [x] TRENCH I ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 11.73' NGVD
[ ] MOUND
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
] INCHES
29.20 ] (I INCHES I FT ] [ ABOVE /) BELOW b BENCHMARK /REFERENCE
[ 61.28 ] [) INCHES r FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE
EXCAVATION REQUIRED: [ 44.00] INCHES
POINT
POINT
1.- Existing 1050 gal. septic tank, certified by Jason's Septic on 03/24/2014, to remain.
2. -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.
3.- Install 225 sf of drainfield in trench configuration.
4.- Install 12" of slightly limited soil at the bottom of the drainfield.
5.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
(Comments Continued on Page 2.)
SPECIFICATIONS
APPROVED BY:
DATE ISSUED:
DH 4016, 08/09
Incorporated:
BY: Jason A Nesenman
TITLE:
aem2zaz lC TITLE: Engineering Specialist II
Erlaade anises
05/02/2014
(Obsoletes all previous editions
64E- 6.003, FAC
v 1.1.4
which may not be used)
The contractor or designee) is required tePtYirl=f4rAfsoll
boring adjacen5Mh$4drainfield excavation at the time of final
inspection. Prior tc Final Approval, the FDOH inspector shall
witness the soil boring 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.
AP1143200
Dade CHD
EXPIRATION DATE: 07/31/2014
,r
noculaN # : PR938417
6. -Invert elevation of drainfield to be no Tess than 7.12' NGVD.
7. -Bottom of drainfield elevation to be no less than 6.62' NGVD.
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.
""THIS REPAIR PERMIT IS NOT FOR ANY ADDITIONS'"'
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 altemative 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.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Aline Nunez
CONTRACTOR / AGENT:
LOT: 7
SUBDIVISION;
APPLICATION # AP1143200
PERMIT # 13-SC- 1532742
DOCUMENT # SE927614
Jason Septic
Miami Shores Sec 3
BLOCK: 70
ID #:11- 3206 - 014 -2330
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST
PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: ()C]YES [ ]NO
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY
AUTHORIZED SEWAGE FLOW: 518.00 GALLONS PER DAY
UNOBSTRUCTED AREA AVAILABLE: 600.00 SQFT
BENCHMARK /REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE
FFE 11.73' NGVD
29.20 II INCHES
NET USABLE AREA AVAILABLE: 0.21 ACRES
[ / OTHER -TABLE 2 ]
RESIDENCES- TABLE1
1500 GPD /ACRE OR
UNOBSTRUCTED AREA REQUIRED:
2500 GPD /ACRE 1
338.00
SQFT
/ FT ] [ ABOVE /
BELOW
] BENCHMARR /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET: [ ]YES [ ]NO
WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON- POTABLE: N/A FT
BUILDING FOUNDATIONS: 7 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 20 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
SOIL PROFILE INFORMATION SITE 1
[ ]YES [X]NO
FT( MSL /
USDA SOIL SERIES:
Munsell # CColor
Urban land
Texture
Depth
10YR 5I1
Sand
0 To 20
10YR 8/3
Oolitic Limestone
20 To 72
NGVD
10 YEAR FLOODING? [ ]YES [X]NO)
] SITE ELEVATION: 9.29 FT I MSL /
SOIL PROFILE INFORMATION SITE 2
NGVD
USDA SOIL SERIES:
Munsell #/Color
Urban land
Texture
1
Depth
10YR 5/1
Sand
0 To 20
10YR 8/3
Oolitic Limestone
20 To 72
OBSERVED WATER TABLE: INCHES (ABOVE / BELOW ] EXISTING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 69 INCHES [ABOVE /
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO
BELOW
[ PERCHED /
EXISTING
DEPTH:
APPARENT
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: Replacement4 -FS /0.80 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [g] TRENCH [ ] BED [ ] OTHER (SPECIFY)
f
REMARKS /ADDITIONAL CRITERIA
GRADE
INCHES
44 INCHES
SITE EVALUATED BY:
Nesenman, Jason (Title:) (JASON "s)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E- 6.001, FAC
DATE: 03/24/2014
Page 3 of 4
AP1143200 E1D1532742 v 1.0.2