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PL-14-1375• Miami Shores Village=RE Building Department10050 N.E.2nd Avenue, Miami Shores, Florida 33138Tel: (305) 795-2204 Fax: (305) 756-8972INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING !waster Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL MN PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 839 NE9q`7 5,7 City: Miami Shores County: Miami Dade Zin: Folio/Parcel#:11-3206-014-2610 Is the Building Historically Designated: Yes No X Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): EDUARDO BECERRA Phone#: Address: 839 NE 97 ST city: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email• CONTRACTOR: Company Name: SOUTHERN SEPTIC Phone#: 305 598-8266 Address: 1421 SW 153 PATH City: MIAMI State: FL Zip: 33194 Qualifier Name: ROBERTO RODRIGUEZ Phone#: 305 598-8266 State Certification or Registration #: SR 0021421 Certificate of Competency #: DESIGNER: Architect/Engineer: N/A Phone#: Address City: State Zip: Value of Work for this Permit: $ 2000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New © Repair/Replace Description of Work: REPLACE DAMAGED SEPTIC TANK AND DRAIN FIELD Specify color of color thm ❑ Demolition Submittal Fee $ Permit Fee $ � CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (RevisedO2/24/2014) Bonding Company's Name (if applicable) N/A Bonding Company's Address city State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 commencement must be pasted 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. (�� /' 1 \ Signature.f e/%9 G!7 -� Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of . 20 , by r C� u u ✓ CCU 6i Cr' C/who is personally known to The foregoing instrument`was acknowledged before me this '2 7 day of J (-V'j, . 20 1 '--1 , by `Z v [ k YE t k06 Z who is personally known to me or who has produced as me or who has produced Identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: V6[1(-6-(-1 as Identification and who did take an oath. NOTARY PUBLIC: Sign: 0 Print: _ `� f (� O Seal:1..04521� JANET VALLECILL0 Seal: a Notary Public -State of FlOr(da "s off: My Comm. Exrw�, Mar 27, 2016 '''•- Commission 9 EE +93586 APPROVED BY 4.2,e t Y Plans Examiner Structural Review (Revised02/24/2014) 1ANET VALLEcILLO Notary Public - State of Florida My Comm' Expires Mar 27.201, rnn....,__. Zoning Clerk 0 MIAMI-DADE COUNTY HEALTH DEPAR74Fi r STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Eduardo Becerra PROPERTY ADDRESS: 839 NE 97 St Miami, FL 33138 LOT: 17-18 BLOCK: 73 SUBDIVISION: PROPERTY ID #: 11-3206-014-2610 CI tern PERMIT #:1;3 -SC -1545765 APPLICATION #: AP1151322 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #TR943467 Miami Shores Sec 3 [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 T [ 1,050 1 GALLONS / GPD septic tank CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY { ]GALLONS @[ ]DOSES PER 24 HRS #Pumps D [ 400 7 SQUARE FEET bed confiquration drainfiel SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND I CONFIGURATION: [ ] TRENCH [xl BED I ] N F LOCATION OF BENCHMARK: FFE 12.1 T NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 25.307[ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE 161.327[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D E O T H E R ILL REQUIRED: L ] INCHES EXCAVATION REQUIRED: L 4t1.UU J 1Nl;tizb 1: Install a 1050 gal min. septic tank with an approved filter. 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 400 sf of drainfield in bed 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 BY: Roberto Rodriguez APPROVED BY: DATE ISSUED Erlande 0misca 06/25/2014 TITLE: TITLE: Engineering Specialist II Dade CHD EXPIRATION DATE: 09/23/2014 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 AP1131322 _ C:��4br?,� i_1,,;�� i f 1 i it",f•:i''n ii c. 5:=iii �i"CL DOCUMENT #: PR943457 6. -Invert elevation of drainfield to be no less than 7.50' NGVD. 7. -Bottom of drainfield elevation to be no less than 7.00' NGVD. 8. -This permit includes the abandonment of the existing septic tank. The system is sized for 4 bedrooms with a maximum occupancy of 8 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 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. STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: Eduardo Becerra CONTRACTOR / AGENT: Southern Septic LOT: 17-18 BLOCK: 73 SUBDIVISION: Miami Shores Sec 3 ID#: 11-3206-014-2610 APPLICATION # API 151322 PERMIT # 13 -SC -1545765 DOCUMENT # SF932146 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: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.32 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCE S-TABLEI / OTHER -TABLE 2 ] AUTHORIZED SEWAGE FLOW: 800.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ] UNOBSTRUCTED AREA AVAILABLE: 1000.00 SQFT UNOBSTRUCTED AREA REQUIRED: 600.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: FFE 12.11' NGVD ELEVATION OF PROPOSED SYSTEM SITE 25.30 [ INCHES / FT ] [ ABOVE / FLOW ] BENCMOXK/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: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 40 FT SITE SUBJECT TO FREQUENT FLOODING? [ LYES [X]NO 10 YEAR FLOODING? [ ]YES IXIN0j 10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL / FGVD ] SITE ELEVATION: 10.00 FT [ MSL / FNTvq Cf%TT. 10`0e% +TT.7.. TNATtt1MA FTAN eTTF. 1 SOIL PROFILE INFORMATION SITE 2 USDA SOIL SERIES: Urban land Munsell #/Color Texture Depth 1 OYR 4/1 Sand 0 To 56 1OYR 8/3 Oolitic Limestone 56 To 72 USDA SOIL SERIES: Urban land Munsell #/Color Texture Depth 10YR 4/1 Sand 0 To 54 10YR 8/3 Oolitic Limestone 54 To 72 OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ] ESTIMATED WET SEASON WATER TABLE ELEVATION: 84 INCHES [ ABOVE / BELOW ] EXISTING GRADE HIGH PLATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.60 DEPTH OF EXCAVATION: 48 INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY) REMARKS/ADDITIONAL CRITERIA SITE EVALUATED BY: DATE: Rodriguez, Roberto (Title:) (Southern Septic Conbactom, Inc.) DH 4015, 06/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC 06/23/2014 Page 3 of 4 AP1161322 H1131545766 v 1.0.2