RC-13-1656 (5) s
PERMIT #: 13-SC-1499972
APPLICATION #:AP1123086
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
K s DOCUMENT #: PR921703
J
NSTRUCTION PERMIT FOR: OSTDS New
)PLICANT: (R ANDREW DE PASS JTRS WILLIAM J JURBERG JTRS) �� 6 u
OPERTY ADDRESS: 9350 NE 12 Ave Miami, FL 33138
LOT: BLOCK: SUBDIVISION:
PROPERTY ID #: 11-3025-007-0150 [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 [ 1,350 ] GALLONS / GPD Septic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 725 ] SQUARE FEET SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: C/L of NE 12 Ave&East P/L Elev+8.90
I ELEVATION OF PROPOSED SYSTEM SITE [ 4.80 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 34.80 ] [ INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES
1"Install a 1350 gal min.septic tank with an approved filter.
O 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
T wi'h s.64E-6.013(3)(f), FAC.
3YInstall 725 sf of drainfield in bed configuration.
H 4.-Install 42"of slightly limited soil at the bottom of the drainfield.
E 5.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed.
6-Invert elevation of drainfield to be no less than 6.50'NGVD.
F_
! SPECIFICATIONS BY: W a TITLE:
Engineering p
TITLE: En in g
APPROVED BY: g' Specialist II Dade CHD
'- 1Colel P GLmbe
DATE ISSUED: 11/08/2013 EXPIRATION DATE: 05/08/2015
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
Y 1.1.d A� actor(or�esign@041"Wired to perform a soil
boring adjacent to the drainfield excavation at the time of final
inspection.Prior to Final Approval,the FDOH inspector shall
witness the soil boring and compare the results to the original
site evaluaticn submitted. A reinspection fee will be assessed
if the Contractor is not at the icbsite at the arranged time.
DOCUMENT #: PR921703
7.-Bottom of drainfield elevation to be no less than 6.00'NGVD.
The system is sized for 5 bedrooms with a maximum occupancy of 10 persons(2 per bedroom),for a total estimated flow of
580 gpd.
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.
1
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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.
1
STATE OF FLORIDA APPLICATION # AP1123086
DEPARTMENT OF HEALTH PERMIT # 13-SC-1499972
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE912352
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: R ANDREW DE PASS JTRS WILLIAM J JURBERG JTRS
CONTRACTOR / AGENT: Cherokee Consulting, Inc
BLOCK:
JBDIVxsxON: ID#: 11-3025-007-0150
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: 0.52 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 580 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 1299.99 GALLONS PER DAY ( 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1105.00 SOFT UNOBSTRUCTED AREA REQUIRED: 1088.00 SOFT
BENCHMARK/REFERENCE POINT LOCATION: C/L of NE 12 Ave&East P/L Elev+8.90
ELEVATION OF PROPOSED SYSTEM SITE 4.80 [FINCHES]/ FT ] [ ABOVE / BELOW ] BENCHMARK/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 [X]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: 40 FT POTABLE WATER LINES: 50 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT [ MSL / NGVD ] SITE ELEVATION: 8.50 FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES: Urban land USDA SOIL SERIES: Urban land
Munsell#/Color Texture Depth Munsell#/Color Texture Depth
10YR 3/2 Sand 0 To 12 1 OYR 3/2 Sand 0 To 12
10YR 8/1 Oolitic Limestone 12 To 72 10YR 8/1 Oolitic Limestone 12 To 72
OBSERVER WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 60 INCHES [ ABOVE /EEI EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES IX]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-S,CS, LCS/0 DEPTH OF EXCAVATION: 72 INCHES
DRARNFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
1
SITE EVALUATED BY: DATE: 10/10/2013
Groce,Ken(Title:)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1123086 EID1499972 v 1.0.2
Village of Miami Shores
Building & Zoning Department
10050 NE 2nd Avenue
Miami Shores, FL 33138
NOTICE TO VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT
OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER
THE FLORIDA BUILDING CODE
I, (We)have been retained by Mr.William Jurberg to perform special inspector
services under the Florida Building Code 2010 at the New Addition project on the below listed
structures as of 8-26-2013 (date).I am,a registered architect or professional engineer
licensed in the State of Florida.
PROCESS NUMBERS: RC13-1656 Address: 9350 NE 12 AVE,MIAMI FL
❑SPECIAL INSPECTOR FOR PILING,FBC 1822.1.20(R4404.6.1.20)
0 SPECIAL INSPECTOR FOR TRUSSES OVER 35FT LONG OR 6FT HIGH 2319.17.2.4.2
0 SPECIAL INSPECTOR FOR REINFORCED MASONRY,FBC 2122.4(R4407.5.4)
0 SPECIAL INSPECTOR FOR STEEL CONNECTIONS,FBC 2218.2 (4408.5.2)
❑✓ SPECIAL INSPECTOR FOR SOIL COMPACTION,FBC 1820.3.1 (R4404.4.3.1
❑SPECIAL INSPECTOR FOR PRECAST UNITS &ATTACHMENTS FBC 1927.12
❑SPECIAL INSPECTOR FOR LIGHTWEIGHT INSULATING CONCRETE FBC 1917.2
0 SPECIAL INSPECTOR FOR HAMBRO SYSTEM
Note:Only the marked boxes apply.
The following individual(s)employed by this firm or me are authorized representatives to perform inspection
1. Nicolas Fernandez, B.S. 2. Abilio Martin, B.S.
3. 4.
`Special Inspectors utilizing authorized representatives shall insure the authorized representative is qualified by
education or licensure to perform the duties assigned by the Special Inspector. The qualifications shall include
licensure as a professional engineer or architect,graduation from an engineering education program in civil or
structural engineering,graduation from an architectural education program;successful completion of the NCEES
Fundamentals Examination;or registration as building inspector or general contractor.
I,(we)will notify Miami-Dade County Building Department of any changes regarding authorized personnel
performing inspection services.
I,(we)understand that a Special Inspector inspection log for each building must be displayed in a convenient
location on the site for reference by the Miami-Dade County Building Department Inspector.All mandatory
inspections,as required by the Florida Building Code,must be performed by the County.The County building
inspections must be called for on all mandatory inspections. Inspections performed by the Special Inspector
hired by the Owner are in addition to the mandatory inspections performed by the Department. Further,upon
completion of the work under each Building Permit I will submit to the Building Inspector at the time of final
inspection the completed inspection log form and a sealed statement indicating that,to the best of my
knowledge, belief and professional judgment those portions of the project outlined above meet the intent of the
Florida Building Code and are in substantial accordance with the approved plans.
r
�.�� NO® C ''i, Engineer/Architect Name: Antonio Canelas
"I ��.•'•\G E/VSe�'Address: 7805 SW 24th ST,MIAMI FL 33155
Signed and Sealed Q•: �' �` '.-�
No. 74099 • N
Date: 8-26-2013 phpne: (305)261-0321
ST ;
� . ANAI'E OF Q
OR IV
"11rrtiii1►0
CESAR M. CAVO A.I.A.
a r c h i t e c t
4906 Campo Sano Ct.
Coral Gables,FL33146
Phone(305)740 7929
Fax (305)740 7929
Response to Comments
Tuesday,December 17,2013
To:Village of Miami Shores
Building Department
10050 N.E.2 Ave
Miami Shores, FL 33138
Re:9350 NE 12 Ave
Miami,FL 33138
Buiiding/Structural Department Comments:
1. Refer to revised sheet S-1,Note No. 1-A and Soil Statement with the information of the Geotechnical Report.
Furthermore the contractor need to follow instructions indicated on this report.,
2. Refer to revised Elevation Certificate.
3. There are no wall.It's a freestanding bookcase dividing both spaces.Refer to Sheet A-1.1 keynote 1-05.
4. Refer to revised sheet A-4.
5. General contractor to coordinate construction of pool before installation of wood deck.
6. Refer to new sections 1 &2 on Sheet S-5.
7. This area shall be protected by a permanent screen enclosure.
8. Refer to revised Sheet S-0 Note 1-D.
9. Second floor windows consist of three panels:two fixed panels at top&bottom and one operable at the middle.
The bottom of the operable panel is at 36"A.F.F.
10. Refer to revised Floor Plan keynote 107 at sheet A-2.1.
11. Refer to new sheet A-8.
12. Refer to new sheet A-8.
13. Refer to all revised architectural and structural sheets.
14. Refer to roof details on sheet A-8 and wall sections on A-7.
15. Refer to revised wall sections on Sheet A-7
Should you have any questions,or need additional information,please do not hesitate to contact me.
Sincerely
Cesar M.Cano
M
CesarM.Cano A.I.A.
State of Florida
Registration#4929
Page 1 of 1
Y
MIAMI MIAMI-DADE COUNTY
PRODUCT CONTROL SECTION
DEPARTMENT OF PERMITTING,ENVIRONMENT,AND REGULATORY 11805 SW 26 Street,Room 208
AFFAIRS(PERA) Miami,Florida 33175-2474
BOARD AND CODE ADMINISTRATION DIVISION T(786)315-2590 F(786)31525-99
NOTICE OF ACCEPTANCE (NOA) www.miamidade.eov/sera
GAF Material Corporation
1361 Alps Road
Wayne,NJ 07470
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction
materials.The documentation submitted has been reviewed and accepted by Miami-Dade County PERA
-Product Control Section to be used in Miami Dade County and other areas where allowed by the
Authority Having Jurisdiction(AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami-Dade County
Product Control Section (In Miami Dade County)and/or the AHJ(in areas other than Miami Dade
County) reserve the right to have this product or material tested for quality assurance purposes. If
this product or material fails to perform in the accepted manner, the manufacturer will incur the
expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such
product or material within their jurisdiction. PERA reserves the right to revoke this acceptance,if it
is determined by Miami-Dade County Product Control Section that this product or material fails to
meet the requirements of the applicable building code.
This product is approved as described herein,and has been designed to comply with the Florida Building
Cale including the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION:VersaShide Fare Resistant Roof Ikxk Protection and VersaShieldo Solo Fire
Resistant Slip Sheet
LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state
and following statement_-"Miami-Dade County Product Control Approved",unless otherwise noted
herein_
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has
been no change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or
change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an
endorsement of any product,for sales,advertising or any ether purposes shall automatically terrninatt-
this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of
Af VH.
ADVERTISEMENT: The TOA number preceded by the words Miami-Mde County, Florida; and
followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is
11iJ1Jia1.YC� "IC11 a 311.1.11 1YC U011C 111 11.5 C11i11Ciz.
INSPEC"ON o A copy of this entire NOA shall be provided to the user by the manufacturer or its
distributors and shall be available for inspection at the job site at the request of the Building Official-
1 dih.'v l dbdt7i hA AA.003 ai——V'LaC-Z l �,I♦t— Y Ad`dA1..l A V-*u"AU 0.UA.,3Aaka U1 pa'L.�-3 iILn1il 4'"V-AA:.
1 fit:SUI>IMUCU UUlMU111C111Ation was reviewcu oy Jorge L.AccoU.
)ADE )W Expiration Date. OZO7117
ROOFING COMPONENT APPROVAL
Category: Roofing
• Sub-Category: Underlayment
Material: Fiberglass
SCOPE:
This acceptance is for VersaShield®Fire Resistant Roof Deck Protection(a.k.a"VersaShield®
Underlayment")and VersaShield®Solo Fire Resistant Slip Sheet(a.k.a"VersaShield Solo"),as described
in this Notice of Acceptance,for use with approved prepared roof assemblies.Designed to comply with
the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building Code.
PRODUCT DESCRIPTION:
Product Dimensions Test Product
Specification Description
VersaShield®Fire 42"x 100' rolls ASTM D 226 Type II Non-Asphaltic fiberglass-based
Resistant Roof Underlayment and/or fire barrier.
Deck Protection
VersaShield®Solo 72"x 166.7' rolls UL790 Non-Asphaltic fiberglass-based slip
Fire Resistant Slip sheet and/or fire barrier.
Sheet
MANUFACTURING LOCATION:
1. Conover,NC
EVIDENCE SUBMITTED:
Test Agency Test Identifier Test Name/Report Date
PRI Construction Materials GAF-270-02-02 ASTM D 226 11/15/10
ELK-063-02-01 TAS 100 09/27/01
Underwriters Laboratories Inc. 99NK45831 UL790 03/21/00
l ONK 11990 UL790 05/18/11
R19254 ASTM D 226 09/13/01
08CA37926 UL790 09/23/09
08CA49140
PRI Asphalt Technologies,Inc. ELK-069-02-01 TAS 100 03/04/02
BRY-003-02-01 TAS 117(B) 03/19/02
BRY-003-02-01 TAS 114(H)
INSTALLATION:
1. VersaSbieldo Fire Resistant Roof Deck Protection or VersaShield®Solo Fire Resistant Slip Sheet
shall be installed in strict compliance with applicable Building Code.
2. VersaShield'Fire Resistant Roof Deck Protection or VersaShield®Solo Fire Resistant Slip Sheet
shall be installed with a minimum 4-inch head lap in a shingle layer fashion.
3. VersaShield®Fire Resistant Roof Deck Protection shall be mechanically fastened with approved
fasteners in compliance with Florida Building Code 1518.2 when used in lieu of a code prescribed
ASTM D 226 Type 11 underlayment.
NOA No.: 11-1110.09
Expiration Date: 02/07/17
MIAM4DAD;COUNTY Approval Date: 01/26/12
Page 2 of 3
i
LIMITATIONS:
. 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials
Directory for fire ratings of this product
2. This acceptance is for prepared roofing applications. Minimum deck requirements shall be in
compliance with applicable building code.
3. VersaShielde Fire Resistant Roof Deck Protection shall not be left exposed as a temporary roof for
longer than 30 days of application.VersaShield®Solo Fire Resistant Slip Sheet shall not be left
exposed to the weather.
4. VersaShield®Fire Resistant Roof Deck Protection and VersaShield® Solo Fire Resistant Slip Sheet
are a component used in roof assemblies. Roof assemblies are approved under specific assembly
Notice of Acceptance.
5. VersaShield® Fire Resistant Roof Deck Protection or VersaShield®Solo Fire Resistant Slip Sheet
may be used with any approved roof covering Notice of Acceptance listing. VersaShield® Fire
Resistant Roof Deck Protection or VersaShield® Solo Fire Resistant Slip Sheet may be used as a
component part of an assembly in the Notice of Acceptance. If VersaShield® Fire Resistant Roof
Deck Protection or VersaShield Solo Fire Resistant Slip Sheet is not listed,a request may be made
to the Authority Having Jurisdiction(AHJ)or the Miami-Dade County Product Control Department
for approval provided that appropriate documentation is provided to detail compatibility of the
products,wind uplift resistance,and fire testing results.
6. VersaShield® Fire Resistant Roof Deck Protection and VersaShield®Solo Fire Resistant Slip Sheet
are a non-asphaltic underlayment that may be used as a fire barrier for prepared roof assemblies.For
fire classification of specific roof assemblies using VersaShield® Fire Resistant Roof Deck
Protection or VersaShield® Solo Fire Resistant Slip Sheet refer to a current Approved Roofing
Materials Directory for fire ratings of this product.
7. All products listed herein shall have a quality assurance audit in accordance with the Florida
Building Code and Rule 9N-3 of the Florida Administrative Code
LABELING:
All packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo and
yellow line to identify the ASTM Standard designation; or logo and the following statement: "Miami-
Dade County Product Control Approved" or the Miami-Dade County Product Control Seal as shown
below.
MIAMI•DADE COUNTY
BUILDING PERMIT REQUIREMENTS:
Application for building permit shall be accompanied by copies of the following:
1. This Notice of Acceptance.
2. Any other documents required by the Building Official or applicable building code in order to
properly evaluate the installation of this material.
END OF THIS ACCEPTANCE
NOA No.: 11-1110.09
Expiration Date: 02/07/17
MIAMhDAD;COUNTY Approval Date: 01/26/12
Page 3 of 3