PL-16-1757 Scheduled Inspection Date: June 29,2016 Permit Type: Plumbing- Residential
Inspector: Hernandez, Rafael P Inspection Type: Final
Owner: GARBER, DOUGLAS PL (6— iq 94 Work Classification: Septic
Job Address:53 NE 107 Street
Miami Shores, FL Phone Number
Parcel Number 1121360070370
Project <NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS Phone: (954)963-0082
Building Department Comments
REPLACE SEPTIC TANK AND DRAINFIELD. Inhactlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS APPROVAL IN FILE
Failed
Correction
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
ti-1761
Miami Shores Village P rrn 7)+ I�lumbing eSI, Will,
�n 10050 N.E.2nd Avenue NEP" Wi 3 � 3eC
PU
Miami Shores,FL 33138-0000
tfrtr �ts 'Ro113' .
� c Phone: (305)795-2204 ..
� .
Issu taat�rf, 412016,41 Expiration: 1212112016
Project Address Parcel Number Applicant
53 NE 107 Street 1121360070370
Miami Shores, FL Block: Lot: DOUGLAS GARBER
Owner Information Address Phone Cell
DOUGLAS GARBER 53 NE 107 ST
MIAMI SHORES FL 33161-7029
Contractor(s) Phone Cell Phone Valuation: $ 4,000.00
STATEWIDE SEPTIC CONNECTIONS (954)963-0082
Total Sq Feet: 225
Type of Work:REPLACE SEPTIC TANK AND DRAINFIELD. Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:
HRS Approval
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# PL-6-16-60318
CCF $2.40
DBPR Fee $4.50 06/24/2016 Credit Card $774.40 $50.00
DCA Fee $4.50 06/23/2016 Check#:5096 $50.00 $0.00
Education Surcharge $0.80 Bond#:3120
Permit Fee $300.00
Scanning Fee $9.00
Technology Fee $3.20
Total: $824.40
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in complian�ce with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this P"rmit 1 assume responsibility for all work done by either myself, my agent, servants, or employes. understand that separate permits are
required for EL TRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AF ID AJi
T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a d ng. Futhermore,I authorize the above-named contractor to do the work stated.
1, June 24, 2016
Authe%rizeSignature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 24,2016 1
Miami Shores Village
JU123Z016 p
V' Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 -A
FBC 20(1
BUILDING Master Permit No.B'( G—I�S;�
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
PLUMBING [:] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
r CONTRACTOR DRAWINGS
106 ADDRESS: O� �T
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE::j
OWNER:Name(Fee Simple Titleholder): S Phone#:+ �3/zla
Address: b� �. )01-) - -
City: % Ci State: c ,Zip: Q
Tenant/Lessee Name: Phone#t
Email:
C
CONTRACTOR:Company Name: �c , (�✓TJ Phone#1:� )
Address: i B0 0 N to
City: DOG Loct 0 State: Zip: 33 0
Qualifier Name: Terms ae r -,O" Phone#:
State Certification or Registration#:�M'cc, Z6'- Certificate of Competency#:
DESIGNER:Architect/Engineer: Pho
Ad Ity: State: •` Zip:
Valu of Work for this Permit:$ Square/Linear Footage of Work• ��
R
Ty f Work: ❑ Addition.. 0 Aiterafion ❑ New Repair/Replace ❑ Demolition
Des ion of Work: ., :.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ C /CC$ r r,�
Scanning Fee$ 00 Radon Fee$ ` ® DBPR$ LJ N tary$
Technology Fee$ �"® Training/Education Fee$ ® ' Double ee$
Structural Reviews$ Bond$�1 CO� -03
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Sgnat i reCSignature G scitc
�
u
WNER or AGENT CONTRACTOR
The foregoing instrume t was acknowledged before me this The foregoing instrument was acknowledged before me this
Z { day of 20 I � ,by 2 i day of1i)�. .20 16 ,by
who is personally known to �►��� J�<�( ho Is personally known to
me or or who has produced as me or who has produced as
identification and h� a an ogh,. identification and - PI
ao4 os r n ,04 I
r• • = `e:•s JLRhi„A L ARM'i r:JNG
Nuia,y PuLuc •State of Florida "°'s PUBLIC-
Notary Puhli„ `;'ate of Florida
NOTARY PUBLIC: ;•: NOTARY PUBLIC:
;g • Commission a '97589 a• _ y
P' Commission a Fr 47589
Comm. Esp,ics reb 9,2019 .. �•
" ' Qui►Comm. Y^Ire. 9,201$ '-
It
Sign: Sign:
Prin • r 1 �• Pri 1
Seal: Seal:
ii!!#8!!i8!!l8888818888881!!88!l8888888li8!!i!i!i#i#!84l888888!!iilii8ilii8888#!!8#8#i##8i8i84iili8lii#8i#i#
APPROVED BY �l Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
14.
b",IAMI-RADE COUMY tiEd4 TH DEPARTMENT
PERMIT #:13-SC-1688392
STATE OF FLORIDA APPLICATION #:AP 1243694
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #TRI
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Douglas Garber
PROPERTY ADDRESS: 53 NE 107 St Miami,FL 33161
LOT: 13 BLOCK: 210 SUBDIVISION: Dunnings Miami Shores Ext#3
PROPERTY ID #: 11-2136-007-0370 [SECTION, TOWNSHIP, RAXGE, 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, E.A.C. DEPARTMENT APPROVAL OF Sy
TEM 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 A.PPLSCANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD septictank 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 [ 225 ] SQUARE FEET trench configuration drainf SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: crown of road 10.12'NGVD _
I ELEVATION OF PROPO'SBD SYSTEM SITE [ 0.36 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 47.64 ] [ INCHE3 FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ 60.001 INCHES
**RE-ISSUE of repair permit AP1210485-R**
° 1.-Install a 900 gal min.septic tank with an approved filter.
T 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
H with s.64E-6.013(3)(%,FAC.
3.-Install 225 sf of dreinfield in trench configuration.
E 4.-Install 12"of slightly,limited soil at the bottom of the drainfield.
R (Comments Continued on Page 2.).
SPECIFICATIONS BY: TITLE:
0
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
Erlande Omisca
DATE ISSUED: 06/13/2016 EXPIRATION DATE: 09/11/2016
DH 4016, 08/09 (Obsoletea all previous editions which may not be used) �����Mlle.s SOIL
64E-6.003, FAC
MIN
v 1.1.4 AP1243694 SE 9 6 5
71,.e contrac?or(or des'gnee)is required to perforin a soil boninq
aoi;acent to t,= drainf:eld excavation at the time C;.. ^,31
^.sc:icn. PrCr Final Approval, the FDOH inspec:c ^a"
witness the soli bo in
ar,d compare the resu is to
s:ie c a!uation suu niGdd A reinspection fee wilt be assessed
'-- i3 rot at the jobs'e at tt a arra-iced .;me.
s .
STATE OF FLORIDA APPLICATION # AP1243694
DEPARTMENT OF HEALTH PERMIT # 13-SC-1688392
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE998696
SITE EVALUATION AND SYSTEM SPECIFICATION
�a
APPLICANT: Douglas Garber
CONTRACTOR / AGENT: Day&Night
LOT: 13 BLOCK: 210
SUBDIVISION: Dunnings Miami Shores Ext#3 ID#: 11-2136-007-0370
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: 0.21 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 300 GALLONS PER DAY [ RESIDENCES-TABLEI / OTHER-TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 529.00 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE )
UNOBSTRUCTED AREA AVAILABLE: 600.00 SQFT UNOBSTRUCTED AREA REQUIRED: 338.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: crown Of road 10.12'NGVD
ELEVATION OF PROPOSED SYSTEM SITE 0.36 [FINCHES]/ FT ] [ ABOVE / BELOW ] SENCBMARK/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: 50 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]N
OI
10 YEAR FLOOD ELEVATION FOR SITE: FTI MSL / NGVD ] SITE ELEVATION: 10.10 FT I 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 8/3 Sand 0 To 60 10YR 8/3 Sand „0 To 54
REFUSAL Oolitic Limestone 60 To 60 REFUSAL Oolitic Limestone 54 To 54
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 73 INCHES [ ABOVE / SELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.80 DEPTH OF EXCAVATION: 60 INCHES
DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
Site evaluation conducted by Day&`Might.
SITE EVALUATED BY: DATE: 06/09/2016
(Title:)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4
AP1243694 EID1688392 v 1.0.2
DOCUMENT #: PR1021968
5.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
6.-Invert elevation of drainfield to be no less than 6.65'NGVD.
7.-Bottom of drainfield elevation to be no less than 6.15'NGVD.
8.-This permit includes the abandonment of the existing septic tank.
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.
i
r
a
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
PART 11 - SITEPLAN ----------------------
Scale:
-------_ __Scale: Each block re resents 10 feet and 1 inch =40 feet.
P
a ,
o '
e
Notes: '
Site Plan submitted by:
Plan Approved Not Approved bate
By C unty Health Department
ALL CHANGES 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. 5744-002-4015-6)