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PLC-17-2563F�ORtDP Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Permit No. PLC-1 0-17-2563 M Permit Type: Plumbing - Commercial ' WofkClassification: Addition/Alteration Permit Status: APPROVED Issue Date: 7/31/2018 1 Expiration: 01/27/2019 Applicant 9801-9845 NE 2 Avenue 1132060134380 Miami Shores, FL 33138- Block: Lot: PARK LLC owner mtormation Address Phone Cell PARK LLC 4141 NE 2 Avenue ()_ MIAMI FL 33137- 4141 NE 2 Avenue MIAMI FL 33137- Contractor(s) Phone Cell Phone J.C. & ASSOCIATES GROUP, INC (305)253-8225 (305)742-3199 ype of Work: PROVIDE SEWER CONNECTION TO NEW CIT ype of Piping: dditional Info: PROVIDE SEWER CONNECTION TO NEW CIT lassification: Commercial canning: 3 Fees Due Amount Bond Type - Contractors Bond $500.00 CCF $12.00 DBPR Fee $9.00 DCA Fee $6.00 Education Surcharge $4.00 Permit Fee $600.00 Scanning Fee $9.00 Technology Fee $16.00 Total: $1,156.00 Valuation: $ 20,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PLC-10-17-65479 07/31/2018 Check#: 1044 $ 956.00 $ 200.00 10/27/2017 Check #: 20182 $ 200.00 $ 0.00 Bond #: 3842 Avaname Inspection Type: Heater Water Service Final Water Main Lavatory Top Out Re Pipe Main Drain Underground Review Building Review Building Review Building Review Planning Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance 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 permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work slated , July 31, 2018 Authorized Signature: Owner / Applicant / Contractor /, Agent Building Department Copy July 31, 2018 O BUILDING PERMIT APPLICATION Miami Shores Village RECEIVE5 Building Department CT 2.7 ;Z/ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �I Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 S FBC 201`j ❑BUILDING ❑ ELECTRIC ❑ ROOFING Master Permit No. 1" 1 �� ^ z 5160 S Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP 1Jf CONTRACTOR DRAWINGS JOB ADDRESS: City' Miami Shores County: Miami Dade Zip: Folio/Parcel#: -- ' `�5/1 - 013 - W Is the Building Historically Designated: Yes 11 NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): // �/ LL G Phone#: Address: City: N ,,S>tate: �-? Zip: Tenant/Lessee Name: �"�1/ -fPL I �o"�2 ' J Phone#: Email: ' CONTRACTOR: Company Name: )C \ � W _ Phone#: Address: Z� City: QLA-k- State: Zip: Qualifier Name: 4i-i Phone#: State Certification or Registration #: �i%©Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ -Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 1 �v C" ' Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 6 ' 00 DBPR $ , c Notary $ Technology Fee $ Structural Reviews $ Training/Education Fee $ Double Fee $ Bond $ ','�- C�DQ • / TOTAL FEE NOW DUE $ 45� • 00 (Revised 02/24/2014) C k / If- Bonding Company's Name (if applicable) Bonding Company's Address City State 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 attac t. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which oc rs ven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not elapioved aid a r inspection fee will be charged. //—'mil Sign or AGENT The foregoing instrument waVacknowledged before me this L J day of 20 ' by C).wn is personally known to me or who has produced _ identification and w di s NOTARY PU LIC: I Sign. Print: r�'s Seal: as Signatu The ++foregoing instrument wa ackn wledged before me this 1� day of 20 �� , by is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC Sign: Print: r-il ISSION # FF 928131 Seal:MY COMM 2019 EXPIRES: October 15,onded?hruNotaryPublkUndervrtiters as APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ��� Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to owner - worKers' compensation insurance r-xerr1PLIVIII Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELO YOU AC NOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Own State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of who is personally known to me or has produced fication. Notary Public Stale of Florida Danny Bazain My Commission GG 131884 '�j� . Expires 08/06/2021 J.C. AND ASSOCIATES GROUP, INC. State Certified General Contractor CGC 05750 7741 SW 122nd Avenue Miami, FL 33183 (305) 742-3199 October 16, 2017 State of Florida County of Miami Shores Before me this day personally appeared Juan Carlos Lago who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 9801 AE 2nd Avenue, Miami Shores, FL a SwornVo (or affirmed) and subscribed before me this 16t" day of October, 2017 by Juan Carlos Lago. 4,60) ke Notary Public Ste* of FbrkW Danay Bwain " Commission GG 131884 Pir oa/08/202] Personally known Or Produced i tification Type of Identific n!P duced Print, Typ p am of Notary Detail by Entity Name Page 2 of 3 Detail by Entity Name Florida Limited Liability Company 9801 PARK, LLC Filing Information Document Number L16000130646 FEI/EIN Number 81-3267935 Date Filed 07/11/2016 State FL Status ACTIVE Principal Address 4141 NE 2ND AVENUE 204-A MIAMI, FL 33137 Mailing Address 4141 NE 2ND AVENUE 204-A MIAMI, FL 33137 Registered Anent Name & Address HOWARD B. NADEL, P.A. 301 W. HALLANDALE BEACH BLVD. HALLANDALE BEACH, FL 33009 Authorized Person(s) Detail Name & Address Title MGR `CI-EMTOV, SHAWN 4141 NE 2ND AVENUE, SUITE 204-A MIAMI, FL 33137 Title MGR SCEMLA, SEBASTIEN 15510 WEST DIXIE HIGHWAY, SUITE 3 MIAMI, FL 33162 Annual Reports Report Year Filed Date 2017 04/03/2017 Document Images 04/03/2017 -- ANNUAL REPORT View image in PDF format 07/11/2016 -- Florida Limited Liability View image TP77 format Florida Department of State, Division of Corporations http://search. sunbiz. org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 10/ 12/2017 10/27/2017 Property Search Application - Miami -Dade County ` 0 OF THE PRuvtRTY APPRAISER Summary Report Property Information Folio: 11-3206-013-4380 Property Address: 9801 NE 2 AVE Miami Shores, FL 33138-2407 Owner 9801 PARK LLC Mailing Address 4141 NE 2 AVE # 204 A MIAMI, FL 33137 USA PA Primary Zone 6400 COMMERCIAL - CENTRAL Primary Land Use 1111 STORE: RETAIL OUTLET Beds / Baths / Half 0/0/0 Floors 1 Living Units 0 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 10,803 Sq.Ft Lot Size 13,000 Sq.Ft Year Built 1953 Assessment Information Year 2017 2016 2015 Land Value $338,000 $338,000 $286,000 Building Value $1,162,000 $463,449 $417,104 XF Value $0 $11,054 $11,090 Market Value $1,500,000 $812,503 $714,194 Assessed Value $1,500,000 $785,6131 $714,194 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction $26,890 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOT 13 & LOT 14 BILK 32 LOT SIZE 100.000 X 130 OR 15605-3244 0692 4 Generated On : 10/27/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $1,500,000 $785,613 $714,194 School Board Exemption Value $0 $0 $0 Taxable Value $1,500,000 $812,503 $714,194 City Exemption Value $0 $0 $0 Taxable Value $1,500,000 $785,613 $714,194 Regional Exemption Value $0 $0 $0 Taxable Value $1,500,000 $785,613 $714,194 Sales Information Previous OR Price Book- Qualification Description Sale Page 08/17/2016 $1,750'000 30224 Qual by exam of deed 4364 06/01/1992 $0 15605- Sales which are disqualified as a result of 3244 examination of the deed 11/01/1977 $1 09873- Sales which are disqualified as a result of 0684 examination of the deed The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING RECEIVED J R 2 5 20�19 ]BY: J-t �. FBC 20 14 7 Master Permit No. PLC - !a. J %' ZSlo 3 Sub Permit No. ❑ REVISION 0 EXTENSION ❑RENEWAL ❑PLUMBING [:]MECHANICAL [:]PUBLICWORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: q901 67 914� I V E, a A v/- City: Miami Shores County: Miami Dade Zip: 351523t, - Folio/Parcel#: i �"�% G{/DJ3 •�a Is the Building Historically Designated: Yes NO 7)�-_ Occupancy Type: Load: Construction Type: Flood Zone: / BFE: FFE: OWNER: Name (Fee Simple Titleholder): I aol �n (iLr, ' Phone#: Address: 4 1411 NO ,�-�� 2 A0V , City:t1mN1( State: Zip: -3:3I377 Tenant/LesseerName: MU L-r( -�]�l�if�,i��L-.��LH���Q1 �l0 Phone#: Email: CONTRACTOR: Company Name: < GA'l Q� Phone#: 50-T 7/- Address: ���� �(�t� r7i7i p'✓ City: lQrYltil 2 State:"" Zip:,�fJ Qualifier Name: 06 ry CA1� S /,4&0 , Phone#: POE 3 Jag State Certification or Registration #: 4:�i-!g7 5 0 of Competency #: DESIGNER: Arch iitect/Engineer: {��0-6pCertificate FarArEC, PjE5 �� - � / —TI fft- Phone#: .1-305 '�O�y�i ' 2�3 �• Address: Co"-r- City: fqf*-wi j State: F�' Zip: 33r�s Value of Work for this Permit: $ 212 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: PK 1 EW6 lV )--JGam- P� l I Rg1- I.1 s u) jjiq 2042 Y 1 DUE JP e—MAEI-4-�5 Fine Z - /'zFs7AvR-NT AS FDPOsi�A.la se-eztu7, Ftgn 1 J Specify color of color thru the: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ CCF $_ Radon Fee $ DBPR $ Training/Education Fee $ CO/CC $ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ I Bonding Company's Name (if applicable) Bonding Company's Address City State ( Zip Mortgage Lender's Name (if applicable) hi )A-- 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. 1--1 Signature ' i OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 j_9, by MARiA AULONL( who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: R The foregoing instrumeht'was acknowledged before me this day of tJ 20 1 R by -TUAQ CA%t. LA60 who is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Sign:_ Print: i+�12`l7Q til Print: Seal: ;•jl�"'ir; MARTA SANG Seal: " , . �' M EXPIRES Mauch 07. 2020� I �eo�� yuw+sy rwurwww� ******************************* APPROVED BY MARTA SANG MY COMMISSION 0 FF968564 EXPIRES March 07. 2020 *********************************** Plans Examiner as Zoning (Revised02/24/2014) Structural Review Clerk JC & ASSOCIATES GROUP INC. 7741 SW 122 AVE MIAMI FL 33183/ PHONE 305 742 3199 / jclago@pagroup.cc January 24, 2019 Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores FL. 33138 Property Owner: 9801 Park LLC Location: 9801-9845 NE 2nd Ave & 211-217 NE 98 St, Miami Shores FL. 33183 Folio: 113206 013 4380 Permit # PLC-10-17-2563 SEWER CONNECTION PERMIT REQUEST FOR TIME EXTENSION We respectfully request a time extension for the above mentioned Permit. The scope consists of sewer connection to new lift station, grease traps for two proposed restaurants and septic tanks abandonment. The work has been delayed as a result of changes at DERM. Specifically, under FOG 2.0 DERM upgraded the requirements for the grease traps as previously approved. This came up after we commenced the work on site, as the plans for the two proposed restaurants were submitted for review, and are still currently pending approval by DERM. Jeration. JC and Associates Group Inc. Certified General Contractor CGCO57500 s NOTE: ALL SHEETS MUST BE REVIEWED MIAMI-DADE COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES Herbert S. Saffir Permitting and Inspection Center 11805 SW 26th Street (Coral Way) • Miami, Florida 33175-2474 • (786) 315-2000 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE AND/OR ENVIRONMENTAL SERVICES PROVIDE MUNICIPAL PROCESS NUMBER HERE r`(1 ' CA U.�� y q Job Address �1� p�- Contractor No. z w Folio 1 — �2 �l v 0 Last four (4) digits of Qualifier No.. _ o w 0 Contractor Name C Lot Block v 0 o a Subdivision PBpg z o v z Qualifier Name �` Addr s � Metes and bounds City State . zip [ ] New Construction on ( ] Demolish Current use of property CZ:K)e7f 1 rn Vacant Land [ ] Shell OnlyU. Z [ ] Alteration Interior [ ] Addition Attached I �� 02 [ ] Alteration Exterior [ ] Addition Detached Descn tion of Work a o f~ [ ] Relocation of Structure [ ] Re-RoofG�-�{ (� S a [ ] Enclosure [ ] Foundation Only C Sq. Ft. Units Floors [ ]Repair [ J Tent` [ ] Repair Due to Fire Value of Work [ ] MBLD` [ ] Chg. Contractor W Owner Address W Category F [ ] Re -Issue a [ ] MELE [ J MPLU [ ] Re -Stamp Revision( N City State _Zip Phone [ ] MLPG w [) w Not Applicable for 3 Last four (4) digits of a [ j MMEC cc Fire p Owner's Social Security No. [ ] FIRE N z Name C%- l Owner z 0. \ n` Address �{ � � X � Z Address City �C��J�,�� State^ Zip lye City State _Zip oc.(rV�� it 0 z as Phone fi?"-, ��Z' �`'-� �W Phone I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible. There is a minimum charge of z a 3 _ a: one -hour Please contact the Fire Department for current rate. QCL a �,,- � CO W 111 Request: Date: ow ¢ 2ntl Request: Date: ¢ 31d Request: Date: If the applicant is a known named violator with: unpaid civil penalties; unpaid administrative costs of hearing; unpaid County investigative, enforcement, testing, or monitoring costs; or unpaid liens, any or all of which are owed to Miami -Dade County pursuant to the provisions of the Code of Miami -Dade County, Florida, a hold on the review may be placed on this application. 123 01-192 5/17 OESGH TEAM: ,- Trench Restoration Trenct Walls Sand Bedding Details Clean Backfill Limerock Foundation 18" Min Cover See Paver Is Sand Embedment General Trench Restoration Notes: 1-Trench Backfill, including base and subgrade shall be compacted to a density no less than Replaced 98 % of AASHTO T-180 (Modified Proctor). I� 2- Where unstable Soils are encountered, Foundation including Peat, Muck, or other organic soils, Elestic Silt or Clay, A 24" Rock fundation is required. ...1 SHEET TITLE: I SHEET Hn: •• ITATE ®f rz#0RzVA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (9801 Park LLC) PROPERTY ADDRESS: 9801 NE 2 Ave Miami, FL 33183 LOT: 1314 32 BLOCK: sUBDs1O�i: PROPERTY ID #: 11-320"13-4380 PERMIT #:13-8C4847562 APPLICATIoN #-AP1344805 DATE PAID - ESE PAID: RECEIPT #: DOCUMENT # : PR1117110 [SECTION, TOWSHIP, 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 PERFOR dWCE 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 [ GALLONS / GPD GALLONS / GPD GALLONS GREASE INTERCEPTOR CAPACITY GALLONS DOSING TANK CAPACITY [ D L ] SQUARE FEET R [ I SQUARE FEET A TYPE SYSTEM: ( ] I CONFIGURATION: [ ] N F LOCATION OF BENCHMARK: STANDARD [ I FILLED TRENCH [ I BED CAPACITY CAPACITY (16J02M CAPACITY SINGLE TANK:1250 GALLONS) ]GALLONS @[ ]DOSES PER 24 HRS #Pumps SYSTEM SYSTEM [ I MOUND [ ] I ELEVATION OF PROPOSED SYSTEM SITE ( I[ / ILABOVE / BELOW IBBNCMOJM/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ][ / ][ABOVE/ BELOW IBENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: E I INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out-(b) The bottom of O the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The T tank shall be filled with dean sand or other suitable material, and completely covered with soil.Have the system inspected H by the health department after it has been pumped , ruptured and filled with sand and covered. E R SPECIFICATIONS BY: APPROVED BY: TITLE: TITLE: Engineering Specialist Ii Dade CHD Loanis E es DATE ISSUED: 05/15/201 DR 4016, 08/09 (Obsoletes all previous editions Mhiah may not be used) Incorporated: 64E-6.003, PAC EXPIRATION DATE: 08/13/2018 Page 1 of 3 v 1.1.4 AP1344805 SE-1 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 A 02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. 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 ord_ er'. 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 SEVIAM TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: _(9801 Park LLC) PROPERTY ADDRESS: 9801 NE 2 Ave Miami FL 33183 LOT: 13 14 BLOCK: 32 SUBDIVISION: PEFOUT # :13-=4 847560 APPLICATION # : AP-1344804 DATE PAID: FEE PAID: RECEIPT #: DocoMBNT # : PR1117107 ISBCTION,, TOIrNSHIP, RANGE`, PARCEL NUMBER] PROPERTY ID # : 11-320E-013-4380 [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 PERK OF TIME. ANY CRANGE IN MATERIAL. FACTS, oiHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO M DIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCS OF THIS PERMIT DOES NOT E703MPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, Sj!ATE, OR LOCAL BERMITTING REQUIRED FOR DVMLO*4=T OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T I ] GALLONS / GPD - CAPACITY A I ] GALLONS / GPD CAPACITY N I ] GALLONS GREASE INTERCEPTOR CAPACITY ICI CAPACITY SINGLE TANK:1250 GALLONS] K I ] GALLONS DOSING TANK CAPACITY I IGALLONS eI ]DOSES PER 24 HRS #Pups I ] D I I SQUARE FEET R [ ] SQUARE FEET A TYPE SYSTEM: I I STANDARD I CONFIGURATION: I I TRENCH N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L SYSTEM SYSTEM [ I FILLED [] MOUND ] BED [ l ] DOVE / BELOW IBENCHMARK/REFERENCE POINT IIABOVE / BELOW] BENCHMARK/REFERENCE POINT D FILL REQUIRED: L V.W ) 1ACM95 jb.L%-MvJ%++%M --- 1, INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of o the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The T tank shall be filled with dean sand or other suitable material, and completely covered with soil.Have the system inspected H by the health department after it has been pumped , ruptured and filled with sand and covered. E s SPECIFICATIONS BY: TITLE: APPROVED BY: y TITLE: Engineering Specialist 11 Dade CHD Loanis X Go DATE ISSOSD: 05/15/2018 EXPIRATION DATE: 08/1312018- . DR 4016, 08/09 (Obsoletes all previous editions which may not be used) Page 1 of 3 Incorporstsd: 64E-6.003, FAC v 1.1.4 AP1344804 SE-1 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an .nistrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such oceedings 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 A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. 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. PLUMBING NOTES EXISTING A 1• 15' ALLEY (N.A.P.) SEWER LINE _ 1. ALL WORK UNDER THIS CONTRACT SHALL COMPLY WITH THE LATEST EDITION OF THE 'FLORIDA BOLDING CODE - " 2014 5TH EDITION' MID ALL APPLICABLE LOCAL ORDINANCES. ING EXISMET WATER METERS 2. CONTRACTOR SHALL VAST THE SITE AND THOROUGHLY FAMILIARIZE HIMSELF WITH AND VERIFY ALL EXISTING [WIN] a] [9 I] CONDITIONS AND REPORT ANY DISCREPANCIES TO THE ARCHITECT/ ENGINEER PRIOR TO COMMENCING WORK. O _ -- 3. THE CONTRACTOR SHALL COORDINATE THE WORK OF THIS TRADE WITH ALL OTHER TRADES TO AVOID INTERFERENCEEXISTING WITH THE PROGRESS OF CONSTRUCTION AND REPORT ANY DISCREPANCIES TO THE ARCHITECT/ ENGINEER. ` m �MH 4. REQUIRED INSURANCE SHALL BE PROVIDED BY THIS CONTRACTOR FOR PROTECTION AGAINST PUBLIC LIABILITY AND PROPERTY DAMAGE FOR THE DURATION OF WORK. _ 5. ALL PERMITS, FEES, INSPECTIONS AND TESTS SHALL BE THE RESPONSIBILITY OF THE PLUMBING CONTRACTOR. / o . ° r z oa \ Y 6. THE CONTRACTOR SHALL VERIFY ALL DIMENSIONS WITH THE ARCHITECTURAL PLANS. ' -oi 7. ALL MATERIALS SHALL BE NEW AND OF AMERICAN MANUFACTURER FREE FROM DEFECTS, INDELIBLY MARKED WTTH OOOO wa' EXISTING MH NAME OF MANUFACTURER, WEIGHT AND/ OR CLASS. L 8. ALL WORN SHALL BE PERFORMED BY A LICENSED PLUMBING CONTRACTOR IN A FIRST CLASS WORKMANLIKE MANNER. 1 ��� THE COMPLETE SYSTEM SHALL BE FULLY OPERATIVE. % EXISTING 9. ALL AUTOMATIC ELECTRIC OR GAS WATER HEATER SHALL MEET THE STANDARDS OF THE LATEST ENERGY EFFICIENCY EXIST. 4'B CODE. STORM DRAIN l �\ 0 10. VERIFY THE LOCATION, SIZE AND ELEVATION OF ALL UTLTTIES PRIOR TO BEGINNING CONSTRUCTION. ADVISE EX15TING eauMOS ARCHITECT/ ENGINEER OF ANY DISCREPANCIES. CATCH BASIN 0 11. DRAWINGS ARE DIAGRAMMATIC. DO NOT SCALE DRAWINGS FOR THE EXACT LOCATION OF FIXTURES AND PIPING. EXIST. 6'0 12. STOPS SHALL BE PROVIDED AT ALL PLUMBING FIXTURES. STORM CRAN 13. PROVIDE DIELECTRIC UNIONS WHERE DISSIMILAR METALS ARE JOINED. EXISTNG MH TO I I MH To 14. ESCUTCHEONS SHALL BE CHROME PLATED BRASS WITH LOCKING SCREWS WHERE PIPES PASS THROUGH FINISHED BE CONDEMT -I r BE CONDEMT WALLS. EXI SEP TANG 1200 GAL. IC TANK WIS. PIT I G 1200 G 15. A CLEM! OUT SHALL BE PROVIDED AT THE BASE OF EACH SOIL, STORM AND WASTE STACK. To EAMNFILLEDWITHSAND�1 O O EPTI STANK WIS PIT To eE f14NDou D SHALL BE SLOPED MINIMUM OF 1/8 INCH PER FOOT FOR 1 I I AND FI LED WI AND 16. ALL HORIZONTAL BRANCHES, SEWER AND DRAIN LINES A 4' PIPES AND LARGER AND 1/4- PER FOOT SLOPE FOR 3- AND SMALLER PIPES. \ I EX15T. 41 17. EVERY FIXTURE CONNECTED TO THE DRAINAGE SYSTEM SHALL BE EQUIPPED WITH A WATER SEAL TRAP. STORM DRAN 1 18. PLUMBING FIXTURES SHALL COMPLY WITH WATER CONSERVATION FS.553.14. — 19. CONTRACTOR SHALL GUARANTEE ALL WORK FREE FROM DEFECTS OF WORKMANSHIP AND/ OR MATERIALS FOR A PERIOD OF ONE YEAR FROM DATE OF ACCEPTANCE. 20. ALL HOT WATER PIPES SHALL BE INSULATED. ALL EXPOSED PIPING WffHIN TOILET ROOMS SHALL BE CHROME PLATED. 22. PLUMBING FIXTURES SHALL COMPLY WITH WATER CONSERVATION FS.553.14. x o� o21. 23. INSULATED EXPOSED DRAIN AND WATER PIPING OF THE HANDICAPPED LAVATORY TO PROTECT AGAINST COLOR BURNING AND TO CUSHION IMPACT. PROVIDE 'HANDILAV-GUARD' INSULATION KIT OR APPROVED EQUAL SHALL BE "' o WHITE. 24. EXTERIOR HOSE BIBBS SHALL BE FLANGED, CHROME PLATED WITH LOOSE KEY STOPS, VACUUM BREAKERS AND SHALL BE VALVED INDEPENDENTLY. I m P w Z W I Q r:* �Fl 0 N�7F� W 02' SLOPE TO ROOF ORAIN I7 I I I I I I I �®0, CF EXISTING SANITARY & STORM DRAIN SITE PLAN 1 1/_ Fol SHEETINDEX iz PLUMBING DRAWING LIST Y Pot-ol EMSTNC PWYBRHG SITE PLANd GENERAL NOTES P01-O2 PROPOSED PLUMBING SITE PUN I DBLEWIS-ARCHITECT 7 UIl 1 H L fin' AAaoa+�z � STATE OF GRID MIAMI SHORES MIMO - CENTRE PROJECT#1709 SIX HE 2ND AVE MIAMI SHORES, R. 33133 ••••• •••• • •TRUCTURA VEER' FE INEER: • • • • �ERGI NEER. • • SOILENCO EER: LANQ5CAPE ARC TECT: REVISIONS DATE ISSUE DATE .. SEPT 6, 2117 DWN _GR._. APPRV _.....DBI.._._ Da., EXITING LAMBING SITE P ENERALNOTES SraM AS INDICATED ON PLANS Ph — SCHEMATIC DESIGN St,ml NvnUer P01-01 M NEW F/B TENANT #1 (2,410 SF) Per Florida Plumbing Code Sill 1003.3.4. Using ASME 112.14.3 Apend3l A, Table A3 Interceptor Sizing MtXNd UbIll M•tbsen Pipe Ce iiv Merceptor size 1 Pie Size (Inches) Slope f Ft. //4 in. minute crab nominal 2• 0.24 25 gpm 3 0.2/ 75 4- 024 150 p G' ON 11 .. Total Seat. Mis1f rnat Total meet. perda 107 6 635 Pump -Out Cycle Production Values by Meal Type M.Grease ProductionMgr Ores.Pro•¢n Lear Rnae Production Coffee Huse, Rua, Grecery Slra (m Frl1el Cesare. Fenly Res w L tielln, SMek 9aldwkh Slap Ofwksanu gar.,Rah.W.WsMSr Bern Pal Cwhil N(no food wp), Jpan.s., Hww, sua lmlNt SNP 0lnies. Buffet Disk-' Slak Ill Fre3ee Yogurt, Mal Medial tar. Fat Food, Cl . Creek Ivan. taw Grassi, e Ma1cs SeefoN. Filed O*Ial Ceopary Slone Residential Out PSE(w If r) recu.. I. f al Bee (A)wFlrwra (B)Wilh Flatware: (q wRalwste, (D)Wtlh Flatware (F) With Flatware: 0005 bamNal 0.0065 Ds/meM 0mlt sin 0.0325 Ibsfmml S 0.0455 lb./meal Maw a (osbnt Oren. Roductkn fay. Pr Grees.OgeceY Graee Cap.., Pr Gey X Re X PonpOd paid Nil In La. Headed inGPkt 635 0.0455 30 730.276 365 lea 1/zATTS eRaee nlrc.Pa. q rneettlle blan ceptor (a) Gress. Cap" ralwleNd shwa Modal GPM 0-my Grease Cap. In lips. ASMEA1121A3C.rtabd Lg 800i Zurn Z11724 400 1 B00 NEW F/B TENANT #3 (2,630 SF) Per Florkb Plumbing Code Section 1011i Using ASME 112.14.3 AparWb A. Table A3 Interceptor Sizing MCOtid Utilizing Maxim= Pipe Capmty Inteiceptor size 1 Pipe Size(Inches) Slope IFt. 1/4 in. mawle drab (nominal) 2- 0.24 25 3' 0.24 75 ♦• 0.24 150 6' 024 TotSaab Yaab rater Total maale rid 1118 I6 680 PurnpOult Cycle Production Vakweby Meal Type Maim Or.. Pr.W.W. Oresse Oree Production Low Rnfe Production Coffee Ii Fez.. Goo Stan (m Fryr). k. C. etarie F" Runal ram, Yaek Sable kh Slop, (onvsYence all Finn. Br. Said 8r. Gnaws Pans. Calslea (no food Pp). Japanese. House. Dounry0oXnt Shop. Othas, Buffet Dilkatiesn, SRI Br, FW3n Yogurt HXW Mosul Br, Fail Food. RNe4. Reek Men. Law Or- Much, SWood, Fried Olkkn, Grocfry Slae Rental 0upwd FsE(w/fryr) Mfryaa Beroacee. (A) w= (8) With Flatware: (q wFLlw re: (D) Wth Flatware (F) With Flatware: duos bnral 0.00651ba/meal Dom boreal 0.0325 ItWmeal s 0,045510s/meal Mass.Onn- Rase Anxii Drys Pr Giness Cepacly Gnae Capaq Por6y X Por Osy X R-wol NNadnlDs. NNNnGPIA 680 1 0.0456 1 30 791.7 396 Ua WATTS. Read Idelceptae ioneat tie Iltereceptor (a) ReaaCbparycalcuesdel Meet GPM OIalIY Grease Cap. In lbs. MMEA11zu.36nftd Lg BOOS Zum Z1172-1- 400 1 B00 ZURN. Z1172 TAG (CATION SHEET LARGE CAPACITY GREASE INTERCEPTOR TAG DlnerwloiW Ona (4ldlea rtl I mm 11 are ill. q Manugctxbp Tobrea ew Cllrwe wwaa Ndin 4CVPVGu nna Fudk FS 4xE Ma. Size IMeU Ou6et 5o. FIIN, Nine G.P.M. ILI CapedtY Weler Gal. (y Greys Ln. pgl L Approx. WL Los. Ik91 Cknenabns in kwhas C RE F G 900 1. 3 PW 15 tog pl. 65 46 Ho P161 15U 200 1911 1 316 143 22.W4 578 1&1rz 38 14 2b5ra 408 [Niel 27 (Vej 23 (58a1 t2-W4 110" 3]58 P541 1100 125 (4721 1W I5871 250 11141 2 749 WI 3 113 17651 NAQ ISM 49-1/4 112511 W Rotq im 1700 4 I'm 1w % zoo Ise ] 270 1021 soil t>d 400 182 40 P"j 3 3(4 [7811 25-1/4 16411 W (1422) 41-M 110I 1016 Ia811 Min 190z1 z9-718 IT") 61 (15p1 4 (11001 1400 1500 5 j1271 250 (945 3n [11MI 46s 1758 8M 125141 500 IT7 800 12n] 1384 I8281 41 [1N11 36 19141 71 118M 615E 11311; 1770 P.) 4 114 1117si 3 se (100W W PM Sl 114M 1800 MO 1323 885 3278 700 318 2086 SPtrz 1283 417�a t11 87 1 P21 8 161 1700 400 n5121 095 14/391 800 1]a]I 2M0 DtOBI 541N 113181112101 94 67 (1702J t900 500 Itesol N0 Isw]i 000 Nul l zS57 (1M]1 57.1N [t45a1 st5a It3ni to I2az1 74 nBBq INCH 21171Lageap.cey Arid ReeiaWeGoeNdiNNerarwexMafehrlraME Ned•eae.Mtert'.pw,ratNN___ GPM aM _ LHa. ginee cpxay. MN 0.a9.Iunesnw.e mmg Ms rm n k i oy-pea, bonze cbanR pkq Iwlidr wn o. usN a. semnFpad aid Wive da wall pee WN rwxaba praaawa �Nas>iw'llpw' ,in n Oe1M, Gr Yegd na..Ytl aoe.d tewr wM rwabN NMee, eb wU ow ronad anew. lary farisad wNl leer aid MM high ppeon EXISTING 151 ALLEY (N.A.P.) SEWER LINE EXISTING POINT OF WATER METERS CONNECTION o ��0 ❑w ❑W NEW B EXISTNC a - �MH r wiz oa •� ZSq 4 OOOO �� MHmNC �.• CO a, L /' \\ 3.0 �EXISTING MH EXIST. 4'0 STORM DRAIN O O EXISTING 9aLwas CATCH BASIN EXIST. 6 0 NEW PH ANIF CAS NEW - _- EW 8'0 CO TANKS MAMF GCO NEW GREASE O STORM GRAIN .INTERCEPTOR 0D Gf#le NEW SAMPLING 4p, ' NEW NEW f1 NEW SAMPLINGGOO .NEWGREASE GOO PORT 400 GPM NG yyMil mro t£ l 3'g A3 I "I n IU co EXIST. 4.0 co CO 3.0 Co 1 STORM DRNNrr r.Ac c roc _ CS-rri- CC z �\ 11==101TO0413 Wi�== IYL ATES ENANT #5 1� (1,025 SF) FrD EXIST. Roy AN #4 (1,01 F) .•7 10, 0 PROPOSED SANITARY & STORM DRAIN SITE PL 1 1/4. _ ,,-0. ❑1 • e• • AREAS y.R. LOT AREA 13,000 BUILDING AREA 9.308 PLUMBING SCOPE OF WORK 1. NEW SANITARY. GREASE WASTE LINES B GREASE TRAPS FOR TENANTS j1 k #3 2. NEW E1(TERIOR SANITARY LINES TO EXISTING SEWER. 3. NEW GAS MANIFOLD AND LINES FOR TENANTS /1 A p. DBLEWIS-ARCHITECT ��3�'/a4in/ryy l rya • h �vr/�TAT off.• A .1 AN ' y 1� domaew• MIAMI SHORES MIMO - CENTRE PROJECT a1709 9801 NE 2ND AVE MIAMI SHORES, FL. 33133 OWNER • .••19 RUCTURALE WEER: MEP F ENGINEERal • WEER:• 901E ENGI ER: LANDSCAPE ARCHITECT: lrr ••) of FIEVL40NS DATE E DATE SEPT6,2117_... O GR All DBL Dil ROPOSED P BING SITE PLAN xale AS INDICATED ON PLANS pte , SCHEMATIC DESIGN Sheet Nv P01-02 I