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REV-19-1582
'�([ J" svp" BUILDING PERMIT APPLICATION CEIVED Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �Y' JU 1 0 2019 Tel: (305) 795-2204 Fax: (305) 756-8972 1 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 l Master Permit No. PLC 10-17-2563 Sub Permit No� o�— IL �� QBUILDING ❑ ELECTRIC ❑ ROOFING ❑■ REVISION ❑ EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9801 NE 2nd Ave City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-4380 Is the Building Historically Designated: Yes NO X Occupancy Type: A-2 Load: 150 Construction Type: III Flood Zone: X BFE: FFE: 10.35' OWNER: Name (Fee Simple Titleholder): 9801 Park LLC Phone#: 305 252 1584 Address: 10820 SW 200 Dr #100 City: Miami State: FL Zip: 33157 Tenant/Lessee Name: Email .,,,,.,,,,.. 7868637798 CONTRACTOR: Company Name: JC and Associates Group Phone#: 305 742 3199 Address: 7741 SW 122 Ave City: Miami State: FL Zip: 33183 Qualifier Name: Juan Carlos Lago Phone#: 3057423199 State Certification or Registration #: CGC 057500 Certificate of Competency #: DESIGNER: Architect/Engineer: Yan Luis Solis PE Phone#: 305 484 5596 Address: 14245 SW 21 Terr City: Miami State: FL Zip: 33175 Value of Work for this Permit: $ Square/Linear Footage of Work: 2,500 SF Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: Revised Paver layout at rear courtyard area. Provide concrete slab perimeter. t a"a,,•.F9.sY ..rx7r .s:ti .�".. ;9!.y�e..pti.;. �:}.� :'r:..,;. .�,�,*n,: Mh.:;ky,-.."..+h ►--� Specify color of color thru tile: d Submittal Fee$--� --. - -w r"!Permit"Fee$ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ �.._. DBPR $ Notary $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 467,0,�s Bonding Company's Name (if applicable) N/A Bonding Company's Address N/A City State _ Mortgage Lender's Name (if applicable) N/A Mortgage Lender's Address N/A City State Zip 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 Signature Signature OWNER or AGENT 0 T ACTOR The foregoing instrument was acknowledged before me this The foregoing instru t was acknowledged before me this —"I day of 1) V 20 by day of Jcl n _ 20 , by j'`�A �1% 1� 5 who is personally known to 11Jgy1 a who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: S Seal: _iii� �i : , ANAYc i err Notary Public - State of Florida Commission r GG 2'a6553 My Comm. Expires Qct 26, 2022 ########### APPROVED BY (Revised02/24/2014) as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: r Seal: I I Plans Examiner Structural Review e�..— ANAYSGO 'N.Notary Public - 5tate of Florida d: Corrmissior. r GG 2'46553 My Comm. Expires Oct 26, 2022 as Zoning Clerk DERM PROCESS NO.: PZGROCWY DATE: TIME: Y"3y3 MUNICIPAL PROCESS/PERMIT NO.:� ADDRESS::: Avg COMMENTS: hw ocU INSPECTOR NAME: rlalf;. ® PHONE NO.: INSPECTOR E-MAIL:t l't��,t •(,CiLa�P tttcia4''.. `°: APPOVEG SIGNATURE:t�t'E�-(. Y . _DIVISION OF Ai 23) flivifonthental: Health Florida Health Miami -Dade County OSTDS/WeR Division DERM PROCESS NO.: DATE: TIME: (-- t I - MUNICIPAL PROCESS/PERMIT NO.: ?L - � C f - ADDRESS: 'ISO - c� At L COMMENTS: H'W(UUEx INSPECTOR NAME: PHONE NO.: SC;5 -2"? 2 L' 25 INSPECTOR E-MAIL: EJAPP�kGYE SIGNATURE: r�r COtlNTY HYDROMECHANICAL FOG CONTROL DEVICE (H-FCD) INSTALLATION INSPECTION' MIAMI-DADE COUNTY RER-DERM FOG CONTROL PROGRAM TO BE FILLED OUT BY THE APPLICANT Building Permit No.: �, LZ , 10 I I _ 25 (0 DERM Process No.: tj2L(g00((o Site Address: c'.�(�' 35 _45- ?lG c2 -AVe City: Folio: ` 2, 0 0 (,P) 4 3o Zip Code: Contact Person: AAOakk. ���( _ �� Title: ?(Osf C Ph: FE�Mail: A-M;� >ZV1 t'lYl'Q. Y�4,1� COWL FOR RER-DER-7M USE ONLY Date: �a r Time: I (1210 ut— GDO: Karim Lopez DERM Inspector: 305 372 6757 Ph: Karina Lopez@miamidade.gov Email: Laura Castillo DERM Supervisor: 305 372 6443 Ph: ura. stillo miami ade.gov Email: INFORMATION FROM APPROVED PLANS Number of FCDs : #1 #2 #3 #4 #5 Manufacturer: �JG�2l�(- �c. t Q C Third Party Certifier: rl.� Model #:���-- Capacity (gpm): j 14 Q.09 / J' Lbs. of Greasel Retention 99% removal��} efficiency: tj Monitoring Alarm System: tjj Solids Separator: 6f( (Q 114- ob 1 MDC Code, Section 24-42.6(7)(ii) ON -SITE INSPECTION CHECK LIST GDO- # ITEM Yes No Not Applicable 1 Are plans available on site with DERM approved stamp ❑ ARE THE FOLLOWING PER APPROVE© PLANS? 2 FCD location ❑ 3 Identification of the FCD visible ❑ 4 Installation of the FCD (inlet/outlet) ❑ 6 FCD type ❑ lc� 6 FCD size (gpm) ❑l ❑ 7 FCD lbs. of grease retention 0, ❑ 8 FCD accessibility 2-' ❑ 9 Sampling point installation ❑ 10 Sampling point accessibility ❑ 11 Monitoring alarm system ❑ ❑ .� 12 Solids separator installation 2--- ❑ ❑ 13 Inspection outcome PASS: ❑ FAIL:.E ** Payment of re -inspection fee required prior to requesting the second re -inspection and thereafter. The total amount to be paid is eighty dollars and sixty-three cents ($80.63). To make the payment contact the DERM Cashier at 305-372-6755. The confirmation number obtained from the DERM Cashier shall be provided to schedule the re -inspection. INSPECTION NOTES ?Q�f l c 1� l n,57Q��rZc� t'FSE% I �� ��►� ; gip,- ,yam� ",OrVVM JIt - l 2 If the inspection results show that the FOG Control Device (FCD) is not what was approved on plans, the applicant would have two options: a) Revise the plans to show alternative FCD, which would need to be approved by DERM and Plumbing, or b) Replace the FCD to match the one on the approved plans, and schedule a re -inspection. r•r GOUhiTY HYDROMECHANICAL FOG CONTROL DEVICE (H-FCD) INSTALLATION INSPECTION' MIAMI-DADE COUNTY RER-DERM FOG CONTROL PROGRAM TO BE FILLED OUT BY THE APPLICANT Building Permit No.: _ �C _ n , nc� DERM Process No.: H68W335T Site Address: 99I .65 �je 4�2 �t /1�e_ City: �J(�� ����� Folio: Zip Code: -3 ,5 Contact Person: Ma<n ► 0"AT \) ca, Title: e L � Ph: scs q 0q� p` Email: A YYt �(yl �Q,N N I co" v FOR RER-DERM USE ONLY Date: 03 t o-M Time: W"30 , GDO: Karina Lopez DERM Inspector: 305 372 6757 Ph: Karina Lopez@miamidade.gov Email: Laura Castillo DERM Supervisor: 305 372 6443 Ph: aura. astillo@miami a e gov Email: INFORMATION FROM APPROVED PLANS Number of FCDs : #1 #2 #3 #4 #5 Manufacturer:ti��C� Third Party Certifier: Model #: Capacity (gpm): ICO PWL- ;1 Lbs. of Grease Retention 99% removal efficiency: Monitoring Alarm System: t ` Solids Separator: cj -- 126 — S: (-- 1 MDC Code, Section 24-42.6(7)(ii) ON -SITE INSPECTION CHECK LIST GDO- # ITEM Yes No Not Applicable 1 Are plans available on site with DERM approved stamp ." ❑ ARE THE FOLLOWING PER APPROVED PLANS? 2 FCD location ❑ 3 Identification of the FCD visible ❑ 4 Installation of the FCD (inlet/outlet) ❑ 6 FCD type ❑ .r 6 FCD size (gpm) ❑ 7 FCD lbs. of grease retention ❑ 8 FCD accessibility ❑ 9 Sampling point installation ❑ 10 Sampling point accessibility ❑ 11 Monitoring alarm system ❑ ❑ '21, 12 Solids separator installation ❑ ❑ 13 Inspection outcome2 PASS: ❑ FAIL:'Fer ** Payment of re -inspection fee required prior to requesting the second re -inspection and thereafter: The total amount to be paid is eighty dollars and sixty-three cents ($80.63). To make the payment contact the DERM Cashier at 305-372-6755. The confirmation number obtained from the DERM Cashier shall be provided to schedule the re -inspection. INSPECTION NOTES c 2 If the inspection results show that the FOG Control Device (FCD) is not what was approved on plans, the applicant would have two options: a) Revise the plans to show alternative FCD, which would need to be approved by DERM and Plumbing, or b) Replace the FCD to match the one on the approved plans, and schedule a re -inspection.