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PLC-18-1008vtcllB*v-koo6 0 —mom �s D 1.-; i Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: PLC-4-18-1008 d ;- ^ -►'�� ti ) L Permit Type: Plumbing - Commercial Work Classification: Addition/Alteration Permit status: Approved Issue Date:07/09/2019 Expiration: 01/06/2020 Location Address Parcel Number Project 9723 NE 2 AVE, Miami Shores, FL 33138 1132060134210 NE 2 AVE SEWER CONNECTION Contacts GATOR 9723 NE 2ND AVE, LLC Owner GATOR 9723 NE 2ND AVE, LLC Applicant 1595 NE 163 ST 1595 NE 163 ST GATOR DEVELOPMENT CORP Contractor MARTIN 0 STELLING CGC057933 NE 163 ST, NORTH MIAMI BEACH, FL 33162 Business: 3059499049 Inspection Description: LIFT STATION CONNECTION Valuation: $ 7,500.00 Inspection Requests: 4949 Total Sq Feet: 0.00 Fees Amount CCF $4.80 DBPR Fee $3.38 DCA Fee $2.25 Education Surcharge $1.60 Permit Fee $225.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $252.43 Building Department Copy Payments Date Paid Amt Paid Total Fees $252.43 Credit Card 04/17/2018 $50.00 Credit Card 07/09/2019 $202.43 Amount Due: $0.00 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 stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date July 09, 2019 Page 2 of 2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (Gator 9723 NE 2 Ave) PROPERTY ADDRESS: 9723 NE 2 Ave Miami, FL 33138 LOT: 10 & 11 BLOCK: 31 SUBDIVISION: PROPERTY ID #: 11-3206-013-4210 PERMIT #:13-SC-1954891 APPLICATION #:AP1417672 DATE PAID: FEE PAID: RECEIPT #: f DOCUMENT #: PR1229260 i [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 [ A [ N [ K [ ] GALLONS / GPD ] GALLONS / GPD ] GALLONS GREASE INTERCEPTOR CAPACITY ] GALLONS DOSING TANK CAPACITY [ CAPACITY CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ D [ ] SQUARE FEET SYSTEM ABANDONMENT PERMIT R [ ] SQUARE FEET SYSTEM EXPIRES So DAYS FROM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: ( ] TRENCH [ ] BED [ ] U it: 0V ISSUANCE F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ][ / ][ ABOVE/BELOW] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ][ / ][ABOVE/BELOW] BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of 0 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 clean sand or other suitable material, and completely covered with soil.Have the system inspected H by the health department after it has been pumped and ruptured but before it is filled with sand and covered. E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: 06005 019 TITLE: TITLE: Environmental Manager Dade CHD DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1417672 EXPIRATION DATE: 09/03/2019 SE-1 Page 1 of 3 MIAMFDADE . '® miamidade.gov PO Box Miami, Florida 3323 T 786-268-5360 F 786-268-5 VERIFICATION FORM DATE: June 5, 2019 BLDG PROCESS #: M2018010712 VF# 19-21790-VF - 14 INVOICE(S)#: N00064801 THIS FORM IS NOT VALID WITHOUT A PAID INVOICE AND EXPIRES ONE YEAR FROM THE DATE ON FORM PROJECT NAME: GATOR 9723 NE 2ND AVE LLC PROJECT/AGREEMENT NUMBER: 21790 PROJECT DESCRIPTION: MULTI -UNIT COMMERCIAL BUILDING CONNECTING TO SEWER FOR FIRST TIME PER PLANS, INCLUDING RETAIL, BAKERY AND MEDICAL OFFICE. Folio Address Zip Code Lot Block Proposed sq. ft. Previous sq. ft. 1132060134210 9717-9727 NE 2 AVE 1 33138 1 10/11 1 31 1 6,129 6 129 1132060134210 210-216 NE 98 ST 1 33138 1 10/11 1 31 1 2,132 1 2,132 r- Connection Type Reason for Connection Information Critical Habitat Wetlands Affordable Housing SIR Inspection # Water, Sewer, Private Pump 1 Station i First Time Connection THIS VERIFICATION LETTER CERTIFIES THAT AVAILABILITY OF A WATER AND/OR SEWER MAIN ONLY, AND IT DOES NOT GUARANTEE THE EXISTENCE OF A WATER SERVICE LINE, FIRE LINE OR OF A SEWER LATERAL WITH SUFFICIENT DEPTH TO SERVE THE PROPERTY. FOR ADDITIONAL INFORMATION EMAIL NEWBUSINESSSUPVLIST@MIAMIDADE.GOV. SHOULD IT BECOME NECESSARY TO INSTALL A SERVICE LINE AND/OR A SEWER LATERAL MDWASD REQUIRES THAT THE DEVELOPER RETAINS SERVICES FROM DESIGNERS AND CONTRACTORS WITH SKILL SETS FOR DESIGNING, BUILDING, AND CONNECTING TO PUBLIC WATER AND SEWER SYSTEMS. A WATER AND/OR SEWER AGREEMENT MAY BE REQUIRED. AN INSPECTION FOR ANY EXISTING SERVICES WILL BE PROCESSED WITH THIS FORM, AND A SERVICE UPGRADE MAY BE REQUIRED WHICH MAY TAKE UP TO 12 WEEKS. THIS IS TO CERTIFY THAT THE MIAMI-DADE WATER AND SEWER DEPARTMENT DOES HAVE A(N) 12 INCH WATER MAIN AND/OR DOES NOT HAVE A(N) INCH GRAVITY SEWER MAIN ABUTTING THE SUBJECT PROPERTY. Proposed Use Square Footage/ # Units Water Gallons Per Day Sewer Gallons Per Day School Training Center 10 d/100 sq ft 2748 275 275 Bakery in Shopping Center 65 d/100 sq ft 533 346 346 Clothing Alterations 10 d/100 sq ft 1044 104 104 Physician's Office (including Dentist, Chiropractor, Optometrist, Acupuncturist, and Ophthalmologist. Rated as office: Psychiatrist, Psychologist, Speech therapist (20 d/100 sq ft 1539 308 308 Retail 10 d/100 sq ft 2397 240 240 Use Square Footage/Previous Day Sewer Gallons Per D. 2018 - School Training Center 10 d/100 s ft 2748 1 275 0 2018 - Bakery in Shopping Center 65 gpd/100 s ft 533 346 0 2018 -Clothing Alterations 10 d/100 s ft 1044 104 0 2018 - BeautyShop25 d/100 s ft 1539 385 0 2018 - Retail 10 d/100 s ft�EEA 2397 240 0 WE ARE WILLING TO SERVE THE SUBJECT PROPERTY, SUBJECT TO PROHIBITIONS, OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF THE ANTICIPATED DAILY WATER AND/OR SEWAGE FLOW FOR THIS PROJECT WHICH WILL BE THE NUMBER OF GALLONS PER DAY INCREASE STATED ABOVE. IF "WILL HAVE", UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF WATER AND/OR SEWER FACILITIES BY THE DEVELOPER UNDER AGREEMENT IF APPLICABLE WITH THE DEPARTMENT. FURTHERMORE, APPROVAL OF ALL SEWAGE FLOWS INTO THE DEPARTMENT'S SYSTEM MUST BE OBTAINED FROM D.E.R.M. SUBJECT TO RER'S TERMS AND CONDITIONS SET FORTH IN THE CONSENT DECREE (CASE NO. 1:12-CV-24400-FAM) OR DOH ONSITE SEWER TREATMENT & DISPOSAL SYSTEM RULES & STATUES. COMMENTS: Refunds are based on the date of payment and subject to State Statute 95-11. Some tees are not retundable. **CONNECTION TO GRINDER PUMP STATION PER AGREEMENT** CUSTOMER NAME: MIKE VAZQUEZ CUSTOMER PHONE: Prepare by: William Martinez Printed Name of Reviewer Approved by: Jacqueline Rodriguez Printed Name of Supervisor Page 1 of 1 2019-ALLOCATION-01618 M IAM I•UADE 5/13/2019 Issued Date: 5/13/2019 GATOR 9723 NE 2ND AVE LLC MIKE VAZQUEZ 7850 NW 146 ST MIAMI LAKES, FL 33016 RE: Sanitary Sewer Certification of Adequate Capacity The Miami -Dade County Department of Regulatory and Economic Resources (RER) has received your application for approval of additional sewer flows for the following project which is more specifically described in the attached project summary. Project Name: LIFT STATION CONNECTION - M2018010712 Project Location: 9723 NE 2 AVE, , FL 00000 Previous Use: COMMERCIAL PLAZA ON SEPTIC Proposed Use: 7384 SF RETAIL & 1539 SF MEDICAL OFFICE Previous Flow: 0 GPD Total Calculated Flow: 1042 GPD Allocated Flow (additional sewer flows): 1042 GPD Sewer Utility: PRIVATE Receiving Pump Station: 99 - 1364A RER has evaluated your request in accordance with the terms and conditions set forth in Appendix A of the Consent Decree (CASE No. 1:12-CV-24400-FAM) between the United States of America and Miami -Dade County. RER hereby certifies that adequate treatment and transmission capacity is available for the above described project, pursuant to the criterion stipulated in Appendix A of said Consent Decree. Furthermore, be advised that this approval does not constitute departmental approval for the proposed project and is subject to the terms and conditions set forth in the Consent Decree. Additional reviews and approvals may be required from other sections having jurisdiction over specific aspects of this project. Also, be advised that the gallons per day (GPD) flow determination indicated herein are for sewer allocation purposes only (in compliance with the Consent Decree requirements) and may not be representative of GPD flows used in calculating connection fees by the utility providing the service. Be advised that this Sanitary Sewer Certification of Adequate Capacity (this letter) will expire within 90 days of the issue date if the applicant does not obtain a building process number from the corresponding building official. However, if the building process number has already been obtained, this letter will expire within 180 days of the expiration date of the process number. Finally, if a Building Permit was secured for this project, this letter will expire within 150 days of the expiration date of the Building Permit. Should you have any questions regarding this matter, please contact the Miami -Dade Permitting and Inspecting Center (MDPIC) (786) 315-2800 or RER Office of Plan Review Services, Downtown Office (305) 372-6789. Sincerely, Lee N. Hefty Director of Environmental Resources Management For/By: Cristian Guerrero, P.E., Chief of Environmental Plan Review. Department of Regulatory and Economic Resources. Page 1 of 2 Sanitary Sewer Certification of Adequate Capacity Project Summary: Owner's Name: GATOR 9723 NE 2ND AVE LLC Owner's Address: .EEOS Allocation Number: 2019-ALLOCATION-01618 Project: LIFT STATION CONNECTION - M2018010712 Proposed Use: 7384 SF RETAIL & 1539 SF MEDICAL OFFICE Pump Station: 99-1364A Projected NAPOT: 999.99 Proposed Projected NAPOT: 1,001.33 Page 2 of 2 ("" Miami Shores Villa0?--d e g 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 RCCC.VLi APR 17 2018I - FBC 204 Master Permit No.PIC•_o - jocg PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL I�IPLUMBING ❑ MECHANICAL []PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1.-1 City: Miami Shores County: Miami Dade zip: 3313% Folio/Parcel#: 1 1320 (eb l3Is the Building Historically Designated: Yes NO i< Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Uo� ��� N� 7.� AcVE LL.C. Phone#: C3os Address: `i 950 010 1444, f( City: W Com LkIGES State: ( Zip: 32`� Tenant/Lessee Name: 9 Phone#: Email: 1--olVA7, JE2- �_ fo r�d1�V. GD.t ^�- • ,�• CONTRACTOR: Company Name: Phone#: f Address: City: VKtay►U lam(✓-1a5 State: 4'-L Zip: 3601(2 Qualifier Name: 1'02Agjy 0-EL,L-k1) S Phone#: State Certification or Registration #: ©s%°i 33 Certificate of Competency #: DESIGNER: Architect/Engineer: v R,% C-4444 v Phone#: Coz!k/(o14' Wt Address: U), Va-�&/.3od l City: State: --L. Zip: 33,317 Value of Work for this Permit: $ -7SO 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration U New ❑ Repair/Replace ❑ Demolition Description of Work: L..LEr ��fA1 lotJ Cr�i7J /OtJ- ��4'idlr•nlI . , R ,. � . "fir. .a`li) y• . , '31` Specify color of cols Yihru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 co. promise in good faith that a whose property is subjec o for the first inspection is inspection will not be a Po Si li�ion to the issuance of a building permit with an estimated value exceeding $2500, the applicant must bpy of the notice of commencement and construction lien law brochure will be delivered to the person tachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the 1 and a reinspection fee will be charged. Signatu ER or AGENT CONTRACTOR The foregoing instru nt was acknowledged before me this day of r L . 20 by me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: I ' 3 a.= COMMISSION � FFi Seal: �i; Fall.or EXPIRES: January 159 019 �WWWAARONN 2019 OTARY,COM The foregoing instrument was acknowledged before me this l d'ay/of L. 20 d by 'fIA1 IJ IiV GU,I 010 _ who i ersonaIIy known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: /// / Print: +i( 7QUeZ * COMMISSION 15, 2012 Seal: - ,%pwEMa0NN0 Alt�•COM &Ai, INM' ********************************************************************************************************* APPROVED BY Z/ , Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Information Folio: 11-3206-013-4210 Property Address: 9723 NE 2 AVE Miami Shores, FL 33138-2310 Owner GATOR 9723 NE 2ND AVE LLC Mailing Address 7850 NW 146 ST. 4TH FLOOR MIAMI LAKES, FL 33016 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 9,459 Sq.Ft Lot Size 12,350 Sq.Ft Year Built 1948 Assessment Information Year 2017 2016 2015 Land Value $321,100 $321,100 $244,530 Building Value $357,252 $340,240 $300,718 XF Value $27,225 $27,570 $0 Market Value $705,577 $688,910 $545,248 Assessed Value 1 $659,749 $599,772 $545,248 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction 1 $45,828 $89,138 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 10 & 11 BLK 31 LOT SIZE 95.000 X 130 OR 17437-1378 1196 4 (2) Generated On : 4/17/2018 Taxable Value Information 2017E 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $659,749 $599,7721 $545,248 School Board Exemption Value $0 $0 $0 Taxable Value $705,577 $688,910 $545,248 City Exemption Value $0 $0 $0 Taxable Value $659,749 $599,772 $545,248 Regional Exemption Value $0 $0 $0 Taxable Value $659,749 $599,772 $545,248 Sales Information Previous OR Sale Price Book- Qualification Description Page 12/14/2012 $594,800 28412- Transfer where the sale price is verified to be 2519 part of a package or bulk sale. 11/01/1996 $0 17437- Sales which are disqualified as a result of 1378 examination of the deed 11/01/1988 $0 13904- Sales which are disqualified as a result of 2796 examination of the deed 06/01/1988 $340,000 13720- Sales which are qualified 2640 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: 4/17/2018 Detail by Entity Name mil- .A4 j I DenArtm^nt of State / Division of Cgrporation5 / Search Records / Detail By Documrnt Nu be / Detail by Entity Name Florida Limited Liability Company GATOR 9723 NE 2ND AVE, LLC Filing Information Document Number L12000146623 FEI/EIN Number 80-0869819 Date Filed 11/21/2012 Effective Date 11 /20/2012 State FL Status ACTIVE Principal Address 7850 NW 146TH STREET., 4TH FLOOR MIAMI LAKES, FL 33016 Changed: 11 /21 /2016 Mailing Address 7850 NW 146TH STREET., 4TH FLOOR MIAMI LAKES, FL 33016 Changed: 11 /21 /2016 Reqistered Agent Name & Address GOLDSMITH, JAMES A 7850 NW 146TH STREET., 4TH FLOOR MIAMI LAKES, FL 33016 Address Changed: 01/17/2017 Authorized Person(s) Detail Name & Address Title MGR GOLDSMITH, JAMES A 7850 NW 146TH STREET., 4TH FLOOR MIAMI LAKES, FL 33016 Annual Reports Report Year Filed Date 2016 04/12/2016 http://search.sunbiz.org/Inquiry/Corporati onSearch/SearchResultDetai I?i nqui rytype=EntityN ame&di rectionType= lniti al&searchNam eOrder=GATOR 9723N E2N. 1/2 ,,.5 '0040b4 Local Business Tax Receipt Miami —Dade County, State of Florida LHT-1-1 -THIS (SNOT ABILL -DO NOT PAY 5546206 BUSINESS NAMKOCATION RECEIPT NO. EXPIRES GATOR DEVELOPMENT CORP RENEWAL SEPTEMBER 30, 2019 - 1595 NE 163RD ST 5786695 Must be displayed at place of business 1 NORTH MIAMI BEACH FL 33162 Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS GATOR DEVELOPMENT CORP 196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED 11T CGO 7933 AxCOItECTOR $45.00 08/14/2018 Worker(s) 1 FPPU05-18-Q0• Thls Local Business Tax Receipt only confirms payment of the Local Business,%: jot is not a Iicenae' permit, or a certification of the holders qualifications, to do business. Holttsf ` any governmental or.nongwernmemef regulatory laws and requirements which apply to M The RECEIPT NO. above must be displayed on all commerc*.,. �1 iatiw wts'Ctd6'Sec Ba-276. For more information, WSW r a g 0�iifgg!l11aIRPt H A� o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) s17/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER Los Angeles-Alliant Insurance Services, Inc. 333 S Hope St Ste 3750 Los Angeles CA 90071 CONTACT NAME: PHONE FAX No -M EAIL ADDRESS: INSURER 3 AFFORDING COVERAGE NAIC 0 INSURER A: Starr Indemnity & Liability Co 38318 INSURED NAMDREA-01 INSURERB: Fireman's Fund Insurance Company 21873 GATOR 9723 NE 2ND AVE, LLC Middleneck Management LLC INSURERC: INSURERD: 7850 NW 146th St, 4th Floor INSURERE: Miami Lakes FL 33016 INSURER F : COVERAGES CERTIFICATE NUMBER: 1408429169 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE DDL SUBR NUMBER MMIDDY EFF POLICPOLICY POLICY MM/DD ExP LIMITS A X COMMERCIAL GENERAL LIABILITY Y 1000305192191 4/9/2019 4/9/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE Fi�] OCCUR PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 10,000 BI/PD Ded:S5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 0 JET—] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SIN LE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) i PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY a B UMBRELLA LIAB X OCCUR S0000049093511 4/9/2019 4/9/2020 EACH OCCURRENCE $25,000,000 X AGGREGATE $25,000,000 EXCESSLIAB CLAIMS -MADE DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILI Y Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE PEROTH_ STATUTE ER E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED4 ❑ NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Terrorism coverage is included to General Liability and Umbrella/Excess Liability policies. 30 days written notice of cancellation & 10 days for non-payment. Additional Named Insured: GATOR 9723 NE 2ND AVE, LLC Location: 9723 NE 2nd Ave. Miami Shores, FL 33138 The Certificate Holder is included as additional insured as respects General Liability coverage as required by written contract subject to the policy terms, conditions and exclusions. Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, FL 33138 I:ANI:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9)1933-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD = Department of Regulatory and Economic Resources MIAMI•DADE Division of Environmental Resources Management ® Pollution Regulation Division 701 NW 1st Court, 7th Floor Miami, FL 33136-3912 T 305-372-6600 F 305-372-6410 October 17, 2019 ELECTRONIC CORRESPONDENCE Tom Benton Miami Shores Village 10050 NE SECOND AVE Miami Shores, FL 33138 e-mail: bentont@miamishoresvillage.com Project Name: MIAMI SHORES VILLAGE LOW PRESSURE SEWER COLLECT. SYSTEM (PRIV. GRINDER) DERM Permit: No.: 2017-SEW-EXT-00226 FDEP Permit No.: 253651-669-DWC Utility DS Number: MIAMI SHORES Re: Partial certification of Completion (PC-21) of the Domestic Wastewater Collection/Transmission System (PS 99-1364A) Folio: 11-3206-013-4210. Dear Tom Benton: This letter serves as notification from the Water and Wastewater Division (W&WWD) of the Department of Regulatory and Economic Resources, Division of Environmental Resources Management (DERM) that the above referenced project has been partially certified by Todd Hendrix, P.E.. Said certification, signed by the corresponding utility on 01/26/2018, indicated that the project was completed in conformance with the approved plans and specifications and/or that the Wastewater Facility Serving the Collection/Transmission System has adequate reserve capacity to accept the flow from this project. Pursuant to the above, and inasmuch as all the specific conditions in the FDEP construction permit have been complied with, the DERM hereby clears the facilities covered under the subject project for service. Partial Certification Completed: one (1) duplex grinder pump (99-1364A) Pending Certification: 3 grinder pump stations (3 duplex). This notification does not relieve applicants from building permits requesting to connect to the sanitary sewer facilities from the requirements of a Sewer System Treatment and Transmission Certification in accordance with the terms and conditions set forth in the Consent Decree between the USEPA and Miami -Dade County (Case No. 1:12-cv-24400-FAM). If you have any questions regarding the above, please contact Ms. Hala Mirza, of the W&WWD 305-372-6600 or via email at Mirzah@miamidade.gov. When referring to this project, please use the DERM project number indicated above. Sin y, Carlos Hernandez, P.E., Chief Water and Wastewater Division Cc: Tom Benton; via e-mail: bentont@miamishoresvillage.com Todd Hendrix, P.E.; via e-mail: THendrix@cphcorp.com Lazaro Guerra, P.E.; via e-mail: Lazaro.Guerra@miamidade.gov Sergio Garcia, P.E,; via e-mail: Sergio.Garcia@miamidade.gov Chris Miranda; via e-mail: mirandac@msvfl.gov stephenbrasgaila architect, p.a. LETTER OF CLARIFICATION Date: April 22, 2019 To: Plan Reviewers/ Building Officials Miami -Dade Building Department - DERM 11805 SW 26 Street (Coral Way) Miami, Florida 33175-2474 Rye: Process Number: M2018010712 Landlord Improvements 9723 Northeast 2 Avenue Miami Shores, Florida 33138 Dear Building Officials & Inspectors: I am the Architect of Record for the above project. Please be advised of the following responses to plan review comments. DERM 1. Please refer to attached Water and Sewer verification form provided by the utility company serving this property. 2. Please refer to attached Allocation Letter. 3. Please see revised sheet SP-2 for detailed list of all spaces depicting their: 3.1. Square Footage. 3.2. Current Occupant, and 3.3. Use. Please also be advised, the eating spaces have been identified as "take out" or non - cooking as shown in Sheet SP-2. Thank you, and if you have questions or comments, please contact me directly. Please add this letter to the permanent permit record for the job. 6991 West Broward Boulevard Suite 100 Plantation, Florida 33317 954.614.3801 Florida License No. AR12239 2019-ALLOCATION-01618 5/13/2019 ' Issued Date: 5/13/2019 GATOR 9723 NE 2ND AVE LLC MIKE VAZQUEZ 7850 NW 146 ST MIAMI LAKES, FL 33016 n RE: Sanitary Sewer Certification of Adequate Capacity The Miami -Dade County Department of Regulatory and Economic Resources (RER) has received your application for approval of additional sewer flows for the following project which is more specifically described in the attached project summary. Project Name: LIFT STATION CONNECTION - M2018010712 Project Location: 9723 NE 2 AVE, , FL 00000 Previous Use: COMMERCIAL PLAZA ON SEPTIC Proposed Use: 7384 SF RETAIL & 1539 SF MEDICAL OFFICE Previous Flow: 0 GPD Total Calculated Flow: 1042 GPD Allocated Flow (additional sewer flows): 1042 GPD Sewer Utility: PRIVATE Receiving Pump Station: 99 - 1364A RER has evaluated your request in accordance with the terms and conditions set forth in Appendix A of the Consent Decree (CASE No. 1: 1 2-CV-24400-FAM) between the United States of America and Miami -Dade County. RER hereby certifies that adequate treatment and transmission capacity is available for the above described project, pursuant to the criterion stipulated in Appendix A of said Consent Decree. Furthermore, be advised that this approval does not constitute departmental approval for the proposed project and is subject to the terms and conditions set forth in the Consent Decree. Additional reviews and approvals may be required from other sections having jurisdiction over specific aspects of this project. Also, be advised that the gallons per day (GPD) flow determination indicated herein are for sewer allocation purposes only (in compliance with the Consent Decree requirements) and may not be representative of GPD flows used in calculating connection fees by the utility providing the service. Be advised that this Sanitary Sewer Certification of Adequate Capacity (this letter) will expire within 90 days of the issue date if the applicant does not obtain a building process number from the corresponding building official. However, if the building process number has already been obtained, this letter will expire within 180 days of the expiration date of the process number. Finally, if a Building Permit was secured for this project, this letter will expire within 150 days of the expiration date of the Building Permit. Should you have any questions regarding this matter, please contact the Miami -Dade Permitting and Inspecting Center (MDPIC) (786) 315-2800 or RER Office of Plan Review Services, Downtown Office (305) 372-6789. Sincerely, Lee N. Hefty Director of Environmental Resources Management For/By: Cristian Guerrero, P.E., Chief of Environmental Plan Review. Department of Regulatory and Economic Resources. Page 1 of 2 Sanitary Sewer Certification of Adequate Capacity Project Summary: Owner's Name: GATOR 9723 NE 2ND AVE LLC Owner's Address: EEOS Allocation Number: 2019-ALLOCATION-01618 Project: LIFT STATION CONNECTION - M2018010712 Proposed Use: 7384 SF RETAIL & 1539 SF MEDICAL OFFICE Pump Station: 99-1364A Projected NAPOT: 999.99 Proposed Projected NAPOT: 1,001.33 Page 2 of 2