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DEMO-18-1704Miami Shores Village 10050 N.E. 2nd Avenue NE _ Ilj '^ Miami Shores, FL 33138-0000 ` W * Phone: (305)795-2204 F�ORiDA Permit No. DEMO-6-18-1704 Permit Type: Demolition Permit Work Classification: Building Permit status: APPROVED Issue Date: 9/12/2018 1 Expiration: 03/11/2019 Project Address Parcel Number Applicant 9801-9845 NE 2 Avenue 1132060134380 Miami Shores, FL 33138- Block: Lot: PARK LLC Owner Information 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 of Demo: Building onal Info: INTERIOR NON -RELATED/ NON -LOADING W ification: Commercial Scanning: 3 Fees Due Amount CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $200.00 Plan Review Fee (Engineer) $60.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $279.40 Valuation: $ 4,000.00 Total Scl Feet: 4930 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO-6-18-68006 06/21/2018 Check #: 1020 $ 200.00 $ 79.40 09/12/2018 Credit Card $ 79.40 $ 0.00 Avauanie Inspection Type: Final Review Electrical Review Electrical Review Structural 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, WINQS.1.1L1i,S, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing/nformatiorVis accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the,6bove-nam9q contractor to do the work stated. September 12, 2018 Authorized Signature: Owner / Building Department Copy/ September 12, 2018 1 01n131VD1g �Ickv^ pg11SI2D18 BUILDING PERMIT APPLICATION 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 ❑ ELECTRIC ❑ ROOFING RECEIVED JUN 21 1018 F C2014 Master Permit No. 1Jcx)-)o I R -1- 'A Sub Permit No. ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: - f bo I - - fb41�) e, 2-9,P - City: Miami Shores County: Miami Dade Zip: 33 Folio/Parcel#: -S2 01�1_ 013 - 4 3 v0 Is the Building Historically Designated: Yes NO Occupancy Type: I,-"> Load: — Construction Type: s Flood Zone: X BFE: NIA, FFE: l a 35 OWNER: Name ((Fee Simple Titleholder): �/ �i� I 60�� "C' Phone#: Address:) Ng s—ey-A-ye jt2,o City: 1N /ArWt l State: r v �1 Zip: Tenant/Lessee Name: &-/Iour I - 7tr 1*Vy- Phone#: Email: �GiLLP�vv�"� •�. G�Ka(rG.�D�• �bY►'� CONTRACTOR: Company Name: J G # Phone#: Address: -7-24I s&-.) IZZ•0-yto City: �1 1AW1 J _ State: Zip: ✓ %�b 3 Qualifier Name:y�-� . C • ! Phone#: A6$• 142 3) 11 State Certification or Registration #: G G-Drj'1501� 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:nog PV-7T37/f*)fJ 1-0.401W o 44coD f w2 J b /-7ah,2 Vc,4 New TLtwA - i...-5p.ecifyr,.'.olpc,of color thru tile: „,.. . Submittal Fee $ 2 06 1 Permit Fee $ �� • u CCF $ 2^• fo CO/CC $ Scanning Fee $ Radon Fee $ 8 DBPR $ Notary $ Technology Fee $ 3 2,0 Tr$in'ing Education Fee $ 0. )50 Double Fee $ Structural Reviews $ b O Bond $ TOTAL FEE -NOW DUE $ I 1 V (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. IV YOU INTEND k 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 thgt 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 aooroved and a reinspection fee will be charaed. Signature OWNER or AGENT Signature _ r)) ACTOR The fforegoing instrument was acknowledged before me this Theforegoinginstrument was acknowledged before me this day of 20 l' byy day of �—+-�r`� 20 f � by 14 A(Lr A ] _ who is personally known to (� iw 1f�, , who is personally known,to me or who has produced identification and who did take an oath. NOTARY PUBLI Y01AN A D. A NCIBIA Print: Commission* GG 189737 Seal: oided My Comm. Expires Feb 25,2022 through National Notary Assn. APPROVED BY as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: l Seal: as D. ARENCIBIA 0 y Commission* GG 189737 i` My Comm. Expires Feb 25, 2022 Bonded through National Notary Assn. Plans Examiner Zoning 0, hall Structural Review (Revised02/24/2014) Clerk 6/21/2018 Property Search Application - Miami -Dade County OFFICE OF TH"'E. PRUPFRTY APPR/i ER 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 $785,613 $714,194 Benefits Information Benefit Type 1 2017 2016 2015 Non -Homestead Cap Assessment Reduction 1 $26,890 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). IShort Legal Description I 1 5341 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 : 6/21/2018 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 OR Previous 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 11/01'17977 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 6/21/2018 Detail by Entity Name Divi;ior, Carr.. '-T JN: DenPnrt ienl of State / Division of Corporation, / r h Records / Detail By Document Numhgr / 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 Last Event LC DISSOCIATION MEM Event Date Filed 12/04/2017 Event Effective Date NONE Principal Address 4141 NE 2ND AVENUE 204-A MIAMI, FL 33137 Mailing Address 4141 NE 2ND AVENUE 204-A MIAMI, FL 33137 Registered Agent Name & Address HOWARD B. NADEL, P.A. 301 W. HALLANDALE BEACH BLVD. HALLANDALE BEACH, FL 33009 Authorized Person(s) Detail Name & Address Title MGR CHEMTOV, SHAWN 4141 NE 2ND AVENUE, SUITE 204-A MIAMI, FL 33137 Title MGR Fuentes, Maria 10820 SW 200th Drive Miami, FL 33157 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetaiI?i nqui rytype=EntityN ame&di rectionType= Initial&searchNam eOrder=9801 PARK%2OL16 .. 1/2 JC & ASSOCIATES GROUP, INC. 7741 SW 122 Ave Miami FL. 33183 June 11 th, 2018 State of Florida, Miami Dade Miami Shores Village 10050 NE 2"d Avenue Miami Shores, FL 33138 RE: Contractor's Affidavit Property: 9801-9845 NE 2nd Ave, Miami Shores FL. 33138 Folio# 11-3206-013-4380 Owner: 9801 Park LLC 4141 NE 2"d Ave, #204A, Miami, FL 33137 Before me this day personally appeared Juan Carlos Lago who, been duly sworn, deposes and says: That he will be the only person working on the project located at: 9801984115 Nt 2nd Avenue Miami Shores FL. 33137 Juan Caglq& Lago Contractor Signature JC& Associates Group. LLC License # CGC057500 Sworn to (or affirmed) and subscribed before me this 11th day of June, 2018 Personal CAROLINA R. HERNANDEZ MY COMMISSION # FF 928131 ¢E r:�"1 Nota r . � ; :,.J:� EXPIRES: October 15, 2019 ..... °v* Bondod Thru Notary Public Underwiters CC. Maria Fuentes Shawn Chemtov for 9801 Park LLC 10820 SW 200" Drive Suite: Office Miami, FL 33157 305-253-8225 • 305-252-18 fax • 305-742-3199 cel Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Uwner — worKers' compensation Insurance Exemption 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature. `� Owner State of Florida County of Miami -Dade The foregoing was acknowle e before me this day of%--) , 20_M B �g who is personally known to me or has produced Y P Y ntification. CAROLINA R. HERNANDEZ b1Y COMMISSION # FF 928131 EXPIRES: October 15, 2019 '9801 PARK LLC 4141 NE Second Avenue #204-A Miami Florida 331871 305 455 1800 Fax 305 455 1805 June 6th, 2018 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 Letter of Authorization for Partial Interior Demolition & rear fence. To whom it may concern, The Owner hereby authorizes the General Contractor JC and Associates Group to perform selective demolition work as requested at the above mentioned property. Specifically, the existing nonbearing nonrated interior 2x6 wood framing demising walls as shown in Plan, between vacated spaces 9801/9805 and 9835/9845. Including the 4 existing bathrooms with related plumbing and electrical subs permits. This is required to prepare for new Tenant Improvements for 2 proposed restaurants under separate T.I. Permits. We thank you in advance for your time and consideration of these improvements. We hope this meets your approval. Sincerely, � aria Fuentes 9801 PARK LLC ( Q8)�kj I (� 2-q� J REPORT OF RESULTS OF PRE -RENOVATION SURVEY, INVASIVE SAMPLING AND ANALYSIS FOR ASBESTOS -CONTAINING MATERIALS COMMERCIAL SPACES 9805, 9835 NE 2 AVENUE MIAMI SHORES, FLORIDA 33138 EBS PROJECT NO.820-1801670.01 June 19, 2018 PREPARED FOR 9801 PARK LLC 4141 NE 2 AVENUE, SUITE 204-A MIAMI, FLORIDA 33137 PREPARED BY EBS ENGINEERING, INC. 4715 NW 157 ST. STE. 202 MIAMI, FLORIDA 33014 Tel. 305-625-5252 • Fax 305-625-7110 EBSENGINEERING, INC. .... ...... .... ...... ENGINEERING AND ENVIRONMENTAL SERVICES ENGINEERING, INC. ENGINEERING AND ENVI THISJune 19, 2018 Nuu. Mr. Juan Carlos Lago JOB AT 9801 Park LLC 4141 NE 2 Avenue, Suite 204-A Miami, Florida 33137 a . DNIVIENTAL SERVICES Subject: Report of Pre -Renovation Survey, Invasive Sampling and Analysis for Asbestos -Containing Materials Commercial Spaces 9805, 9835 NE 2 Avenue Miami Shores, Florida 33138 EBS Engineering Project Number 820-1801670.01 Dear Mr. Lago: •... . . .... ...... EBS Engineering, Inc. (EBS) has completed the pre -renovation survey, ?mvasive SaMe?ng '. and analysis of suspect asbestos -containing materials (ACMs) in M%brcial spaces ;••••; 090 located at 9805 and 9835 NE 2 Avenue in Miami Shores, Florida. The fLeamp ng was :'•••: performed on June 14, 2018 by Mr. Francisco Gomez of EBS. Aulhorizatiori for our ••;••. services was provided by you on June 12, 2018. This report presetftS theoproject ;;;;;• information, bulk sampling procedures, the analytical results with recomme at" ; for the removal of any ACMs identified, if any. • • • • • EBS appreciates the opportunity to be of service to you and looks forwardto bur coAti►iued • association. If you should have any questions concerning this report, please contact us at your convenience. Sincerely, EBS ENGINEERING, INC. Business License # ZA-0000069 Francisco Gomez Senior Environmei EBS\820-1801670.01 REPORTS Ben' in S. Es ien, P.E. FI rida Asbesto Ccinsultan License Number EA000007 EBS ENGINEERING, INC. 4715 NW 157 ST. STE. 202 MIAMI, FLORIDA 33014 Tel. 305-625-5252 • Fax. 305-625-7110 Commercial Spaces 9805, 9835 NE 2 Avenue, Miami Shores, Florida June 19, 2018 TABLE OF CONTENTS E B S ENGINEERING, INC. I. BACKGROUND INFORMATION..........................................................................1 II. FACILITY DESCRIPTION.....................................................................................1 III. SURVEY PROCEDURES.....................................................................................1 IV. RESULTS OF LABORATORY ANALYSIS "" ........................................ .. • V. FINDINGS AND RECOMMENDATIONS ................................... ...,.,............... 14..5 ••••�• •••••• VI. QUALIFICATIONS • • • • • •0066 • • • • • •••••• • • • • • •• • •• • • • APPENDIX A: LABORATORY ANALYTICAL RESULTS • • EBS Engineering Project No. 820-1801670.01 RAJ Commercial Spaces 9805, 9835 NE 2 Avenue, Miami Shores, Florida E B S ENGINEERING, INC. June 19, 2018 I. BACKGROUND INFORMATION EBS Engineering, Inc. was contacted by Mr. Juan Carlos Lago, concerning the pre - renovation survey, invasive sampling and analysis of suspect asbestos -containing materials in the commercial spaces located at 9805 and 9835 NE 2 Avenue in Miami Shores, Florida. It is our understanding that this sampling is necessary prior to the planned renovation of the spaces and for permitting purposes. The purpose of the invasive sampling was to locate and identify asbestos -containing building materials within the commercial spaces prior to any renovation or demolition activities which may disturb them. The sampling of the roof, other interior and exterior areas of the building was not included in the scope of this survey. II. FACILITY DESCRIPTION The subject facility is the commercial spaces located at 9805 and 9835 NE 2 AwbWe in Miami Shores, Florida encompassing approximately 4,200 s uare%fqel• Th •.nerior •��.'• finishes in spaces include; drywall board, plaster on the ceilings, dr#,call board/feint ••••�• compound and plaster on the interior partition walls, ceramic tile, vinyl•ti6 and wood on :....: the floor. Air conditioning was wall mounted units. ."". • ...... . . ..... III. SURVEY PROCEDURES • General •�•••• '. . . . . ...... The invasive survey was performed by observing accessible building. Maierials.in-the commercial spaces. The primary purpose of the survey was to locate, identify ancrels*94ss building materials which were suspected to contain asbestiform minerals. Friable and non -friable asbestos -containing materials (ACMs) encountered during the survey are addressed in this report. Friable materials, when dry, will crumble and release fibers under normal hand pressure, whereas non -friable materials will not. The sampling protocol used in this asbestos survey is in general accordance with Title 40, Code of Federal Regulations (CFR), Part 763.86 and State of Florida Statutes. Bulk Samplina Procedures The bulk sampling procedures used for the collection of suspect materials first required the establishment of homogenous sampling areas, which are defirie�; ;as areas of , materials of the same type and applied during the same general time, period, The homogenous sampling areas were then examined and representative sarnples of suspect materials were obtained from these areas. The U.S. Environmental PfdfeCtion Aclzr'cy (EPA) has published guidelines and recommendations for obtaining samples,of asbestos - containing materials. These guidelines were followed during our, survey, ;where appropriate. Additionally, samples of these materials were obtained at;the,discretion of our personnel based on past experience. ; EBS Engineering Project No. 820-1801670.01 Page 1 Commercial Spaces 9805, 9835 NE 2 Avenue, Miami Shores, Florida June 19, 2018 EB S ENGINEERING, INC. TABLE 1 - SUMMARY OF ANALYTICAL RESULTS Commercial Spaces 9805, 9835 NE 2 Avenue Miami Shores, Florida 33138 SEQUENCE NUMBER SAMPLE NUMBER HOMOGENOUS AREA SAMPLE DESCRIPTION SAMPLE LOCATION RESULTS OF PLM ANALYSIS 01 01 HA-1 White Wall Plaster 9835, NW Wall No Asbestos Detected 02 02 HA-1 White Wall Plaster 9835, North Wall No Asbestos Detected 03 03 HA-1 White Wall Plaster 9835, NE Wall No Asbestos Detected 04 04 HA-2 Gray Drywall Board 9835, NW Wall No Asbestos Detected 05 05 HA-2 Gray Drywall Board 9835, North Wall No Asbestos Detected 06 06 HA-2 Gray Drywall Board 9835, NE Wall No Asbestos Detected 07 07 HA-3 White Joint Compound 9835, NW Wall No Asbestos Detected 08 08 HA-3 White Joint Compound 9835, North Wall No Asbestos Detected 09 09 HA-3 White Joint Compound 9835, NE Wall No Asbestos Detected 10 10 HA-4 Gray Ceiling Board 9835 Restroom No Asbestos Detected 11 11 HA-4 Gray Ceiling Board 9835 Restroom No Asbestos Detected 12 12 HA-4 Gray Ceiling Board 9835 Restroom No Asbestos Detected 13 13 HA-5 Yellow/Green 12" Floor Tile 9835 North No Asbestos Detected 14 13 HA-6 Black Floor Mastic 9835 North No Asbestos Detected 15 14 HA-5 Yellow/Green 12" Floor Tile 9835 North No Asbestos Detected 16 14 HA-6 Black Floor Mastic 9835 North No Asbestos Detected 17 15 HA-5 Yellow/Grppr1 J2".Flpor•Tilp 9$�5 North No Asbestos Detected 1-6, 1ti , HA-6 Black Flo r M jti•- 9§35 North No Asbestos Detected HA-7 White WeAl'PkAer•: '. 9605 SW Wall No Asbestos Detected 20 17 HA-7 White Wall Plaster 9805 South Wall No Asbestos Detected 21 18 HA-7 White yNall9Rtastq*. ••; e8p5,SE Wall No Asbestos Detected 22 19 HA-8 Gray wa Board •• •08b5;SW Wall No Asbestos Detected ` 23 ` 20 HA-8 Gray Dr wan BoaYB' 6980t South Wall No Asbestos Detected 24 21 HA-8 Gray Dr wall Board 9805 SE Wall No Asbestos Detected EBS Engifieeting Preiec:t No. 520-1%301670.01 :.'.: Page 3 ... . . 0 ... 0 0 Commercial Spaces 9805, 9835 NE 2 Avenue, Miami Shores, Florida E B IS ENGINEERING, INC. June 19, 2018 TABLE 1 - SUMMARY OF ANALYTICAL:RESULTS��- �-� -Commercial Spaces,; 6 , 9805,.9835 NE 2 Avenue} �r f Miami'Shores;.Florida 33138`` SEQUENCE SAMPLE HOMOGENOUS SAMPLE SAMPLE RESULTS OF PLM NUMBER NUMBER AREA DESCRIPTION LOCATION ANALYSIS 25 22 HA-9 White Joint Compound 9805 SW Wall No Asbestos Detected 26 23 HA-9 White Joint Compound 9805 South Wall No Asbestos Detected 27 24 HA-9 White Joint Compound 9805 SE Wall No Asbestos Detected 28 25 HA-10 Gray Ceiling Board 9805 West No Asbestos Detected 29 26 HA-10 Gray Ceiling Board 9805 Center No Asbestos Detected 30 27 HA-10 Gray Ceiling Board 9805 East No Asbestos Detected EBS Enginee. inq rmijot IVY. 620-1 �01670.01 EMSL Analytical, Inc. 19501 NE 10th Ave. Bay A N. Miami Beach, FL 33179 Tel/Fax: (305) 650-0577 / (305) 650-0578 http //www.EMSL.com / miamilab@emsl.com Attention: Francisco Gomez EBS Engineering, Inc. 4715 NW 157th St. Ste 202 Miami, FL 33014 Project: 9801-9845 NE 2nd Ave EMSL Order: 171803399 Customer ID: EBSE50 Customer PO: Project ID: Phone: (305) 625-5252 Fax: (305)625-7110 Received Date: 06/14/2018 11:40 PM Analysis Date: 06/14/2018 - 06/15/2018 Collected Date: 06/14/2018 Test Report: Asbestos Analysis of Bulk Materials via EPA 600IR-931116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type 01 White Wall Plaster White 100% Non -fibrous (Other) None Detected Non -Fibrous 171803399-0001 Homogeneous 02 White Wall Plaster White <1% Glass 100% Non -fibrous (Other) None Detected Non -Fibrous 171803399-0002 Homogeneous 03 White Wall Plaster White 100% Non -fibrous (Other) • • • None Detected Non -Fibrous • • • •••• •••••• • 171603399-0003 Homogeneous • • • • • • • • 04 Gray Drywall Board Brown/White 10% Cellulose 90% Non -fibrous (OVerf ; • • None detected • • • • • • Fibrous 666009 • • • 171803399-0004 Heterogeneous so** •••••• • • • • • 05 Gray Drywall Board Brown/White 20% Cellulose 30% Non -fibrous (Other? • • • No"&tected • • • • • Fibrous •••••• • • • • ••••• 171603399-0005 Heterogeneous � • • • • • • • • • 06 Gray Drywall Board Brown 10% Cellulose 90% Non -fibrous (O"r4 • • • No4e Detected • • Fibrous • • • • 171803399-0006 Heterogeneous • • • • •••••• • • • • • • 07 White Joint White 100% Non -fibrous ( O;er� • • n Detected • • • • Compound Non -Fibrous • • 6 171803399-0007 Homogeneous • • • 08 White Joint White 100% Non -fibrous (Other) None Detected Compound Non -Fibrous 171803399-0008 Homogeneous 09 White Joint White 100% Non -fibrous (Other) None Detected Compound Non -Fibrous 171803399-0009 Homogeneous 10 Gray Ceiling Board White 100% Non -fibrous (Other) None Detected Non -Fibrous 171803399-0010 Homogeneous 11 Gray Ceiling Board White 100% Non -fibrous (O'her) \r:E Detected Non -Fibrous 171803399-0011 Homogeneous 12 Gray Ceiling Board White 100% Non -fibrous (01horl None Detected Non -Fibrous 171803399-0012 Homogeneous ' 13-Floor Tile Yellow/ Green Floor Yellow/Green 100% Non -fibrous (Other) None Detected Tile/ Mastic Non -Fibrous 171W3399-0013 Homogeneous 13-Mastic Yellow/ Green Floor Black 3% Cellulose 97% Non -fibrous (Other) None Detected Tile/ Mastic Non -Fibrous 171803399-0013A Homogeneous ' 14-Floor Tile Yellow/ Green Floor Yellow/Green 100% Non -fibrous (Othai-) -NanE. Detected - Tile/ Mastic Non -Fibrous J 171603399-0014 Homogeneous 14-Mastic Yellow/ Green Floor Black 5% Cellulose 95% Non -fibrous (Other) None Detected Tile/ Mastic Non -Fibrous 171803399-0014A Homogeneous Initial report from: 06/15/2018 09:14,43 ASS_PLM_0008_0009 1 73 Printed: 6/15/2018 9-14 AM Page 1 of 2 EMSL Analytical, Inc. EMSL Order: 171803399 19501 NE 10th Ave. Bay A N. Miami Beach, FL 33179 Customer ID: EBSE50 Tel/Fax: (305) 650-0577 / (305) 650-0578 Customer PO: http://www.EMSL.com / miamilab@emsl.com Project ID: Test Report: Asbestos Analysis of Bulk Materials via EPA 600IR-931116 Method using Polarized Light Microscopy Non -Asbestos Asbestos Sample Description Appearance % Fibrous % Non -Fibrous % Type 15-Floor Tile Yellow/ Green Floor Yellow/Green 100% Non -fibrous (Other) None Detected Tile/ Mastic Non -Fibrous 171803399-0015 Homogeneous 15-Mastic Yellow/ Green Floor Black 100% Non -fibrous (Other) None Detected Tile/ Mastic Non -Fibrous 171803399-0015A Homogeneous 16 White Wall Plaster White 100% Non -fibrous (Other) None Detected Non -Fibrous 171303399-0016 Homogeneous 17 White Wall Plaster White 1 DO% Non -fibrous (Other) None Detected Non -Fibrous 171803399-0017 Homogeneous 18 White Wall Plaster White 100% Non -fibrous (Other) None Detected Non -Fibrous 171803399-0018 Homogeneous • • • • 19 Gray Wall Board Gray/White 100% Non -fibrous (tither) • *10me Detected• • • • • • Non -Fibrous • • � • 171803399-0019 Heterogeneous •• • ••• • • • • • 20 Gray Wall Board Gray 100% Non -fibrous (gtI;ei),•• • Nape Detected• Non -Fibrous • • • • • • • • f71603399-0020 Homogeneous 16000 • • • • • 21 Gray Wall Board Gray 100% Non -fibrous (Other) None Detected • • Non -Fibrous •••••• • • ••••• 171803399-0021 Homogeneous • • • • • • • • • • • • • • • • • • • 22 White Joint White 100% Non -fibrous (C:ITbl"): • ± Note Detected Compound Non -Fibrous • • • • • • • • • • • 171803399-0022 Homogeneous • • • • • • 23 White Joint Gray 100% Non -fibrous (Othe•)• • •None Detected• • Compound Non -Fibrous • • • 171803399-0023 Homogeneous •• • 24 White Joint White 100% Non -fibrous (Other) None Detected Compound Non -Fibrous 171803399-0024 Homogeneous 25 Gray Ceiling Board Brown/Gray 20% Cellulose 80% Non -fibrous (Other) None Detected Fibrous 171803399-0025 Heterogeneous 26 Gray Ceiling Board Brown/Gray 20% Cellulose 80% Non -fibrous (Other) None Detected Fibrous 171803399-0026 Heterogeneous 27 Gray Ceiling Board Brown/Gray 20% Cellulose 80% Non -fibrous (Cther) None Detected Fibrous 171603399-0027 Heterogeneous Analyst(s) Edgar Rodriguez (6) Kim Wallace (24) h�lz"LAI �Z � Kimberly Wallace, L x/ratji•/ Manager or Other Apprrved Signatory EMSL maintains liability limited to cost of analysis This report relates only to the samples reported and may not be reproduced, except in full, without written approval by"EMSL. LMSL bears no responsibility for sample collection activities or analytical method limitations Interpretation and use of test results are the responsibility of the client. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST or any agency of the federal government Non -friable organically bound materials present a problem matrix and therefore EMSL recommends gravimetnc reduction prior to analysis. Samples received in good condition unless otherwise noted Estimated accuracy, precision and uncertainty data available upon request. Unless requested by the client. building materials manufactured with multiple layers (i e. linoleum, wallboard, etc.) are reported as a single sample. Reporting limit is 1 Samples analyzed by EMSL Analytical, Inc N. Miami Beach, FL NVLAP Lab Code 200204-0 J Initial report from: 06/15/2018 09:14.43 ASB_PLh1_00o9_J001 - 1 78 Printed: 6/15/2018 9,14 AM Page 2 of 2 K zo[go q2qq IC I-DADE FIRE�RES�CUE Pro ss No: Munic al Ins No: Project ame: Address: m - 45 I�NT IE DATE ppro'� isa Not Applicable t Revision Pro ss 0: DATE App oved Not Applicable t T S IS NOT A PERMIT. MUST PROVU)E FIitE ICIPAL INSPECTION REQUIREMENTS AND CORD CARD AT THE TI:".iM OF A FIRE INSPECTION. . . .... •..•.. .. . ..• 00 .•.... •. ...... ...... so 00 so 69 •.••.• • . •• • •• • • • •• . 1 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 MUNICIPAL PROCESS NUMBER HERE j QPROVIDE Job Address 0 ` ` —I� 1 � Contractor No. C.G, © ` p z u+ U Folio oil- 1��0 ' o o Last four (4) digits of Qualifier N. 22 -> Q a �� Contractor Name Lot Block a o o Qualifier Name O a j Subdivision PBpg O L6 z Address -- Metes and bounds City State _Zip [ ]Pew Construction on [ ] Demolish Current use of property un Vacant Land [ ] Shell Only Og [ Alteration Interior [ ] Addition Attached EC1bl Mc��t O ] Alteration Exterior [ ] Addition Detached Description of Work a o �a [ ] Relocation of Structure ( ] Re -Roof Sq. Ft. ?_SCO its Z Floors [ ]Enclosure [ ]Foundation Only [ ] Repair [ ] Repair Due to Fire [ ] Tent Value of Work �ccc) [ ] MELD` C) 1 [ ] Chg. Contractor W Owner © � W0. Category [ ] MELE F [ ] Re -Issue a Address 2 ' [ ] Re -Stamp N City (-iilO�.�r. State Zip [ ] MPLU [ ] Revision W Phone w M [ ] LPG W � [ ]Not Applicable for o Last four (4) digits of a [ ] MMEC Fire Owner's Social Security No. [ ] FIRE \ Vl I.►"7 Name l'�>�,1 (�J�C!� Owner vn z FZ Addres(s'�'12�1 �t4\e' 9� Q `7�WC>A Address za 00. it 10 Cityl t> �'� State Zip �' City State a a '''�� QQ '� Phone G '- 2 ^ � � � ' a W _Zip Phone � I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible. There is a minimum charge of J z ^ a g ¢ one -hour Please contact the Fire Department for current rate. 00. co 1" Request: Date: LLw ¢ 2n° Request: Date: cc 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 Miami Shores Viflage JUN 221201 ���VC Building Department RE4.,,�-- 188I 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 COl F Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 (� FBC 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑'MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Gi °ra City: Miami Shores County: Miami Dade Zip: 33 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: S Flood Zone: is BFE: FFE: IQ 351 OWNER: Name (Fee Simple Titleholder): l o LLc- Phone#: 3" S • Address:_ 4I Ne a--eg-74-ye- jt2p p-;z- City: • /"I State: Zip: I Tenant/Lessee Name: tit V l.T I - 7tr�Arry_ Phone#: �— Email: IF54:,ke-n4bA:E- G /1��! /�C • �Yr f CONTRACTOR: Company Name: �S"L1Aq;K Phone#: 7�T�f -Z Address: -7-24 w) IZZ�✓� City: �l State: Zip: Qualifier Name:yA'� . C !�'�'�(�y Gt Phone#: A65- /ter 2 N lli State Certification or Registration #: G G -Orj'{ 5017 Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: City: State: Zip: Value of Work for this Permit: $ C-� d(�3z, Square/Linear Footage of Work:�3o�rF Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: N7 Je.lo,� /VptJ- j - ►-%�7/1 tQJ 1,QA0iW& 4,JoDD fr►1Jrlirs RoomSi RELD•TVD TvR� eCG� IOW 7NNi P . , I niloVrc-rr1E�i'T� I N 5�� �e�7 P;ER-M•);• .. _, Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revi sed02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF DBPR $ CO/CC $ . Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ )u' 9 A _j < T 4 M.") LLI > CL C �J� 0 Cp7le ~ Lti < I Ll R F C3 L LU C=D 7"\" O.V1 IL kA IPTr*4c4z F-j&�Tjjll Ot4 PENOLTTIO� (�00 V7e.,P-F-JO& qt�cqj - p7tqgv"- I 9A-9 - -1 22A-5 �J E- &N/ V--- A J • • • • • • • • • ••••• • • • 00 • • • • • • • • • • • • • M2Ofp, 014 241 FA .1,' Insp No: ILI FAW.�.� ,�f� , .. �'l I 19 I \ �I �l Li 9801 NE 2nd Ave Miami Shores FL Comments ID/Remarks Correction on Engineer Notes Plans #1 Indicate on plans if Building is See Life Safety This is a non-sprinklered protected by fire sprinklers ... Plan Note on existing Building. There is no sheet A2.05 emergency power system on site #2 Indicate on plans if Building is See Life Safety This Building is not protected by protected by fire Alarm Plan Note on an existing Fire Alarm system.. System ... sheet A2.05 Any new requirements for a Fire Alarm System will be part of the Tenant Improvement documents under separate Permit. #3 Show on plans Existing and See Sheet A2.05 Existing exit/Emergency lights proposed Emergency lights are label on plan N=New, E=Existing. Manufacturer part numbers also in the legend. #4 Add a note indicating that See Life Safety Demolition/Construction demolition and construction Plan Note on Scope shall not limit or degrade work shall not limit or sheet A2.05 any existing Life Safety features degrade any existing life in the existing Building, safety fixtures of the facility.. including Exit and Emergency lighting. Any temporary shut- down of any Life Safety component shall be coordinated with the MDFD, prior to scheduling work. In case of having any questions please call me at 305-484-5596