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CC-20-518CL-D 3 •51g Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: 03/17/2020 Parcel Number 1700 NE 105TH ST 216, Miami Shores, FL 33138 1122300500250 Contacts Permit NO.: CC-03-20-518 Permit Type: Building (Commercial) Work Classification: Alteration Permit Status: Approved Expiration: 09/14/2020 DAVID KAHN Owner 1700 NE 105TH ST 216, Miami Shores, FL 33138 Mobile: 7863010151 EE&G CONSTRUCTION & ELECTRICAL LLC Contractor DONAL SCHAMBACH 1615 COOLING ST, MELBOURNE, FL 32935 mnoya@eeandg.com Description: REMOVAL OF ASBESTOS CONTAINING FLOOR TILE , MOSTIC This permit is for the removal of asbestos containing materials only. A separate permit is require for the Fees Amount Application Fee - Other $50.00 CCF $4.20 DBPR Fee $2.80 DCA Fee $2.00 Education Surcharge $1.40 Permit Fee $136.45 Scanning Fee $9.00 Technology Fee $4.66 Total: $210.51 Valuation: $ 6,215.00 Inspection Requests: 305-762-4949 Total Sq Feet: 512.00 Payments Date Paid Amt Paid Total Fees $210.51 Credit Card 03/17/2020 $160.51 Check # 4630 03/09/2020 $50.00 Amount Due: $0.00 Building Department Copy 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 w be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above namyed contr�etgr�Q , stated. Authorized Signature: Owner / Applicant / Contractor Agent "`1— Date March 17, 2020 Page 2 of 2 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 ENTZV XID MAR 0 9 2020 BY: FBC 201 - Master Permit No. CC' b3-20 — SIR Sub Permit No. 0 BUILDING ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION DRENEWAL PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS Ej CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1700 NE 105th Street, Unit 216 City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-2230-050-0350 Is the Building Historically Designated: Yes NO XX Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): David J. Kahn Phone#: 786-301-0151 Address:8551 N. Bayshore Drive City. Miami State: FL Zip: 33138 Tenant/Lessee Name: NSA Phone#: Email: CONTRACTOR: Company Name: EE&G Construction & Electrical,LLC Phone#: 305-374-8300 Address: 5751 Miami Lakes Drive City. Miami Lakes State: FL Zip: 33014 Qualifier Name: Donald Anthony Schambach, Jr. Phone#: 321-626-6463 State Certification or Registration #: CJC1154179 Certificate of Competency #: DESIGNER: Architect/Engineer: NIA Phone#: Address: City: State: Zip: Value of Work for this Permit: $6,215.00 Square/Linear Footage of Work: 512 Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Removal of Asbestos -Containing Popcorn Ceiling Texture. No Repalcement RPi%Y1 GY/a oi�/Q s/�3TLJ/L`l5 �iav T S �G Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ I ' (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mo City N/A State E---L 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 rei ection fee will be charged. Signature Signature ✓tit,Wl c. 0,YV\\0(3, OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of t v(, P� ck'� , 20 —10 , by )�Pw V10 )(— N4KIN , who is personally known to me or who has produced The foregoing instrument was acknowledged before me this _ ttday of i /% (,o,dn , 20 a P, , by paw k'y H • cJ' 1am, who is personally known to as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI as Sign: L Sign: Print: 1-,q )S' a-y Print: —0111 :►*� P MARILYN NOYA Seal: __ Comm.a�GG9 131�ea1: � MYCOMMISSION#IGGti"M EXPire8: 0CM >, , = EXPIRES: May 4. 2022 Bonded ThrU Aar n8No023 F�F Bw,dorrnn,Naarv�ut . APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) I"OG WF"Hr.,AS 7 'aYraff,t 3R4*4 ri-CRkf..s.¢ fjpt,ir"A. S3":3@- PHONE ,�`6� *Y3.,ti'741 fAif {305' "I rxW . r vk" W March 10, 2020 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 To Whom It May Concern: This letter is to verify that the popcorn ceiling removal/asbestos abatement that will be performed in Apartment 216 of The Shores Condominium, owned by David Kahn, has been approved by the Board. hank you, Nina Konnan Board President The Shores Condominium CFN: 20200147117 BOOK 31842 PAGE 1941 DATE:03/09/2020 12-03:08 PM DEED DOC 918.00 HARVEY RLIVIN, CLERK OF COURT, MIA-DADE CTY Prepared by and return to: Donald J. Kahn, Esq. Attorney at Law Green and Kahn, P.L. 317 71st Street Miami Beach, FL 33141 305-865-4311 File Number: GK-20-0019 [Space Above This Line For Recording Data] Warranty Deed This Warranty Deed made this 18th day of February, 2020 between Hope Fernans-Steutel whose post office address is 399 NE 98 St, Miami Shores, FL 33138, grantor, and David J. Kahn, a married man whose post office address is 8551 N. Bayshore Dr., Miami, FL 33138, grantee: (Whenever used herein the terms "grantor' and "grantee" include all the parties to this instrument and the heirs, legal representatives, and assigns of individuals, and the successors and assigns of corporations, trusts and trustees) Witnesseth, that said grantor, for and in consideration of the sum of TEN AND N0/100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in Mlami-Dade County, Florida to -wit: Unit No. 216 of The Shores Condominium, a Condominium, according to The Declaration of Condominium recorded in Official Records Book 4247, Page 707, and all exhibits and amendments thereof, Public Records of Miami -Dade County, Florida. Parcel Identification Number: 11-2230-050-0350 Grantor warrants that at the time of this conveyance, the subject property is not the Grantor's homestead within the meaning set forth in the constitution of the state of Florida, nor is it contiguous to or a part of homestead property. Grantor's residence and homestead address is: 399 NE 98 St, Miami Shores, Florida 33138. Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 2019. DoubleT[me® CFN: 20200147117 BOOK 31842 PAGE 1942 In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written. Signed, sealed and delivered in our presence: fitness Name , Wit ss §ameJ-4Cdc State of Florida County of Miami -Dade it (Seal) Hope Ferna s-Steutel The fpregoing instrument was acknowledged before me by means of [XI physiO presence or L] online notarization, this Z6 day of February, 2020 by Hope Fernans-Steutel, who L] is personally own or [X] lyls produced a driver's license as identification. A � [Notary Seal] Notary Publ� THOMAS J. PALMIERI r hinted Name: Commis( # GG 197545 `•;;;��` Expires March 18, 2022 Commission Expires: BMWTlwTMYFdommsson nlnBWWUb00,U 701, y s+ Warranty Deed - Page 2 DoubleTime® • • • CFN: 20200147117 BOOK 31842 PAGE 1943 i$7NCk7S:tti'.UM ,?v. %K)w: wAs'r m5+ art?c: o • M1-Vl l'i4,RFS. fLMOA 33136 • Fn4CtNE,3,%. i 4K?41 FAX :N%5! W M10) • E VA 4 het CERTIFICATE OF APPROVAL WAIVER OF RIGHT OF FIRST REFUSAL &. STATEMENT OF ASSESSMENT In reference to: Condominium Unit No. 21(a—of THE SHORES CONDOMINIUM, a condominium according to the Declaration thereof, recorded at Official Records Book 4247 Page 707, et seq. and at Official Records Book 21068 of the Public Records of Miami -Dade County, Florida. At the request of the present owner, the undersigned officers of THE SHORES CONDOMINIUM, INC (The Association), operating the above -described condominium, hereby certify as follows: 1. That%yft�, K"N as purchaser(s), has/had been duly approved by the undersigned Condominium Association pursuant to the provisions of the above described Declaration of Condominium, and the Association waives its right.of first refusal. 2. Current assessments owing for this unit are $1.,1Q: •.,W (if none are owing, insert the word "none") 3. That all maintenance against the above parcel for common expenses is fully paid as of this date and that the next payment is due on theAZ-day of MARCtL , 20 2.0 in the amount of $1LfiS, for a period of�Rcif a.9T to MARCft 31sr . 20_. DATED this 2.0!M day of rgaftV W , 20—. STATE OF FLORIDA COUNTY OF MIAMI-DADS THE SHORES CONDOMINIUM, INC. By: Director _ Attest: Director (Corporate Seal) The foregoing instrument was acknowledged before me this �1�. day, of f� (' 2 20 �_by t t )4. 1Ko 12.n'UW as direcioF and„ OV V, I I. as director, respectively, of THE SHORES CONDOMINIUM, INC., on behalf of the Corporation. W COMMISSION # 00075MO EXPIRES March 18, 2021 � J At - Notary Public, State of�Fclora a at Large M Commission Expires* I RI64A A. S UU5 Y p (Y�fi �� zl �yy�j:�._. �F�. . THE SHQ S CONDOMINIUM APARTMENTS 1700 N.E. 105th STREET • MIAMI SHORES,flORIOA w o � L; _ v r o Li LL J C LLI L) > 0 _� C- LL `' i UNIT 216 LIVING Id!- e x 2 e-x• DINING • • • • • • • • • • • • • • • • • • • • • • • •••• •••• ••••• •••••• • •• ••••• BEDROOM •• •• �••• •••••• II' -ex IV-0• . . . . . .. . •..•.• j WALK-IN CLOSET i BATHO FOYER HALL p p OM ASBESTOS FLOOR TILE/MASTIC 49 ASBESTOS CEILING FINISH -17.W V o,,1►1G 33 6;w, ... one bedroom, 1V2 baths, powder room I L_ I -1 KITCHEN a Florida Department of Department of Regulatory and Economic Resources Environmental Protection Environmental Resources Management 701 NW 1st Court, 2nd Floor Division of Air Resource Management Miami, Florida 33136-3912 T: 305-372-6925 Fax: 305-372-6954 NOTICE OF DEMOLITION OR ASBESTOS RENOVATION miamidade.gov TYPE OF NOTICE (CHECK ONE ONLY): ■ ORIGINAL REVISED AW' TYPE OF PROJECT (CHECK ONE ONLY): DEMOLITION . RENOVATION IN6 IF DEMOLITION, IS IT AN ORDERED DEMOLITION? YES El NO I�GD � 2 0 2020 IF RENOVATION: IS IT AN EMERGENCY RENOVATION OPERATION? YES ■ NO Air IS IT A PLANNED RENOVATION OPERATION? ■ YES NO fi,}� I 1. Facility Name The Shores Condo EE&G nAM Address 1700 NE 105th Street Unit Z26 00090, City Miami Shores State FL Zip 33138 County • Miami -Dade Site Living/Ditthlg Room & Bedroom Consultant Inspecting Site Presumed Based on Condo AlspSiilgd� Inforrrlatipp:. Building Size app. 891 Square Feet) k of Floors 1 Building Age in Years • 55 t& Prior Use: 71 School/College/University Residence Small Business ■ Other QiWe • • • • • • • Present Use: ❑ School/College/University Q Residence Small Business ■ Other a ;;8 • • • • • • • • • II. Facility Owner David Kahn Phone ( ) 000000 • • • • • • • Address 8551 N. Sayshore Drive • • • • see* • • • • • • City Miami State FL Zip 33138 • • • • • • a • III. Contractor's Name EE&G CONSTRUCTION & ELECTRICAL LLC Phone ( 305 ) 37{-83db ' • •• • •••••• Address 5751 MIAMI LAKES DRIVE EAST 0 City MIAMI LAKES State FL Zip 33014 • • • • • • •' • Is the contractor exempt from licensure under section 469.002(4), F.S.? 11 YES ■ NO Florida License No. • -UG-1154179 IV. Scheduled Dates: (Notice must be postmarked 10 working days before the project start date) START TIME 9:00 AM Asbestos Removal (mm/dd/yy) Start: 3/5/2020 Finish: 3/10/2020 Demo/Renovation (mm/dd/yy) Start: Finish: V. Description of planned demolition or renovation work to be performed and methods to be employed, including demolition or renovation techniques to be used and description of affected facility components. Pre -Renovation Abatement Containment, wet removal, regulated, demarcated work area with asbestos danger signs, engineering controls to include HEPA filtration exhausted from work area, double bagged and labeled, disposal in Class I Landfill. Procedures to be Used (Check All That Aoelvi: Strip and Removal Glcve Bag Bulldozer ■Wet Method Dry Method Explode Wrecking Ball Burn Down OTHER: VI. Procedures for Unexpected RACM: KEEP WET AND NOTIFY DERM AIR SECTION 305.372.6925 VII. Asbestos Waste Transporter: Name EE&G CONSTRUCTION & ELECTRICAL Phone ( 305 ) 374-8300 Address 5751 MIAMI LAKES DRIVE EAST City MIAMI LAKES State FL Zip 33014 Vlll. Waste Disposal Site: Name MIAMI-DADE COUNTY'S SOUTH DADE LANDFILL Phone ( 305 ) 258-2830 Address 23707 SW 97TH AVE., GATE A City MIAMI State FL Zip 33190 I MANAGEMENT DIVISION IX. RACM or ACM: Procedure, including analytical methods, employed to detect the presence of RACM and Category I anA T6,9kli1P15 J Presumed Based on Condo Association Information This is to ooft that they Nquired. Amount of RACM or ACM' Notification(s) Regarding asbestos have n 512 square feet surfacing material square feet cementitious material submitted in Compliance with linear feet pipe 25 square feet resilient flooring & MASTIC Applicable regulations. cubic feet of RACM off facility components square feet asphalt roofing *Identify and describe surfacing material and other materials as applicable: t ` V _ DBtE�i- •RACM Cegl A x 512 SF &RACM Floor Tile and Mastic- x. 25 SF Signed c t t e e n rma correct and that an IndrvTdual trainecl in the provisions of this regulation part will be on -site during the demolition or renovation and evidence that the required training has been accomplished by this person will be available for inspection during normal business hours. I have read and understood the additional information provided on the back of this form. Name of Owner/Operator) //" _ /4e1�'�" (� (ifs � 305-374-8300 Ld,Who of Oemer/Opereft i mew (Contact phone lid COUNTY Receipt Receipt Date: 02/20/2020 Receipt Notes: ASB-FEES ABAT THE SHORES CONDO. 1700 NE 105 ST. Customer Name: EE&G CONSTRUCTION & ELECTRICAL, LLC. Miami -Dade County Department of Regulatory and Economic Resources 701 NW 1 CT Miami, FL 33130 305-372-6789 20200220155730051980 Asbestos Reviews(PERAIRPRASB][OTHER] [ - 20200220155744447203 RER Surcharge[PERSURCHGPL][OTHER] 20200220155801042428 Check Payment [CK 4607] Receipt Number: 20200220166633626766 Register: CR1 . . .... ...... ...... .. .. ...... ...... .. . $580.00 .. r e , •• ••• ($537.50) �• Total As :'. C.00 .—. - EE&G„CON$TRUCTION & ELECTRICAL, LLC Miami Lakes, FL 33014 /" k—I' 1'1..�... ninninnnn 4607 Invoice Number Date Voucher Amount v v Discounts Previous Pay Net Amount 2202020 2/20/2020 1000000256512 537.50 537. Miami -Dade County TOTAL 537.50 537. 07 Suntrust OperatingOperaflng DER04 FOR REORDER: CALL AMERICAN COMPUTER FORMS $05-284-1234, FAX 305-883-6748 OR EMAIL saies®adbrms.com EVA001LC15 2/20/2020 3:58:15 PM Page 1 of 1 �.r,. 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: Hiram Aguiar Gallagher Bassett Technical Services 5751 Miami Lakes Drive East Miami Lakes, FL 33014 Project: 1700 NE 105 Street EMSL Order: 172000847 Customer ID: GBTS42 Customer PO: Project ID: Phone: (305) 374-8300 Fax: Received Date: 02/07/2020 11:49 AM Analysis Date: 02/07/2020 - 02/10/2020 Collected Date: 02/07/2020 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 Popcorn Ceiling White 98% Non -fibrous (Other) • • • 2%, hrysoble Finish Non -Fibrous • • • • • • 000000 172000847-Doo1 Homogeneous • .. • ; 41 . . • 2 Popcom Ceiling White 98% Non -fibrous (Gthert) • • • • • 2%.•Chrysoti1ei • •: • Finish Non -Fibrous • 172=847-oo02 Homogeneous • • • • 3 Popcorn Ceiling White 97% Non -fibrous (ft 114 • • . , 3°b�hryso%% s o * Finish Non -Fibrous • • •••••• • •• ••••• 172000847-0003 Homogeneous • • • • • 4-Vinyl Floor Tile VFT + Mastic White 98% Non -fibrous (Qtplrl • J% Chrysotile • • Non -Fibrous • • • • • 172000847-0004 Homogeneous : • • • • • • • • • • 4-Mastic VFT + Mastic Black 97% Non -fibrous (eth ert 3% c+ Chrysot • • • Non -Fibrous • • • 172000847-0004A Homogeneous • • • • Analyst(s) Edgar Rodriguez (4) Kim Wallace (1) jA�" Z� a W aQl Z Kimberly Wallace, Laboratory Manager or Other Approved Signatory EMSL maintains liability limited to cost of analysis. The above analyses were performed in general compliance with Appendix E to Subpart E of 40 CFR (previously EPA 600/M4-62-020 "Interim Method"), but augmented with procedures outlined in the 1993 ("final") version of the method. This report relates only to the samples reported above, and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities or analytical method limitations . Interpretation and use of test results are the responsibility of the client. All samples received in acceptable condition unless otherwise noted. 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. EMSL recommends gravimetric reduction for all non -friable organically bound materials prior to analysis. Estimation of uncertainty is available on request. Samples analyzed by EMSL Analytical, Inc. N. Miami Beach, FL NVLAP Lab Code 200204-0 Initial report from: 02/10/2020 09:09:11 ASS_PLM_0008_0001- 1.78 Printed: 2/10/2020 9:09 AM Page 1 of 1 OrderID: 172000847 19 xx Sq -7- 2700 West Cypress Creek Road, D122 Fort Lauderdale, Florida 33309 UALLAGHER 1 TECHNICAL SERVICES BASSET. BULK TRANSMITTAL FORM CHAIN OF CUSTODY CLIENT: �o�� . S7�cv7�c/ PROJECT: / %at% 10-r �'f�ccJL CLIENT CONTACT: PROJECT NUMBER: DATE COLLECTED: -z• - 7 BILL GROUP/PHASE: DATE SENT: DATE VERBAL NEEDED: STOP AT FIRST POSITIVE: Y circle one) DATE WRITTEN NEEDED: SAMPLE PREFIX SAMPLE NUMBER COLQR 1. 41 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. CHAIN OF CUSTODY: SAMPLE DESCRIPTION DATEITIME PRINT NAME/SIGNATURE a-v -a � qqLka C= Collection T= Transportation A= Analysis ,�. ✓ x.t�1 J94MPLE'E0CATIOV •'; • •• •....• . . . •• . •....• . ...... •.• PURPOSE VT A A C T A M--- 1 nF 1