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PW-09-20-2167, 9705 NE 2nd AveMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/22/2021 Location Address Parcel Number 9705 NE 2ND AVE, Miami Shores, FL 33138 1132060134230 Contacts Permit No... PW-09-20-2167 Permit Type: Public Works Work Classification. Public Works Permit Status: Approved Expiration: 07/22/2021 Cochran Miami Shores LLC Owner AWESOME CONSTRUCTION, INC. Contractor 97052 ROBIN DEAN laura@fitzgeraldgroup.com 3766 NW 124 AVE, CORAL SPRINGS, FL 33065 Business:9543456776 robin@awesomeconstruction.com Mobile: 5617560742 Description: PARKING LOT ASPHALT MILLING PAVING 3 Valuation: $ 3,542.00 Inspection Requests: STRIPING. CONCRETEE CURB AND SIDEWALK REPAIRS AS 1305-762-4949 REQUIRED BY VILLAGE CODE VIOLATION Total Sq Feet: 200.00 Fees Amount Education Surcharge $0.80 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $112.30 Payments Date Paid Amt Paid Total Fees $112.30 Check # 1952 01/22/2021 $112.30 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 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 ��Qc tiyn -�I ?Oa-� January 22, 2021 Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9705 NE 2ND AVE, Miami Shores, FL 33138 Contacts issue Date: 01/22/2021 Parcel Number 1132060134230 Permit NO.: PW-09-20-2167 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 07/22/2021 Cochran Miami Shores LLC Owner AWESOME CONSTRUCTION, INC. Contractor 97052 ROBIN DEAN laura@fitzgeraldgroup.com 3766 NW 124 AVE, CORAL SPRINGS, FL 33065 Business:9543456776 robin@awesomeconstruction.com Mobile: 5617560742 Description: PARKING LOT ASPHALT MILLING PAVING 3 Valuation: $ 3,542.00 Inspection Requests: STRIPING. CONCRETEE CURB AND SIDEWALK REPAIRS AS 1305-762-4949 REQUIRED BY VILLAGE CODE VIOLATION Total Sq Feet: 200.00 Fees Amount Education Surcharge $0.80 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $112.30 Payments Date Paid Amt Paid Total Fees $112.30 Check # 1952 01/22/2021 $112.30 Amount Due: $0.00 Applicant Copy For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. January22, 2021 P- Miami Shores Village �cEiVE� g v I� 21 �`' Building Department N ®� 2019 BY: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 l INSPECTION LINE PHONE NUMBER: (30S) 762-4949 lid �\ ���\ FBC 20� BUILDING Master Permit No. -Ds - PERMIT APPLICATION Sub Permit No. PUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP Q� CONTRACTOR DRAWINGS JOB ADDRESS: F M� p l�'E VD bA 1y ar Folio/Parcel#: i I - a 2.0161) " i01 ) ' Lt 2- 30 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): G O c H r-AW Addresses: /---p 1Qrrz_&l�-E�L�j t 3 City: l,--r L kL -,ftez) ti State: Tenant/Lessee Name: Email: l (I1A(_L lr-N -PI�LA6ra1 p A q Phone#: "1 0 (0 SAKE '2 12-� Zip: 2)")�_Tii Phone#: CONTRACTOR: Company Name: 6UAA&V4W_ (Jp24' 1e'11; /yj Phone#: 93%/-,3q, —(0 7�1 Address: j-? o a Y¢/i due City: State: CCCc - Zip: na Qualifier Name: D 2 Phone#:! �V -J c/S "6 7 %( State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: one#: Address: City: State: Zip: Value of Work for this Permit: $ K_A 15 • j 0 Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ wAlteration ❑New Repair/Replace ❑ Demolition Description of Work: 1V__S V� F_4mz- 16vi- Vccae c6b vcj i"'� nl Specify color of color thru tile: Submittal Fee $ w 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 $ Ck� (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 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 notbeapproved a,ad a reinspection fee will be charged. Signature ��' l Signature OWNER or T CONTRACTOR The foregoir>instrument was ackn wledged before me this The foregoing instrument was acknowledged before me this ((ay of C� 1� t� 20 �� by ' day of eldddf!20� by 9-L74A - d, wholis personally knows to 0 L— ° who ' personally know to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: / Sign: ���c�` Sign: Print: �t' ihn L. M& 5(=rCc d-c � Print: Seal: Seal: REGINA L. MASCIARELLI y SILVANA J MCLEA�I �•'�` ����'sg Notary Public - State of Florida Mv. coMHnssloN x pataoa 9*28544 I �e�0.d EerutEs: August 17, 2020 ****** ** * **^********* My Comm. Explies Feb . 20 w'I, ,,,it���,, Bonded through N tonal ' — AP IIfans Examiner Zoning U� Structural Reviews Clerk (Revised02/24/2014) u1'� �� C v�vb(-s 2019 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT DOCUMENT# L08000034368 'Entity Name: COCHRAN MIAMI SHORES, LLC Current Principal Place of Business: 1800 ELLER DRIVE, SUITE 212 FT. LAUDERDALE, FL 33316 Current Mailing Address: 1800 ELLER DRIVE, SUITE 212 FT. LAUDERDALE, FL 33316 US FEI Number: 52-6050863 Name and Address of Current Registered Agent: FITZGERALD PROPERTY MANAGEMENT 1800 ELLER DRIVE, SUITE 212 FT. LAUDERDALE, FL 33316 US FILED Mar 18, 2019 Secretary of State 2816503252CC Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Authorized Person(s) Detail Title MGMR Name COCHRAN, JOHN C Address 135 BELLAIRE STREET City -State -Zip: DENVER CO 80220 Title PROPERTY MANAGER Name DOZIER, LAURA Address 1800 ELLER DRIVE, SUITE 212 City -State -Zip: FT. LAUDERDALE FL 33316 Title MGRM Name COCHRAN, SHELIA S TRUSTEE Address 8205 KERRY ROAD City -State -Zip: CHEVY CHASE MD 20815 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 605, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: LAURA DOZIER PROPERTY MANAGER 03/18/2019 Electronic Signature of Signing Authorized Person(s) Detail Date POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS that I, John C. Cochran, have made, constituted and appointed, and by these presents do make, constitute and appoint Bradford Fitzgerald true and lawful attorney for me and in my name, place and stead, to execute any and all documents incident to the leasing, management and operation of the real property described on Exhibit "A", attached hereto and made a part hereof (the "Property) or any portion thereof, and to do and perform all and every act and thing whatsoever requisite and necessary for this appointment, to all intents and purposes that I might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney shall do or cause to be done by virtue hereof. The powers granted herein shall remai n full force and effect until termination of that certain Management Agreement dated I l, by and between Cochran Miami Shores and FITZGERALD PROPERTY M NA EMENT, INC., a Florida corporation, or until otherwise revoked in writing by me or upon my death. IN WITNESS WHEREOF, I have hereunto set our my hand and seal this day of 114AeCt, , w/ Signed, sealed and delivered in the presence of., "A' hn C.Cochran Cie ,ic Z [Print me ofwithess] �sdvs � ArlLso,1 [Print name of witness] STATE OF �162 COUNTY OF 6-7 UC /I The �Tfregoing instrument was acknowledged before me this i day of ✓VI ^gr �', by , who is personally known to me or who produced �P, •„ �Lf�., r� .d &t as identification. AS_ OTARY PUBLIC [Print name] My Commission Expires: - —a IT,Z0Z. 1 JESSICA MCGA'JGHY (Nc LarySeal) NIC)TARY PUBI W STATE OF CG: .OHAGO (J�-)TAHY ID -C1," )4(j?6- My C�n.uSsiO i E-xput� July 22.'021 EXHIBIT A LEGAL PROPERTY DESCRIPTION Lots 13, 14, 15 and 16 Blocks 31 of "An amended plat of Miami Shores Section No. 1," according to the plat thereof as recorded in Plat Book 10, at page 70, of the public records of Dade County, Florida Property Address: N.E. 97th Avenue, Miami -Dade, Florida Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF (FLORIDA) COUNTY OF (DADE) The undersigned Affiant,BPWb1-)P'-10 -fITY Odoes hereby attest that (Property owner) The attached survey, performed by _ L✓"� t �`t �+ �1T,1A � � (Name of surves company) For address: _ 1 5 1y 2��PA-: Performed on i 6 1414 � (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, Affiant say eth naught. X 8e0'r?4'-'k c'a° Property Owner Signature SWORN TO AND SUBSCRIBED before me this .-2 day of Affiant is personally known to me, produced as identification. .$'v"�.,, REGINA L. MASCIARELLI `A`% Notary Public - State o1 Florida ? Commission #F FF 928544 Revised on 5/2212009/ Revised on 6112/09 '%9+. �My Comm. Expires Feb 10, 2020 ��� ��� Bonded through National Notary Assn Notary 6m o4di 4-o Jd pa,vz' Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. LI/ OPY OF QUALIFIER'S STATE LICENCES B. ✓ COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ■�rr��s�r�i�����■ ■��s���������■ ■�r����������i�rrrr r���rrrr�r�rr■rr���a�r�����r�rrrrr�r��■ BUSINESS NAMEWC. BUSINESS ADDRESS:�%(, J�W t2— __ 1VL)e— CI t TATE R— ZIP 33C BUSINESS PHONE: () FAX NUMB ) CELL PHONE QUALIFIER'S NAME:ER tea-n QUALIFIER'S LIC NUMBER: C RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY d bFlodd P�D STATE OF FLORIDA DEPARTMENT OF BUSINESS -AND PR\' 0 --" FESSIONAL REGULATION CONSTRUCT---iOt'4'�"]'Nl-')-"U'--:tT--MttiCEt4SING BOARD THE GENE PROV Q-TTORI ff&W.15 tE RT"t, ;UNDER THE M-PTER489--RRrb 1DATATTUTES EXPIIRATIIONDk7 AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com FEB] 0 'M Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. �F%901- Development Services Department CORAL SPRINGS Business Tax Office 9500 West Sample Road, Coral Springs, FL 33065 BUSINESS TAX OFFICE — Mon-Thurs. 7:30Am - 5pm, Fri: 7:30AM - 2:30FM Phone:954-344-5964 jw .CorclSpdngs.org/businesstax LOCAL BUSINESS TAX RECEIPT AWESOME CONSTRUCTION, INC 3766 NW 124 AVE CORAL SPRINGS FL 33065 License #: BTS9364 Expiration Date: September 30, 2020 Aniount�--- -- $14-5.85----- -- — --- --- ---- - PaymerttDate - September- 4, 201— Type of Business: BUSINESS TAX RECEIPT Business Location: 3766 NW 124 AVE *POST THIS BUSINESS TAX RECEIPT IN A CONSPICUOUS PLACE* ALL WINDOW SIGNS SHALL COMPLY WITH LAND DEVELOPMENT CODE CHAPTER 18 CONDITIONS (If no conditions exist, then TYPE OF BUSINESS is only condition) DATE ADDED REQUIRED SATISFY DATE TYPE STATUS DEPARTMENT DATE NOTES: AWESO-2 DATE/DD/YYYY) 1E (MM ACORO' CERTIFICATE OF LIABILITY INSURANCE 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(ies) 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 endorsemen s . PRODUCER 954-776-2222 Brown & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 C EACT Andrew Noye, CIC, CRIS PHONE 954-776-2222 FAX 954-776-4446 (A/C, No, En): (A/C, No): AIAI P.O. Box 6727 Ft Lauderdale, FL 33310-5727 Andrew Noye, CIC, CRIS INSURE S AFFORDING COVERAGE NAIC # INSURER A:Amerisure Mutual Ins. Co.+ 23396 INSURED Awesome Construction, Inc. INSURER B : *Amerlsure Insurance Company+ 19488 Attn: Robin Dean 3766 N.W. 124 Avenue North River Insurance Com an + INSURER C : P Y 21105 INSURER D : Coral Springs, FL 33065 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMRFR- RFVISION Nt]MRFR- 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 ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR CPP20465061202 07/01/2019 07/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ipeT 7 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. 1,000,000 B AUTOMOBILE X UABIUTY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS p AUTOS ONLY AUTOS ONLY CA20465051201 07/01/2019 07/01/2020 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY Per person)$ BODILY INJURY Per accident BODILY $ PPeOacEci'Z, AMAGE $ C X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 5811113799 07/01/2019 07/01/2020 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 8,000,000 DED X I RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS'UABIUTY ANY PROPRIIETOR/PARTNER/EXECUTIVE Y / N ?Ma dER'M InBEREXCLUDED? NFI) It es, describe under DESCRIPTION OF OPERATIONS below N/A WC204651012 07/01/2019 07/01/2020 X PER OTH- E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) License Number: CGC1507113 CFRTIFICATF WAI nFR RANCFI I ATInN MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, WILL BE DELIVERED IN ACCORDANCE WITH THEOCY PROVIS ONS.E Attn: Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE 'TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (Cochran Miami Shores LLC) PROPERTY ADDRESS: 9701 NE 2 Ave Miami, FL 33138 LOT: BLOCK: SUBDIVISION: PERMIT # :13-SC-2137462 APPLICATION #: AP1551386 DATE PAID• FEE PAID: RECEIPT #: DOCUMENT #: PR1392656 PROPERTY ID #: 11-3206-013-4230 [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 [ ] GALLONS / GPD CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS Ca ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET R [ ] SQUARE FEET A TYPE SYSTEM: [ ] STANDARD I CONFIGURATION: [ ] TRENCH N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D E 0 T H E R SYSTEM SYSTEM [ ] FILLED [] MOUND [ ] [ ] BED [ ] ][ABOVE/BELOW] BENCHMARK/REFERENCE POINT [ ] [ ] [ ABOVE/ BELOW ]BENCHMARK/REFERENCE POINT ILL REQUIRED: L u.uuJ INCHES EXUAVATIUN REQUIRED: L 1 1NC:HZb Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. SPECIFICATIONS BY: TITLE: APPROVED BY: IsabeLPvxey7tioSBmwo TITLE: OPS Engineering Specialist II Dade CHD Isabel RB Perez DATE ISSUED: 08/12/2020 EXPIRATION DATE: 11/10/202C DH 401.6, 08109 (OhsolAtnn all previous editions which may not he used) Incorporated: 69E-5.003, FAC Page 1 of 3 v 1.1.4 A?15513B6 SG-1 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be In writing and must be received by the Agency Clerk for the Department, within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. cast concrete ael s to 'ptcdl (? Xi7�Xro� iv' 'averment Logo ---. optional p,-- [4:6A{2xa)a lze 3 or 5 reset In he12ht and , whltca- In color. STRIPING AND HA NDICA P D ETA TI . SHERT. WN9 A< cesslble Parkln_q 51gn (recommended loca tton) M f tc single sCi.l1 ,line la" to r WHITE ON BWE ~ PAWNG'mr =Am= - - KI CK ON Pabo OMY tow^AWAY 7w WHRE W/ X FINE UP TO S35Q 1 1 /2' LEFFE ; b • •4b3 .andlor '--.—'t= "— Tc plcal Parkln_q Spac,- 9, _0 , , Min. sib1� F�arkinc Spaces Inc _I with Florida and dry OF r i w FOR: C ARLYLE V.D. COo C HR° N LWO TRUST PROPERTY Z 5 �,, o� I�ofi Cd'„��- 1 y � [AU� CGS c c. �°� � sa a/ C eaE �NOTAPART L�II17a CaP f I ► � �> a t1 N 90°WOW E 130.00 t.ID .Baca _ _ _ _ _ _ _ _ I I I 1 aelo...�h.rse I 1 I I I I t I I I 1 11 59705\0 / rM Im 81C Y CtAVC."�: Z- $ 1 1 I I I 1 i A 58 ST < PC- W4 W�cavl LIP .0 Z7 N. E. 97th STREET N.E. 98th STREET r W F Mn /l/s,61111mg: . AI C fk7aL. OTOCI-T w Z LOCATION PLAN N.T.S I SCOPE OF {FORE 1. He. on.0 as plan part. l In toortyud Vast of F TOPIM Lt..■tth ago 1. laohct summers c4unb to gams fram dame ale ded.l Pselnl reme n.L 1. EnaamltS n■oat Stem Dalmatia Salamis Pit se/ 1 Click Bottom. Eslc Recestehaslal of aoalale pit all catch basis labdon nusel ...anUnm. OMme sm0 setovctd fns seUdor.l.tohl. Ptt Val etoctpi4 Grpnpr ihponitioo g cuG■IU G/. s. EcatnG S n..ve s.hif. I a.pdc Tint Oralof4tl tarv.omdlal atom Dallas SysGme. sate: Okmtns a ....led .oil sed ohclplis for paper dispomW.1 If .nta■haGl. I. Eatov.ta to, SqU. Tsek., Pa.p Task, led Paste.. PhomtAase mloml mow •an.f a. b.0eh1..1G ....a. 1. ?..an 111a Pnss Sgl4 Task, Me l.Do Stage Task, sea IIU p0os !up TUY la ncaysbd ma. Shy urvl ntl of t►a Istant1.0stt link. moms;. UGrcahO►. •ttb Pyiap tY.n n at.... Replace medial tomcat. income of it lace service his. Ca■p4b silctdcli co unD.n For Pup Talk Pup. S ca.taller T. Prepan$.pit. task lahfhb 0l .• bow a. the P on. U E.un,."be. pla.4ran1s.1o111sa.a0 of metU landUl sot earth tog of Imldjumsa. Obbh Estivago. laspsetlos fin■ Blame!-Ddo Canty Health DgarOosetasd City el/laa Sboas Flemebhl Dhhlae. 1. Eleanhi tome an.O.cascnU Septic Task. 1. Eelbl lo0di.1 St.n from ald sedge not to nw septic task sy.G.. 11. Uatall dalageid pi/hl sal lnhfUU rock as shove as the Plan. 11. OYhh F1.11 lo.leotie. fro. ■hmel-Od. County Nsa tk D.partmaw set Cfly 011h.1Shea. Flomebbl Division. 11. lacknupmiou phatar ■ran,On dnGgeN, Septle Tasls,S Pup Tut na -�) 6— k-1uis PROPE�SSW�E.2 tITADtNalAVME1BAINSHO16.FLORn]A331311 EXISTING SITE PLAN LEGEND LEGAL DESCRIPTION SCALE:P=2lr4r / EXISTING tma+tuaaaaosraa+mv3®avaas+.sma BUILDING tSlrwenre¢V morovaawll�Js�s nQemc m _ QF#SA V1NdPIBS1✓�S4tFDA8WNLA ffi1 I,y' �/�j��I /�,/y`� ' e� a� mu,m.nsm¢ameOnueavaoasee � CJ CHARLES C. MITCHELL P.E. CIVIL RESMIRkTIOFb 11127 1515 N.W. 16M ST. SUIT 10D•T MLAIA RZFMA33159 TE M HONE (3m 945A202 RIVE wwri s13mcm. bte. LUIS RIIALES 1182 SW 7M Pl. M Ah% FLORIDA33144 TE7.EPHOt� 257-09311 ❑� ❑a.:sa El Im m a.mma, ❑ omv sa ❑ a..�..d.a w 9r t+=v.�ly m m. Ym>ma � m�ar�mnam. REVISIONS: sEAt: Cam/ EXISTING SITE PLAN DATE 09RI2007 SCALE AS SHOM CRAM L RULES JOB Now: 200709 a'► C(0 A-1 T i d GRAPHIC SCALE 20 0 70 0 40 60 (IN FEET) 1 INCH- 20 FT, ABBREVIATIONS Brg - DENOTES BEARING N - DENOTES NORTH S - DENOTES SOUTH E - 7F7TOTES EAST W - O. VOTES WEST - LB - DENOTES LICENSE BUSINESS _ W/ - DENOTES WITH Q - DENOTES PROPERTY LINE A - DENOTES RECORD (M) - DENOTES MEASUREMENT (LCE) - DENOTES LIMITED COMMON ELEMENT (C.E) - DENOTES COMMA ELEMENT CB - DENOTES CATCH BASIN -{ - DENOTES (ENTER LINE _ HC - DENOTES HANDICAP W/M - DENOTES WATER METER F.F. - DENOTES FINISH FLOOR EL - DENOTES ELEVATION LEGEND ASPHALT PAVEMENT ® EXISTING BUILDING CONC. SIDEWALK —.—a— WOOD FENCE —.—.— IRON FENCE ® CATCH BASIN METAL LIGHT POLE ev N WATER VALVE 0 ELECTRIC BOX HANDICAP O SEPTIC TANK O WATER METER T%OPO ELEVATION W I R=25.UP mil :A=39.1V F• 1`624.9P ff A�9°4841' 2 BOUNDARY SURVEY 7F7 RECEIVEID NO 0 6 2019 BY: IF, a • x • nn�elT� . ®aat.MW,ms LOCATION PLAN N.T.S. • • f•r•i• • LEGAL DESCRIPTION: • • • f • LOTS 13, 14, 15, & 16 BLOCKS 31 OF 'AN AMENDED PLAT OF MWMI SHORES •••• SECTION NO.I*, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, • • • • • . AT PAGE 70. OF THE PUBLIC RECORDS OF DADE COUNTY. FLORIDA • • PROPERTY ADDRESS: N.E 97th AVENUE, MWMI-DARE, FLORIDA • • • • • i • SURVEYOR'S NOTES '.. • I_- LANDS_ SHOWN HEREON WERE NOT ABSTRACTED BY THE SURVEYOR FOR _ RIGHTS -OF WAY AND\OR EASEMENTS OF RECORD OR OWNERSHIP. 2- NO ATTEMPT WAS MADE BY THIS FIRM TO LOCATE UNDERGROUND UTILITIES, FOOTINGS OF BUILDINGS, WALLS OR FENCES, EXCEPT AS SHOWN HEREON, IF ANY. 3- NO UNDERGROUND OR UTILITY SERVICE INVESTIGATION PERFORMED AT THIS TIME EXCEPT AS INDICATED. 4- THE NORTH ARROW AND BEARINGS SHOWN HEREON ARE BASED ON AN ASSUMED BEARING OF S 90• 00'00'k ALONG THE CENTER -LINE OF N.E. 97TH STREET. MIAMI SHORES, FL. AND ALL OTHER BEAPINGS ARE RELATIVE THERETO. 5- FLOOD ZONE DATA: COMMUNITY/ PANEL #120652/0093 SUFFIX: J DATED: 03/02/94 FLOOD ZONE: 'X' 6- BECHMARK NAME: N-397 ELEVATION: 9.80 SURVEYOR'S CERTIFICATE: 1, HEREBY CERTIFY, THAT IN THE PROFESSIONAL OPINION OF THE UNDERSIGNED, PROFESSIONAL SURVEYOR & MAPPER, IN THE STATE OF FLORIDA. THE ATTACHED SKETCH MEETS THE REQUIREMENTS OF THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF SURVEYORS AND MAPPERS IN CHAPTER 61G17, FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES, FURTHER, THIS CERTIFICATE IS BASED ON FIELD MEASUREMENTS PERFORMED JANUARY 14. 2005., OTHER INFDRMATION AVAILABLE TO THE PROFESSIONAL SURVEYOR AND MAPPER AT THE TIME THE SERVICES WERE RENDERED. COPIES OF THIS SKETCH ARE NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. SAID EMBOSSED COPIES ARE FOR THE SPECIFIC USE OF THOSE ENTITIES THAT THE SKETCH HAS BEEN CERTIFIED TO. J.H. MANUCY , INC. LB M32 JACOB DATED: PROFESSIONAL SURWYOR,AND MAPPXR NO. 621l • SATE OF FLORIDA w. NOTES 1) THIS CERTIFICATION IS ONLY FOR THE LAND AS SHOWN- ,HEREON. 2) THIS IS NOT A CERTIFICATE OF TITLE, ZONING, EASEMENTS OR FREEDOM FOR ENCUMBRANCES. 3) THIS CERTIFICATE IS NOT VALID "THOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA UCENSED SURVEYOR AND MAPPER. DATE R E V I S 1 0 N S By l —il T LBSM PROJECT NAME' SURVEY DATE: OCT. 25, 2006 L✓ • •M ANUCY, INC. . �`�, e .a .�h CARLYLE V.D. COCHRON LIVING TRUST DRAWN: �,G 9rvevveIF CM & ErWomwrtd Ergs s aw SCALE '"=20' 4 ge Averse m 203 :mB� FIELD BOOK: SKETCH Teter �N.E 97th AVENUE, MIAMI, FL. ---ORDER ND.: 107181 1 OF 1 SHEETS (TIT CnPYDIRYT ---- -- -- --- - - •--•-••• -• �.•..-•-..��.r ,..... ,.vr �v ,ac �rruccr. ur Vnncn V� VInCR r'nR,iC....... OT t•RIII H4KLCMLI T . J. H. NAHUUT. INU. a f •••1t •••fea •••••• • z � f •, C " Jl ^ 3Z ><O MZ r r ? D ►� r k# - 7'7� l v�; !j QUII;E ii :ITS AND AT THE Ti OF A FIRE INSPECTION. Ma�aao�33� 0001045687 PERMIT ADDRESS: 9705 NE 2ND AVE Miami Shores, FL 33138 APPLICATION DATE: 11/06/2019 SQUARE FEET: EXPIRATION DATE: 02/20/2021 VALUATION: PARCEL: 1132060134230 1,106.00 DESCRIPTION: PARKING LOT ASPHALT MILLING PAVING 3 STRIPIP $34,065.00 CONCRETEE CURB AND SIDEWALK REPAIRS AS REQUIRED BY VILLAGE CODE VIOLATION CONTACTS NAME COMPANY ADDRESS Contractor ROBIN DEAN AWESOME CONSTRUCTION, INC. 3766 NW 124 AVE CORAL SPRINGS, FL 33065 Owner Cochran Miami Shores LLC 97052 REVIEW ITEM STATUS REVIEWER Building v.1 Requires Re -submit Ismael Naranjo email: bo@msvfl.gov Review item used to allow building to comment during a plan review Comments: 1. Zoning approval require. 2. DERM approval require. 3. Provide details and specifications for the full scope of work, including parking lot accessible route and stalls. Chapter 5 of 2017 FBC, Accessibility. Building v.2 Requires Re -submit Ismael Naranjo email: bo@msvfl.gov Review item used to allow building to comment during a plan review Comments: 1. Zoning approval required. 2. Provide details and specifications for the full scope of work, including parking lot accessible route and stalls. Chapter 5 of 2017 FBC, Accessibility. Planning 0 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov Review conducted by the planning and zoning department Comments: Please provide stall dimensions and design. Please indicate the dimensions of the drive lane. Planning v.2 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov Review conducted by the planning and zoning department Comments: REquested info not provided. Public Works v.1 Approved Chris Miranda email: Mirandac@msvfl.gov October 15, 2020 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1 Miami Shores village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #:�� �� r�l DATE: (Name) ❑ Contractor ❑ Owner ❑ Architect Picked up 2 sets of plans and (other) Address: From the building department on this date in order to have corrections done to plans And/or get County stamps. understand that the plans need to be brought back to Miami Shores Village Building epartment to continue permitting process. Signature: (SIGNATURE) PERMIT CLERK INITIAL: 4 4 RESUBMITTED DATE PERMIT CLERK INITIAL: I I / r-/ 7,3 Z-----� PERMIT ADDRESS: 9705 NE 2ND AVE Miami Shores, FL 33138 APPLICATION DATE: 11/06/2019 SQUARE FEET: EXPIRATION DATE: 05/04/2020 VALUATION: CONTACTS Contractor Owner NAME ROBIN DEAN PARCEL: 1132060134230 1,106.00 DESCRIPTION: PARKING LOT ASPHALT MILLING PAVING 3 STRIPII` $34,065.00 CONCRETEE CURB AND SIDEWALK REPAIRS AS REQUIRED BY VILLAGE CODE VIOLATION COMPANY AWESOME CONSTRUCTION, INC. Cochran Miami Shores LLC ADDRESS 3766 NW 124 AVE CORAL SPRINGS, FL 33065 97052 REVIEW ITEM STATUS REVIEWER Building v.1 Requires Re -submit Ismael Naranjo email: naranjoi@msvfl.gov Review item used to allow building to comment during a plan review Comments: 1. Zoning approval require. 2. DERM approval require. 3. Provide details and specifications for the full scope of work, including parking lot accessible route and stalls. Chapter 5 of 2017 FBC, Accessibility. Planning v.1 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov Review conducted by the planning and zoning department Comments: Please provide stall dimensions and design. Please indicate the dimensions of the drive lane. Public Works v.1 Approved Chris Miranda email: pw November 21, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1 PERMIT ADDRESS: 9705 NE 2ND AVE PARCEL: 1132060134230 Miami Shores, FL 33138 APPLICATION DATE: 11/06/2019 SQUARE FEET: 1,106.00 DESCRIPTION: PARKING LOTASPHALT MILLING PAVING 3 STRIPII' EXPIRATION DATE: 05/04/2020 VALUATION: $34,065.00 CONCRETEE CURB AND SIDEWALK REPAIRS AS REQUIRED BY VILLAGE CODE VIOLATION CONTACTS NAME COMPANY ADDRESS Contractor ROBIN DEAN AWESOME CONSTRUCTION, INC. 3766 NW 124 AVE CORAL SPRINGS, FL 33065 Owner Cochran Miami Shores LLC 97052 REVIEW ITEM STATUS REVIEWER Building v.1 Requires Re -submit Ismael Naranjo email: naranjoi@msvfl.gov Review item used to allow building to comment during a plan review Comments: 1. Zoning approval require. 2. DERM approval require. 3. Provide details and specifications for the full scope of work, including parking lot accessible route and stalls. Chapter 5 of 2017 FBC, Accessibility. Planning v.1 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov Review conducted by the planning and zoning department Comments: Please provide stall dimensions and design. Please indicate the dimensions of the drive lane. Public Works v.1 Approved Chris Miranda email: pw November 21, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1