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DEMO-10-800Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 142699 Permit Number: DEMO -5 -10 -800 Scheduled Inspection Date: November 09, 2010 Inspector: Bruhn, Norman Owner: SYLVAIN, FRED Job Address: 9100 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: UNITED GENERAL BUILDING CORP Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number (305)759 -6235 Parcel Number 1132060133200 Building Department Comments Passe Inspector Comments e7c. Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 08, 2010 For Inspections please call: (305)762 -4949 Page 8 of 33 Dekt^-s° Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 RMOMW17411 MAY 0 " 2010 L)J BY: Permit No. Lc- Lo _ifs Master Permit No.C( C) g-OO Permit Type: BUILDING ROOFING e/, %fr Owner's Name (Fee Simple Titleholder) AM( gavo Owner's Address 1I 0d iJ i(r 2 ` / City Mt qua( State Zip 13138 Tenant/Lessee Name � Phone # Email Job Address (where the work is being done) q c o o ,,Ct 0M)& X 7'?- 623s City Miami Shores Villa a County Miami -Dade Zip 3� 2 FOLIO / PARCEL # ll •- 013 3Z0Cj Is Building Historically Designated YES NO Flood Zone Contractor's Company Name i)i 4 ( 6e414 P. . . Phone # 3O — 77 - 19c7 Contractor's Address 2 71 /l/u) • 38's City (I/N1( State Zip 3 5/ Z � p p � Qualifier Name /�,%�i % �G, 2 Phone # . " - (� 'Jj ✓' - 2�! J State Certificate or Registration No. /505276/ Certificate of Competency No. 9:90 12 er VS O7 'Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # yo° D° 7%0 Value of Work For this Permit $ Type of Work: ['Addition DAlteration Describe Work: /Ct{ ,'g4.4'6., /441, .419 Act c/ A4t. Square / Linear Footage Of Work: t 2/ DNew D Repair/Replace "'Demolition °; l.° ** * * * * * * *: * * ** *** * * * * ** * * * *** * * * *** * ** Fees****** x****** * *, * * * ** * * * * * * * * * * * * ** * * * * * * * ** Submittal Fee $ Permit Fee $ Ai° Notary $ Training/Education Fee $ O' 2O Scanning $ 000 Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 1 /A ° (00 CCF $ Q CO /CC .$ Technology Fee $ D Bond $ See Reverse side —> Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 y d a r pection fee will be charged.: • ,�or Agent The forego , g instrum . was acknowledged before me this 2.4 day of 441, ,20 1.0,by OW who is personally known to me or who As iden NOTARY ItUBL My Commission Expires: 2'7,-I 12, Signature Contractor The foregoing instrument was acknowledged before me this '1¢. day of ''Vie ,20/0 ,by 1q1Z 044 Al , who is personally known to me or-who has produced as identification and who di �, oath. NOTARY PUBLIC• 0p,t -`)' 3946 Sign: Ittr c,0014%,005 ,,- c ' Print: My Commiss * * * * ** * * * * * *** * ** * ** * ** * : * * * * ** * * ** * * * ** * ** * * * ** ** * * * * * * * ** * * * * * * * * * * * * * *: * pax * * **** *** *** ** * * * * * * *, * * ** APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06110/2009) GEOTECHNICAL ENVIRONMENTAL HYPROGEOLOGY ASBESTOS Miami, April 20, 2010 /////tG !n1= �\M* 1/ X DYNATECH ENGINEERING CORP. Mr. Peter Lopez MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES 9100 NE 2"4 Avenue Miami Shores, FL 33138 Re: Property At 9100 NE 2 "d Avenue Miami Shores, FL 33138 TESTING LABORATORIES DRILLING SERVICES. INSPECTION SERVICES ROOFING Dear Mr. Lopez: Pursuant to your request, DYNATECH ENGINEERING CORP. conducted an Asbestos Interior Survey on 04 -20-10 at the above referenced project. The purpose of our inspection was to secure bulk samples for analysis to determine the presen ce of Asbestos Containing Materials. The scope of our inspection covered the following areas: - Interior was tested only at the above referenced project. (see attached plan). Based on our laboratory analysis; it was evident that asbestos fibers were found in the following secured bulk samples: A- Friable Asbestos - Containing Materials Friable ACBM means any material containing more than one percent asbestos that when dry can be crumbled, pulverized, or reduced to power by hand pressure. Friable ACBM was found in the following bulk samples: 1- Ceiling Tiles: White 2' X 4' holes pattern ceiling tiles were found with 10-15% Chrysotile fibers. (Sample numbers 16,17 & 18) The above ACBM is considered friable and must be removed prior to any disturbance Asbestos�ed by renovation or demolition. All work must be conducted by a Florida-certified Abatement Contractor under the full supervision of a Florida - licensed Asbestos Consultant. 750 West 84 Street, Hialeah, FL 33014 -3618 Phone (305) 828 -7499 o Fax (305) 828 -9598 Page 2 9100 NE 2`d Avenue Miami Shores, FL 33138 B- Category I Non-Friable Material: 1) Black A/C Mastic: Black a/c mastic was found with 9 -10% Chrysotile fibers. Sample number 25, 26 & 27. Black a/c mastic is considered Category I Non - Friable material this material is presently in good condition and does not need to be removed; however; in the event of renovation; where the black a/c mastic will be disturbed and removed, all work should be conducted by a Florida Licensed Asbestos Abatement Contractors under full supervision of a Florida Licensed Asbestos Consultant and in compliance with Federal, State and Local regulations. This report is designed to aid the building Owner, Architect, Construction Manager, General contractors and Potential Asbestos Abatement Contractors in locating ASBESTOS CONTAINED MATERIALS. Under no circumstances is this report to be utilized as a proposal or a project specification document. In the event removal of the Asbestos Containing Building Material is not scheduled in the near future; an operation maintenance (O&M) plan is recommended to minimize customers and workers exposure to potential fiber release. This inspection report is the results of a customary search of the facility for asbestos potentially hidden building materials (A.C.B.M.). This survey was destructive in order to expose po materials. We do not claim to have identified all of the asbestos containing building material present in the facility. If in the course of a renovation or demolition activity, suspect is become exposed, all activities should immediately cease and ration (DEC), ill attention for evaluation and recommendation. h En • Corpo (D C), not be responsible for these conditions. Page 3 9100 NE 2 °d Avenue Miami Shores, FL 33138 When implementing the response actions, parties responsible for final selection should remember that actions shall be sufficient to protect HUMAN HEALTH AND THE ENVIRONMENT, but may also be the least burdensome method Nothing in these recommendations should be construed as PROHIBITING or discouraging removal. It has been a pleasure serving you at this phase of your project and look forward to do so in the near future. Sincerely yours, W' u aamani, P.E. DYNATECH ENGINEERING CORP. Engineer Florida Reg. No 39584 Asbestos Consultant Number-EA 0000045 Asbestos Business No. ZA 0000045 JM DYNATECH ENGINEERING CORP. ASBESTOS SAMPLING REPORT 750 W. 84th Street, Hialeah, FL 33014 Date : 04-20-2010 Client : MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Project : 9100 NE 2ND AVENUE MIAMI SHORES, FL. 33138 Surveyor No. : 09132004 By P.B Sample Type : Bulk Samples Analysis: P.L.MJD.S• F = Friable NF = Non Friable NAD = No Asbestos Detected CHRY = Chrysotile Coggifign G =Good D = Damaged S = Significantly Damaged Potential For Damage L =Low M = Medium H = High DYNATECH ENGINEERING CORP. Analyzed by: Premnath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 Sample No. Location Description Approximate Amount a F NF Condition for Damage Analysis Interior. Wall Core Sample Of Plaster Wall 3500 SF X G/L NAD 1 2 Interior. Wall Core Sample Of Plaster Wall NA X G/L NAD 3 Interior. Wall Core Sample Of Plaster Wall NA X G/L NAD 4 Interior. Wall White 4" Vinyl Base Board With Glue 200 LNFT X G/L NAD 5 Interior. Wall White 4" Vinyl Base Board With Glue NA X G/L NAD 6 Interior. Wall White 4" Vinyl Base Board With Glue NA X G/L NAD 7 Interior. Wall Gray 4" Vinyl Base Board With Glue 100 LNFT X G/L NAD 8 Interior. Wall Gray 4" Vinyl Base Board With Glue NA X G/L NAD - 9 Interior. Wall Gray 4" Vinyl Base Board With Glue NA X G/L NAD 10 Interior. Wall Core Sample Of Concrete Blocks With Plaster Wall 3500 SF X G/L NAD F = Friable NF = Non Friable NAD = No Asbestos Detected CHRY = Chrysotile Coggifign G =Good D = Damaged S = Significantly Damaged Potential For Damage L =Low M = Medium H = High DYNATECH ENGINEERING CORP. Analyzed by: Premnath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 DYNATECH ENGINEERING CORP. ASBESTOS SAMPLING REPORT 750 W. 84th Street, Hialeah, FL 33014 Date :04-20 -2010 Client : MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Project : 9100 NE 2ND AVENUE MIAMI SHORES, FL. 33138 Surveyor No. : 09132004 By: P.B Sample Type : Bulk Samnies Analysis: P.L.MJD.S. Sample N Location No. II 11 Interior. Wall 1 Description Approximate Amount Condition F NF Potential for Damage Analysis Core Sample Of Concrete Blocks With Plaster Wall NA X 12 Interior. Wall Core Sample Of Concrete Blocks With Plaster Wall NA X G/L G/L NAD NAD 13 Interior. Wall Fiberglass Wall Insulation 100 SF 14 Interior. Wall Fiberglass Wall Insulation NA X 15 Interior. Wall Fiberglass Wall Insulation NA X G/L X G/L 16 Interior. Ceiling White 2' X 4' Holes Pattern Ceiling Tiles 2500 SF x NAD G/L 17 Interior. Ceiling White 2' X 4' Holes Pattern Ceiling Tiles NA X NAD G/L G/L 18 Interior. Ceiling White 2' X 4' Holes Pattern Ceiling Tiles NA X G/L 19 Interior. Ceiling White 2' X 4' Buckshot Pattern Ceiling Tiles 500 SF X 20 Interior. Ceiling White 2' X 4' Buckshot Pattern Ceiling Tiles NA X NAD 10-15% CHRY 10.15% CHRY G/L G/L 10-15% CHRY NAD NAD F = Friable NF = Non Friable NAD = No Asbestos Detected CIIRY = Chrysolite Condition G = Good D = Damaged S = Significantly Potential For Damage L =Low M = Medium Damaged H = High DYNATECH ENGINEERING CORP. Analyzed by: Premnath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 DYNATECH ENGINEERING CORP. ASBESTOS SAMPLING REPORT 750 W. 84th Street, Hialeah, FL 33014 Date : 04-20-2010 Client : MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Project : 9100 NE 2ND AVENUE MIAMI SHORES, FL. 33138 Surveyor No. : 09132004 By: P.B Sample Type : Bulk SamDles Analysis: P.L.NL/D.S., Sample No. Location Description Approximate Amount F NF 1 Condition Analysis Potential for Damage 21 Interior. Ceiling White 2' X 4' Buckshot Pattern Ceiling Tiles NA X G/L 22 Interior. Ceiling White 2' X 4' Star Pattern Ceiling Tiles 500 SF 23 Interior. Ceiling White 2' X 4' Star Pattern Ceiling Tiles NA X X G/L 24 Interior. Ceiling White 2' X 4' Star Pattern Ceiling Tiles 25 Interior. Ceiling Black Mastic On A/C Fiberglass Duct NA 75 LNFT 26 Interior. Ceiling Black Mastic On A/C Fiberglass Duct NA X X G/L X 27 Interior. Ceiling Black Mastic On A/C Fiberglass Duct 28 Interior. Ceiling Core Sample Of Plaster Ceiling NA 2000 SF NAD G/L NAD NAD G/L X X 29 Interior. Ceiling Core Sample Of Plaster Ceiling NA 30 Interior. Ceiling Core Sample Of Plaster Ceiling NA G/L NAD Mastic Only 9- 10 %CHRY G/L X Magic only 9-10% CHRY G/L X Mastic Only 9-10% CHRY G/L NAD G/L NAD' NAD F = Friable NF = Non Friable NAD = No Asbestos Detected CHRY = Chrysotile Condition G =Good D = Damaged S = Significantly Potential For Damage L Low M = Medium Damaged H = High DYNATECH ENGINEERING CORP. Analyzed by: Premnath Baodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 DYNATECH ENGINEERING CORP. ASBESTOS SAMPLING REPORT, 750 W. 84th Street, Hialeah, FL 33014 Date : 04-20-2010 Client : MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Project : 9100 NE 2ND AVENUE MIAMI SHORES, FL. 33138 Surveyor No. : 09132004 By P.B Sample Type : Bulk Samples Analysis: P.L.M./D.S. Sample No. Location 31 Interior. Floor Description Approximate 11 Amok F NF Potential for Damage Terrazzo Floor 4000 SF 32 Interior. Floor Terrazzo Floor NA X 33 Interior. Floor Terrazzo Floor NA X G/L G/L G/L 34 Interior_ Floor Blue Carpet Over Glue Over Concrete Floor 500 SF X G/L 35 Interior. Floor Blue Carpet Over Glue Over Concrete Floor NA X 36 Interior. Floor Blue Carpet Over Glue Over Concrete Floor NA X G/L G/L 37 Interior. Floor Brown Carpet Over Padding Over Glue Floor 2000 SF 38 Interior. Floor Brown Carpet Over Padding Over Glue Floor NA X X 39 Interior. Floor Brown Carpet Over Padding Over Glue Floor NA G/L X G/L G/L 40 Interior. Floor Green Rubber Matting Over Glue On Stairs 100 SF X G/L F = Friable NF = Non Friable NAD = No Asbestos Detected CHRY = Cbrysotile Condition G = Good D = Damaged S = Significantly Potential For Damage L= Low M = Medium Damaged H = High DYNATECH ENGINEERING CORP. Analyzed by: Premaath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 DYNATECH ENGINEERING CORP., ASBESTOS SAMPLING REPORT 750 W. 84th Street, Hialeah, FL 33014 Date : 04-20-2010 Client : MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Project : 9100 NE 2ND AVENUE MIAMI SHORES, FL, 33138 Surveyor No. : 09132004 By: P.B Sample Type : Sulk Samples Analysis: P.L.M./D.S. F = Friable NF = Non Friable NAD = No Asbestos Detected GARY = Chrysotile Condition G =Good D = Damaged S = Significantly Damaged Potential For Damage L = Low M = Medium H =High DYNATECH ENGINEERING CORP. Analyzed by Premnath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 Sample No { Location I Description Approximate Amount I 1 F I ' i N Condition Potential for Damage Analysis NA X G/L NAD 41 Interior. Floor Green Rubber Matting Over Glue On Stairs 42 Interior. Floor Green Rubber Matting Over Glue On Stairs NA X G/L NAD 43 Interior. Floor Ceramic Floor Tiles 100 SF X G/L NAD 44 Interior. Floor Ceramic Floor Tiles NA X G/L NAD 45 Interior. Floor Ceramic Floor Tiles NA X G/L NAD 46 Interior. Floor Concrete Floor 500 SF X G/L NAD 47 Interior. Floor Concrete Floor NA X G/L NAD 48 Interior. Floor Concrete Floor NA X G/L NAD F = Friable NF = Non Friable NAD = No Asbestos Detected GARY = Chrysotile Condition G =Good D = Damaged S = Significantly Damaged Potential For Damage L = Low M = Medium H =High DYNATECH ENGINEERING CORP. Analyzed by Premnath Boodoosingh McCrone Research Institute Microscopical Identification of Asbestos NO. # 09132004 C 32 b ® 2t O LJ co e FIRST FLOOR e ___ r ,44 SECOND FLOOR Dynatech Engineering Corp. Client MIAMI SHORES CONGREGATION OF JEHOVA'S WITNESSES Scale: N.T.S. Project 9100 NE 2ND AVENUE MIAMI SHORES, FL. 33138. Date: . 04-20 -2010 Miami Shores Vinage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 REQUIREMENTS FOR DEMOLITION PERMIT —igs oProvide notarized letter from homeowner authorizing contractor to demolish house- letter to be accompanied with copy of warranty deed. Er Submit permit application for demolition, electrical, plumbing and g connection if applicable. Submit Asbestos Report. 1,4\ip Provide copy of notification to utility companies for discontinuance of services such as gas, water, electric, etc... A% // IProvide copy of certification letter from a pest control company, that property has been cleared of rodent, roaches, pest, etc... ,p , ❑' Provide notarized letter from contractor doing the demolition, notifying the date of scheduled demolition. 2007 F.B.0 Section 3303 Revised on 5/22/2009 Miami Shores Congregation ofJehovah's Witnesses, Inc. 9/00 i E Second .1 renue, :Shores Village, Florida 33/38 -2804 April 26, 2010 Miami Shores Village Building Department 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Dear Sir or Madam: This is to inform you that Mr. Mizraim Perez is authorized to act in our behalf in the capacity of General Contractor. He is further authorized to perform demolition work in our building located at 9100 NE 2nd Avenue in Miami Shores. 4.1x4 rip lukat 6'"'" Pilaw I CA4:216 Air-sar0 Ago 406444611, fto/v/e M- 21.0.4 I 441294.• t Zo1 o i1 `vido (y "( )PaoWt o� ;� A* •. DAYNlEL DEL LLANO •*: MY COMMISSION # DD763946 • EXPIRES March 02, 2012 81% oroics com (401) 398-0153 FlorMallotaryS _ - 1 UNITED GENERAL €3UILCDING CORP.: 3274 l 3S* Street IVIland, 7133 42 Ph., (403) * P (3f) 8204212 April 26th, 2010 To: Miami Shores Village Atm: Building Department Re: 9100 NE 2 Avenue Miami Shores 1, Mizrain Perez qualifier of United General Building Corp. hereby notify die Village of Miami Shores that three (3) weeks from today on May 17, 2010 we will start the demolition project on the above mention property. If you should have further questions please feel to contact me at your earliest convenience, Sincerely, Mizrain Perez -- (G.C) UNITED GENERAL BLD. CORP. Ph. (305) 206-39 State of FLORIDA County of MIAMI -DADE Affirmed and subscribed before me the Xf day of Xprt , 20 /0 . By Mi od*, who is personally known r produce identification. Identification Signature of Notary Public Print Name SEAL: DAYNIEL DEL LLANO 0': MY COMMISSION # DD763948 EXPIRES March 02, 2012 9 ervlce.com (401)398.0953 FlortdaMoteryS _ --