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DEMO-11-92102x( -11-1 Miami Shores Village 9 Building Department MEM 050 N,E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CTION'S PHONE NUMBER: (305) 762.4949 mit No,D BUTLDIN PERMIT A FBC 20 11-012, Permit Type: BIJIL OWING Owner's.Name (Fee Simple Titleholder)} -� c:s r �� Owner's Address 3 � -� City `('fi c'. 5 �'r 1 _ State r j Email l i= t< LIN `T ES F 1,1 Cam- . P c`') r e\ Job Address {where the work is being done) City Miami Shores Vi11age County Miami-Dade Tenantiessee Name er-,J -'t .' Phone # � J ``j - 0 Phone# bloc -- tiLti+� ley j Jv Zip 13 FOLIO / PARCEL # I_E: " C7 '1) C, c Is Building Historicall Desi_nated. YES NO Contractor's Company Name P'vc tx'te Contractor's Address - '3 e{ -e lood Zone Co v-1 Ply - ILl y 3 Oc `7 City 1 -Ca.h State Cknd(Ci I L Qualifier Name FL State Certificate or Registration No. CC's C, 151 -1Lo' - Contact Phone ?j5 • -1(7'1'4 . 0c)"i Phone # '305 csfirt • 0 tU4 Certificate of Competency No, -Llp� E -mail Q -v"- eCt000 r cre c ' -- a_ cd 'Arc » ec Value of Work For this Permit $ Type of Work: Describe Work: DAddition jC CZ . ! DAlteration i )1' `iSquare / Linear Footage Of Work: ' ❑ .-_. t New [] Re air/Replace e intto lition C CAF - C) J, 3 :7, *is * *x:4 ** ** *k* * ** k* it ;4;t it it 7:a-* ******** Fee*kk**?:* k: 4* lc* :4 * *n * *:4 *i:;+: -fir * * * iskk * * * * *a` Submittal Fee $ Notary $ Scanning $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ Permit Fee $ CCF $ Training/Education Fee $ Radon $ DPBR CO /CC $ Techno10 )' ee Bond $ Bonding Company's Name (if applicable) Bonding Company's AdJresS City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City,_, s Appll �, hereby m to obtain a: permit to do tlxe;`rk. and installations as inciicated, I certify that no work or installation has coinnienc • prior to the Issuance of a permit and that ail work will be, performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that „separate permit must be sec • '• ,,LLLCTRJCAL WORK.. PLUiyI) SI WELLS, POOLS, FURNACES. BOILERS, HEATERS, T.4KS a n�'Ai� C4. � Y °�S ETC.... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be applicable laws regulating constructi,. and zoning. "WARNING :O OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY REST IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE ZECORDING YOUR NOTICE OF COMMENCEMENT," k IOC Notice to Applicant: Asa condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good fait) P , t�opv of the notice of commencement and construction lien law brochure will be delivered to the person whose property is su n'e 't o, attachment. Also, a certified copy of the recorded notice of commencement must be pasted at the fob site for the first inspec(inn:which riccurs seven 0-days after" the build! ,:.'; >.: 0444-214 4 :4s' uc:....lrz the absence of s.44.1 ' ;ted n . i =.. inspection will not he,ctpproved°and a r- ction fee will be charged. Owner or Agent he Toregoln : instrumlerit was acknowledged before me this The foregoing instrument was ac nowledged before ius day of , 20 ire by ' 1 rte", C-4°.�v6( .17 3 day of , 20 ‘13 , by c Ti-ths� is all knOWif, to me r who has produced entification and w who is personally known to me or who has produced as identification and who did take an oath. NOT Y PUBLI VOTARY PUBLIC: Sign: �j Print: Y My Commission Expires: k:Y Sign: ARY FLt11RtDA My Commission 1 ��:?».� Pi�Bi°TC- ST�TEOF l;t rtan,ler Carntn nT T#DD 67598 manile�2 lssid �,. Jt_ i� 01 2013 *** ***:l'I,k::a:k-k;4-�1�i;tk;kitx it **,***-;;M: i'1. *. �yc:k:y +akd�s44k�k�+-k xR;t Plans Examiner ROT Victor I t 3r Yt ick z�3cx*w**. / /,>1% / Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. I I °.2.0 ` ` 1 i °C°(4)C STATE OF FLORIDA COUNTY OF MIAMI -DADE: THE UNDER , eSh jrfNV , � it ;!a N �" 1 A that imp made to certain real lowing information wiTN p1AR 111111 11111 11111 11111 11111 11111 11111 1111 1111 CFN 2011R0297390 OR Bk 27679 Ps 3s' -o;; Ups) RECORDED 05/06/2011 12:16:51 HARVEY RUVIWt CLERK OF COURT MIAMI-DADE COUNTY/ FLORIDA LAST PAGE Space above reserved for use of recording office 1. Leg= description of property and street/address: ri e' 0 6 .1- r j r,,/,„ a I ,; c9 i ca- . I 2. Description of improvement: I 3. Owner(s) name and address:. Interest in property: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number: 1) /41 % 055) 372 40739 St)/71.- j Ali AN Vii (c) 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: - rA11:e, r. ` %'^ S �$ SO as �-°� F\ cA, Cl t°t9 , e" i J l k4. r, 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE •F COMMENCEMENT. Signature(s) of Prepared By Print Name Title /Office s)' Authorized Officer/Director/Partner/Manage Prepared By :'t ASS t.h.)13 -- •p3 II Print Name LC Ic -12vt -^ f JJotz. Title /Office ace STATE OF FLORID COUNTY OF MIAMI -DADE The foregoing instrument was acknowledged before me this day of By l Individually, or ❑ as for ❑ Personally known, or ❑ produced the following type of identificati Signature of Notary Public: Q .... Print Name: P v,.e (SEAL) VERIFICATION PURSUANT TO SECTION 92525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in It are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manag By By 123.01-52 PAGE 3 3/10 >Mn v,ct5 ab — — — — — •em" � ALENE EDMONDS i,►� Notary Public - State of Florida •= My Comm. Expires Aug 29, 2014 Commission • EE 8916 led 4I1 :Through National Notary Assn. IMPACT FEES 2011 -01 -13 15:24 A &R Equipment Corp 786 -573 -3338 » 3055124759 ACORD,, CERTIFICATE OF LIABILITY INSURANCE PRODUCER Insurance Grp. Services, Inc (formerly INS) 3000 WLs1 Cypress Creek Road Fort Laudedale, FL 33309- Phone: (954) 507 -6611 Fax: (1 4) 587 -003$ INIIIJNfD A 1C R EQUIPMENT NT CORP )42 w 114 S•r)t►;r-r 1H l.EAI.1. I'L 3:1012 51 P 2/2 OATt}(MM/DOIYYYY) 1)13/21)(1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY OLDER, THIS AND OCE TIRICAOTE RIGHTS UPON THE DOES NOT AMEND, EXTEND OOR ALTER THE COVERAGE AFFORDED BY THE POLICIES Br ELOW. INSURERS AFFORDING COVERAGE NAIL 0 • INSUREZIA WESTERN linkrrAc(s „(Nso RAN,, .1.�.I .37 ......................... INOORER8 PROCIRESSJVE EXPRESS INS. co 10193 ......... ...... INeurcn c. �lInIIAISIJItANG .. co „_— _....._ ._ i(Il . },._ .............__ IN:uurR 0. _. . IN$uMrlt,r COVERAGES TI IC POLICIES OF INSURANCE LISTED NFL.OW IiAVL (ICG.N ISSUED TO THE INSURED NAMED ABOVE FOR THC PUL ICY' PERIOD INOICATL() NOTWITHSTAUINi� ANY REQUIREMENT. TERM OR CONDITION Or ANY CONTRACT OR OTHER DOCUMENT WITH RCSPLCI' 10 WHICH THIS CERTIFICATE MAY DE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED r Y TI1E POLICIES DESCRIBED HEREIN IS SUBJECT '1'(1 Al L THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH PialcIr$ AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS —••••• 1,000,000 1u CENTRAL UA111LITY X COMMERCIAL DENP,IiAI 1 IAITh ITV • . I ru.MRS MADE. 1 Xi OCCUR Xi 11.000131/1'()111-3X: GEN1. Act:NPLLA II, LIMIT APPLIES PER: ,,,X1.1,$,01 Ir 1 1 jj i 1 1 I.t,c: 13 AUTOMOBILE LIABILITY ANY AU 10 ALI OIATIF:O AUTOS X SI:MEfVLP0 AUTr) 4 I ;RID AUTOS NUN OWNt,aAUTOS $ 10,400 PIT' WrSO n1;1). GARAGE UARLIDT I ow AUTO EKCt SAISR0R{LLA LIABILITY I.._j OCE0R I , CLAIMS MADE NI:TEN /WM 1 woRxili1 COMPENSATION AND EMPLOYERS' LJADILITY ANY PpoPRIFYO1v1AN )NLP.A.A .CVTIVC OrfIC@RAIutAInKN FYI) IJDI 1)'r yes II VIM, alrrt.4 1 UAW ;;PI,19 :t. PNOVISIIN s wow Omen sL:P0816909 0$410214 -1 ID/ 20 I U 511$12010 W SA1.11I:(') 2054002 9/23/2010 III16 /2()11 5/15 /2011 9/23/2011 rAGJJ 1)ccuIV+FwCf DAMAGE 'War= PREMISES (Fri m ctggra, MCV b 7<I' IAe a lW.r9onl . S I.0(H) PGRSO►fAL A AOV wa&IRY 1• l; lNNIAXN) oCNI:RAL AC.c:FR1i.(iAl1, 1 2,111111,00)„ 1••,I ;11l11�•�Illlll PRODUCTS - ComP/OP AGG COMBINED SING) r LIMIT (La uecaent► nog Y 1N.IUMY (Pm Ir.iRtY1) BODILY INJURY (Par gadoni) PROPERTY DAN>ACC (Por acid al) purl ONLY • EA ACCInkNI VTi•I %R MAN FA ARC 1 AUTO ONLY Ann S 1 1.000,000 CSI, 1 It 1 MCII tiCGUfiRrNCI AGGRL% I F S 1 1 1 1 T'wc tirAtu. utu. 1 -TU1l:LUMII$ LR.. -- E L EACH ACI:IUYN I 11 11)0,000 01sr..ASr-. AeMr1.0YFr t.l UIsI,A,?F, • r)LICY LIMB 1 $40.1100 DCSCRIPT/ON OF OPERADENS L/ OCATI ONS 1 VANICrLES I F:xCLUSIOn AODtO RY ENDORSEMENT! SPECIAL PIOYISION% MIAMI SIIORF.S VILLAGE 10050 NI? 2ND AVE MIAMI SHORIi,4, FL 33138 Fax (786) 573 -333 Aun: ACORD 26 (2001 /01) SHOULD ANY OF THE AOOVF EIESCR1aE0 POLICIES O4CANCELLEDIREPORE TNT` QxPIRAYIOH OATS TuEncor, TNC IIOAUINI1 IN$UREA W)LL CN0EAV00 10 MAIL __11„ _ PAPA WRITTF,N NOTICE TO DIE PICA ro waLacR NAMED TO RIB I.I•PT. (Wr• FAILURE TO 00190 SHALL IMPOSE NO OBLIGATION ow LIABILITY OF ANT KIND UPON THE INSURER, ITS AGENTS OR 1 RRERESENTAT1VES. • AU'INORiZEDRrmESENTATIVe „ it ..�.� .>f /La- . - • ACORD CORPORATION 1988 2011 -01 -19 1439 A &R Equipment Corp 786 - 573 -3338 » 3055124759 MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAOLER ST. let FLOOR MIAMI, FL 33130 655671 -7 9USI■ESS NAME / LOCATION A & R EQUIPMENT 12371 SW 128 CT 33186 UNIN DADE 2010 LOCAL BUSINESS TAX RECEIPT 2011 MIAMI -DADE COUNTY • STATE OF FLORIDA EXPIRES SEPT. 30, 2011 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 THIS 1S NOT A BILL — 00 NOT PAY FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 RENEWAL RECEIPT NO. 682731-6 CORP STATE* CGC1517634 104 COUNTY OWNER A & R EQUIPMENT CORP Sec. Type 1 Business WORKER /S BUILDING CONTRACTOR 1 mm C: DNLY AgW1FRAL AUSINEAE TAX RECEIPT. IT DOES NOT PERMIT THE NOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OA CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REDUIRED SY LAW. THUS IS NOT A CERTIFICATION OF Tout motixow DUALSIt:A- I10nS. PAYMENT RECEIVED NIAMU DADE COUNTY TAX COLLECTOR: 10/12/2010 09010112001 000082.50 SEC OTHER SIDE DO NOT FORWARD A & R EQUIPMENT CORP ANGEL RUIZ PRES 12371 SW 128 CT 104 MIAMI FL 33186 29 P 212 A Z" ARS EIVCIIRONMENTAL, INC. Asbestos Business License #ZA- 0000164 Environmental Consulting Services Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations September 28, 2010 Client: Shore Square Investment LLC C/O CFH Group LLC 9005 Biscayne Boulevard Miami Fl 33146 ARS- Report- 2010- 0860 - Asbestos Job Site: Commercial Building 9005 Biscayne Boulevard Miami, Florida ASBESTOS BUILDING SURVEY •SAN t l BY: Pursuant to your request; ARS Environmental, Inc., has performed an Asbestos Building Survey on 09- 27 -10, and limited to the above referenced location. The interior, exterior & roof of the above referenced location was visually inspected to identify building materials that may contain asbestos. Suspect materials were collected and samples sent to laboratory for analysis. Based on the laboratory analysis No Asbestos was detected greater than 1% in the secured bulk samples. There is important information in these sections that is not included in this executive summary. This report should be read in its entirety, including detailed information that is contained in other sections and appendices of this report. Appendix A: Appendix B: Appendix C: Appendix D: Appendix E: Appendix F: TABLE OF CONTENTS Bulk Sample Itemization Sheet 3 Asbestos Containing Building Material Damage and Hazard Assessment 6 Recommendations 8 Chain of Custody & Laboratory Analytical Results 9 Inspectors Certificate & Company License 14 General Terms & Conditions 17 Page 1 of 19 Mailing Address: 10097 Cleary Boulevard • #305 • Plantation, Florida 33324 Phone: (954) 227 -2402 • Fax: 866 - 748 -1264 URL: www.arsenvironmental.com • Email: sales @arsenvironmental.com ARS EIVIJIIWNMENTAL, INC. Asbestos Business License #ZA- 0000164 Environmental Consulting Services Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations September 28, 2010 Client: Shore Square Investment LLC C/O CFH Group LLC 9005 Biscayne Boulevard Miami Fl 33146 ARS- Report- 2010- 0860 - Asbestos Job Site: Commercial Building 9005 Biscayne Boulevard Miami, Florida I hereby certify that the above referenced asbestos survey was conducted on 09- 27 -10, and performed by Alex Front an E.P.A. Accredited A.H.E.R.A. Inspector utilizing the code of the Federal Regulation Standards, 40 C.F.R., Part 763, Subpart E, Section 763. 80- 763.99 and the State Asbestos Regulations, Florida Statutes 469.003. imothy ''aughey, !'.H. Florida Licensed Consultant Cert #IA0000016 Page 2 of 19 Al: �rr• t, Certified Asbestos Surveyor ARS Environmental, Inc. Certificate #:128740 Mailing Address: 10097 Cleary Boulevard • #305 • Plantation, Florida 33324 Phone: (954) 227 -2402 • Fax: 866 - 748 -1264 URL: www.arsenvironmentaicom • Email: sales @arsenvironmental.com ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860 - Asbestos Appendix A Bulk Sample Itemization Sheet Page 3 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL INC Asbestos Business License #ZA- 0000164 Project #: September 28, 2010 2010 -0860 BULK SAMPLE ITEMIZATION SHEET (HA) Areas Sample Id Material Class Sample Description Sample Location Estimated Quantity Sample Condition Physical Damage Water Damage Material Contact Sample Friability HA -100 1 M 12° x 12 tan with flecks floor tile & mastic Restroom & Employee Area 1200 S.F. Good No No High NF HA -100 2 M 12° x 12 tan with flecks floor tile & mastic Restn om & Employee Area Included Above Good No No High NF HA -100 3 M 12" x 12 tan with flecks floor tile & mastic Restroom & Employee Area Included Above Good No No High NF HA -101 4 M 2' x 4' wormlike design ceiling tiles Throughout Area 3000 S.F. Good No No High F HA -101 5 M 2' x 4' wormlike design ceiling tiles Throughout Area Included Above Good No No High F HA -101 6 M 2' x 4' wormlike design ceiling tiles Throughout Area Included Above Good No No High F HA -102 7 g WallboardlJoint Compound Throughout Area 1400 S.F. Good No No High NF HA -102 8 S Wallboard/Joint Compound Throughout Area Included Above Good No No High NF HA -102 9 S WallboardlJoint Compound ThroughoutArea Included Above Good No No High NF HA -103 10 M Yellow floor tile 8. mastic under carpeng Throughout Area 3000 S.F. Good No No High NF Checked Below are Non - Typical Suspect Material that were observed during inspection (No Samples Were Obtained) ❑No Insulation Behind Wallboard UCeramic Tiles URubber Flooring ❑A/C Wall Units ❑Exterior Wood Facade UWood Roof Trusses UFront Entrance Metal Doors ❑Metal NC Duct UTerrazzo Flooring UWood Paneling UCarpeting ❑Fiberglass Attic Insulation UT-111 Insulation Rubber ❑ Pipe Lagging ❑A/C Fiberglass Insulation ❑Foam Glass Pipe Insulation ❑Marble Tile UFiberglass Ceiling Tiles ❑A/C Wall Units UPVC Piping Note: All Quantities are approximations and actual square footage should be verified prior to any disturbance. TBD =To Be Determined Homogeneous Area: area of surfacing material, thermal system insulation material, or miscellaneous material that is uniform in color and texture. S= Surfacing Materials T= Thermal System Insulation (TSI) M= Miscellaneous Materials F= Friable: Material that may be crumbled, pulverized, or reduced to powder by hand pressure when dry. NF= Non - Friable that, when dry, may not be crumbled, pulverized, or reduced to powder by hand pressure. Page 4 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC Asbestos Business License #ZA- 0000164 Project #: September 28, 2010 2010 -0860 BULK SAMPLE ITEMIZATION SHEET (HA) Areas Sample Id Material Class Sample Description Sample Location Estimated Quantity Sample Condition Physical Damage Water Material Sample Damage Contact Friability HA -104 11 M Interior/Exterior Concrete Structure Throughout Building 3000 S.F. Good No No High NF HA -105 12 M Roof Material (Field Membrane) Throughout Building 3000 S.F. Good No No Low NF HA -105 13 M Roof Material (Field Membrane) Throughout Building Included Above Good No No Low NF HA -106 14 M Roof Material (Flashing) Perimeter of Roof 410 L.F. Good No Low NF Checked Below are Non - Typical Suspect Material that were observed during inspection (No Samples Were Obtained) No Insulation Behind Wallboard Ceramic Tiles (]Exterior Wood Facade ❑Wood Roof Trusses UTerrazzo Flooring ❑Wood Paneling OT-111 Insulation Rubber ❑ Pipe Lagging ❑Marble Tile ❑Fiberglass Ceiling Tiles ❑Rubber Flooring Front Entrance Metal Doors ✓Carpeting ✓A/C Fiberglass Insulation 0A/C Wall Units UNC Wall Units ❑Metal NC Duct ❑Fiberglass Attic Insulation ❑Foam Glass Pipe Insulation LIPVC Piping Note: All Quantities are approximations and actual square footage should be verified prior to any disturbance. TBD =To Be Determined Homogeneous Area: area of surfacing material, thermal system insulation material, or miscellaneous material that is uniform in color and texture. S= Surfacing Materials T= Thermal System Insulation (TSI) M= Miscellaneous Materials F= Friable: Material that may be crumbled, pulverized, or reduced to powder by hand pressure when dry. NF= Non - Friable that, when dry, may not be crumbled, pulverized, or reduced to powder by hand pressure. Page 5 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860- Asbestos Appendix B Asbestos Containing Building Material Damage and Hazard Assessment Page 6 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, iNC Asbestos Business License #ZA- 0000164 September 28, 2010 2010- 0860 - Asbestos Asbestos Containing Building Material Damage and Hazard Assessment Homogeneous Areas (HA) Sample Id Material Class Sample Description Sample Location Estimated Quantity Hazard Rank N.E.S.H.A.P. Category Physical Assessment Sample Friability None Detected HOMOGENEOUS AREA: system insulation material, in color and texture. for ACM that is "significantly that is "damaged" damage," damage." reserved for materials currently range of moderate to low need of immediate removal both a health hazard be damaged or accessible, immediate response damage. Minor repairs and monitor the material or renovation /demolition. not represent a health in place until demolition/ FRIABILITY Material that reduced to Material that, pulverized, pressure. may be crumbled, powder by hand when dry, or reduced CODE pulverized, or pressure when dry. may not be crumbled, to powder by hand miscellaneous or miscellaneous) An area of surfacing material, or miscellaneous material MATERIAL QUANTITY thermal that is uniform is reserved - 4 reflect ACM for significant for moderate for damage 5 to 7 are but with a disturbance. F= Friable: NF= Non - Friable: MATERIAL CLASS TBD =To Be Determined HAZARD RANKING, 1 The highest ranking damaged." 2-4 Hazard ranking 2 2 indicating "potential 3 indicating a "potential 4 indicating a "potential 5 -7 Hazard ranking of in good condition, likelihood for future DAMAGE ASSESSMENT S= Surfacing Materials T= Thermal System Insulation M= Miscellaneous Material N.E.S.H.A.P. CATEGORY Cat 1= in the Cat 11= Fri= PHYSICAL Category I Category II Friable ASSESSMENT or significantly friable damaged or significantly with potential with potential ACBM or Applicable Non - Friable Non - Friable High Risk: The material is in repair and represents regulatory non - compliance. Moderate Risk: The material may but does not require access or potential necessary. Manage periodic maintenance Low Risk: The material does and can be managed renovation. or 1. Damaged and 2. Damaged 3. Significantly 4. Damaged due to 5. ACBM may be 6. ACBM until 7. Friable hazard X. Not damaged (TSI) surfacing friable surfacing damaged friable for damage for significant damage friable suspected ACBM (material is non - friable surfacing Page 7 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations A R ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010 -0860- Asbestos Appendix D Recommendations Based on the laboratory analysis No Asbestos was detected greater than 1% in the secured bulk samples. Page 8 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860- Asbestos Appendix D Chain of Custody Laboratory Analytical Results Page 9 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations 6 Ho 01. abed ETS E4v1Z''i,o4414u4, �. 12334 73 Court North West Palm Beach, FL 33412 • (954) 236 -0053 0144144, 14.Am+s. tzesous #M000021$ REPORT NUMBER: FL10- 1134B3A LAB CODE: 920 REPORT OF CLIENT SUBMITTED BULK SAMPLE ANALYSIS CLIENT: ARS Environmental, Inc. #2010- 10097 Cleary Boulevard #305 Plantation, Florida 33324 SAMPLING DATE: 09127(10 PROJECT: Commercial Building 9005 Biscayne Blvd. Miami, Florida ANALYSIS DATE: 09(27110 Sample Number Anal. init. Sample Item Description Asbestos Percentage & Type Identified Percentage &Type Non- Asbestos Fibers Percentage Non-Fiber Mat. 1 DKE Floor Tile wlMastic NAD 100 Matrix 2 DKE -Floor Tile wlMastic NAD 100 Matrix 3 DKE Floor The w /Mastic NAD 100 Matrix 4 DKE . Ceiling Tile NAD 25 -30 Fiberglass 30-35 Cellulose 35-45 Matrix 5 DKE Ceiling Tile NAD 25-30 Fiberglass 30 -35 Cellulose 35-45 Matrix 6 DKE Ceiling Tile NAD 25 -30 Fiberglass 30-35 Cellulose 35-45 Matrix . 7 DKE Drywall wlCompound NAD 3-5 Fiberglass 7 -10 Cellulose 85 -90 Matrix 6 DKE Drywall wCCompound NAD 3-5 Fiberglass 7 -10 Cellulose 85-90 Matrix 9 DKE Drywall wCCompound NAD 3 -5 Fiberglass 7 -10 Cellulose 85-90 Matrix in nKF // M *stf WAD inn Matrix Dennis Emerson LH. *= In Mastic Portion Only Microscopist 1.2334 73 COURT NORTH, 9012k1. PALM BEACH, FI,. 33412 (954} 236 -0053 (561) 333 -0624 FAX (561) 333 -0684 Page 1 of 1 xx 7 0 U Id Wdzb:II OWE 'd g Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations 6 1 . 1 0 I.I. e6ed ET5 E44.4ve4-41 14‘4,. 12334 73 Court North West Palm Beach, FI. 33412 (954) 236 -0053 Moto* F044.614 i #Z1000021 REPORT NUMBER: FL10- 1134BSA LAB CODE: 920 REPORT OF CLIENT SUBMITTED BULK SAMPLE ANALYSIS CLIENT: ARS Environmental, Inc. #2010- 10097 Cleary Boulevard #305 Plantation, Florida 33324 SAMPLING DATE: 09/27/10 Sample Number 11 12 13 14 PROJECT: Commercial Budding 9005 Biscayne Blvd. Miami, Florida ANALYSIS DATE: 09/27110 Anal. Intl Sample Item Description Asbestos Percentage & Type identified Percentage & Type Non- Asbestos Fibers Percentage Non -Fiber Mat. I DKE Concrete NAD 100 Matrix DKE Membrane NAD 12 -15 Fiberglass 13-15 Cellulose 70-75 Matrix DKE Membrane NAD 12 -15 Fiberglass 13-15 Cellulose 70-75 Matrix DKE Flashing NAD 3-5 Fiberglass 7-10 Cellulose 85 -90 Matrix Dennis Emerson I.H. Microscopist c In Mastic Portion Only Page 2 of 2 12334 73 COURT NORTH, ROYAL PALM SRAM. FL. 33412 (954 )236 -0053 (581)333 -0624 FAX (561)333 -0684 N r Asbestos Consulting • Lead Assessments • Radon Gas Measurements • plow • Aglen° a!V Joopu 61. Jo Z 1. e6ed ARS ENOROAIMENTAL, !NC. CHAIN OF cusTorry Poeltiog flit* licquentrgi a Point Couni recmded Inabe Mate:Astro reports Berm:Irina D3k4 ,_9 Samples Taken Sy; Project Number: 201 PLM As Tionareand Um Requested: Siglu Day Page cat s Bulk Samples 413. Mud, f2 Fkgy 4 4 Prafect Localtrigi Itatigat_CAMDMAt (3,1)05 ziwytiq ow, _ tAtt_ai_04 - Sauk hi Modal Class r-, Sem Ottes tar 1. 'Q w -iNe.1 le el vi.,, TtP-- SgetiO4 Lannon ks-ovaarts1,--t- , ,c. it., tvfx Al IfroX. Ste 140 It &NW Physle41 Wader Fig Sample Cigsdit 14n Bongs Emma MO Igy _ 1 •M 1101 O II 11111111 TA , 1 L . . o, 4 N'tkciIQA,1C IIE -e IIIIII11 11111111111111 1111111111111 _ . 1111 . fr : I k ith°111111/111111112 ■ iktil <MO, NA r 1511111111111111111111111111 IIIII•IIIII III 0,, NN 11111111111111111111111LILII -1,\.6wvii,9444\vtc..., r • ,..Adc !Maud caw It.9.1tongValutt Vihemfd5 at•minlamoarkgms. Nib ilker.sawro nreabllitylltion.Forde f'f4itiVediffididthar6468GrIntAA Paa4rtieeleinftilt.469.1Vb0.4 Transfered By: Oat= 7 Raceived tr peon Add : Rig/ Cleary Bo4b:tvol • r 05 • Pla.tatirn, 32:.V4 • 1-110'10: (954) 2f-'-'.4p2 • Fag: 951227-'409 Toll Flee Narruer: (3.77? WI -P41 I SI9: Woad £d Wd£'b:TT 0TOE LE 'daS Asbestos Consulting • Lead Assessments • Radon Gas Measurements • plow • Amen° JlyJoopu 61. JO£1.e6ed ARS EntoRmENTAL, buc. CHAIN OF CUSTODY Pcaliva %.1plisquested &Past CLnT Rabb Ivlattsfals it al tepoals 41% PLM Page CI; . of s Bulk Samples Sampling Deter Samples Taker By: Project Meeker 1 I4IL ao4 Soneroand Time Requested: BOOM! Day or 48 Flour 7P Hour Project Lamellas 07(3V1•11 rez.e.4.44,40, Aka. fiscft4c. _top Semple Id tfialabl Ora o nagerpon Somas Maks El= . 11111=11111111 IU11II 11111MIMEN vi.om ,,.. 1111111111111111111111 N= 1111 mei a [ E = 1111 ' • I' 1 KAT • . • til,* .23W rc*CIL 'b 4, '-L . .:. 1,..-- 325S ZA 11 fr‘ 1,- g-,r724 NcivuOV---V\INAPt te-ArNzeit--- Lc. - •„ , toss I C 4 ,„v 1, 7 * 411 1 riti 411%0 C • t s Lk5 '-- NCI 314, itA .111 tiffiCDtt Mg " piq •-8 IA .............: 1111111111111111111111111111.11.1111111111 MEM Safidisl iqu Skrorfrwrertalelpla Transform! or Adds iontSysITIO PM (TS} tagalmeow or moat] Fr.Firrilt (t/Soiallui rap hs wronlird.o-Confrott ot rentiDI 1011:011 triband 'orrirogril or swot m. . may Receive m 10 7(e HOUIEWel • •31:15 • Para` .011, da 23324 • Pt KIIIE (1.454) 227.2.1C2 • Fax: Pbrl-227-2409 • Fulti-roe:titrItte*. (51?) ?27-24131 bd Wdbb:TT owe LZ 'daS ARS ENVIRONMENTAL,, INC September 28, 2010 Asbestos Business License #7A- 0000164 2010- 0860- Asbestos Appendix E Inspectors Certificate & Business License Page 14 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860 - Asbestos DATE Asbestos Business License DEPARTMENT 0 BAT cH NUMBER STATE OF FLORIDA BOO P OF CE ?SE N1R 09 16 2009 098043726 ::ZA0000164 The. ASBESTOS BUSINESS ORGANIZATION Named below IS LICENSED Under the provisions of Chapter 469 PS. Expiration date NOV 30. 2011 ARS ENVIRONMENTAL, INC. TIMOTnY CAUGUEY 120397 CLEARY BOULEVARD PLANTATION FL 33324 CHARLIE CRIST GOVERNOR SIoNAL GULATION 03 is O1SPtA A a 1 EQULRWW ti !.AW Page 15 of 19 ARLES w. OPAGO SECRETARY Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations tlii IV Uy O O 000 Qt1 cn co (D O ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860- Asbestos Appendix F General Terms & Conditions Page 17 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC September 28, 2010 Asbestos Business License #ZA- 0000164 2010- 0860 - Asbestos GENERAL TERMS AND CONDITIONS Scope Of Work ARS ENVIRONMENTAL, INC., inspection is limited and non - destructive in nature, Any conditions or materials which were not able to be visually observed on the surface, or in easily accessible areas, were not inspected and may differ from those observed. It was not within the scope of this investigation to remove surface materials to investigate portions of the structure or materials which lay beneath the surface. Our selection of sample locations and frequency is based upon our observations and the assumption that like materials in the same area are homogeneous. This inspection report is the result of a diligent search of the facility for Asbestos Containing Building Materials (A.C.B.M.). The purpose of this inspection was to identify those materials which may pose a health hazard to occupants of a building and impart future liability to the Owners and Insurers of the property. However, we do not claim to have identified all of the Asbestos Contained Building Materials present in the facility. Materials such as underground pipes, any material inside walls, ceilings, floors or other enclosed and inaccessible areas were not sampled and are not covered in this report. This report is designed to aid the building Owner, Architect, Construction Manager, General Contractors and potential Asbestos Abatement Contractors in locating ASBESTOS CONTAINING BUILDING MATERIALS. Under no circumstances is this report to be utilized as a proposal or a project specification document. This report is based upon conditions and practices observed at the property and information made available to the surveyor. This report does not intend to identify all hazards or unsafe practices, nor to indicate that other hazards or unsafe practices do not exist at the premises. Right Of Entry The client will provide for right of entry of ARS ENVIRONMENTAL, INC., personnel in order to complete the above referenced work. Invoices ARS ENVIRONMENTAL, INC., will submit invoices to client upon completion of services. Ownership Of Documents All reports, field data, field notes, laboratory test data, calculations, estimates and any other documents prepared by ARS ENVIRONMENTAL, INC., as instruments of service shall remain the property of ARS ENVIRONMENTAL, INC. Page 18 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations ARS ENVIRONMENTAL, INC Asbestos Business License #ZA- 0000164 2010- 0860- Asbestos September 28, 2010 Assumptions And Limitations The results, finds, conclusions and recommendations expressed in this report are based only on conditions which were observed during inspections by this report. ARS ENVIRONMENTAL, INC., makes no representation or assumptions as to past conditions or future occurrences. Assigns Neither the client nor ARS ENVIRONMENTAL, INC., may delegate, assign, sublet or transfer his duties or interest in this agreement without the written consent of the other party. Roof Cuts To obtain accurate information in a roof investigation, roof cuts (approximately four inch (4 ") squares), may be deemed necessary. It is the responsibility of our client to make appropriate repairs to these roof cuts, using materials consistent with the roofing system and in accordance with any existing material manufacturer's warranties. A roofing contractor or maintenance personnel selected by our client should be on the roof to make any necessary repairs at the time the samples are being obtained. Although, every attempt will be made to make these repaired areas water tight, ARS ENVIRONMENTAL, INC., will in no way be responsible for any water damage to the roofing system, building, or it's contents resulting from ARS ENVIRONMENTAL, INC temporary repairs. Disclaimer If in the course of a renovation or demolition activity, suspect materials become exposed, ALL FURTHER ACTIVITY SHOULD IMMEDIATELY CEASE AND THE ASBESTOS FORM STATUS OF THE MATERIAL SHOULD BE DETERMINED BEFORE PROCEEDING Page 19 of 19 Asbestos Consulting • Lead Assessments • Radon Gas Measurements • Indoor Air Quality • Mold Investigations 2011042714091484 M I A M I•DADE COUNTY Carlos Alvarez, Mayor TREE REMOVAL PERMIT Permit Number: TREE- 002980 -2011 Environmental Resources Management Pollution Regulation & Enforcement Division 701 NW 1st Court • 7th Floor Miami, Florida 33136-3912 T 305 - 372 -6600 F 305 - 372 -6410 miamidade.gov Issue Date: 04/27/2011 DERM Project Manager: NATALIA STRATMAN Expiration Date: 04/27/2012 Permittee: TOMAS CABRERIZO TOMAS CABRERIZO D /B /A SHORE SQUARE INVESTMENT, LLC 9005 BISCAYNE BLVD MIAMI LAKES, FL 33016 - Folio(s): 1132060110060, 1132060010060 Project Location: 9005 BISCAYNE BLVD MIAMI, FL 33138 - Bond Required: N Approved Work: Approval for the removal of the following REGULAR size trees: Eleven (11) Sabal Palms (Sabal palmetto) and five (5) Gumbo Limbo trees (Busera simaruba). Total amount of canopy approved for removal= 952 SQ FT. REPLANTING REQUIREMENTS To replace lost tree canopy, the permittee shall replant 952.00 sq ft of tree canopy. NO more than thirty (30) percent of the replacement trees shall be palms. See the attached Tree Replacement Plan for details and options. At least, 952.00 sq. ft. of the trees must be NATIVE to South Florida. Native plant lists are available upon request. All replacement trees shall have a minimum quality of Florida No. 1 grade or better. Mulch shall be placed around all replacement trees. All trees shall be planted on -site or at an approved off -site location. Replanting shall take place within 12 months of the issuance of this permit. Replanting must be verified and approved by DERM. The applicant shall notify the DERM project manager when the replanting is complete and schedule a final inspection (two weeks notice is required). PLANTING RECOMMENDATION Miami -Dade County Department of Environmental Resources Management ,Carl o sa, P.E., Director The DERM recommends the following techniques for planting tree(s). 1. All synthetic or non - degradable materials such as nylon rope or treated burlap must be removed from the rootball prior to planting. The tree(s) should be placed in' the center of the planting hole with the top of the rootball flush with the surrounding soil surface. Planting too deeply can cause the tree(s) to die. 3. The surrounding soil should be lightly tapped with no heavy impacts to the top of the rootball to ensure no damage to the fine roots at the surface. 4. The tree(s) should be watered at time of planting and should watering should occur on a regular basis until the tree becomes established. 5. Surrounding mulch should be placed directly on the tree(s) trunk. GENERAL PERMIT CONDITIONS The survival of all trees counted towards canopy mitigation shall be ensured to live at least one (1) year from the date the final inspection was passed. If the tree(s) die, they must be replaced by the same Florida grade number one tree of equal or. greater size. If the property owner of the mitigated tree(s) changes, the Permittee will be held as the responsible party and will be required to replace any destroyed or non - living tree(s). Replanting /relocation must be verified and approve by DERM. The applicant shall notify :'<-DERM when the replanting is completed and call to schedule a final inspection (two weeks notice is required) . ALL WORK SHALL BE IN ACCORDANCE WITH THE CONDITIONS CONTAINED HEREIN. THE PERMITTEE IS RESPONSIBLE FOR COMPLIANCE OF ALL CONTRACTORS AND SUBCONTRACTORS WITH THE CONDITIONS AND LIMITATIONS OF THIS PERMIT. EXCEPT AS AUTHORIZED BY THIS PERMIT, ANY PROTECTED TREE(S) THAT IS REMOVED OR EFFECTIVELY DESTROYED SHALL CONSTITUTE A VIOLATION OF SECTION 24 -49 OF THE CODE OF MIAMI DADE COUNTY AND WILL BE PURSUED AS SUCH. IN ADDITION, ANY NON - COMPLIANCE WITH THE CONDITIONS OF THIS PERMIT WILL SUBJECT THE PERMITTEE AND RESPONSIBLE CONTRACTORS OR INDIVIDUALS TO THE PENALTY PROVISIONS OF SECTION 24 -29, 24 -30, 24 -31 AND 8CC OF THE CODE OF MIAMI DADE COUNTY. ,THIS PERMIT AND PLANS SHALL BE KEPT ON SITE DURING ALL PHASES OF CONSTRUCTION Miami Shores Viiiage Building Department RECEIPT PERMIT #:00100 11 DATE: 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 foil ❑ Contractor ❑ Owner ❑ Archi up 2 sets of plans and Addre �„o 1-10 4kQm z 661m ROrt3, From the building department on this date in orde s have corrctions done to plans And /or get County sta _ . I understand that the plans - „d to be brought back to Miami Shores Village Building Depa'° ment to continue, permit ss. ic L - Acknowledged b 9 by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: 2131 d - Lrt -3CaC- Permit No: 11 -92 Job Name: February 2, 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Plans must be reviewed and approved by Miami Dade County DERM. A pre - construction meeting is required. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 AMC —5ia— 4-759 02/04/2011 13:08 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 11001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 1028 RECIPIENT ADDRESS 93055124759 DESTINATION ID ST. TIME 02/04 13:07 TIME USE 00'16 PAGES SENT 1 RESULT OK 41111 - Lrt - )C1L Permit No: 11 -92 Job Name: February 2, 2011 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Plans must be reviewed and approved by Miami Dade County DERM. A are - construction meeting is required. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Permit No: 11 -92 Job Name: February 2, 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Plans must be reviewed and approved by Miami Dade County DERM. A pre-construction meeting is required. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Miami Shores ViHage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 REQUIREMENTS FOR DEMOLITION PERMIT Provide notarized letter from homeowner authorizing contractor to demolish house- letter to be accompanied with copy of warranty deed. ❑ Submit permit application for demolition electrical, plumbing and gas connection if applicable. ❑ Submit Asbestos Report. ❑ Provide copy of notification to utility companies for discontinuance of services such as gas, water, electric, etc... Provide copy of certification letter from a pest control company, that property has been cleared of rodent, roaches, pest, etc... ❑ Provide notarized letter from contractor doing the demolition, notifying the date of scheduled demolition. 2007 F.B.0 Section 3303 Revised on 5/2212009 PEST MANAGEMENT. September 21, 2010 • To: Miami Shores Village Building Department 10050 N.E. 2nd Avenue • Miami Shores, F133138 • Re:. Shore Square Investments, LLC 9005 Biscayne Blvd Folio number 11 -3206 -011 -0040 RADIO DISPATCH 77 7.7 17 r1► LU To whom it may concern We currently service on. a monthly basis Shore Square Investments, LLC located at 9005 — 9099 Biscayne Blvd for exterior insect control and rodent control. The location 9005 is included in this service. The service consists of a perimeter power spray for insect control and the monitoring of 18 Tamper resistant rodent bait stations. The bait stations are . cleaned and replenished with fresh bait once per month. *Thank you Luis Fernandez :Office Manager www.carepestmanagement.com 12032 S.W. 132nd Court, #205, Miami, Florida 33186 • Tali (305) 234.3922. • Fax: (306) 234 -3015 Shore Square Investment LLC 3850 Bird Road Suite 800 Miami Florida 33146 Tel: 305- 779 -8048 Fax 305- 779 -8348 January 13, 2011 A &A Fonte, Inc. 12963 W. Okechobee Road, Suite 8 Hialeah Gardens, F133018 Re: Demolition authorization of the building located at 9005 Biscayne Boulevard. Dear Sirs, RT(N,,,TRIT7 p t lei j i BY: OOOOOOOOOOOOO e,...eeo,o This letter shall serve as our authorization to demolish the building/structure located at 9005 Biscayne Boulevard Miami Florida 33138 Miami Dade County Folio # 11- 3206 - 011 -0040. If y have any questions and or concerns please contact me at your earliest convenience. fr Tom of abrerizo As Managing Manager Shore Square Investment LLC 3850 Bird Road 8th Floor Miami, FL 33146 (305)779 -8048 Office (305)779 -8348 Fax STATE OF FLORIDA ) COUNTY OF MIAMI -DADE ) I HEREBY CERTIFY that Tom Cabrerizo , • ersonally known or did take an oath., this day acknowledged before me that they executed the foregoing Amendment this 3 day of January , 201- My Commission Expires: NOTARY PUBLIC -STATE OF FLORIDA Victor I. Fuentes =Commission #DD667598 °••.., , „, Expires: JUNE 15, 2011 BONDED ATLANTIC BONDINGCO.,INC. Victor I Fuentes / N.tary 04/27/2011 13:22 3056207004 K. 1.1J,,IUI1 UU:)brM L) IM PUMPOUTSUHLIMITED PAGE 05/05 NU. 5U6 Y. 9 ATM JT&C FDA T Qir` lazMati ONSITE SIM= TREATMENT AND DISPOSAL eristias COi 0* =MIT Wit: APPLCOMIT 1 Torn Cabreeto ]PRO ERT! ADDRESS: LOD: 5 OS'Tl S Abandonment T #110971307702 11LzCarTas d1Ap998218 DIAMM MD: NON PAID: SECKM, DOMINO . PR8387,09 2205.9299 $iscme Blvd moss: nla MORONI m tr: 114208- o11■0070 Miami, FL 3317E SaDlPiaiOlir e [saes, TOWRSIOD, RADCR, PARCEL s tO>A TAX :GO MOM MT= NORT tiY comaraocmaD xar immoral NMI WESCIF7CAMICOS was SIMINZO OF 8mO3iCt7t 3.0015, , r.8 . , ND 0W t48 ■e, t.x. G. ZORMIRMEIR2 ansoVaz Cr maw Dams sop sana a cpoaY' Teamosapcp PORK char Mem= 1P,g1SC° OP PM. an Ctliltta; 3R lausant i7luC'1'fi, Mal Wu= as 7► awe VA itMaga OP Tai4 mem, RSQttl as pea ApPZ X0 1ar aro wpm '.Paa o AeP% I. eV= 145DZIPZOMIZOIS MaX MO= XVI Piga MOW a3Zai9 lJADE 2Xthil al • *MD. i68tiawaa tat kleeka2 11O03 NOS' XXISIOY =OS Ate,+ CIIVC CO SM11.11 Ham t TUP. FXDPIAL, 8RM, OR Z.00AL PEA apomard _C>n cataX0a14112 OF 3118 >R+OD 'tC" Maw DPS= APO EP11=12CALTOtaB r t I GREMO 98 / ORD +CiMaC as t a oarmOSS OEM' Ili 9702 attattaX D Xamtt reP corn sue satt1C :1250 MIAMI X t 3 ORZMORt DORM TAM CA1ACt7 t maim I1 ]'Dons ass 24 tae Amps t i r 1 EOM TaXT OEM >A 4113 SUM: t I BEM- = t !'MUM i ioxste I I , t ZG P I8ICIRi1 j 7 PUMP [ 7 so i 1 P loca'lton OP Xxa1CillaiPX: ✓ triois OW PROM= swam iroi 7 t / 1 t ABdvs / DELON Isescissatisissoutwea PO= X *Mat Or batatartato NE D fa & MIMED 0 1 0.00 ] ZiiCEOS 1 i t / ] t marl I BELMIM 31211Eistaar/azraiortate raw magtvazzOtt 11821721Sti Neva the tank abandoned in accordance wih the following procedurest(a) Ito tank shell berm/need OUL(b) The bottom et the bank sing be opened or rup ged, or ant *Wm tank OObapisd a se to portent me rank firom ertainina water, and( The i�1k rsilati be Mad with clean end or other suitable material, end completely oovered with aotliave the masa lneprposl by the health depariment after It has beret pumped and ruptured but beler* it is Plied wet sand and covered. 1 =MU Nodbo s Nokia XXIZIVAPSCP Mai Oel18/2011 (Obsoletaa a71, pgovions edttiems *Aeh acay cot In ussdi $4z- 4.001, aac Dada CeD v i.2.i 11!49•218 617.1 Page 1 of 3 i Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9005 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060110060 Block: Lot: SHORES SQUARE INVESTMENT Owner Information Address Phone Cell SHORES SQUARE INVESTMENTS 3850 BIRD Road MIAMI FL 33146- Contractor(s) A&R EQUIPMENT CORP Phone CeII Phone (305)794 -3097 Valuation: Total Sq Feet: $ 12,000.00 0 1 Type of Demo: Building Additional Info: DEMOLITION Classification: Commercial Scanning: 8 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $7.20 $5.40 $5.40 $2.40 $360.00 $60.00 $24.00 $9.60 $474.00 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -1 -11 -39846 05/06/2011 Check #: 7417280( $ 474.00 $ 0.00 Available Inspections: Inspection Type: Final 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 Building Department Copy May 06, 2011 Date May 06, 2011 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9005 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060110060 Block: Lot: SHORES SQUARE INVESTMENT Owner Information Address Phone Cell SHORES SQUARE INVESTMENTS 3850 BIRD Road MIAMI FL 33146- I Contractor(s) Phone INDUSTRIAL ELECTRICAL SYSTEM C 305/228 -1384 Cell Phone Valuation: $ 350.00 Total Sq Feet: 0 Type of Demo: Electric Additional Info: BUILDING DEMOLITION Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -1 -11 -39900 05/06/2011 Check #: 7417280( $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final 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 Building Department Copy May 06, 2011 Date May 06, 2011 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 11- 9 2-- Inspection Number: INSP - 155272 Permit Number: DEMO -1 -11 -130 Scheduled Inspection Date: May 09, 2011 Inspector: Devaney, Michael Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number Parcel Number 1132060110060 Phone: 305/228 -1384 Building Department Comments DISCONNECT POWER FOR BUILDING DEMOLITION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments /L-(0 )7 May 06, 2011 For Inspections please call: (305)762 -4949 Page 3 of 21 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 1353.R"/ BY: .. .................. BUILDING Permit No. `s 0 11 PERMIT APPLICATION Master Permit No. O FBC 20 Permit Type: Electrical 4 �V OWNER: Name (Fee Simple Titleholder): 51--1!)..--4_, .S C(0e -r.� 1--- -- +r, � i3""�' Phone#: ��"'�� Address: 3 Iii ra Co C Rci VD I rn e Gee, rr a F i i 14 So City: rrN a c1, rr. I State: F i Zip: . 114 Tenant/Lessee Name: 14 Pt Phone#: 14 in Email: lei JOB ADDRESS: el ® i S c-� City: Miami Shores ounty: Miami Dade Zip: Folio/Parcel #: 11'. 2_0 0 1 1® 0 0 I, 0 Is the Building Historically Designated: Yes NO Y Flood Zone: CONTRACTOR: Company Name: ki, p sb%t "' /�f { ,' �• Phone#: 506 .22I to day Address: 0�. �/(�� el?' ,k29,5° [ ' FL Zip: Sf72 City: wtZ /C- State:. Qualifier Name: AI 3 1- C0 r V et, Phone #: State Certification or Registration #: EC' 3 O0 21 k2,. Certificate of Com etency #: Contact Phone #:. Ob 2 ,011' Email Address: /$' fl0a7 °'I0 C CO/r/ Ceti Q k DESIGNER: Architect/Engineer: k o at-® kill ii 0 A r% i- Fis 6 e c--1 ea-zuS i Phone #: 30s- 21 4.` :Q L a g Value of Work for this Permit: $ -5 5 0 Square/Linear Footage of Work: Type of Work: Address DAlteration ONew DRepair/Replace emolition Description of Work: D 1 5, Q Lt,.4.L' ,l 1 0 ,/ b u . 6 I ******* x: **** ****************+x******a * ** Fees**** *********** ******* ******:x+x *********u:x *** Submittal Fee $ Permit Fee $ O e CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 prope is ' !.ject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first n which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection t ' approver and a reinspection fee will be charged. Signature Signature 4140/0Y 2 . a0514' Owner or Agent Contractor The foregoing ins ° ment was acknowledged before me this Z The foreg ing instrument was acknowledged before me this ZI day of 7"-•`" , 20 t i , by ° � ��1 D "Z_ *, day of JO-461r , 20? ( , by l �L . s oe CO21l>`7a who is ' ersonall —I own to me or who has produced who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTA Sign: L4 V Print: 15 J �� t/ T F �✓a .. �� PUBLIC: tification and who did take an oath. My Commission Expires: * * * * * * * * * * * * * * * * ** APPROVED BY Sign: ��'C� , , . • Print: ra-£Pr7C" c6r 41 a lei ' `r �r ,� t y • •tic- �i.� - of Florida My Commission Expire4OrtIttlita101# DD 913453 My Commission Expires 11 -17 -2013 Bonded Through Atlantic Bonding Co. Inc. ********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** m � �/� � Plans Examiner "/1/; 77/ (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Structural Review Zoning Clerk Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9005 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060110060 Block: Lot: SHORES SQUARE INVESTMENT Owner Information Address Phone Cell SHORES SQUARE INVESTMENTS 3850 BIRD Road MIAMI FL 33146- I Contractor(s) BLUE BAR PLUMBING INC Phone CeII Phone Valuation: Total Sq Feet: $ 600.00 0 1 Type of Demo: Plumbing Additional Info: BUILDING DEMOLITION Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -1 -11 -39901 05/06/2011 Check #: 7417280( $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final 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 Building Department Copy May 06, 2011 Date May 06, 2011 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 a i•9L nspection Number: I NSP- 155273 Permit Number: DEMO -1 -11 -131 Inspection Date: May 13, 2011 Inspector: Hernandez, Rafael Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: BLUE BAR PLUMBING INC Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1132060110060 Building Department Comments DISCONNECT WATER SERVICE FOR BUILDING DEMOLITION Passed Inspector Comments III Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 May 13, 2011 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 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Permit No. 001 'S1 Master Permit No. Owner's Name (Fee Simple Titleholder) � - � �01 kJ ( I °.4", I" ,,, Phone# It---.1/ 9 -%0 4" Owner's Address. 3% S Q Bo T ei R c- # j City t c g`c-o 1 State F i Tenant/Lessee Name ©i P Email 4 A Zip ij Phone # 1■1:1 Job Address (where the work is being done) 9 0 �;> �"'v� 13 1 u City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # ° 0 ( i — 0 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name - S e Phone # `3 0 1 re' Z 7'4 Contractor's Address Zip 3 C City State Qualifier Name Phone # 30 S - 9 5 (or' 0-2- - State Certificate or Registration No. CE----Co r 6 Certificate of Competency No. Contact Phone -3 O / r 0(6 2. 2 —4° E -mail Architect/Engineer's Name (if applicable) kt _ i4 c r r i- FISSel phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: EAddition ❑Alteration [New ❑ Repair/Replace p ❑Demolition Describe Work: ******** * * * * * ** * * *** * * * * *** * * * * * *** * * ** Fees* * * * * * * *, * ** * *, *, * * * ** *** * *** * * * * * *, *** * * ** Submittal Fee $ Permit Fee $ /00 -'--- CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ '` o Total Fee Now Due $ 11 01 COO Radon $ ■ 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 insp, :, ion hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n e a oved and a reinspection fee will be charged. r Agent Contractor The foregoing ins' Vent was acknowledged before me this ° The foregoing instrument was acknowledged before me this 2-0 day of °4'-Un , 20 1 t , by z;�L- a , day of 9 Kls,•r•I , 20 , by who is personally %nown .1,,gar who has produced who is personally own to me or who has produced As identification and who did take an oath. as identific ion and who did take an oath. NOTAR UBLIC: NOTAR ; UBLIC: Sign: .) L 4 Sign: Print: IL c *o .' 4 %.1 �� Print: My Commission Expires: NOTARY PUBLIC-STATE 0� FLORIDA My ".•;•,, ! RID Victor I. Fuentes y Commission Expire". Victor I Fuentes L ; < Commission 598 i v Commission #DD667598 `••••�,,•�••' ExPires� ,TUN��y �011 SONDE) u Expires: ATLANTIC B NE 15, 2011 BOATED TMAT neB UMMI69,,SVQ, * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** . * * * * * * * * * * * * * ** ************************* * * *** ** * ** * * ** * * * * * * * * ** * * * * * ** APPROVED BY 26—// Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Zoning Clerk checked i Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number 9005 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060110060 Block: Lot: Owner Information Address Phone Applicant SHORES SQUARE INVESTMENT Cell SHORES SQUARE INVESTMENTS 3850 BIRD Road MIAMI FL 33146- Contractor(s) Phone CeII Phone RESULTS AIR CONDITIONING CO 305 - 886 -2534 Valuation: Total Sq Feet: $ 1,000.00 0 1 Type of Demo: Mechanical Additional Info: BUILDING DEMOLITION Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 Total: $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -1 -11 -39902 05/06/2011 Check #: 7417280( $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final 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 Building Department Copy May 06, 2011 Date May 06, 2011 1 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 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): c Sc r-45-;, " �� -� � Phone #: 3OS —119 — 7 ©4'q Address: St S S C R d 2, 0 1 City: M ' e 1 State: F 1 Zip: Tenant/Lessee Name: i4 Phone #: !rt Email: Nt P Permit No. IMCZITY BY: ................. Master Permit No. JOB ADDRESS: City: Folio/Parcel #• 9045 ecs r*N9.s Miami Shores County: Miami Dade Zip: Is the Building Historically Designated: Yes NO Flood Zone: ra. j CONTRACTOR: Company Name: l� eSQ / 45 Address: 7157 N ttt City: M I 141; F' / / State: Zip: ,.,3 f 6 State Certification or Registration #: - i G. D 51 ft 42 Certificate of Competency #: Contact Phone #: 3 *5 7c 7 i ri Email Address: DESIGNER: Architect/Engineer: o m °� fr- F1 S 0 Phone #: Value of Work for this Permit: $ 1 1000. Square/Linear Footage of Work: Phone #: 3°5 Qualifier Name: " Air Pr Phone #: :5t$5 .7 FS 791'..r Type of Work: Address UAlteration ONew ORepair/Replace ❑Demolition Description of Work: ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** s************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Double Fee $ Structural Review $ Training/Education Fee $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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 -: ''..sjec o attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp. . n • ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no . - 'ip;' ved a . a reinspection fee will be charged. Signature er or Agent The foregoing instrumen was acknowledged before me this ?.,C3 day of atpfNUCN. 20 i ( , by who is personally known to me •r who has produced As identification and who did take an oath. NOT ' Y PUBLIC: Sign: Id Print: 1 My Commission Expires: NOT •" "1'' °- Victor , -. I. Fuentes s Commission #DD667598 ,,., r Expires: JUNE 15, 2011 C�. r 74w:t 4 .�, Y �11 i._ r1 , B014151; THRD ATLANTIC BONDING CO, INC. * * * ** * * * * * * * * * * **** * * * * *** APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this day of � % , 20 1 / , by r ,4!-t e who is personally known to me or who has produced Aa/ as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: XI0� Ate% 4S iau40. 111181111. 4190111 ..11.411.181181104.11.11811.u1111411.e My Commission Expires: XIOMARA ARIAS `e��awnry'`'o Comm# DD Sts�YPcva 0694343 vox x Expires 7/11/2011 r * * * ** * *** ** :: * * *: **** * * *** * * *s: *:�**** **** * * * ** 411: :�:� *: 'lw�ka 4� * ■11.11 4444. 114.4. 4.1O 14.11111..44...411.Ae1N 5BE Examiner Zoning Structural Review Clerk (Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4 "CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: (t S5%1 / / 71'1 , //Z- Phone: -J 0.5' - ,;6 Y State Certificate or Registration N. C. C C' 5.'7 6 53 Certificate of Competency N. Signature j (Qualifier's signature only) Date: 7-4' ;"O (9u t 2 ( • / • — ..' c / . I :. l • i /--/• • •• . . 4*.:i.i..7tioNOOtiiir401/000 „a:4 FIRST-CLASS *A1i1COUNTY't:'61*V0P:ir: POSTAGE PAID . DtEPUVIEIMPAADAOWNINB tmAmi, OL. -0:070firtoPelY0 • PERMIT NO, Om • , poi ! :I, • • c • •••,,tilafrott•ktTlr.R.%.!k?soy, Vkce; tlev4iv. :•■•• , BOSINESSNANIE:PLOCATION RESULTS AIR.CONDTTioNINS co 7441ww 72 AVE 33166 MEDLEY OWNER RESULTS AIR CONDITION/Ns co Sm. Typtrof Business woRKER/S ".„,LIAAggp MEcfiANIcAL,CONTRACToR to DIENAM874, ,:amm 1177.M werayAIVA 4=4n0 gattWeikor mon6 mmetommu _07107/2sio • 60.03tiOn473 • 000D4S.D0 SEE OTHER SIDE THIS IS NOT A BILL - DO NOT PAY RENEWAL RECEIPT NO. 032392-3 STATE* CAC057653 DO NOT PORWARO RESULTS AIR CONDITIONING CO JOSE A coRBERA PRES 7461 NW 72 AVE MIAMI FL 33166 4. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 CORBERA, JOSE ALEX RESULTS AIR CONDITIONING COMPANY 7451 NW 72ND AVENUE MIAMI FL 33166 Congratulstionsi With this Iicehte "you 6ec5ime ono of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to starve you better, For information about our services, please log onto www.naytlotfdalicense.com. There you can find more Information about our divisions and the regulations that impact you, subscribe to department newsletters and Teem more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly, We Thank you strive dto g busiiness better Forida hand you ngratulat serve your an your new license! DETACH HERE DATCH NUPOSE'R 5 ' i81�' fly »�"x:•Caa ••�,� ly:.., + 3 Z • b 114�:Lf'XF".1.'f a s J�MS'e • '-dt R y7, ¢ •'i au PRODUCER CERTIFICATE OF LIABILITY INSURANCE oP rg DATEt$$rDDlYYY1fl RESUL -1 01/06/0.1 All Safe Insurance 7171 Coral Way #209 Miami F% 33155 Phone: 305262 -5244 Fax:786 -388 -7244 memo Results Aix Condiot i onning 7�t57. 72 Ave Wan& VIA 33186 COVERAGES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA'T'E HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE PISURER A: NATIONAL GROUP INSURER B: URXDGEFIELD INSURER C iNsURER INSURER E NAIC S 12216 THE POLICIES OF INSURANCE UST , BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POLICY PERIOD INDICAI TERM OR WAY RPERTAINR .N INSURANCE RDED BY CONTRACT OR OTHER S DESCRIBED HEREIN SUBJECT-113 ALL THE TERMS .EEXCLUSIONS AND POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. TV iNS OF INSURANCE POLICY NUMBER GE71 RAl. LIABILITY .fL COMMERCIAL GENERAL LIABILITY CLAIMS MADE © OCCUR GIRL AGGREGATE LIMIT APPLIES PER: x1 POLICY n 7 ROC AUTOMOBILE LIABILITY U ANY AUTO ALL OWNED AUTO$ SCHEDULED AUTOS HflEO AUTOS NON - OWNED AUTOS GARAGE LIABILITY ANY AUTO 01x,0000468 -04 DATE 01/08/11 01/08/12 ED. N ITF$STANDING AY BE ISSUED OR CONDITIONS OF SUCH UMTIS EACH OCCURRENCE S 1, 000,000 PREMIB4ES H;d oaaue, ) $ 100 , 000 WO DIP (AM ass person) x5,000 PERSONAL &ADV INJURY $ 1, 000 , 000 . GENERAL AGGREGATE $2,000 000 PRODUCTS- COMP/OP AGG 81, 000, 000 COMBINED SINGLE l IMR I(E • ( se;s n BODILY INJURY (per a Raxue t?AM AG c3ss/ UMBRELLA Unan rrY OCCUR OLNM S MADE DEDUC'rySLE RETENTION Wal— COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETDRIPARTNERMXECUTIVr Y r N OFFICER/MEMBER EXCLUDED? L_ f 8FE IAL MOVISIONS berm OTHER 0830 -35672 01/26/11 AUTO ONLY -EA ACCIDENT THAN AO ONLY:: EA ACC AGO s $ $ EACH OCCURRENCE AGGREGATE $ $ $ TORY LIMITS ER 01/26/12 EL EACH ACCIDL ' E L DISEASE - EA EMPLOYEE DESCRIPTION OF OFERATIOr�r IIHCTION3 rvExlta Esr EXCLUSIONS ADDED ev ENDORSEMENT l, r`IALPRrnnsp CERTIFICATE HOLDER VILtAGE OF MANI SHORES 10050 1E 2 AVE SHORES FL 3313E ACORD 26 (2009104] El. DISEASE -POUCY LIMIT $100 000 $100,000 5500,000 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLLS BE CA NDELLED BEFORE THE EXPIRATION Vizain Am DATE THEREOF. TEE I$3u1p(I INSURER WILL ENb8AVOR TO MAIL 30 UAY3 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED Tome LEFT, nu? FAILURE TAD no so SHAM, $$POSE No aQ1giATION OR LIABILITY OP ANT HIND UPON THE INSDHE R, ITS A0Ep7S on REPRESENTATIVES. AUTHORIZED REP A CO 19884009 ACORD CORPORATION. All fights renamed. eL Tho ACORD name and logo aHo mgloterod marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 11 -9Z Inspection Number: INSP - 155274 Scheduled Inspection Date: May 10, 2011 Inspector: Perez, JanPierre Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: RESULTS AIR CONDITIONING CO Permit Number: DEMO -1 -11 -132 Permit Type: Demolition Inspection Type: Final Work Classification: Mechanical Phone Number Parcel Number 1132060110060 Phone: 305 -886 -2534 Building Department Comments A/C & DUCT WORK REMOVAL FOR BUILDING DEMOLITION (24, 11 Inspector Comments Passed uu, Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 09, 2011 For Inspections please call: (305)762 -4949 Plana Anf9't Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Il -92 Inspection Number: I NSP- 155274 Permit Number: DEMO -1 -11 -132 Scheduled Inspection Date: May 10, 2011 Inspector: Perez, JanPierre Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: RESULTS AIR CONDITIONING CO Permit Type: Demolition Inspection Type: Final Work Classification: Mechanical Phone Number Parcel Number 1132060110060 Phone: 305 -886 -2534 Building Department Comments A/C & DUCT WORK REMOVAL FOR BUILDING DEMOLITION Inspector Comments Passed uu Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 09, 2011 For Inspections please call: (305)762 -4949 Page 5 of 23