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PLC-10-1642Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C'- Inspection Number. INSP- 169677 Permit Number: PLC -9 -10 -1642 v. Scheduled Inspection Date: June 08, 2012 Inspector: Hernandez, Rafael Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: A&A FONTE INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060110060 Phone: (305)512 -4739 Building Department Comments CONNECTION TO SEWER AND SEWER EXTENSION PERMIT Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 164995. CREATED AS REINSPECTION FOR INSP - 151197. U TO TIE- IN FOR BUILDING #9005 AND #9007 -9023. June 07, 2012 For Inspections please call: (305)762 -4949 Page 1 of 8 Carlos A. Gimenez, Mayor 06/06/2012 Fernando J. Alonso Miami Dade Water & Sewer Department 3071 SW 38 AVENUE Miami, FL 33146 E -mail: FALONSO@miamidade.gov Re: Shores Square Shopping Center 9031 BISCAYNE BLVD MIAMI SHORES, FL 33138 RER Permit Number: 2011- SEW -EXT- 00121 FDEP Permit Number: 253649- 681 -DWC CERTIFICATION OF: 100% Dear Fernando J. Alonso: Permitting, Environment and Regulatory Affairs Environmental Services 11805 SW 26th Street, Ste. 124 Miami, Florida 33175 -2474 T 786 - 315 -2800 F 786 -315 -2919 ELECTRONIC CORRESPONDENCE miamidade.gov This letter shall serve as notification that the above referenced Sewer Extension project has been certified by Aristides Reyes- Gavilan, P.E. Said certification, signed by the corresponding utility on 04/09/2012, indicated that the project was completed in conformance with the approved plans and specifications. Pursuant to the above, and inasmuch as all the specific conditions in the FDEP construction permit have been complied with, we hereby clear these facilities for service. This notification does not relieve applicants from building permits, requesting to connect to this sanitary sewer facility, from the requirements of a Sewer System Treatment and Transmission Certification in accordance with the terms and conditions set forth in paragraph 16C of the First Partial Consent Decree (Case No. 93- 1109CIV- MORENO). If you have any questions, contact me or Oscar Aguirre at (786) 315 - 2800. When referring to this project, please use the sewer extension number indicated above. Sincerely, Carlos Hernandez, P.E., Chief Plan Review and Development Approvals Division CC: Yoram lzhak Ifuentes @cfhgroup.com Aristides Reyes- Gavilan P.E. ari @reves>avilaneng.com Sergio Garcia, P.E. GARSERG @miamidade.eov 14'° -14 BUILDING 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 2010 j . Permit No. R 10— ( tU t-2 PERMIT APPLICATION Master Permit No. FBC 20 b Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) 5k0I4' ��. ' J' Phone # 3 d r ` 9 L ` Owner's Address 3% a i �c d c J City 7Y t o ca, 1 State F I Zip a �p Tenant/Lessee Name i4 I Phone # 0 1 -19 %0 4 0 Email 1 F U F f Y f= y c c F H G' r A U P °y Job Address (where the work is being done) o d S ° 9 0'9 c Ci City Miami Shores Village County Miami -Dade Zip �� 3 c FOLIO / PARCEL # i ° �.� ° A i i 4 r� (:).1 ( + 0 e. 0 + o S i `4" 06 k Is Building Historically Designated YES NO Y Flood Zone Contractor's Company Name 4 * A tom ) I N:_Q Phone # ‘t:5'S- - SA 2 4-139 Contractor's Address 1r).S1 L'")j U . O ® 4 , 2 s =Vz -4T City 1.41-k { State e - Zip ,'3S) ( Qualifier Name \ ply Phone # ,z5&----- c51.2-4--7 ") State Certificate or Registration No. Certificate of Competency No. ®b 9 t 4(a, Contact Phone 3DG E -mail `LMA 6.`tCt.ux j 04 , GINA ^ Architect/Engineer's Name (if applicable) � �� P e Phone # A 0 S ,S9 j Value of Work For this Permit $ rS :3a O S /uare / Linear Footage Of Work: ' Type of Work: ['Addition Alteration New El Repair/Replace ❑ Demolition Describe Work: pct Submittal Fee $ "'-' Permit Fee $ -2 6,2 CCF $ CO /CC $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ Technology Fee $ Bond $ Total Fee Now Due $ See Reverse side -� Bonding Company's Nani;e (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 I' 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 Applicon.: a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in goo' f�Iit t at a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose prope 11 ,jec to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first i'spec''on x#zich oc, s seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wi l not % 1pp ov- and a reinspection fee will be charged. Q c, �* . crc'.r,9.9 r'1'2— t/ ( i r Signature er or Agent The foregoing instrument Was acknowledged before me this 1 Z day of 7,./ i L , 201 0, , by C c.a.- f .L( r 1 day of r who has produced who is personally known to me or who h. produced As identi$ cation and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: The forego', g instrument was acknowledged before me this O , 20 10, by Sign: Sign: Print: V1 L., t. e ----._;.._ ., Fos,- 4,4,,,,, Print: NOTARY PUBLICSTATF FLORIDA s• Victor I. Fuentes �` Commission #DD667598 •o,, �s Expires: JUNE 15, 2011 My Commission Expires: My Co fission Expir sOTARi' 3't'R?.T�: -STATE OF FLORIDA Je;;'sica Hernandez Conan slur' # DD893152 BONDED THEY ATLANTIC BONDING CO.,INC. £xmr�s: JUNE 01, 2013 * * * * * * * * *,r * * * * * * * * * * * * * * * * * ** ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * *�` �i i�`�5i'43'E ,,,ir4'h1�°i At°1 Fr YG�* APPROVED BY Plans Examiner Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Clerk checked Miami Shores ViHage Building Department 10,11'04 RECEIPT 10--PIL DATE: 2 PERMIT #: ontractor ❑ Owner ❑ Architect Picked upsets of plans and (other) 4.-- IZ Address: 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 17,81-0 From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: 7,0 C — ABC 64 s-4 7 1 ,d, PERMIT CLERK INITIAL: 0A Permit No: 10 -1641 and 10 -1642 Job Name: September 20, 2010 Miami Shores Vi Building Departr Building Critique Sheet lage gent 10050 N.E.2nd venue Miami Shores, Florid 33138 Tel: (305) 7 5.2204 Fax: (305) 7 6.8972 Page 1 of 1 1) Plans must be reviewed and approved by Miami Dade County DERM.9need final approval stamp) 2) Plans must be approved by HRS for the septic system. 3) Provide a receipt from Miami Dade County Water and Sewer for impact fees. 4) Provide a "maintenance of traffic: plan for all roads. 5) Provide a detail for the repair of roadways. Detail must show method of compaction, layers and depth of base and asphalt repair curb to curb. (Note: trench repair must be a minimum of 8' wide. 6) Provide a permit for repairs to parking lot including any details of accessible features being altered or repaired. Plan review is not complete, when all items above are corrected, we will do a complete plan 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. review. Norman Bruhn CBO 305 - 795 -2204 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Job Name PLUMBING CRITIQUE SHEET 7;443 k/Af'S 4.€#€/e /led 4,41 --/e, jet, /4, ," A-OeroD e- pd-- serif te_...s R-014-1. 71/44 DefF (j) PI-OH-70 j Alit= Sylteunlimriades. TelpapayWiter.404413votalitiatite 4011thAn lab 4.334% Immt: **120.78f5 fez 304S- • , $ t,""v. i'• Job Mdrc 9005 'AWN. et l's■ • •■•• .* 4151202- irw 11*.t4.010.4fibakt ....4144124dd........WW444441_4401t14,•b44 Mt. Aa'iil r Rob adtfatatkOMAtkONIM /4,••<'t te'e t aliMatigitAle04 ,;,.,,A„,\Aftgattalt„ Zfittulte4,-ZU;l: 1 ITo Set.Up AccardinkMt t * FOOT Index 60.5 a:NEW AM 4 . kr. re knal,./daving 0:4 OOP*: .f4Fet togif *a.** vr..r—rt4 -rte . • • if wort urogi I to an outside oustitoy Me worn &co ,stot .c.na riAam ,40,,makated by Roo W80N MEAD egos. FAVOets am WI' r6.494114 • Flantwa Ghat? 64. Irt 00 of wish other or To dIreat aOlse‘tnifenen Ot all times. 5. no PODGIER Mora sisto oroy bo substituted :for MO sY m O . Tho sp " sPaziog Ogdw000 spsrk,s she/1 O 0n4fer thin a r„ nor poorof rcz rowfromonts era octSt7forsoi Wometteo,refer ftO Irder Na. 6011 • Iwo aimmowng &tames cureeiy tarpmf onct &Wet at *4 WO of Ihs was* orso 10 000gotbd only*. 4 Valeta with Olvaree high-Intdosffy rolottoik f-I,~v.osolltottoo.cr strobe fights. DURATION NOTES MAE) WM( AHEAD and the 8E Pf?EPA£M0 TO STOP signs moy be omitted If on of the "allowing ondifions are met, o WarA operations are 00 minutes or S. 0) Speed limit 5 45 aph or iess. ; O obstruattoos to vehicles approaching the WO,* area for 0 dlol000s etroof tO the teter Voce, d Vehicles in the worf ores tape AIgh-infensity, rotating. f lashing, ascii/cling, or strobe lights operating, e ; Vattane and complexity of the reodegy hos teen considered. CONDITIONS WHERE ANY VEHICLE, EQUIPMENT . WORKERS OR THEIR ACTIVITIES ENCROACH THE WA BETWEEN THE CENTERIJNE AND A LINE 2' OUTSIDE THE EDGE OF TRAVEL WAY. roVe 1 Dov i Asa, Mama Between Serb.? let i 1) )I ve t o, ravens noor ZS to 45 20 5!) 50 to 70 4', 5 0,7 beyond the ROAD WORK AHEAD sign or mieway between signs wniono,er Is less. *4* 6.6 PREPAREO TO STOP sign may be omitted for speeds of 45 MP/1 or less. SYMMS Mai lettli 4,4 Olt& v. rthie0dirie~*e a t14.0 8 olfWgria.reukro=rt tro,,axv.t....avoiliorg*?~04i, 1...,noothok0io o018/ 0/0 g ryAiit Or 1, 4401*(10 0F 50J Ago,. 044/ 5' FloMmt. 040 At NitgAWy..) D' Mak Zane Von U' Flogger Lane IttentiffoatfOn Ovation of Trottle When Buffer Spate cannot to attained due he geometric ..aansfroints, the greatest ottoinablo toner 36311 be used. 44 not less firm 200 ft, 11- 3206-011 -0060 1 1 68 1 MIAMI CQ.U�,T. GO,UaT COR xtr, Moir INtr#: VERIFICATION FORM EXPIRES ONE YEAR FROM DATE ON FORM FORM#: 201027343 DATE: Water & Sewer P.Q. Box 330316 • 3071 SW 38th Avenue Miami, Florida 33233 -0316 T 305 -665 -7477 F 786 -552 -8763 miamidade.gov 11/1512010 NAME OF OWNER: PROPERTY ADDRESS: PROPOSED USAGE / NO. OF UNITS: REPLACES: PREVIOUS USAGE / NO. OF UNITS: PROPERTY LEGAL FOUO NUMBER: PREVIOUS FLOW: PROPOSED FLOW SHORE SQUARE SHOPPING CENTER 9005.9099 BISCAYNE BLVD 2,000 SF TAKE OUT RESTAURANT, 7,350 SF MEDICAL OFFICE , 57,555 SF RETAIL SPACE (DERM LETTER) RETAIL SHOPPING CENTER (CIS#9447452200) 478.01FTW OF SE COR LOT 5 RUN W219.07FTALG N RNWL NE 9 0TH ST N12.20FTTO E RNWL RISC BLVD TH NELY210.73FT E85FT S177FT TO POB 3.345 9,228 GALLONS PER DAY INCREASE: PREVIOUS SQUARE FOOTAGE: PROPOSED SQUARE FOOTAGE 66,905 i 8,881 ❑ NEW CONSTRUCTION FA INTERIOR RENOVATION THIS IS TO CERTIFY THAT THE MIAMI -DADE WATER AND SE WEER DEPARTMENT DOES HAVE A(N) _12 INCH WATER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING TO SERVE THE SUBJEC T PROPERTY, (OR, IF "WILL HAVE, UPON PROPER CONVEYANCE AND PLACEMENT 11'470 SERVICE OF WATER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT, (AGREEMENT ID 8 20303) SUBJECT TO PROHIBITIONS 911 ' *NS OF GOVERNMENTAL JURISDICTION ENTAL AGENCIES HAVING JURISDICT OVER MATTERS OF WATER SUPPLY OR IGNA • ' E O �: RESENTATIVE at = ESS COMM PLANS REVIEW CONVENTS: CRITERIA: Jadde G.ia C- Jackson - New Business Representative AUTHORIZED BY IF CONNECTION TO 12* MAINS IN RISC BLVD AND/OR NE 90 ST IS NEEDED EITHER FOR SERVICE, FH, OR EXTENSION, COLLECTS WM CCC. MES 11-9-2009. THIS IS TO CERTIFY THAT THE MIAMI -DADE WATER AND SEWER DEPARTMENT WILL HAVE A(N) S INCH GRAVITY SEWER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILING TO SERVE THE SUBJECT PROPERTY, (OR, IF 'WILL HAVE'. UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF SEWER SEWER FACIUTIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT, (AGREEMENT ID 620303). SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF SEWAGE DISPOSAL FURTHERMORE, APPROVAL OF ALL SEWAGE FLOWS INTO THE DEPARTMENTS SYSTEM MUST BE OBT- ■ FROM D.E.R.M. THE ANTICIPATED DAILY WATER SEWAGE now FOR THIS PROJECT WILL BE: FIVE TH • m • .Ili ), NDRED E ONE (5881) GALLONS PER DAY INCREASE. Jackie ClarkJ adcson - New Business Representative TUBE SINESS COM ESENTATIVE PLANS REVIEW COMMENTS: D.E.R.M. S COLLECT 94 ALLOCA D..WTR AUTHORIZED BY ON TED: 1011512010. #2010 - ALLOCATION- 02480. C• .1, 1 i.' , 51286PD SCC=$28.716.80.TL0,027.57 CONTACT NAME: / Printed On: 11/18/2010 NB: Jackie Clark - Jackson CONTACT PHONE: ( jj 3848622 9 2B a AM PR: u? ,...L .r ■..� ..:.._:.ail_. Carlos Alvarez, Mayor 10/18/2010 Issued Date: 10/18/2010 Ivan Fuentes 3850 Bird Rd #801 Miami, FL 33146 III 1 EnvnifinkilltiMgdgiii124aliagement Plan Review and Development Approvals Division 701 NW 1 st Court • 2nd Floor Miami, Florida 33136 -3902 T 305 -372 -6899 F 305- 372 -6550 miamidade.gov RE: Sewer System Treatment and Transmission Capacity Certification The Miami -Dade County Department of Environmental Resources Management (DERM) has received,your application for approval of a sewer service connection to serve the following project which is more specifically described in the attached project summary. Project Name: Shore Square Shopping Center/2010100813310680 Project Location: 9005 - 9099 BISCAYNE BLVD, MIAMI SHORES, FL 33138 Previous Use: 66,905 SF Shopping Center on septic connecting to sewer. Proposed Use: 57,555 Retail, 7,350 SF Physician Office and 2,000 SF Take Out Restaurant. PERMITTING, CONSTRUCTION, COMPLETION AND CERTIFICATION OF THE SANITARY SEWER EXTENSION NO. SE 2010 - SEW-EXT- 00073. PLEASE BE ADVISED THAT ISSUANCE OF ANY CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLETION, CERTIFICATE OF USE AND /OR OCCUPATIONAL LICENSE FOR THE SUBJECT PROJECT WILL BE WITHHELD PENDING COMPLIANCE WITH ANY AND ALL CONDITIONS STIPULATED BY APPLICABLE LOCAL AND STATE PERMITS FOR THE COLLECTION/TRANSMISSION SYSTEM IMPROVEMENT(S) HEREIN REQUIRED. Previous Flow: 0 GPD Total Calculated Flow: 9226 GPD Allocated Flow: 9226 GPD Sewer Utility: UNINCORPORATED DADE COUNTY Receiving Pump Station: 30 - 0049 DERM has evaluated your request in accordance with the terms and conditions set forth in Paragraph 16 C of the First Partial Consent Decree (CASE NO. 93 -1109 CIV- MORENO) between the United States of America and Miami -Dade County. DERM hereby certifies that adequate treatment and transmission capacity, as herein defined, is available for the above described project. Furthermore, be advised that this approval does not constitute Departmental approval for the proposed project. Additional reviews and approval may be required from sections having jurisdiction over specific aspects of this project. Also, be advised that the gallons per day (GPD) flow determination indicated herein are for sewer allocation purposes only (in compliance with Consent Decree requirements) and may not be representative of GPD flows used in calculating connection fees by the utility providing the service. Please be aware that this certification is subject to the terms and conditions set forth in the Sewer Service Connection Affidavit filed by the applicant, a copy of which is hereby attached. Should you have any questions regarding this matter, please contact the Miami -Dade Permitting and Inspecting Center (MDPIC) (786) 315 -2800 or DERM Office of Plan Review Services, Downtown Office (305) 372 -6899. Sincerely, Carlos Espinosa, P E. Director Dep By: rces Management Car :`R' - dez, P.E. Chief, Office o Plan Review Services ye- Page 1 of MIAMI-DADE Carlos Alvarez, Mayor 1 Owner's Name: Owner's Address: Mil lJ� EnvbdB14M,agement Plan Review and Development Approvals Division 701 NW 1st Court • 2nd Floor Miami, Florida 33136 -3902 T 305- 372 -6899 F 305 - 372 -6550 miamidade.gov EEOS Allocation Number: 2010 - ALLOCATION -02480 Project: Shore Square Shopping Center/2010100813310680 Proposed Use: 57,555 Retail, 7,350 SF Physician Office and 2,000 SF Take Out Restaurant. PERMITTING, CONSTRUCTION, COMPLETION AND CERTIFICATION OF THE SANITARY SEWER EXTENSION NO. SE 2010 - SEW -EXT- 00073. PLEASE BE ADVISED THAT ISSUANCE OF ANY CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLETION, CERTIFICATE OF USE AND /OR OCCUPATIONAL LICENSE FOR THE SUBJECT PROJECT WILL BE WITHHELD PENDING COMPLIANCE WITH ANY AND ALL CONDITIONS STIPULATED BY APPLICABLE LOCAL AND STATE PERMITS FOR THE COLLECTION/TRANSMISSION SYSTEM IMPROVEMENT(S) HEREIN REQUIRED. Pump Station: 30 -0049 Projected NAPOT: 4.13 1132060110051 / 9005 -9099 P10164 Biscayne Blvd, Miami Shores 1132060110060 / N/A 1132060110070 / N/A Total: 9,226 APP 10/18/2010 0 0 9,226 GPD _ 10/18/2010 1/16/2011 1/16/2011 10/18/2010 1/16/2011 Page 2 of Miami-Dade Water and Sewer Department New Business Office .P.O. Box 33.0316 Florida 33233-Q316 PeopleSoft Acct ID# 3575 South Le.kiate Roact Room 114 Miscellaneous Gawps CUSTID: LA_Hi-i1137.) INVOICE 9 DATE: Febpacy 11.2010 121026 PiE..:A(2744EINVESTMENTIALC • . • Lai, $'1,' .3 34.4 6 • • 5872498973 140361 li•Okli;SWR:COS AS PRESCRIBED BY AGMNT FOR SHORE SQUARE SHOPPING CENTER-Nos-pow BISCAYNE BLVD FOLIO # 11-3206-011- 0080.4W CCC DUE IF 'CONNECTION TO 17' MAINS IN BISC BLVD SID/011 NE 90 ST IS NEEDED' EUMEIT 444. Conn Chg - WASO Water 5128 onn Chg WASD Sewer • ER WATER: ER SEWER: AGMT 1D: • N/A N/A 1 20303 • 1..stNitRiliOt .1.39 81,310.77 ' TOTAL: .• • • • • : ••. . •' WATER DEPOSITS: I. SEWER PEPOVA Imes 40:g0 llery INVOICE P10 121028 TOTAL: r - - $30,027.87 311 SIN3WLS3IINI 3NttflOS MOMS 110), simati OG°0$ 'L00$ . L&72116GES ..inipice 121026 frinted On 2/11/2010 9:22:28 AM : Richard Robinson . IA` Ltal OE, TOGO 40 TOGO Disiktiutic* White,Customer, Yellow-General Office, Pink-Local Of/ice, acid:New Business 4uataLed TTe4aH Efltd TOGO 3Nfl 0317I 0f0 !NEM OTOUTT/U LS0IY0013 EL6860USS SR g. P3V 3ONVH3 '43 O4e8 513$1 MIAMI- COUNTY CQU�l7Y Carlos A. Gimenez, Mayor 01/11/2012 TOM CABRERIZO SHORE SQUARE INVESTMENT, LLC 3850 BIRD ROAD MIAMI, FL 33146 Dear TOM CABRERIZO: Permitting, Environment and Regulatory Affairs Environmental Services 11805 SW 26th Street, Ste. 124 Miami, Florida 33175 -2474 T 786 -315 -2800 F 786- 315 -2919 CERTIFIED MAIL NO. 7001 1940 0001 0393 1274 RETURN RECEIPT REQUESTED miamidade.gov „Lei g alaut- JAN 3q :; PLO 0 —1 2® The Permitting, Environment and Regulatory Affairs Department, under delegation by the Florida Department of Environmental Protection, hereby gives Notice of Permit Issuance to construct a domestic wastewater collection /transmission system (FDEP Permit No. 253649 - 681 -DWC, Permit Number 2011 -SEW- EXT- 00121) to the applicant, TOM CABRERIZO, SHORE SQUARE INVESTMENT, LLC. The project is located at 9031 BISCAYNE BLVD., MIAMI SHORES, FL 33138. UPON COMPLETION OF CONSTRUCTION OF THIS PROJECT, THE WASTEWATER COLLECTION SYSTEM SHALL NOT BE PLACED INTO SERVICE UNTIL THE DEPARTMENT HAS RECEIVED, REVIEWED, AND APPROVED A COMPLETELY EXECUTED REQUEST FOR APPROVAL TO PLACE A DOMESTIC WASTEWATER COLLECTION /TRANSMISSION SYSTEM INTO OPERATION. PLACING THIS SYSTEM INTO OPERATION WITHOUT THE PROPER APPROVAL FROM THE DEPARTMENT SHALL CONSTITUTE A VIOLATION OF STATE AND COUNTY REGULATIONS AND ENFORCEMENT ACTIONS MAY BE TAKEN ACCORDINGLY. The applicant's mailing address is Attn: TOM CABRERIZO, SHORE SQUARE INVESTMENT, LLC, 3850 BIRD ROAD, MIAMI, FL 33146. The Department's Permit File (FDEP Permit No. 253649 -681 -DWC, Permit Number 2011 - SEW -EXT- 00121) on this matter is available for public inspection by contacting the Water & Wastewater Engineering Section at (786) 315 -2800 and making an appointment to view the files during normal business hours, 8:00 a.m. to 4:00 p.m., Monday through Friday, except legal holidays, 11805 SW 26 Street, Suite 124, Miami, Florida 33175- 2474. A person whose substantial interests are affected by the above proposed agency action may petition for an administrative determination (hearing) under sections 120.569 and 120.57 of the Florida Statutes. The petition must contain the information set forth below and must be filed (received) in the Office of the Miami -Dade County Attorney, 111 N.W. 1st Street, Suite 2810, Miami, Florida 33128. Petitions filed by any . persons other than those entitled to written notice under section 120.60(3) of the Florida Statutes must be filed within fourteen (14) days of publication of this notice or receipt of the written notice, whichever occurs first. The petitioner shall mail a copy of the petition to the applicant at the address indicated above at the time of filing. The failure of any person to file a petition within the appropriate time period shall constitute a waiver of that person's right to request an administrative determination (hearing) under sections 120.569 and 120.57 of the Florida Statutes, or to intervene in this proceeding and participate as a party to it. Any subsequent intervention (in a proceeding initiated by another party) will be only at the discretion of the presiding officer upon the filing of a motion in compli nce with rule 28-1p6.205 of the Florida Administrative Code. �1 �`lli E,xce-Lexce EYery a A petition that disputes the material facts on which the Department's action is based must contain the following information: (a) The name, address, and telephone number of each petitioner, the applicant's name and address, the Department File Number and the county in which the project is proposed; (b) A statement of how and when each petitioner received notice of the Department's action or proposed action; (c) A statement of how each petitioner's substantial interests are affected by the Department's action or proposed action; (d) A statement of all material facts disputed by petitioner or a statement that there are no disputed facts; (e) A statement of facts which the petitioner contends warrant reversal or modification of the Department's action or proposed action; (f) A statement of which rules or statutes the petitioner contends require reversal or modification of the Department's action or proposed action; and (g) A statement of the relief sought by the petitioner, stating precisely the action the petitioner wants the Department to take with respect to the Department's action or proposed action. A petition that does not dispute the material facts on which the Department's action is based shall state that no such facts are in dispute and otherwise shall contain the same information as set forth above, as required by rule 28- 106.301 of the Florida Administrative Code. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means that the Department's final action may be different from the position taken by it in this notice. Persons whose substantial interests will be affected by any such final decision of the Department have the right to petition to become a party to the proceeding, in accordance with the requirements set forth above. In accordance with Section 120.573, F.S., the Department advises that mediation is not available in this case as an alternative to filing a petition for an administrative determination. Any party to this permit has the right to seek judicial review under Section 120.68, Florida Statutes, by the filing of a notice of appeal under Rules 9.110 and 9.190, Florida Rules of Appellate Procedure with the clerk of the Department in the Office of General Counsel, 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida, 32399 -3000; and by filing a copy of the notice of appeal accompanied by the applicable filing fees with the appropriate district court of appeal. The notice of appeal must be filed within 30 days from the date when this permit is filed with the clerk of the Department. If you have any questions please contact Oscar Aguirre, or me at (786) 315 -2800. Executed in Miami, Miami -Dade County, Florida Perm [nviro. m =s't a s d„ egulat. Affairs arl H-'rnan ief Plan Review :nd Dev° opment Approvals Division Copies furnished to: Aristides Reyes - Gavilan, P.E. CERTIFICATE OF SERVICE This is to certify that this notice of permit and all copies were mailed before close of business on �- ''- /oZ to the listed persons. FILING AND ACKNOWLEDGEMENT FILED, on this date, pursuant to the 120.52 Florida Statues, with the designated Department Clerk, receipt of which is hereby acknowledged. Clerk Carlos A. Gimenez, Mayor Permitting, Environment and Regulatory Affairs Environmental Services 11805 SW 26th Street, Ste. 124 Miami, Florida 33175 -2474 T 786 -315 -2800 F 786 -315 -2919 Domestic Wastewater Collection /Transmission System Construction Permit Permit Number: 2011- SEW -EXT -00121 Township Range Section: 534206 Project: Shores Square Shopping Center miamidade.gov Permittee F.D.E.P SHORE SQUARE INVESTMENT, LLC TOM CABRERIZO 3850 BIRD ROAD MIAMI, FL 33146 FDEP Permit #: 253649- 681 -DWC Date of Issue: 01/11/2012 Expiration Date: 01/10/2017 This permit is issued under the provisions of Chapter(s) 403.087, Florida Statutes and Florida Administrative Code Rule(s) 62 -4 and 62 -604. The above named permittee is hereby authorized to perform the work or operate the facility shown on the application and approved drawing(s), plans, and other documents attached hereto or on file with the department and made a part hereof and specifically described as follows: TO CONSTRUCT: A wastewater collection /transmission system connecting the proposed project to the MIAMI -DADE WATER AND SEWER DEPARTMENT CENTRAL /SOUTH W. W. T. P. The new Total Average Daily Flow (ADF) is estimated to be 1,050 GPD. The system will consist of one duplex grinder pump station and 479 LF of 2 -inch PVC schedule 80 force main. # of Pump Pumps Type Operating TDH Capacity(GPM) (ft) 2 submersible grinder 22.5 16 # of Sanitary Manholes: 1 And the following Gravity / Forcemain lines: Length Type Slope Diameter Material (L.F.) ( %) (inch) 479 Force 2 PVC Schedule 80 IN ACCORDANCE WITH: Permit application on FDEP Form 62- 604.300(7) (a) with $ 300ta'ye# n DEP FORM 62- 1.201(5) Effective November 30, 1992 LOCATED AT: 9031 Biscayne Blvd. Miami Shores, FL 33138 TO SERVE: Shopping Center SUBJECT TO: General Conditions 1 -15 and Specific Conditions 1 -10 General Permit Conditions 1. The terms, conditions, requirements, limitations and restrictions set forth in this permit, are "permit conditions" and are binding and enforceable pursuant to Sections 403.141, 403.727, or 403.859 through 403.861, F.S. The permittee is placed on notice that the Department will review this permit periodically and may initiate enforcement action for any violation of these conditions. [62- 4.160(1)] 2. This permit is valid only for the specific processes and operations applied for and indicated in the approved drawings or exhibits. Any unauthorized deviation from the approved drawings, exhibits, specifications, or conditions of this permit may constitute grounds for revocation and enforcement action by the Department. [62- 4.160(2)] 3. As provided in subsections 403.987(6) and 403.722(5), F.S., the issuance of this permit does not convey any vested rights or any exclusive privileges. Neither does it authorize any injury to public or private property or any invasion of personal rights, nor any infringement of federal, state, or local laws or regulations. This permit is not a waiver of or approval of any other department permit that may be required for other aspects of the total project which are not addressed in this permit. [62- 4.160(3)] 4. This permit conveys no title to land or water, does not constitute State recognition or acknowledgment of title, and not constitute authority for the use of submerged lands unless herein provided and the necessary title or leasehold interests have been obtained from the State. Only the Trustees of the Internal Improvement Trust Fund may express State opinion as to title. [62- 4.160(4)] 5. This permit does not relieve the permittee from liability for harm or injury to human health or welfare, animal, or plant life, or property caused by the construction or operation of this permitted source, or from penalties therefore; nor does it allow the permittee to cause pollution in contravention of Florida Statutes and Department rules, unless specifically authorized by an order from the Department. [62- 4.160(5)] 6. The permittee shall properly operate and maintain the facility and systems of treatment and control (and related appurtenances) that are installed and used by the permittee to achieve compliance with the conditions of this permit, as required by Department rules. This provision includes the operation of backup or auxiliary facilities or similar DEP FORM 62- 1.201(5) Effective November 30, 1992 2 of 6 systems when necessary to achieve compliance with the conditions of the permit and when required by Department rules. [62- 4.160(6)] 7. The permittee, by accepting this permit, specifically agrees to allow authorized Department personnel, upon presentation of credentials or other documents as may be required by law and at reasonable times, access to the premises where the permitted activity is located or conducted to: a. Have access to and copy any records that must be kept under conditions of the permit; b. Inspect the facility, equipment, practices, or operations regulated or required under this permit; and c. Sample or monitor any substances or parameters at any location reasonably necessary to assure compliance with this permit or Department rules. Reasonable time may depend on the nature of the concern being investigated. [62- 4.160(7)] 8. If, for any reason, the permittee does not comply with or will be unable to comply with any condition or limitation specified in this permit, the permittee shall immediately provide the Department with the following information: a. A description of and cause of noncompliance; and b. The period of noncompliance, including dates and times; or, if not corrected, the anticipated time the noncompliance is expected to continue, and steps being taken to reduce, eliminate, and prevent recurrence of the non - compliance. The permittee shall be responsible for any and all damages which may result and may be subject to enforcement action by the Department for penalties or for revocation of this permit. [62- 4.160(8)] 9. In accepting this permit, the permittee understands and agrees that all records, notes, monitoring data and other information relating to the construction or operation of this permitted source which are submitted to the Department may be used by the Department as evidence in any enforcement case involving the permitted source arising under the Florida Statutes or Department rules, except where such use is prescribed by Sections 403.111 and 403.73, F.S. Such evidence shall only be used to the extent it is consistent with the Florida Rules of Civil Procedure and appropriate evidentiary rules. [62- 4.160(9)] 10. The permittee agrees to comply with changes in Department rules and Florida Statutes after a reasonable time for compliance; provided, however, the permittee does not waive any other rights granted by Florida Statutes or Department rules. A reasonable time for compliance with a new or amended surface water quality standard, other than those standards addressed in Rule 62- 302.500, F.A.C., shall include a reasonable time to obtain or be denied a mixing zone for the new or amended standard. [62- 4.160(10)] 11. This permit is transferable only upon Department approval in accordance with Rules 62 -4.120 and 62- 730.300, F.A.C., as applicable. The permittee shall be liable for any non - compliance of the permitted activity until the transfer is approved by the Department. [62- 4.160(11)] 12. This permit or a copy thereof shall be kept at the work site of the permitted activity. [62- 4.160(12)] 13. This permit also constitutes: a. Determination of Best Available Control Technology (BACT). b. Determination of Prevention of Significant Deterioration (PSD). c. Certification of compliance with State Water Quality Standards (Section 401, PL 92 -500). DEP FORM 62- 1.201(5) Effective November 30, 1992 3 of 6 d. Compliance with New Source Performance Standards. [62- 4.160(13)] 14. The permittee shall comply with the following: a. Upon request, the permittee shall furnish all records and plans required under Department rules. During enforcement actions, the retention period for all records will be extended automatically unless otherwise stipulated by the Department. b. The permittee shall hold at the facility or other location designated by this permit records of all monitoring information (including all calibration and maintenance records and all original strip chart recordings for continuous monitoring instrumentation) required by the permit, copies of all reports required by this permit, and records of all data used to complete the application for this permit. These materials shall be retained at least three years from the date of the sample, measurement, report, or application unless otherwise specified by Department rule. c. Records of monitoring information shall include: i. The date, exact place, and time of sampling or measurements; ii. The person responsible for performing the sampling or measurements; iii. The dates analyses were performed; iv. The person responsible for performing the analyses; v. The analytical techniques or methods used; vi. The results of such analyses. [62- 4.160(14)] 15. When requested by the Department, the permittee shall within a reasonable time furnish any information required by law which is needed to determine compliance with the permit. If the permittee becomes aware the relevant facts were not submitted or were incorrect in the permit application or in any report to the Department, such facts or information shall be corrected promptly. [62- 4.160(15)] DEP FORM 62- 1.201(5) Effective November 30, 1992 4 of 6 Specific Permit Conditions 1. Start of construction prior to fourteen (14) days following to the issuance of this permit is undertaken at owner's risk due to the public's right to object pursuant to Section 120.57 Florida Statutes. 2. This approval is only for the construction of a wastewater collection system and does not relate to the wastewater transmission and treatment aspects. Moreover, this approval does not grant the applicant the right to connect any facilities to be served by this wastewater collection system. In order to connect the applicant shall obtain approval from the receiving utility and a Sewer Capacity Certification Letter (allocation) from PERA, in conformance with the provisions of paragraph 16C of the First Partial Consent Decree (Case No. 93 -1109 CIV- MORENO), between the United States of America and Miami -Dade County and section 42.3 of Miami -Dade County Chapter 24. This project will also be contingent upon the placing into service of all the necessary encumbrances by each sanitary sewer utility participating in the transmission of the flows from the point of origin up to the wastewater treatment plant. 3. Provisions must be made to assure uninterrupted service in the area during the time of construction. 4. Provide visual /audible alarm system for the pump station. 5. A non - resettable Elapsed Time (ET) meter must be installed at each pump to record the operating hours of each pump independently. In addition, a similar Elapsed Time meter must be installed to record when the back -up pump is required to operate by the control system. The operator must notify the Department of Permitting, Environment and Regulatory Affairs (PERA) whenever the back -up pump meter exceeds thirty (30) minutes per month, including an explanation for the inability of the pumping station to handle the peak flows without the use of the back -up pump. 6. Provide air release valves at high points on the new forcemain. 7. Pump station operating levels shall be field adjusted in order to avoid odors, nuisance, surcharged conditions and excessive pump cycle time. 8. Before a Certification of Completion and release for use letter is issued for the operation of this private sanitary system, an Operation and Maintenance Manual (0 & M Manual) must be submitted to the Water and Wastewater Engineering Section of PERA. Call PERA's PSO Program at (786) 315 -2800 for additional information. 9. Before a Certification of Completion and release for use letter is issued for the operation of this private sanitary sewer system, a Private System Operating Permit (PSO) must be obtained from the Water and Wastewater Engineering Section of PERA. Call PERA's PSO Program at (786) 315 -2800 for additional information. 10. Upon completion of construction of this project, the wastewater collection system shall not be placed into service until the Department has received, reviewed, and approved a completely executed Request for Approval to Place a Domestic Wastewater Collection/Transmission System into Operation, DEP FORM 62- 604.300(8)(b); pages 1, 2, and 3 and the following attachments: DEP FORM 62- 1.201(5) Effective November 30, 1992 5 of 6 'r a) A completely executed Miami -Dade County Permitting, Environment and Regulatory Affairs (PERA), Water and Wastewater Engineering Section form: Domestic Wastewater Collection /Transmission Systems Certification of Completion of Construction, page 1 of 1. b) Copy of the field report of the pressure test of the forcemain. Placing this system into operation without the proper approval from the Department shall constitute a violation of state and county regulations and enforcement actions may be taken accordingly. Day of sJ , 2012 Miami -Dade County Permitting, Environment and Regulatory Affairs DEP FORM 62- 1.201(5) Effective November 30, 1992 6 of 6 Arlenis Silvers From: Jhonnatan Escalante [jhonnatan @aafonte.com] Sent: Tuesday, April 05, 2011 11:53 AM To: Arlenis Silvera Subject: PW -9 -10 -1641 Shores Square Shopping Center Good morning Ms. Silvera, I am sending this e-mail in order to get an extension of the permit PW -9 -10 -1641 for the project Shores Square Shopping Center located at 9005 Biscayne Blvd. This permit is for the new sewer main that we are installing over NE 90th st and is part of the WASD permit DS 2010 -521. We were not able to continue with the work due to an existing FPL duct band that is in direct conflict with the proposed new main. The owner is in discussions with FPL for this duct band to be relocated but the process is taking several weeks. Hopefully in the next 4 weeks we will be able to continue the job. This permit is schedule to expire on 04/28/2011 and we are looking to get it extended for 90 more days Please let me know if the extension can be granted. Thank you and best regards Jhonnatan Escalante A & A Fonte Inc. 12963 W. Okeechobee Rd. #8 Hialeah Gardens, FL 33018 phone (305) 512 -4739 fax (305) 512 -4759 jhonnatan@aafonte.com Information from ESET NOD32 Antivirus, version of virus signature database 6015 (20110404) The message was checked by ESET NOD32 Antivirus. http: / /www.eset.com Information from ESET NOD32 Antivirus, version of virus signature database 6017 (20110405) The message was checked by ESET NOD32 Antivirus. http: / /www.eset.com Information from ESET NOD32 Antivirus, version of virus signature database 6017 (20110405) The message was checked by ESET NOD32 Antivirus. 1 Permit Number: PLC -9 -10 -1642 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 164995 Inspection Date: January 23, 2012 Inspector: Hernandez, Rafael Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: A&A FONTE INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060110060 Phone: (305)512-4739 Building Department Comments CONNECTION TO SEWER AND SEWER EXTENSION PERMIT Passed '� Inspector Comments CREATED AS REINSPECTION BUILDING #9005 AND FOR INSP- 151197. UP TO TIE - IN FOR #9007 -9023. Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until January 23, 2012 For Inspections please call: (305)762 -4949 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 OWNER: Name (Fee Simple Titleholder): N 30L; BY: vooaooaoeoo 000 oa°o Permit No. Ph'U J� Master Permit No. ,� Ate, LIeNC-1 � , � hone #. Address:Mb it) a- l ? S1'' City: 1 o,T, \ State: FL zip: �� CCs 31 Tenant/Lessee Name: Phone #305 5" 9SS Email: JOB ADDRESS: Ct 0 3 g t SCty %!!(\ City: Miami Shores County: Miami Dade Zip: SS y Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: NO Flood Zone: �^ tea (3 Phone#: 3D5— 2 ° ! 39 Address: 6 - Qlvv V�4, 4 � >� *E4 City: 14i t .' &k. 60040,,s State: FL Zip: 33 0 Qualifier Name: S®S9%. CA\ p Phone #: 3 - sl 2 State Certification or Registration #: l` „{ Certificate of Competency #: Contact Phone #: 3 S ° 5/ . - mail Address: DESIGNER: Architect/Engineer: `. `, "` Phone#: Value of Work for Type of Wo Descriptid • l . Square/Linear Footage of Work: ❑New ❑Repair/Replace ****+ x**** ************* ********** ** *x:*** Fees**** ***m ***************** * * * * * * * * * * * ** * * ** ** Submittal Fee $ Permit Fee $ ®;d CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 'aiD Bonding Company's Name (if applicable) Bcc+3hhdng Cumpany'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 CONDMONERS, 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 occ rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appro' ed,* a reinspection fee will be charged. Signature 3),...- V ontractor The fore! oing ins ' ent was acknowledged before me this 97 The foregoin instrument was acknowledged before me this day of ' , ! �, 20 9",'by0 day of s / 20 by k et L • who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PI ,IC: Sign: Print: My Commission Expires: itAL o:ry u I Claudia M Lopez v My Commission 00993321 -1o,n" Expires A5 /18/2014 NOTARY PUBLIC: Sign: Print: Con Ie My Commission Ex ** *+ x***+ x+ x*****+x******x:***** * ***: xa:* ***** ****** *x:***** *** ********* APPROVED BY I —3° ®� glans Examiner (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 1 ME it Tres: MANUELA ARROYAVE ' . MY COMMISSION # EE113801 407) . 153 Florid No1»ry o ... com • Zoning Structural Review Clerk 11_ BUILDING PERMIT APPLICATION FBC 20lc� Permit Type: 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 OWNER: Name (Fee Simple Address: -S6 B 100M111113111 see 2.0 2011 NJ Y: •1 ................... permi. P1c-10 —I(04-2— Master Permit No. JOB ADDRESS: City: Miami Sh Folio/Parcel #: 11 Is the Building Historically Designated: Yes CONTRACTOR: Company Address: o7963 hL ,I, e clil �'� �► NO Flood Zone: City: Qualifier Name: one #: X73 33PJf State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engi Value of Work Type of WQr Descripd IA 411_14k Rr, ddress: Footage of Work: Bra ORepair/Replace ODemolition **** ***********. x +x************** *** * **** Fees*********** **e**. a***** **.x** ******** ***.x***** 1' Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 5.3.00 , 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 o uch posted notice, the inspection wt be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this ?-1 day of '' , 20 & , by -IV -0 , day of who is personally known to me or who has produced Signature Contractor The foregoing instrument was acknowledged before me this 20 tl,by who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY (407) 398.0153 NUELA ARROYAVE MY COMMISSION # EE113801 * * *�fg *Juy tg,�20 *15 * ** Florteallolaryservke_com P1— Examiner Zoning NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * ** .43/411":%. MANUELA ARROYAVE :'1 MY COMMISSION # EE113801 EXPIRES July 18, 2015 Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 793.2204 Fax: (305) 756.8972 Permit No. plc la- (441/4 Job Name PLUMBING CRITIQUE SHEET 0 ■ is 1 Permit Number: PW -9 -10 -1641 J Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: I NS P- 164894 Inspection Date: September 28, 2011 Inspector: Bruhn, Norman Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: A&A FONTE INC Permit Type: Public Works Inspection Type: Final Work Classification: Public Works Phone Number Parcel Number 1132060110060 Phone: (305)512 -4739 Building Department Comments EXTENSION OF SEWER MAIN Passe. V� '7 Inspector Comments CREATED AS REINSPECTION FOR INSP- 151187. y 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 September 28, 2011 Page 1 of 1 Miami Shores ViIlage Public Works Department 10050 N.E. 2nd Avenue, Miami Shores. Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Public Works Permit Application FBC 2047 Pew& Type: Public Welts WATER " :1 9 o 0 Owners Name (Fee Simple Titleholder) owners Address T/ ad r v ^d P.. c., L City ev vr, y sip; -F j 10MEMEn SEP 1 4 20i0 BY: pemit„Put0—tVii T Name Job Address (whale the wart is being done) al v G) i Vr' V Phone*: City Mliamt Shores Village County Wand Dade Is Building Historically Designated: YES NO Contractor's Company Name 4 A b f. 1,4,,Q. , Contractors Address 10-9(c> City Ak S state Architect/Engineer's Name (if applicable) S Value of Work For this Permit li C /®`0 e �� Type of Work: Describe Work: rip Rona #: 4— 1 t Phone*: Lineal. Footage Of Work: 35 ❑ Addition I Atterafion n New ❑ Repair/Replace ❑ nemamton • <.sr d'1 1� .rA.o, rr. Fees Submittal Fee Permit Fee $ D Q CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning § Radon $ Zoning Bond $ Code Enforcement § Total Fee Now Due $ (Continued on opposite side) Structural Plait Review $ Bonding Company's Name (if applicable) Bonding.Cdrppany's Address WA City �, State • Mortgage Lenders Name (if applicable) Mortgage Lenders Address City State WA 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 ati 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 C)NDMONERS, ETC .... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done ka 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 oondflon to this Issuance ofa PubIIC Works permit with an estimated value exceeduag $2560, tire segment must promise in good faith that a copy of the notice of conunen ement and construction fien law brochure will be red to the person whose I property is subject to afacturent Also, a certified copy of The recorded notice of�must be p�d at the Job rule forth° first y which occurs seven (-0 days aftert a building penult is issued In the•absence of such posted notice, the inspection will not be app and a refnspection fee will be charged. '' eh r— c,..c i L •91. ' I 0 Signature f°4-1 q.---C1 x '® 1 rTV..korr% 1:ttd= 1 Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this I The foregoing instrument was acmowledged before me this i "I- day of , 20 t 0, by To .r C cm LC D i day of A'' 204, by U (AAc __ who has produced Who is personally know to me or has prociluced as identification and who did take an oath. ass identification and who did take an oath. NOTAR UBLIC: S' d Print: a C2k `•17 My Commission Expire OT MARY PUBLIC -STATE OF FLORIDA Victor I. Fuentes 4.5 #DD667598 a eI 1 NOTARY PUBLIC: Sign:____ Print: JQ�SAQO My Commission Expires: BONOI D TmW ATLANTIC B APPLICATION APPROVED B 11/17/2005 LNG CO, INC. NOT Y PUBLIC -STATE OF FLORIDA . Jessica Fernandez o, -' Commissions a#DDS93152 ;_ .lkiE 01, 2013 BONDED TI; <1 ATi.A \�'IC BONDING CO., INC. Public Works Director or his designee. Permit No: 10 -1641 and 10 -1642 Job Name: September 20, 2010 Miami Shores Viiiage Building Departrhent Building Critique Sheet 10050 N.E.2nd venue ■ Miami Shores, Florida 33138 Tel: (305) 765.2204 Fax: (305) 756.8972 Page 1 of 1 1) Plans must be reviewed and approved by Miami Dade County DERM.9need final approval stamp) 2) Plans must be approved by HRS for the septic system. 3) Provide a receipt from Miami Dade County Water and Sewer for impact fees. 4) Provide a "maintenance of traffic: plan for all roads. 5) Provide a detail for the repair of roadways. Detail must show method of compactidn, layers and depth of base and asphalt repair curb to curb. (Note: trench repair must be a minimum of 8' wide. 6) Provide a permit for repairs to parking lot including any details of accessible features being altered or repaired. 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 Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. t ld W Job Name PLUMBING CRITIQUE SHEET /l%e A loci -rifle L e-�/ — '; ,f/e- "Le) ./264/4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 169081 Permit Number: ELC -9 -11 -1783 Scheduled Inspection Date: March 14, 2012 Inspector: Devaney, Michael Owner: , SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: MEGA ELECTRIC INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060110060 Phone: (305) 828 -5205 Building Department Comments ELECTRICAL PUMP FOR SEWER SYSTEM Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 164916. Contractor stated that he did not Call this inspection in. March 13, 2012 For Inspections please call: (305)762 -4949 Page 6 of 27 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: Electrical OWNER: Name (Fee Simple Titleholder): St-, epic Address: 3 WS° G. i®cei 14 8-0 1 puw-vion SEP 3 0 2011 Permit NorJC) ° 1 ! 1 Master Permit No. S t" r- 1'. 7 iC$Iji Phone#: 30C- -'o City: ,c'°� a State: (' -. Zip: 331 `IC e Y Tenant/Lessee Name: Phone#: Email: I F H Cr 1D'J P , c .e m JOB ADDRESS: /.0 3( iSCy', e a)1 . City: Miami Shores County: Miami Dade zip: 33 1 -2i 2 Folio/Parcel #: 1 e C) LO 0 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Mele01 g(ejv Phone#: 50 ° 9Z8- 0' Address: (7 Z.5' Nw 11,1% e City: All i a..., 6 LS fc 2S State: Ft- Zip: 53 °I 4 Qualifier Name: A' i S-1 -A.es fl-eye 5 -- (i �a t i w Phone#: $°S— "" 'VI Z State Certification or Registration #: � . Oo : j } Z Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: G r z..cNA 0 -14.; Phone#: Value of Work for this Permit: $ 3 0 0 o o rs, 0 Square/Linear Footage of Work: Type of Work: CI Address DAlteration ❑New ❑Repair/Replace ❑Demolition Description of Work: ****: x****: x**** ******** ** *****: x**: x: x= x: x*** Fees** ******* ***** ** *: x**: x**: x********:x***:x** ***** /It 07 Submittal Fee $ Permit Fee $ 67 X i 9 " 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, BOTT FRS, 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 a promise in good faith that a copy of the notice of commencement and cons whose prop'rty is subject to atta 'nt. Also, a certified copy of the rec for the first spection which occurs : ven (7) days after the buildin inspection wit be approved and rei ection fee will be charge Signature Owner or Agent The foregoing instrument was acknowledged before me this 27 day of SLD( , 20 , by (tf G4■Xt5 who is person ly know teAlne or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * APPROVED BY ing $2500, the applicant must ill be delivered to the person ust be posted at the job site of such posted notice, the Contractor The foregoing instrument was acknowledged before me this 2_Z day of Sei2len,Se/ , 20 I I , by MS nom.! tZ€YCS -61."(e- who is p@:_cgatown to me or who has produced as identification and who did take an oath. NOTARY P ; LI Sign: Print: RICARDO E. BERMUDEZ My Commission Expires: 4 NOTARY PUBLIC STATE OF FLORIDA Comm# DD971115 ,Z Ste" / Plans Examiner Zoning "EXPIRES: OCT.13, WWW,AARONNOTAIrLo m * * * * * * * * * * * * * * * * * Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk MIAMI-DADE TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, Fl. 33130 2010 LOCAL BUSINESS TAX RECEIPT 2011 MIAMI -DAMP EXPIRES OF FLORIDA MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 FIRST -CLASS U.S. POS1 AGE PAID MIAMI, FL PERMIT NIA. 231 THIS IS NOT A BILL - DO NOT PAY RENEWAL 529532-4 RECEIPT NO. 553266-9 BUSINESS NAME 1 LOCATION STATE* EC0001728 MEGA ELECTRIC INC 16252 NW 79 AVE 33016 MIAMI LAKES OWNER MEGA ELECTRIC INC WORKER /S SL 1 Business 3 -c. Type D THIS ly 196AELECTRICAL CONTRACTOR ONLY BUSINESS TAX RECEIPT. IT DOES HOLDEN MOT O VIOLATE ANY OR ONIN�iu LAW SOFRYTHE COUN'"t OR CITIES. NOR DOES IT EXEMPT THE HOLDI'4 FROM ANY OTHER PERM', OR LICENSE REOU a�£.D SY LAW. THIS IS NOT ? CERTIFICATION OF THE HOLDER'S OUALIFICA- TION°. PAY6:LNT RECEIVED t.iAMI DADE COUNTY TAX COD• CTOR: 09/08/2010 60020000290 000045.00 SEE OTHER SIDE DO NOT FORWARD MEGA ELECTRIC INC ARISTIDES REYES GAVILAN PRES 16252 NW 79 AVE MIAMI LAKES FL 33016 i „11,,,11,�I,,,,,,Ilt II,111,,,1,i1:11 „1111111t,.,i1 s211 tevale-4 saw 01601 Fi;7. 4:111Ltrtvi'dil. NO tAws, :OF THE "tsV .1474, IT P.-oftars. • NOR T THE EH`FROM,AHT OTHER OR g,,,LopiEp,B,,LAW.LI&S.11 Ft4 -cERTtFicalioN OF ciligOLOF-FeS OLIALIFICA- DO NOT FORWARD MEGA ELECTRIC INC ARISTIDES REYES GAVILAN PRES 16252 NW 79 AVE MIAMI LAKES FL 33016 .1/1 nlAtint.I$M1/1 H1i.J 'tie! ifiei. the „e Sea A -C- .enses Any o -commercial ,_ ....1 1 a E .. :TENSE RI- :t retains$ as. or ,,, . :V DAYS ” 'kDDRES,.a NA "— e'en. Executive Electra ii. Sancir Direct $05©9;' t iw.i'a �riv.st 0le02O00060083; EL Herminio Gonzalez P.E. Secretary of the Boar Miami aunty ret; 3 all pr in. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YY) 06/11/11 PRODUCER Floridian Consultants Insurance 9371 S.W. 40th St. Miami, FL 33165 Phone (305)225 -9711 Fax (305)225 -7477 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED MEGA ELECTRIC INC 16252 NW 79 Ave Miami Lakes, FL 33016- 1 (305) 828 -5205 INSURER A: SCOTTSDALE INSURANCE COMP INSURER B: PROGRESSIVE INSURANCE COMP INSURER C: COMMERCE & INDUSTRY INSURANCE CO INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER �I'50995827 POLICY EFFECTIVE DATE (MM /DD /YYYY) 06/11/2011 POLICY EXPIRATION DATE (MM /DDYYY) 06/11/2012 LIMITS EACH OCCURRENCE 1,000,000 GENERAL LIABILITY ] COMMERCIAL GENERAL LIABILITYMia ]' I] CLAIMS MADE 'V OCCUR ] DAMAGE TO RENTED PREMISESJEa occurrence) 100,000 MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 ] GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: V POLICY PROJECT LOC PRODUCTS - COMP /OP AGG 2,000,000 B ] AUTOMOBILE LIABILITY ] ANY AUTO H' ALL OWNED AUTOS SCHEDULED AUTOS v. HIRED AUTOS NON OWNED AUTOS H 05351579 -1 03/25/2011 03/25/2012 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) ] GARAGE LIABILITY ] ANY AUTO ] AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY OCCUR ] CLAIMS MADE DEDUCTIBLE RETENTION $ EBU026045296 06/23/2011 06/11/2012 EACH OCCURRENCE 4,000,000 AGGREGATE 4,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (Mandatory in NH) if yes, describe under SPECIAL PROVISIONS below ❑ WC STATU- 7 OTH- TORY LIMITS — ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL WORK WITH BUILDINGS 30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS FOR -NON PAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 N.E. 2nd Ave. Miami Shores, Fl 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE FELIPE GOMEZ ACORD 25 (2009 /01) QF © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGORD, CERT FICATE OF LABILITY INSURANCE PRODUCER (305) 824-3464 !JACKSON AGENCY INC 12075 WEST 76TH STREET HIALEAH NSUREFS FL 33016- DATE ;MM/DD/YYYY) 03/01/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC GA ELECTRIC INC. 116252 N.W. 79TH AVE I MIAMI LAKES COVERAGES FL 330 I !SURER A: BUSINESS FIRST INS CO. INSURER B: INSURER Cs INSURER D: INSURER E. THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT \PATHSTANDING ANY REQUIR.ErVIENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN: I THE INSI.IRANCE. AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IINSRiADD'L LT R 11 NSRD 1 POLICY EFFECTIVE TYPE OF INSURANCE POLJCY NUMBER DATE (MMEDDNY> POLICY EXPIRATIONI DATE (MMiDDIYY) ' LIMITS GENERAL LIABILITY : ' COMME.RCI.4L GENERAL LIABILITY 1 / / / / / / / / / / EACH OCCURRENCE S DAMAGE TO RENTED PREMISES (Ea occurrenc,e) F-1 1 CLAIMS MADE , 1 C.XECURI MED EXP (Any one person) $ i PERSONAL & ADV INJURY GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER:: i P(-5 ICY I JECT 1 LCC ' PRODUCTS - COMP/OP AGG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS / / / / / / / / / / / comeINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per ace:dent) PROPERTY DAMAGE (Per accident) GA AGE LIABILITY i ANY ,--,u-ro 1, I / / / / AUTO CNLY - EA ACCIDENT $ OTHER THAN EA A(-2,C, $ AUTO ONLY: AGG 5 EXCESS/UMBRELLA. IJABIUTY I I OCCUR CLAIMS MADE I DEDUCTjBLE RETENTION S 1. / / / / / / / / EACH OCCURRENCE S AGGREGATE S 5 A WORKERS COMPENSATK)N AND 521-01440 EMPLOYERS LJABiLITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? 5 yes, describe under PEG:AL PROVISIONS below 12/07/2010 / / 2/07/2011 / / TORY LIMITS 10TH- , ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 5 ,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 , OTHER / / / / / / / / / / / / DESCRIPTION OPERATIONSILOCATONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE H DER CANCELLATION ,•! ) MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE (305) 756-8972 MIAMI SHORES FL 33138°- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE SSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) J,INS025 (01()E, 05 ELECTROMC FORMS, INC. - (800)327-0545 (,e,) ACORD CORPORATION 1988 Page 1 cf 2 Miami Shores Village Building Department 0050 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: BUILDING ROOFING Permit No. Master Permit No. OWNER: Name (Fee Simple Titleholder): Phone#: Address: City: State: Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: ` Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect /Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition OAlteration UNew ❑Repair/Replace ODemolition Description of Work: ******** * ********* * * *** * ************ * ** Fees*:************ *************** **** **** ** ** **** Submittal Fee $ Permit Fee $ 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 property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 27 The foregoing instrument was acknowledged before me this day of 9ar , 20 IL, by /it4,J G , day of , 20 _, by ho has produced who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: who is perso y known to As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My C.: IP+� 'pLOZ/biai se idx3 SIRL6OO #wawa VO12IO Id 40 31VIS raanacri cm** Sign: Print: My Commission Expires: ROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Miami Shores Village & -7/20n 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 DING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: 1�J� FBC 201® Permit No. D5 -l2 -525 Master Permit No. ROOFING City: Miami Shores County: Miami Dade Folio/Parcel#: ) 1-. 32b(o- 011- COLA Zip: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder):y 5h()vr �Ci /X) Vim ope,Vi-1e5 L1- Phone#:. State: fi- Address: (Dq (o NE )25 4. City: I'lorfh (Ala M i 3(,t5- E613-gg55 Zip: 331 Cp I Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address: �� Ate- d►, :_. �'�►'� ,' city: � / %.�� i ��. - state: R.,e,g-li Zip: 3.304' " Qualifier Name: ■.-E Ij dita- -emu,_. Phone#: (3) s12-171737 State Certification or Registration #: C:Lie., 12, -2 LidZ Certificate of Competency #: �= er),//' Contact Phone#: -5- X737 Email Address: DESIGNER: Architect/Engineer: Ste' -IiFM.COS Phone#: 177(2 Value of Work for this Permit: $ Type of Work: OAdslition C3Altera Description offWork: l ) �1 7-t- Phone#: S/004, • ?3$a Work: eplace ❑Demolition Color thru tile: ************* * * * * * * * * * *****************F *************** ****** * *** * * * *+x********* *** ** Submittal Fee $ Permit Fee $ L)7315k CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 41 PO 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. o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs en (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be appro ed 't; a reinspection fee will be charged Signature wner or Agent The foregoing instrument was acknowledged before me this h day of C)UIi , 201 bby \c*T1 rn who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: C i My Commission Expir * * * * * * * * * * * * * * * * ** APPROVED BY Notary Public State of Florida Jacqueline Ortiz Q My Commission EE 189537 Expires 04/15/2018 The foregoing instrument was acknowledged before me ' e day of- Tt.5t..7 , 20 IL by ! , w e VI-r lly 1E1,1.2..4 to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio® tr NOTARY PUBLIC CF STATE OF FLORIDA a Commit ©1)971115 l Expires 3614!2014 * * * * * * * * * * * * * * * * * * * * * ** * *~* * ** * * *>k * * * * * * * * * * * * * * * ** Plans Examiner ..z ,r/7;-- Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 14- Miami Shores Village Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20 I O BUILDING Permit No. PERMIT APPLICATION Master Permit No. `PL.0 ° ( ®T 1(A-`Z Permit Type: JOB ADDRESS: BUILDING ROOFING County: Miami Dade Zip: City: Miami Shores Folio/Parcel #: — 3206— 611 — t) , Is the Building Historically Designated: Yes NO � Flood Zone: OWNER: Name (Fee Simple Titleholder): Phone #: Address: :�� Iw�� I2 4. State: City: It j/ Tenant/Lessee Name: N/p Email: Phone#: �� - �12A -1 Zip: b Phone #: CONTRACTOR: Company Name: 4, � `lv�, . c— Address: \Z1�et� R O-i3 City: c atkA State: C Qualifier Name: State Certification or Registration #: Contact Phone #: 335 -90.4T3l Email Addre Zips tb Phone #: JC3 ` S1,241 Certificate of Competency #:(c)E, r`1 DESIGNER: Architect/Engineer: Value of Work for this Permit: Type of Work: Addition Description of Work: - CA� sk'�. L $ cY) 0 e Square/Linear Footage of Work: Ate f{ Phone #: UAlteration UNew ❑Repair/Replace y)t 6(t Ak3 %ek ❑Demolition * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** �© CCF $ CO /CC $ DBPR $ Bond $ Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ A-7 1-• 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 o curs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved an a reinspection fee will be charged. Signature 0 . Agent The foregoing instrument '.a cknowledged before me this 210• day of LQ C , 20 IL, by 1-40f Coln SeIrtal who is personally known to me or who has produced As identific ion and who did take an oath. NOTARY PUBLIC: Sign: Print: f va0 OL My Commission Expire. 41114..11110, APPROVED BY 1.1/4 Notary Public State of Florida a! Claudia M Lopez My Commission DD993321 of olY Expires.05 /18/2014 Signature ontractor The foregoing instrument was acknowledged before me this 11 day ofQ , 20\% , by D who is personally known to me nr who has produced as identification and who did take an oath. Plans Examiner Structural Review (Revised 3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) NOTARY PUBLIC: Sign: Print: My Commission Expires: '` ," i.. MANUELA ARROYAVE •9 MY COMMISSION # EE113801 ** *Mtn: - r j *** 04 k*** rJ Zoning Clerk /`�. Rbe CERTIFICATE ��`� - /� CERTIFICATE OF LIABILITY INSURANCE OP ID ML (MM/DD/YYYY) 03/28/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BROWN & BROWN OF FLORIDA INC 14900 NW 79th Court Suite #200 Miami Lakes FL 33016 -5869 Phone:305- 364 -7800 Fax:305- 714 -4401 40NIA41 NAME: aHMa° t, Ext): FAX No): ADDRESS: CUSTOMER IDff: A &AFO-1 WSURER(S) AFFORDING COVERAGE NAIC# INSURED A & A Forte, Inc. Andres Forte, Jr. 12963 W Okeechobee Road #8 Hialeah Gardens FL 33018 INSURERA: FCCI Insurance Company* 10178 INSURER B : SCCI Commercial Insurance Co 33472 INSURERC: National Trust Insurance Co. 20141 INSURER D : 03/02/13 INSURER E : $ 1,000,000 INSURER F : ILD PREMISES(Eatoccurrence) COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR SVWD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS B GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR Liabi GL00099863 03/02/12 03/02/13 EACH OCCURRENCE $ 1,000,000 X ILD PREMISES(Eatoccurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 X Contractual PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY ]( JET LOC $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA0016615 08/15/1108/15/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE UMB00113551 01/16/12 01/16/13 EACH OCCURRENCE $1,000,000 AGGREGATE ' $ DEDUCTIBLE RETENTION $ 10,000 $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECuT�v�--� OFFICER/MEMBER EXCLUDED? U (Mandatory In NH) if yes, DESCRIPTION OF OPERATIONS below N / A 001WC11A63837 04/01/1104/01/12 X TORYUMITTS OTH- ER El. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Dept 10050 NE 2nd Avenue Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MIAMI- DADECOUNTItttse"p it3114 ill ITr t►jtLI NOtt ?A}{ t( "I 2012 TAX COLLECTOR IAMI -DADE CO NTY - STATE OF FLORIDA 140 W. FLAGLER ST. EXPIRES SEPT. 30, 2012 1st FLOOR MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL 33130 PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 23 THIS IS NOT A BILL — DO NOT PAY 594765 -1 RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 620458-0 A & A FONTE INC CC # E0601146 12963 W OKEECHOBEE RD 8 33018 HIALEAH GARDENS OWNER A & A FONTE INC Sec. Type of Business WORKER /S This Is lit 6A SgcFCIALTY ENGINEERING CONTRACT 13 BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 09/06/2011 60000000473 000054.00 SEE OTHER SIDE MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 DO NOT FORWARD A & A FONTE INC ANDRES FONTE PRES 12963 W OKEECHOBEE RD 8 HIALEAH GARDENS FL 33018 10 2011 LOCAL BUSINESS TAX RECEIPT 2012 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2012 MUST BE DISPLAYED AT, PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 THIS IS NOT A BILL — DO NOT PAY 395746 -2 BUSINESS NAME / LOCATION A & A FONTE INC 12963 W OKEECHOBEE RD 33016 HIALEAH GARDENS OWNER A & A FONTE INC Sec. Type of Business 213 SERVICE BUSINESS 2 BUSINESS T"ALX R CEIIPPT.. R NOT A CONTRACTORS RECEIPT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. 8 RENEWAL RECEIPT NO. 412964 -9 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 23' EMPLOYEE /S PAYMENT RECEIVED M1AM1 -DADE COUNTY TAX COLLECTOR: 09/06/2011 60000000457 DO NOT FORWARD A & A FONTE INC ANDRES FONTE 12963 W OKEECHOBEE RD 8 HIALEAH GARDENS FL 33016 1 11 11 11 111 1 %% 11 1 1 1 i 11 1 i_ _ 111 MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 RECEIPT NO 2011 MUNICIPAL REN CONTRA CTOR'S 2012 MIAMI -DADE COUNTY - STATE OF FLORIDA PURSUANT TO COUNTY CODE SEC. 10 -24 EXPIRES SEPT. 30, 2012 THIS IS NOT A BILL — DO NOT PAY 30- 7167406 CC NO: E0601146 BUSINESS NAME / LOCATION A & A FONTE INC 12963 W OKEECHOBEE RD OWNER :A & A FONTE INC SEE BACK-OF RECEIPT FOR A LIST OF NON- PARTICIPATING MUNICIPALITIES Receipt holder must register in the city where work is to be done. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX cakr072 5 / 2 011 02280027001 000300.00 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. GENERAL BUILDING CONTRACTOR DO NOT FORWARD A & A FONTE INC ANDRES FONTE PRES 12963 W OKEECHOBEE RD 8 HIALEAH GARDENS FL 33018 CTQB Construction Trades Qualifying Board o BUSINESS CERTIFICATE OF COMPETENCY E0601146 A &AFONTE,INC D.B.A.: HAN JOSEPH Is certified under the provisions of Chapter 10 of Miami -Dade County QUALIFYING TRADE(S) 0001 GENERAL ENGINEERING Charles Danger P.E. Secretary of the Board MIAMFDADE www.miamidade.govibuilding Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132060110060 Owner's Name: SHORES SQUARE INVESTMENTS Job Address: 9005 BISCAYNE Boulevard Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: $ 8,000.00 0 Contractor(s) A&A FONTE INC , Phone (305)512 -4739 Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 7/25/2012 : Yes Comments: 7/25/12 NEW PLAN OK