ELC-17-538 Permit WELC-3-17-638
Miami Shores VillagePerrr;it TY Ele riC81-Coml ercial
10050 N.E.2nd Avenue NE
INorltClation.sign ,
Miami Shores,FL 33138-0000 PV r i..
Phone: (305)79`x2204 01-
Pe�C?I Stat0s.AI I R EI
�COFt
Istte Date.X712017 Expiration: 10/04/2017
Project Address Parcel Number Applicant
L9501 NE 2 Avenue 1132060133920
DVS LLC
iami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
DVS LLC 9400 NE 2 Avenue (305)756-3711
MIAMI FL 33138-
Contractor(s) Phone Cell Phone $ 1,800.00
FOREVER SINGS INC (305)885-3411 Valuation:
Total Sq Feet: 11
Type of Work:REVERSE CHANNEL LETTERS-BACK LIT F Available Inspections:
Additional Info:REVERSE CHANNEL LETTERS-BACK LIT F Inspection Type:
Classification:Commercial Final
Scanning:1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# ELC-3-17-63119
DBPR Fee $2.25 04/07/2017 Credit Card $ 110.70 $50.00
DCA Fee $2.25
Education Surcharge $0.40 03/02/2017 Credit Card $50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $160.70
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 ELECT 51PL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFID IT: ; ce iN that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and onin Fu ore,I authorize the above-named contractor to do the work stated.
i April 07,2017
uth d 'gn re: wner / Applicant / Contractor / Agent Date
Building Department Copy
April 07, 2017 1
Miami Shores Village
MAR 0 2 2017
Building Department
90050 N.E.2nd Avenue,Miami Shores,Florida 33138 -----
Tel: (305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 2014
BUILDING Permit No. S G N 4-7®53`7
PERMIT APPLICATION Master Permit No. �—,LG 1-7 "�538
Permit Type: Electrical I
JOB ADDRESS: 211
` � C-p� q S4 s+
City: Miami Shores County: Miami Dade Zip: 3 I�
Folio/Parcel#: 11 r 32-®(o —®1 3 a---Sq 2 0
Is the Building Historically Designated:Yes
-�� NO Flood Zone:
1 p p
OWNER:Name(Fee Simple Titleholder)- fi&CS� aC 12 on �_ Phone#:
Address: ,2®1 N E 7 S 44 V � p�
City: h°I f an1l; s State: FL Zip: e^` 3 i zc
Tenant/Lessee essee Name: ht er5,n Q�:k fie? Phone#: �5'1-2 U 02-
Email: Qnde�s�.P1�Qr�-�►nez aC, g�i Y,
C
LJ
CONTRACTOR:Company Name: FOREVER SIGNS Phone#: 305.885.3411
Address: 2400 WEST 3RD COURT
City: HIALEAH State: FLORIDA Zip: 33010
Qualifier Name: RAFAEL A.ALVAREZ Phone#: 305.885.3411
State Certification or Registration#: E13003878 Certificate of Competency#:
Contact Phone#: 305.885.3411 Email Address: FOREVERSIGNS@AOL.COM
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ goo Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑`New ❑Repair/Replace ❑Demolition
Description of Work: je"✓Si? C/Rn'7 0�4 47�
��xx�xxxxxx�xxx�xx�xxxxxx��x��x�xx�xx�xFeesx�xxxxxxxxxxxxxxx�xxxxxxxx:�xx���x�xx:xx�xxxxx
Submittal Fee$ 504003A 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 Corrpany'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 inspectiony-ed
s seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not bea reffis ion fee will be charged.
r- a
Signature Signature
Own6r or Agent Contractor
The foregoing instrument was acknowledged before me this�� The foregoing instrument was acknowledged before me this 13
day of x& ,20 J by /G?1%�=6 kE&eeQ81 zV day of -J::;' ,20 °-7,by a6 M6-
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. 1
NOTARY PUBLIC: NOTARY PUBLIC: 1
Sign: Sign:
Print: d Print: /�� P�� Z
lift, EU��tH OLOARA" ,H„
My Commission �,, My Com rtes R081NPERQ
•`s MY COMMI8310N M RF98353g " MY COMMISSION#FF 951968
EXPOWS JeuNtaty 25,2= 'ea EXPIRES:May 18.2920
••''.. eaataroryPomrs�a �
�aa� xo•bI
APPROVED BY fLJ /S' Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)