ELC-16-3423 1
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Permit NO. ELC-1246-3423
`SNORES Y�! Miami Shores Village Permit Type:Electrical -Commercial
10050 N.E.2nd Avenue NE
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Work Classification. SignMiami Shores,FL 33138-0000 Permit Status:APPROVED
tiF! Phone: (305)795-2204
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Issue Hate: 1/11/2017 Expiration: 07/10/2017
Project Address r Parcel Number Applicant
9501 NE 2 Avenue 1132060133920
Miami Shores, FL 33138- Block: Lot: DVS LLC
Owner Information Address Phone Cell
LVS
LLC 9400 NE 2 Avenue (305)756-3711
MIAMI FL 33138-
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Contractor(s) Phone Cell Phone Valuation: $ 150.00
FOREVER SINGS INC (305)885-3411
Total Sq Feet: 17.28
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Type of Work:REVERSE CHANNEL LETTERS AND ALUMINU Available Inspections:
Additional Info:REVERSE CHANNEL LETTERS AND ALUMINU Inspection Type:
Classification:Commercial Final
Scanning:3 Review Electrical
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Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# ELC-12-16-62418
$2.25 01/11/2017 Check#: 13179 $ 109.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 12/21/2016 Check#: 13142 $50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
January 11, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
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January 11, 2017 1
IL Miami Shores Village mac:
Building Department DEC 21 2016
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JBY: "t--N
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit Nos`i N `1 —3q z2
PERMIT APPL ATION Sub Permit No.C_ ,���=�(A 23
BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9517 & 9519 NE 2ND AVE
City: Miami Shores County: Miami Dade Zip
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):DVS LLC Phone#:305.484.1606
Address:201 NE 95TH ST
City: MIAMI SHORES State: FLZip: 33138
Tenant/Lessee Name: MIAMI INDEPENDENT LEARNERS, LLC Phone#:305.895.8481
Email: ANAOLAYA@IKUMON.COM
CONTRACTOR:Company Name: FOREVER SIGNS Phone#: 305.885.3411
Address: 2400 W 3RD CT
City: HIALEAH State: FL Zip: 33010
Qualifier Name: RAFAEL ALVAREZ Phone#: 305.885.3411
State Certification or Registration#: EC 13003878 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: �7 City: State: Zip:
Value of Work for this Permit:$ `S�/ 'U� Square/Linear Footage of Work: 7' Z t
Type of Work: ❑ Addition ❑ Alteration ❑ New J Repair/Replac _ ❑ Demolition ,
Description of Work: ` i/4'1:5< G� -1 5
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Specify color oC of color thru tile: �
Submittal Fee$ PAJ IN Permit Fee$ A, O'A'40 (0
CCF$ o Q CO/CC$
Scanning Fee$ Radon Fee$ Z . Z S DBPR$ 0. Z_5 Notary$
Technology Fee$ so Training/Education Fee$ ' Z 0 Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014) i
Bonding Company's Name(if applicable)
Bonding Company's Address i
Cit F —
y 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
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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 oc ..seven-{7 days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved'and a n ecti n fee will be charged.
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Signatu _ Signature
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OW R or A NT CONTRACTOR
The foregoing instrument was a nowledged before me this The foregoing instrument was acknq#eclgecl before me this
7 day of 120 /G by 17 day oft' _ 20 iL b
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^�e`'•-c4�- (�who is personally known to %z/9i/tEG d<} /j-t r"'rtl
�- o is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Print: 12o ` `� / {'f �'' Print:
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Seal: ~`
ROBIN PEREZ
Seal: fl
MY COMMISSION tf FF 951968 2 ^"""y" ROBIN PEREZ
`' .: MY COM Sl
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EXPIRES:May 18,2020 ; "c
�' EXPIRES:Ma 18,2020
! ''; �^ Bonded Thru Notary Public Underwriters I'; a y
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)