ELC-18-2452Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:10/22/2018
Parcel Number
Permit No.: LC-9-18-2452
Permit Type: Electrical - Commercial
Work Classification: Sign
Permit Status: Approved
Expiration: 04/22/2019
Project
9830 NE 2 AVE, Miami Shores, FL 33138-2347 1132060132240 <NONE> LLJ
Contacts
MIAMI SHORES CENTER LLC Owner MIAMI SHORES CENTER LLC Applicant
210 71 ST 309, MIAMI BEACH, FL 33139 210 71 ST 309, MIAMI BEACH, FL 33139
Mobile:7862368569 ORIT@ELYSEEINC.COM Mobile:7862368569 ORIT@ELYSEEINC.COM
Other:3058648885 Other:3058648885
KLEAN POWER ELECTRIC INC Contractor
GUILLERMO ALONSO
6601 SW 80 ST, MIAMI, FL 33143
Description: NON ILLUMINATED LETTER WITH 2 LED LAMPS. Valuation: $ 1,810.00 Inspection Requests:
305-762-4949
Total Scl Feet: 0.00
Fees
Amount
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$110.20
Payments Date Paid
Amt Paid
Total Fees
$110.20
Credit Card 10/22/2018
$60.20
Credit Card 09/17/2018
$50.00
Amount Due:
$0.00
Building Department Copy
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 e that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regul�tirf cti nd oning. Futhermore, I authorize the above named contractor to do the work stated.
"n�c �d tit Z-
Owner / Applicaht / Contractor / Agent
Date
October 22, 2018 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No*-,
PERMIT APPLICATION Sub Permit Nov
❑BUILDING f6ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: _f-1? Q 2 Aj 6 2 V-P_
City: Miami Shores / If County: Miami Dade zip: 3 e
~ 2
Folio/Parcel#: 2� 6 ^ I 4Q Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address: 2/ b —� I Y �' ii)= 3o `I
City: h', O�ml �C`h State: �L Zip: -� -'A'14j
Tenant/Lessee Name: L" 0"3 Coles Phone#: :41 6 - 30 1-
Email
CONTRACTOR: Company Name: J fC� �� "� rG�y 0e�E`*�`C� Phone#: �t��j 2}02 l
✓ �-
Address: 5 101 5 cam 16 0
City: ':;� 0 �J' U/Q J T_��lD�j'/� state: F G 3 zip: �33
Qualifier Name: (� v �19�'� r`�lJyXS O a Phone#: '-7 z? G - 241 - C)2/q
State Certification or Registration #: 0 Z O G T Certificate of Competency #:
DESIGNER: Architect/Engineer: �o:�C1n.n`� ���Usi �n1 g Phone#: �-�C� - L�21- 0
Address: I Z 6 S W 2 t Jety City: kkl O� M k State: rL Zip: i s
Value of Work for this Permit: $ ti " - i' Q Square/Linear Footage of Work: Z 5`j ,L�
Type of Work: ❑ Addition ❑ Alteration Zf New ❑ Repair/Replace ❑ Demolition
Des1criptionof.WSork:�f ,�CN1'- / I'�°1�/1�ti`�i��►�o �i``��V�Vvtf� �p�?c�j ���1 2 LP9
Specify color of color thru the:
Submittal Fee
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee CCF $ CO/CC $ _
Radon Fee $ 'Z CA DBPR $ �� Notary $
Training/Education Fee $
Double Fee $
Bondrb
$
TOTAL FEE NOW DUE $ d '
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
W,
9
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."
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 f e will be charged.
Signature A�aSignature
OWNER or AGEN CONTRACTOR
The foregoing instru ent was acknowledged before me this The foregoing instrum nt was acknowledged before me this
b
a of 20 i� by day of 20y by
who is personally known to Q I ' o is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: „
�P"''••;, STACYOSKOLSKI
Notary Public - State of Florida
Commission M GG 071356
My Comm. Expires Apr 11,2021
APPROVED BY )A�b
identification and who did take an oath.
NOTARY PUBLIC:
**************************************************************
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)