ELC-19-404Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
�II
Issue Date:
Location Address Parcel Number
9710 NE 2ND AVE, Miami Shores, FL 33138 1132060132350
Contacts
Permit NO.: LC-0-19-404
Permit fie: Electrical - Commercial
World Classification: Sign
Permit status Closed
Expiration:
SHORES LANDING LLC Owner Shores Landing LLC Owner
GLADYS MATZ 97102
Other: 3055258816 GLADYSMATZ@AOL.COM
SIGNALITE INC Contractor
OMAR GALAN
7230 NW 46 ST, MIAMI, FL 33166
Business: 3054702333 info@signaliteinc.com
Description: CHANNEL LETTERS COPY "CANO HEALTH Valuation: $ 400.00 Inspection Requests:
iTotal Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Check # 1975
03/18/2019 $60.30
Check # 1825
02/20/2019 $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.
OWN RS AFFIDAVIT: Icethat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
reg n construction d zon ng. Futhermore, I authorize the above named contractor to do the work stated.
6&(i 'ti� ? D Ij Lo �z F
Authorized Sig a Owner / Applicant / Contractor / Agent Date
April 04, 2019 v 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
BUILDING
PERMIT APPLICATION
❑BUILDING Q ELECTRIC ❑ ROOFING
EB 2 Z 9
FBC 20 Master Permit No. SG I —Z � r G�
-463
Sub Permit No.0 ,2 Iq -404
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9700 NE 2 AVE
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1 1-3206-013-2350 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): SHORES LANDING LLC
Address:714 NE 59 ST
Phone#:3o S+ J als— U 1 ks
City: MIAMI State: FL Zip: 33137-2326
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: SIGNALITE INC. Phone#: 305-406-3054
Address: 7230 NW 46 ST
City: MIAMI State: FL Zip: 33166
Qualifier Name: OMAR GALAN
Phone#:
State Certification or Registration #: EC13008031 Certificate of Competency #:
DESIGNER: Architect/Engineer:
hone#:
Address: City:
Value of Work for this Permit: $ 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace
Description of work: Channel letters, copy "CANO HEALTH"
State: Zip:
❑ Demolition
Specify color of color thru tile: `
Submittal Fee $ J 1 Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
if
Bonding Company's Name (if applicable)
A r .
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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."
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 aaaroved and a reinsaection fee will be charged.
Signature
iWNER or E T
The foregoing instrument was acknowledged before me this
rd day of1)C- Y1bQY- 20 1 q, by
jq 5 M 04'�-& who is personally known to
me or who has produced i' L�p L - as
id tification and who did take an oath.
N TARY P BLIC:
t �1
Sign: U
Print: 1 / ✓►� ( C`I
Seal: Ag-A- Irk,= MIRNACUADRA
W COMMISSION N FF 244638
• 4 EXPIRES: June 25, 2019
s��.• Banded Thru Notary Public Underwriters
************* *
Signature 04
CON ACTOR
The foregoing instrument was acknowledged before me this
10 day ofrr //D-((,e-Mi�-c+� , 20 I' by
��tj2 lam ( CLn w is personally known Dt9
me or who has produced _ as
identification and who did take an oath.
NOTARY PUBLIC:
` L% 18
Sign: Q:, GG21M
Print: r EMRM JUIRO 24, 20Z'1
..........,,a,eu atam t41ff ArN
Wjt%dN
Seal:
****************************************************************
APPROVED BY Z/ Z1-II 1 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)