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ELC-18-1158sHO1lts y Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 FLOlR1Op' Permit NO. ELC-5-18-1158 Permit Type: Electrical - Commercial Work Classification. Sign lrit Status: APPROVED Issue Data: 511612018 1 Expiration: 1 1112/2018 Project Address Parcel Number Applicant 9050 BISCAYNE Boulevard 1132060100010 Miami Shores, FL 33138- Block: Lot: PUBLIX SUPERMARKETS, INC Owner Information Address Phone Cell PUBLIX SUPERMARKETS, INC P O BOX 407 (863)688-747_ LAKELAND FL 33802-0407 Contractor(s) Phone Cell Phone ART SIGN CO INC (954)644-2011 of Work: CONNECT O EXISTING ELECTRIC onal Info: ification: Commercial Scanning: 1 Fees Due Amount CCF 0.60 DBPR Fee 2.00 DCA Fee 2.00 Education Surcharge 0.20 Permit Fee 100.00 Scanning Fee 3.00 Technology Fee 0.80 Total: 108.60 Valuation: $ 50.00 Total Sq Feet: g Pay Date Pay Type Amt Paid Amt Due Invoice # ELC-5-18-67373 05/16/2018 Credit Card $ 58.60 $ 50.00 05/01/2018 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Electrical 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 AF IT: I certify that all the foregoing i rm tion is accurate and that all work will be done in compliance with all applicable laws regulating construction q zo ing. Futhermore, I authorR&the a e med contractor to do the work stated. May 16, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy May 16, 2018 Miami Shores Village Building Department M of o18 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972'Y _ INSPECTION LINE PHONE NUMBER: (305) 762-4949 FRC 2® _ BUILDING PERMIT APPLICATION BUILDING ELECTRIC ROOFING Master Permit No. S 6N 19 - 1 iJ , Sub Permit No.__%0_ 1 REVISION EXTENSION RENEWAL PLUMBING MECHANICAL PUBLICWORKS CHANGE OF CANCELLATION SHOP Zip: :3 ke Tenant/Lessee Name: 724,4-099, iZ Phone#:_'fiy CONTRACTOR DRAWINGS JOB ADDRESS: D ["//ji l/ awb City:, IIAit/G 2 4-C6 State /—"Z - City: City: Miami Shores County: Miami Dade Zip: 33/3P Folio/Parcel#: // 3 Zo 6 4910 0010 Phone#: ' 7:r4 Is the Building Historically Designated: Yes NO Value of Work for this Permit: $ C-5-0 .' Square/Linear Footage of ork: I f Type of Work: Addition Alteration © New Occupancy Type: Load: Construction Type: Flood Zone: BFE: _ FFE: OWNER: Name (Fee Simple Titleholder): NO2%l L/v /&64& G 1!1P Agr,Phone#: Address: A ig , /, 3 ox 370 ,-!5 City: W66q/JA State: Zip: :3 ke Tenant/Lessee Name: 724,4-099, iZ Phone#:_'fiy Email: 'Qin%'IOi?x1Gtf ll%P D/SGS. OY12 CONTRACTOR: Company Name: hrflew1cle Phone#: /J qw-zoll Address: F36-111al 111;gA City:, IIAit/G 2 4-C6 State /—"Z - City: Qualifier Name: /TTft/l Phone#: JI yl,FZv!/ State Certification or Registration #: C 5/Z000 7` /y Certificate of Competency #: DESIGNER: Architect/Engineerr:' lr.L*,, 1< -'s tJ a --j Phone#: ' 7:r4 P S Address: /b3 W " n -CODwn d /D 3 City: °xke C State: L Zip: 3Z 0 Z-3— Value of Work for this Permit: $ C-5-0 .' Square/Linear Footage of ork: I f Type of Work: Addition Alteration © New Repair/Replace Demolition Description of Work: 6A1,vFcr To Z14-tSr1oy67 E151i77L1C*_1 Specify color of color thru tile: Submittal Fee $ 9()' 0 3 Permit Fee $ Scanning Fee $ Radon Fee $ 2 - M Technology Fee $ Training/Education Fee $ Structural Reviews $ Revisedo2/24/2014) CCF $ CO/CC $ DBPR $ = Notary; Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) N/,+ Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Al 1'14- 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." Notice to Applicant: As a condition to the issuance ofa 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 certrfled copy ofthe recorded notice ofcommencement 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. A ACA&xSignature OWNER or AGENT The foregoing instrument was acknowledged before me this i day Of me" ch , 20 t O . by L - '4 who 1s p sonally know o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of NIAlLa —.20 by 4"aoqzz who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: as Notary Public • StM 01 Florida Seal: ' T Y so'S My Comm. Expires Jun 9, 2020BondedthroughNationalNotaryAssn. 4IIU, APPROVED BY / I8 Plans Examiner Zoning Structural Review Revised02/24/2014) Clerk 6J - Sign: U Print: Seal: rostYP`e, KIMBERLYBAKER Commission 0GG 114969 w9i \oma Expires September 3, 2021 fOF F10 Bonded ThN BudgetNotarySeerlees Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of NIAlLa —.20 by 4"aoqzz who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: as Notary Public • StM 01 Florida Seal: ' T Y so'S My Comm. Expires Jun 9, 2020BondedthroughNationalNotaryAssn. 4IIU, APPROVED BY / I8 Plans Examiner Zoning Structural Review Revised02/24/2014) Clerk