REV-19-1583OWNER: Name (Fee Simple Titleholder): 9801 Park LLC Phone#: 305 252 1584
Address: 10820 SW 200 Dr #100
City: Miami
Tenant/Lessee Name: Sins Gastrobar
Email: sins@sinsgastrobar.com
State: FL
CONTRACTOR: Company Name: Same and Q Electrical
Address: 950 SW 104 Court C301
City: Miami State: FL
Qualifier Name: Manuel E Quesada
zip: 33157
e#:7868637798
305 219 0427
zip: 33174
one#: 305 219 0427
State Certification or Registration #: EC13007128 Certificate of Competency #:
DESIGNER: Architect/Engineer: Yan Luis Solis PE Phone#: 305 484 5596
Address: 14245 SW 21 Terr City: Miami State: FL
Value of Work for this Permit: $ Square/Linear Footage of Work: 2,500 SF
Zip: 33175
Type of Work: Addition Alteration New Repair/Replace Demolition
Description of work: Revised bar layout, floor plans and MEP accordingly and electrical panels.
Specify color of color thru tile:,
Submittal Fee $-----o • I-mPermit Fee '$ CCF $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Z+
Miami Shores Villagec,-TED
Building Department Ju 0 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:—
Tel: (305) 795-2204 Fax: (305) 756-8972 e"
f
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 -
BUILDING Master Permit No. CC-10-18-328610CV-0!iic} jjrjj
PERMIT APPLICATION Sub Permit No. `-vi-0--IGl `1
BUILDING ELECTRIC ROOFING Q REVISION EXTENSION RENEWAL
PLUMBING MECHANICAL DPLIBLICWORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9835 NE 2nd Ave
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -3206-013-4380 Is the Building Historically Designated: Yes NO X
Occupancy Type: A-2 Load: 150 Construction Type: III Flood Zone: X BFE: FFE: 10.35'
OWNER: Name (Fee Simple Titleholder): 9801 Park LLC Phone#: 305 252 1584
Address: 10820 SW 200 Dr #100
City: Miami
Tenant/Lessee Name: Sins Gastrobar
Email: sins@sinsgastrobar.com
State: FL
CONTRACTOR: Company Name: Same and Q Electrical
Address: 950 SW 104 Court C301
City: Miami State: FL
Qualifier Name: Manuel E Quesada
zip: 33157
e#:7868637798
305 219 0427
zip: 33174
one#: 305 219 0427
State Certification or Registration #: EC13007128 Certificate of Competency #:
DESIGNER: Architect/Engineer: Yan Luis Solis PE Phone#: 305 484 5596
Address: 14245 SW 21 Terr City: Miami State: FL
Value of Work for this Permit: $ Square/Linear Footage of Work: 2,500 SF
Zip: 33175
Type of Work: Addition Alteration New Repair/Replace Demolition
Description of work: Revised bar layout, floor plans and MEP accordingly and electrical panels.
Specify color of color thru tile:,
Submittal Fee $-----o • I-mPermit Fee '$ CCF $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Z+
Bonding Company's Name (if applicable)
Bonding Company's Address N/A
City
N/A
State _
AI/A
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address N/A
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 approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The fore oing instrument was acknowledged before me this
day of 20 by
cJ who isAersonally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: : "' E AWAYS LAGO
Notary Public - State of Florida
Commission = GG 246553
r My Comm. Expires Oct` 26. 2022
APPROVED BY
Revised02/24/2014)
Signature bi-;
CONTRACTOR
The foregoing instrum nt was acknowledged before me this
day of 20, by
Rivvi t AD who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:ti R" tie.. 'ANAYS LAGO
Notary Public - State of Florida
tIi 'p; Commission = GG 246553
My Comm. Expires Oct 26, 2022
BondeC through National Notary Assn.
as
y.........................................a ate.#########
Plans Examiner Zoning
Structural Review Clerk