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MCC-19-852Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Parcel Number 9835 NE 2ND AVE, Miami Shores, FL 33138 1132060134380 Contacts Permit NO.: MCC -04=19-852 Permit Type: Mechanical - Commercial Work Cisrssifrcation: Alteration Permit status: Approved Expiration: 10/21/2019 Description: MECHANICAL FOR NEW PROPOSED RESTAURANT Valuation: $ 48,700.00 Inspection Re uests: 305INEXISTINGRETAILBUILDING. DINING, BAR & FULL KITCHEN. i2 -r A9 UNIT#9835 BUSINESS NAME: SINS Total Sq Feet: 2,480.00 Fees 9801 PARK LLC Owner 4141 NE 2 AVE 204 A, MIAMI, FL 33137 UNITED RESTAURANT EQUIPMENT & Contractor SERVICES CORP REINALDO LOPEZ 509 W 27 ST, HIALEAH, FL 33010 Home: 3052190427 50.00 CCF 29.40 Description: MECHANICAL FOR NEW PROPOSED RESTAURANT Valuation: $ 48,700.00 Inspection Re uests: 305INEXISTINGRETAILBUILDING. DINING, BAR & FULL KITCHEN. i2 -r A9 UNIT#9835 BUSINESS NAME: SINS Total Sq Feet: 2,480.00 Fees Amount Application Fee - Other 50.00 CCF 29.40 DBPR Fee 21.92 DCA Fee 14.61 Education Surcharge 9.80 Permit Fee 1,411.00 Scanning Fee 3.00 Technology Fee 36.53 Total: 1,576.26 Building Department Copy Payments Date Paid Amt Paid Total Fees 1,576.26 Check # 1056 04/24/2019 $1,576.26 Amount Due: 0.00 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. Authorized Signature: Owner / Applicant / Contractor / /Agent Date April 24, 2019 Page 2 of 2 Miami Shores Village RECEIVED AP 1 +82019 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201 --_ BUILDING Master Permit No. CC -10-18-3286 PERMIT APPLICATION Sub Permit No.M(? BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL PLUMBING Q MECHANICAL PUBLIC WORKS 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#: 305 455 1800 4141 NE 2nd Ave. Suite #204A City: Miami State: FL Zip: 33137 Tenant/Lessee Name: Sins Gastrobar Restaurant Phone#: 786 863 7798 Email: sins@sinsgastrobar.com CONTRACTOR: /Com'(AllpanyName:T P IeC—, / gMRW 6Y • Phone#: Address:_,6M00 -275F City: H 14 State: FL Zip: d Qualifier Name: l/sl O LOPZE -Z / Phone#: 3 0_15- y2`JP63 State Certification or Registration #: C DESIGNER: Architect/Engineer: YCM E Address: 14245 SW 21,Terr—' Value of Work for this Type of Work: Description of Work: it: $ 00 0 ificate of Competency #: ne#: 305 484 5596 City: Miami State: FL Square/Linear Footage of Work: 2410 SF Zip: 33175 itio urant New Repair/Replace Demolition poin existing Shopping Center, all interior improvements. Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $ DBPR $ CO/CC $ _ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ 5 r0 . 2GnAV Bonding Company's Name (if applicable) N/A Bonding Company's Address N/A City State _ Mortgage Lender's Name (if applicable) N/A 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 goodfaith 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 OWNERorAGENT The foregoing instrument was acknowledged before me this day of rl 20by i who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature C TRACTOR The foregoing instrument was acknowledged before me this day of 20 by VNwrA V who is personally known to me or who has produced as identification and who did NOTARY PUBLIC: Sign: Print: q VT Sign:_ Print: Seal: Seal: tary Public State of Florida Danay Bazain C CPN My Commission GG 131884 APPROVED BY U Is Structural Review Revised02/24/2014) Z 0 °os Notary Public State of FloridaDanayBazain Wires08/06/2021 GG 131884 ires08**8***2********** ********** Zoning Clerk A CERTIFICATE OF LIABILITY INSURANCE- , ' MIS UN BATE IS 1ST AS A IMT111Et OF BffOFJBM0N CMLY No GONYM SO MMM WW TM tM[WATE WILML 11g CHZ WWATE DOES NOF AMMUNRY OR NEGMELY AMMM MaMM OR AUM THE 0049tAM AffM= BY THE AOLR=g BELOW. MM-CiMMI `M OF RMWANCE DOES NO! CONSMUTE A CoNMACT 9EIVOM TttE Immim mss), AuTHi IZ RF 1MWdE oft PSR, MIDIM CIE3i WN-* gigX XNL q TANT Etht 6aMietr is A Ei IAI. Bim, tle pe1li(issi mast inva AD lIAL fl er6e nderaod. I7 SUl3ROGMI IN IS WAIVED, s &jeer to dw temn:z and oouti o, - afGee pdIM call• P lI nqdm an A stet on thisedoesttat000ler ietleeehoMiertaliafsadi Pi T SANDRA PERQ IVS bmwance AgenCy a FAz QM SW Btle SL .. UNRID RESTAURANT SOMI M ASH2ACE CORP WBW275I Hlablate FL 33010- tamammF• i J 7M IS TO CERTIFY IMT TIE POLIOS OP 9MRAi'NZ LWW BELOW HAVE BEEN !== TO THE INS NPJMD ABOVE FOR 7HE POLICY PL3iiOD MCATEX NOTWtHMMMiS ANY MQUOUMIENT. TE W OR CGIMITION OF MY GGNTI ACF OR OTHER DOMMOIT VOTH EST TO VOUCH 7TAS CBMICATE MY BE ISSIOR MXY PHifAK THE HiE ARMM BY THE POLIM DEX=W RMEN 15 SUBJECT TO ALL THE TMW EXCJ..t15t01IS AIS CONDnIUM OFSLIGH PO<[IE, LMM SHOVi MAY HAVEBEBi ftEMM OY PAID CLAN& testae TymcF PO>RYE3 naucr 04h7I19 04/17/20 Lam X M c tAtLEA9ttimt CLAVA54MDE px Oexeae A G8 t.AG3T9GATSEAQTAPPE MPM p =El - LOC e7me3t 2987815A ENNO S 1 0,000.00 s ee m i aa. S E;.aoEi ao - PBMIM LiACneEaULM S OM S ZAUROUO UO PImDUCiS-CMUMPAW S Z.OW,ODOJ>0 S ANTAUEO iiif UMAUTOMM a wr ctax U0iB1fA fill om=14 S L10 YOtR&t1f(Ple S " S S IIi 1AtE1as EXCESSLMS CLAic I itE,BtEtOeLS SAM S i S VtOR[iiCP Ammwmwr ennr YIB AM R NIA iLsq nrra+I SE IiOEtOFaPBiAIE0L6Eidmr OtH' F1t31CeiAOCEB![ S EL06EASi-EA S FL0WAM-P0L0rUNffT S' RIt>lt ePHtA:10l6laorJ ZD/YBIA:ft3 fAOt]9Bf.AdA Im®ds9.m)bealfaet+di maas toLimgtma - NEOUMCAL CONTRACI'gR%CAM818M Sim ANY OFMMABCFVEDEStROM POLE BEC BEFORE 7M- Eeffm 1 DATE I -Know, EEmm VALE. EEE ETQEVmm IN MMMT SHORES VILLAGE 10050 NE 22d AVENUE MIAMI SHORES, FL, 33138 305767-4870 COWDRAMM AB tight rewrved. ACOM2512MGNM The ACORD time and logo we * of ' ACORU® CERTIFICATE OF LIABILITY INSURANCE °0,t " THIS CERTIFICATE 6 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT. if thecc holder is an ADDITIONAL INSURED, the policy(les) most have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorammeft A statement on this certificate does not corder rights to the cr -IHcmfe holder in lieu of such endOCONTACTrsmrterht(s). PRODUCER NAME Automatic Data Processing Agency, lnc- MrQ Ift Eft "a): 1 Adp Boulevard Roseland NJ 07068 INSURED UNITED RESTAURANT EQUIPMENT AN 509 W 27TH ST TadmdoV kmraneeCw4=N kr- E: r- rNSURER E _ HRhleah FL 33010 u P- 44 QFhnC W fit PARFR_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN LSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITt1.STANDM ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPE OFD6URANCE POLICY NUI LOOM COMMERCIAL. GENE3ALLIABOJTV C AW MADE OCCUR EACH OCCURRENCE S PR9N6e5 S MED EXP (AM one paoon) S PENAL & ADV PUURY $ GEMLAGGREGATELIMIT APPLESPER: POLICY O JJECT E-1 LOC OTHER: GENERAL AGGREGATE S PRODUCTS-COt<IPIOPAGG S AUTOMOBILELU18RJrY ANY AUTO AUTOS ONLY HIRED NON47ANED AUTOS ONLY AUTOS ONLY aa ir S BOOLY KFURY (Per P—wQ $ BODILY RWRY (Por acmae S S S UMBRELLA VAa EXCESS LIAR H OCCUR CLAMS.hMDE EACH OCCURA64C E 5 A[ ATE S OED RErEwm S A YI mm! COOMENSATION ANYPROPRIETORlP ATI rnE YIN Qk= dm1M lyyeessY m DESC ihPrhON OPERATIONS baba p/A N TWC378188.4 0410.V2019 041)9=20 UrH- STAME ER EL EACHAOG IT S 1,000.000 E.LOW-WE-EAMPLOY 5 T.. E.LDISEASE- POLICY UMIT S 1.. D>CRIPTtONOFOPEFiATIM/LOCA7Wr6/VBacLES V=Ml( h.AddMmW Rr- S mahbm' is MECHANICAL CONTRACTOR/CAC1818782 MIAMI SHORES VILLAGE 10050 NE 2nd AVENUE MIAMI SHORES, FL, 33138 305 762 4870 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE , TNF 0(pIRATION DATE THEREOF. NOTICE WILL BE DELIVERED: IN ACCORDANCE WITH THE POLICY PROVISIONS AUn1Dp® 1TAMVE 1988-2015 ACORD CORPORATION. All rights reserved.