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.