ELC-19-9101-1
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
9835 NE 2ND AVE, Miami Shores, FL 33138 1132060134380
Contacts
Permit NO.: ELC-04-19-910
Permit Type: Electrical - Commercial
Work Classification: Low'Volt;age
Permirstdtus. Approved
Expiration: 10/23/2019
9801 PARK LLC Owner SAME & Q ELECTRIC INC Contractor
4141 NE 2 AVE 204 A, MIAMI, FL 33137 MANUEL E QUESADA
5310 SW 7 ST, CORAL GABLES, FL 33134
Business: 3052190427
Inspection Requests:
Description: LOW VOLTAGE, CCTV, DATA, TV, PHONE ANDValuation: $ 5,800.00
4 SOUND FOR PROPOSED NEW CORNER RESTAURANT IN r 762-4949
EXISTING SHOPPING CENTER, ALL INTERIOR IMPROVEMENTS Total Sq Feet: 2,480.00
Fees Amount
Application Fee - Other 50.00
CCF 3.60
DBPR Fee 2.61
DCA Fee 2.00
Education Surcharge 1.20
Permit Fee 124.00
Scanning Fee 3.00
Technology Fee 4.35
Total: 190.76
Payments Date Paid Amt Paid
Total Fees 190.76
Check # 1059 04/26/2019 $190.76
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.
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 thepork stated.
Authorized Signature: Owner Applicant / Contractor / Agent Date
April 26, 2019 Page 2 of 2
CONTRACTOR: Company Name: Same & Q Electric Inc Phone#: 305 219 0427
Address: 950 SW 104 Court C301
City: Miami State: FL Zip: 33174
Qualifier Name: Manuel E. Quesada Phone#:
State Certification or Registration #: EC13007128 Certificate of Competency #:
DESIGNER: Architect/Engineer: YcM Engineering Phone#: 305 484 5596
Address: 14245 SW 21 Terr City: Miami State: FL Zip: 33175
Value of Work for this Permit: $ S rj Square/Linear Footage of Work: 2410 SF
Type of Work: Addition Alteration New /Re laceReairpp F1 Demolition
Description of Work: LOW VOLTAGE; CCTV, Data, TV, Phone and Sound for
Proposed new corner Restaurant in existing Shopping Center, all interior improvements.
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ - (
j
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1
Miami Shores Village PSR 5 2 19
Building Department BY:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
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. U "— I 1
g
BUILDING Q ELECTRIC ROOFING REVISION EXTENSION RENEWAL
PLUMBING M MECHANICAL PUBLIC WORKS Ej CHANGE OF M CANCELLATION M SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9801 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
Address: 4141 NE 2nd Ave. Suite #204A
City: Miami State: FL Zip: 33137
Tenant/Lessee Name: SINS GASTROBAR Phone#: 786 863 7798
Email: sins@sinsgastrobar.com
CONTRACTOR: Company Name: Same & Q Electric Inc Phone#: 305 219 0427
Address: 950 SW 104 Court C301
City: Miami State: FL Zip: 33174
Qualifier Name: Manuel E. Quesada Phone#:
State Certification or Registration #: EC13007128 Certificate of Competency #:
DESIGNER: Architect/Engineer: YcM Engineering Phone#: 305 484 5596
Address: 14245 SW 21 Terr City: Miami State: FL Zip: 33175
Value of Work for this Permit: $ S rj Square/Linear Footage of Work: 2410 SF
Type of Work: Addition Alteration New /Re laceReairpp F1 Demolition
Description of Work: LOW VOLTAGE; CCTV, Data, TV, Phone and Sound for
Proposed new corner Restaurant in existing Shopping Center, all interior improvements.
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ - (
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10C •
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1
Bonding Company's Name (if applicable) _
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City
n
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 v D.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of r 20 , by
YVV&L Gy OC4 who is personally known to
11—mer who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The fore oing instrument was acknowledged before me this
dayof !' 20 1!1 by
i YIIJ who is personally known to
me r who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: >A,,Tt j Sign:
Print: i( Print: L
Seal: _ Seal: :
EApires
ucoANAL. LAW w
ti c. F^ Nat=ry Pu -State of Florida4cta•. P.,C:r .atc c` Fonda
Cc— issicn : GG 2;65:; .._y M ' ComriGG 146557
My Cor—, Ezp res Oct Z6. 2C2 a MY Comm. Oct 26. 20225cnwctnroupNationalNotaryA.S'. sondec tnraugai 40tary Assn.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
Revised02/24/2014)
1_t: A. r%__ •u_ _. ..
Miami shoresViliage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
LV Vrv11CI — rrur RFdrs %oompensation insurance txemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the- Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior toobtainingabuildingpermit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to beexemptif:
1. The officer owns at least 10 percent of the stock ofthe corporation, or in the case of
an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members areallowedtobeexempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not usedaylabor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she willbetheonlypersonallowedtoworkonyourproject. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITSCONTENTS.
Signature: 7
Owne
State of Florida
Countv of Miami -Dade
The foregoing was acknowledge before me this t/ day of fifee1. ( 20 /7.
By P-66462t4 who is personally known to me or has produced
as identification.
E ANAYSLAGO
Notary:r: Notary Public - State of Florida
o: Commission ; GG 246553
My Comm. Expires Oct 26, 2022SEAL: onded through National Notary Assn.
SAME & QELECTRICI INC.
Miami FL.
LIC & INS (LIC) EC# 13007128 PHONE (305)-219-0427
14110 SW 165 STREET MIAMI, FL, 33177
RESIDENTIAL, COMMERCIAL AND INDUSTRIAL
APRIL 10th, 2019
State of Florida, Miami Dade
Miami Shores Village
10050 NE 2nd Avenue
Miami Shores, FL 33138
RE: Contractor's Affidavit
Property: 9801 NE 2nd Ave, Miami Shores FL. 33138
Folio# 11-3206-013-4380
Owner: 9801 Park LLC
4141 NE 2nd Ave, #204A, Miami, FL 33137
Permit # CC -11-18-3517
Before me this day personally appeared Manuel Quesada who, been duly sworn, deposes and says:
That he will be the only person working on the project located at:
9801 NE 2"d Avenue Miami Shores FL. 33138
Contrac or Signature
Same & Q. Electric License # /-1._6
Sworn to (or affirmed) and subscribed before me this 10`h day of April, 2019
Personally k
Notary Public State of Florida
Danay Bazain
c My COMmission GG 131884
of a° Expires 08/08/2021
10820 SW 200' Drive Suite: Office Miami, FL 33157
305-253-8225 • 305-252-18 fax • 305-742-3199 cel
RE9Stateof Florida
ain
ion GG 131884
2021
Public Notary
CC. Maria Fuentes
for 9801 Park LLC
10820 SW 200` Drive Suite: Office Miami, FL 33157
305-253-8225 • 305-252-18 fax • 305-742-3199 cel