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ELC-19-853r t0'Q 6a eci8-32$6 1 s r ti .>-., ..---•- ---- _ - atr- c-f-w.wu'N+14-R...r-.. r .... -.a 1. ;.ao Location 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.: ELC-04-19$53 Permit Type: EledriCal - Commercial Work Classification: Alteration Permit status: Approved Expiration: 10/21/2019 Description: ELECTRICAL NEW PROPOSED RESTAURANT IN Valuation: $ 33,750.00 Inspection Requests: EXISTING RETAIL BUILDING. DINING, BAR & FULL KITCHEN. tt-762-4949 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 SAME & Q ELECTRIC INC Contractor MANUEL E QUESADA 5310 SW 7 ST, CORAL GABLES, FL 33134 Business: 3052190427 CCF Description: ELECTRICAL NEW PROPOSED RESTAURANT IN Valuation: $ 33,750.00 Inspection Requests: EXISTING RETAIL BUILDING. DINING, BAR & FULL KITCHEN. tt-762-4949 UNIT#9835 BUSINESS NAME: SINS Total Sq Feet: 2,480.00 Fees Date Paid Amt Paid Application Fee - Other CCF DBPR Fee DCA Fee Education Surcharge An Permit Fee Scanning Fee Technology Fee Total: Building Department Copy Payments Date Paid Amt Paid Total Fees 1,093.33 Check # 1047 04/22/2019 $1,093.33 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./cr tactor to do the work stated. Authorized Signature: Owner Applicant / Contractor Agent Date April 22, 2019 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION BUILDING ELECTRIC ROOFING RECEIVED AjjR 1 2019 BY: FBC 201 Master Permit No. CC -10-18-3286 Sub Permit No.,y`y— 53 REVISION EXTENSION [:]RENEWAL F-IPLUMBING 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 Address: 4141 NE 2nd Ave. Suite #204A City: Miami State: FL Tenant/Lessee Name: Sins Gastrobar Restaurant Email: sins@sinsgastrobar.com Phone#: 305 455 1800 lip: 33137 786 863 7798 CONTRACTOR: Company Name: Same & Q Electric Inc. Phone#: 305 2.G( Qe42:4 Address: 5 3 b (;" W City: Miami Ck,aA ('0 ado lC-S State: FL Zip: Qualifier Name: _ M Acr,- V ETA— Q C—S Aid A Phone#: \%30 )Z I L1 o 4 2) 11 State Certification or Registration #: -EC- 4 1 )(DQ T 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: $_ 3 cn - Cg Square/Linear Footage of Work: 2410 SF Type of Work: Addition Alteration New Repair/Replace Demolition Description of Work: Proposed new Restaurant in existing Shopping Center, all interior improvements. Specify coloroo(f'color thru tile: Sub \`ittal Fee $ ` C 3 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 $ a c 3, 33 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 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 foregoing instrumentwasacknowledged before me this B day of f'1 'i 20 l q , by who is personally known to me or who has produced iden NOT Sign Print Seal as Signature Oq CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 0,- -,by q( IP -S who is personally known to me or who has p oduced as identification and who did talon oathN NOTARY PUBLIC: Print: Seal: r 0 'F Danay?azain My Commission GG 131884 nf o°A Expires 08/06/2021 APPROVED BY { kck Plans Examiner Zoning Structural Review Clerk Revised02/24/2014) SAME & QELECTRIC? INC. 5 310 SW 7 STREET Miami FL. 33134 APRIL 10th, 2019 State of Florida, Miami Dade Miami Shores Village 10050 NE 2"d 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 2nd Avenue Miami Shores FL. 33138 Contractor Signature Same & Q. License # Sworn to (or affirmed) and subscribed before me this 10"' day of April, 2019 Personally known _ l Public Notary 1:1Y i'',, ANAYSLAGOo °L Notary Public -State o` =fonca Commission : GG 246553 or . My Comm. Expires Oct 26, 2022 Bonded through National Notary Assr. 10820 SW 200't' Drive Suite: Office Miami, FL 33157 305-253-8225 • 305-252-18 fax • 305-742-3199 cel 4, 19MiamishoresVillage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption 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 to obtaining a building permit. 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 be exempt if: I . The officer owns at least 10 percent of the stock of the 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 are allowed to be exempt. 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 use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. 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 ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade Q The foregoing was acknowledge before me this day of l '20 _I . By_ Pr r 0E&t[e=3 who is personally known to me or has produced as identification. E.41 ANAYS LAGONotary: Notary Public - State of r;oricaCommissionrGG246553°` My Comm. Expires Oct 26, 2022 SEAL: Bonded through National Notary Assr.