ELC-19-1291Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 06/27/2019
Location Address Parcel Number
9801 NE 2ND AVE, Miami Shores, FL 33138 1132060134380
Contacts
Permit NO.: ELC-06-19-1291
Permit Type: Electrical - Commercial
Work Classification: Sign
Permit Status: Approved
Expiration: 12/24/2019
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
Description: INDIVIDUAL BOX LETTER SIGN ON BUILDING Valuation: $ 1,200.00 Inspection Requests:
CANOPY AS APPROVED IN ZONING HEARING OF 05/23/2019 AT
AMARANTHINE NEW CORNER RESTAURANT IN EXISTING Total Sq Feet: 0.00
SHOPPING CENTER
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
06/05/2019 $50.00
Credit Card
06/27/2019 $61.10
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 AV�Irtifyat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
reoulatco cor
ruction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
June 27, 2019 Page 2 of 2
RECEIVED
Miami Shores Village �� 05 2019
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 20
BUILDING Master Permit No.SGN — 0(,,,- 1 q- i 2q 0
PERMIT APPLICATION Sub Permit No., L---o6-1G C 29
❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ 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
Tenant/Lessee Name: AMARANTHINE RESTAURANT
Email: yiannikg@gmail.com
CONTRACTOR: Company Name: Same & Q Electric Inc.
Address: 950 SW 104 Court C301
City: Miami State: FL
Qualifier Name: Manuel E Quesada
State Certification or Registration #: EC13007128
DESIGNER: Architect/Engineer: Forever Signs
Address: 2400 West 3rd Court
33137
hone#: 9543944140
hone#: 305 219 0427
Zip: 33174
hone#: 305 219 0427
Certificate of Competency #:
Phone#: 305 740 0150
city: Hialeah State: FL Zip: 33010
Value of Work for this Permit: $ $1200 Square/Linear Footage of Work: 30' LF
Type of Work: ❑ Addition K Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Individual box letter sign on building canopy as approved in Zoning Hearing of 5/23/19
at Amaranthine new corner Restaurant in existing Shopping Center.
Specify color of color thru tile:
Submittal Fee $ ` W Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
2
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 '"" —� Signature
�GWNER or AGENT CONTRACTOR
The for oing instrume as acknowledged before me this
rday of �� 20 by
vvho is personally known to _
me or who has produced
identification and who di
NOTARY P
Sign:_
Print:
Seal: .4P
4010 %� 4otary Public State of Florida
cDanay Bazai4n
My Commission GG 131884
N,or A Expires 08/06/2021
**********
APPROVED BY E\ 00 I ► 9
The forgoing instrumerg.,0 wasacckknowledged before me this
`& 20 by
IN r who is personally known to
as _pe-ar who has produced _
identification and who did
NOTARY PUBLI
Sign: r F r
Print:
Seal: �yt ► tary p blic State of Florida
anay azain
My Commission GG 131884
Expires 08/06/2021
****************
Plans Examiner
Structural Review
as
************
Zoning
Clerk
(Revisedo2/24/2014)
Notice to Owner — Workers' Com
Miami shores Vil"lage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
nsation 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.
l . 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 pennit 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:
Owne
State of Florida
Countv of Miami -Dade
The foregoing was acknowledge before me this 10 day of
By ,—b1IZ/ who is pers—ronallly known to me or has produced
as identification.
.,..'iire�e., ANAYS LAGO
o��G.
Notary: _� v ..C`, Notary Public -State of florica
)tea` Commission ; GG 246553
r ev f � My Comm. Expires Oct 26, 2U22
SEAL: Bonded through National Notary Assn.
SAME & QELECTRICI INC.
Miami FL.
LIC & INS (LIC) EC#13007128 PHONE (305)-219-0427
14110 SW 165 STREET NIIAMI, FL, 33177
RESIDENTIAL, CONINIERCIAL AND INDUSTRIAL
APRIL loth, 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 2°d 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
Contra or Signature
Same & Q. Electric License # /'Z-6
Sworn to (or affirmed) and subscribed before me this 10"' day of April, 2019
��,Rr v� Notary Public State of Florida
Danay Bazain
My Commission GG 131884
40 Expires 08106/2021
10820 SW 200' Drive Suite: Office Miami, FL 33157
305-253-8225 * 305-252-18 fax • 305-742-3199 cel