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ELC-19-1406Miami Shores Village 10050 NE 2 Ave Miami Shores Fl. 33138 305-795-2204 Location Address Issue Date: 07/11/2019 Parcel Number 9835 NE 2ND AVE, Miami Shores, FL 33138 1132060134380 Contacts Permit NO.: ELC-06-19-1406 Permit Type: Electrical - Commercial Work Classification: Sign Permit Status: Approved Expiration: 01/07/2020 9801 NE 2 AVENUE Owner SAME & Q ELECTRIC INC Contractor 98352 MANUEL E QUESADA 5310 SW 7 ST, CORAL GABLES, FL 33134 Business: 3052190427 Inspection Requests: Description: PROPOSED SIGN ON CANOPY AT SINS GASTRO Valuation: $ 500.00 Inspec ion Re BAR Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Building Department Copy Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 07/11/2019 $110.30 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 t all wo will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above named cont*V to doffie stated. Authorized Signature: Owner / Applicant / Contractor / Date July 11, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION ❑ BUILDING M ELECTRIC 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 RECEIVED St��- �-19�IMaster Permit No.405 BC 1-1 JUN 191019 4 t—EL_& C� -Iq, I4-06 Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ 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 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: City: Miami state: FL Zip: 33174 Qualifier Name: Manuel E. Quesada Phone#: 305 219 0429 State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Forever Signs Phone#: 305 484 5596 Address: 2400 West 3rd CtCity: Hialeah State: FL Zip: 33010 Value of Work for this Permit: $ • • p S7� C* -`� Square/Linear Footage of Work: 12 LF Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Proposed Sign on Canopy as per approved Zoning Hearing of 5/23/19 at new Sins Gastrobar Restaurant in existing Shopping Center. Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $. Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ Bdnding 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 r11iL-4D- OWNER or AGENT The foregoing instrum nt was acknowledged before me this day of: yl t- , 20 by who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: Seal: ANAYS LAGO '°.' •4 4ot3ry Public - State of ; eri« Commission 8 GG 246541 ford My Comm. Expires Oct 26. R tlonded throw h Nat' I r APPROVED Signatureim / CONTRA OR The foregoing instrument was acknowledged before me this 14 day of 20 by Mm"I Qy" who is personally known to as me or who has produced identification and who dl NOTARY P LN Sign: Print: Seal: J /Blans Examiner _ oath. Notary Public State of Florida Danay Bazaln �j My Commission 001131884 pia, nod Expires 08/06/2021 as Zoning - SAME & Q ELECTRIC, INC. Miami FL. LIC & INS (LIC) EC#13007128 PHONE (305)-219-0427 14110 SW 165 STREET MIAMI, FL, 33177 RESIDENTIAL, COMMERCIAL 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 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 Contra or Signature Same & Q. Electric License # Sworn to (or affirmed) and subscribed before me this 10'h day of April, 2019 PAYAY i` Notary Public State of Florida L� Danay Bazain My Commission GG 131884 oFaoiP Expires 08/06/2021 10820 SW 200' Drive Suite: Office Miami, FL 33157 305-253-8225 • 305-252-18 fax a 305-742-3199 cel 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. § 440.0-' allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior tc 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 coverag excinpt if: e. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be 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 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: h4411" I rz=, Owne State of Florida County of Miami -Dade The foregoing was acknowledge before me this 10 day of � ( 20 - / BY '—�17 i4 �v� S who is personally known to me or has produced as identification. otiY "fie'. ANAYS LAGO NotaNotary Public - State of Florida Commission ; GG 246553 a rti�.�- My Comm. Expires Oct 26, 2022 SEAL: Bonded through National Notary Assn.