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.