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SGN-09-23-2242Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: SGN-09-23-2242 Permit Type., Sign Work Classification: New Permit Status: Approved Issue Date: 01/25/2024 F Expiration: 07/25/2024 Location Address Parcel Number ..__ ..-............. -..... �.....-------_- 9899 NE 2ND AVE, Miami Shores, FL 33138 1132060134360 Contacts SOUTHTRUST BANK NAIL ASSOC Owner Stephanie Kelleher Applicant P.O. BOX 2554, BIRMINGHAM, AL 35290 Mobile: 9547866142 kristen.mahoney@wellsfargo.com FLORIDA CERTIFIED SIGN ERECTORS LLC Contractor DAVID HUGHES 2824 HORACE SHEPARD DR, DOTHAN , AL 36303 Business: 8636038497 dhughes@fs-se.com Mobile: 8638995751 Description: E03 INSTALL 1 ILLUMINATED WALL SIGN AND Valuation: $ 3,000.00 Inspection Requests: CONNECT TO EXISTING ELECTRIC Total Sq Feet: 29.00 Fees Amount CC F $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.90 Permit Fee $100.00 Planning and Zoning Review Fee $70.00 Scanning Fee $9.00 Structural Review ($60) $60.00 Technology Fee $10.00 Total: $255.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $255.70 Check# 13149 01/25/2024 $255.70 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 regulaAi g construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Sig ture: Owner / Applicant / Contractor / Agent Date January 25, 2024 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 [2'B'UILDING ❑ ELECTRIC ❑ ROOFING SEP 12 2023 By FBC 20,)LD C Master Permit No.SL-)Iv1) i`�— Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: C D`19 t'� E_ 30d City: Miami Shores County: Miami Dade Zip: n6 CP Folio/Parcel#: 11Q-'-�Lpn is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): !� } � 1 IL N(L oar 11 NCPhone#: Address1s"TcrfrKf'ix ICI City: l (. k%bco 1 State: C� Zip: W Tenant/Lessee Name: rl S ,._,_._____._Phone#:v1 0 Lo)Lf';) Email: ',Am. MLh c" Q� l t,1Jrl��-�1�+~n-Cdr►'� CONTRACTOR: Company Name: Address: 4 _ dz�( arc Email: Qualifier Name: hone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: 4' W(-blydMG MCh Phone#: c2 Address blhryC City: (2W1b_ (%1 State]t Zip: Value of Work for this Permit: $��1,�) Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: Ifl51cjl ! l llt M,n(1b_(,1('{ C%� t]Lne noci l- f't,_ &1 /1Q Ci�(�►�/�L Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ DCA Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ lRevised04/05/2022) CCF $_ DBPR $ P&1 Review $ CO/CC $ _ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State 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. 'c Signatur OWNER or AGENT The egoing instrumen was acknowledged before me this day of 20, by /y�who is personally known to me or who ha ro ecl as identification and who did take an oath. NOTARY PUBLIC: Sign: ��, / Print: ��" Seal: *01*0� JENNIFER FRIDAY Commission Number 841977 My Commission Expires i F ski * A 4. APPROVED BY (Revised04/05/2022) 1 �. Signature CONTRACTOR The foregoing instrument was acknowledged before me this 4�_1_4day of. NilA' -(L_X r_ , 20 3 by �CC, I t<_ IV� , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sea P`'RYF CANDACE ROJ'n ?2' _Notary Public -State of Florida = _ Commission # HH 127635 My Commission Expires .lima 1R 9MF k •F �R tit M�i�>�#�YM�M•ik+k M�h+M� /a �j� Plans Examiner Structural Review �M �Y+M �M+M �M �F♦i�M4�Y �Yk4 /L e,r - IAd Zoning r,�MR0 Clerk OFFICE OF THE PROPERTY APPRAISER Summary Report Generated On: 09/12/2023 Folio 11-3206-013-4360 9899 NE 2 AVE Property Address MIAMI SHORES, FL 33138-2350 Owner SOUTHTRUST BANK NAT'L ASSOC PO BOX 2609 Mailing Address CARLSBAD, CA 92018 Primary Zone 6400 COMMERCIAL - CENTRAL 2313 FINANCIAL INSTITUTION: OFFICE Primary Land Use BUILDING Beds / Baths /Half 0/0/0 Floors 1 Living Units 0 Actual Area 3,430 Sq.Ft Living Area 3,430 Sq.Ft hY Adjusted Area 3,212 Sq.Ft Lot Size 12,350 Sq.Ft Year Built 1986 Year 2Q23 2022 2021 r COUNTY Year 2023 2022 2021 Exemption Value $0 $0 $0 Land Value $432,250 $321,100 $321,100 Taxable Value $1,034,326 $940,297 $854,846 Building Value $787,750 $778,900 $623,900 SCMOOL BOARD Extra Feature Value $0 —__..___ $0 $0 Exemption Value $0 $0 $0 Market Value $1,220,000 $1,100,000 $945,000 Taxable Value $1,220,000 $1,100,000 $945,000 Assessed Value $1,034326 $940,297 $854,816 Exemption Value $0 $0 $0 Benefit Type 2023 2022 2021 Taxable Value $1,034,326 $940,297 $854,816 Non -Homestead Assessment $185,674 $159,703 $90,1$4 REGIONAL. Cap Reduction - Note: Not all benefits are applicable to all Taxable Values (i.e. County, Exemption Value $0 $0 $0 School Board, City, Regional). Taxable Value $1,034,326 $940,297 $864,816 MIAMI SHORES SEC 1 AMD PB 10-70 OR Book- Qualification LOTS 10 & 11 BLK 32 Previous Sale Price Page Description LOT SIZE 12350 SQ FT 07/01/1998 $540,200 18197-2693 Other disqualified OR 18197-2693 0798 6 11/01/1984 $170,000 12396-0080 Sales which are qualified 08!01/1973 $85,000 00000-00000 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http:!/ovww.miamidad e.gov/info/disclaimer.asp D � � L, i_ SEP 1 z 1 23 l L ViCUMBENCY CERTIFICATE By L WELLS FA1FtGO BANK, NATIONAL ASSOCIATION I, Clara S. Blanding, hereby certify that I am an Assistant Secretary of Wells Fargo Bank, National Association, a national banking association organized and existing under the laws of the United States of America (the `Bank"), and I hereby further certify as follows: 1. The following is a true and correct extract from resolutions duly adopted by the Board of Directors of the Bank on March 31, 2023, and no modification, amendment:, rescission or revocation of such resolutions has occurred affecting sucht extract as of the date of this certificate: RESOLVED, that agreements, instruments, or other documents, including amendments and modifications thereto, relating to or affecting the property or business and affairs of the Bank, whether acting for its own account or in a fiduciary or other representative capacity, may be executed in its name by the persons hereinafter authorized.; RESOLVED, that for the purposes of these resolutions, "Senior Executive Officer"' shall mean any person appointed, designated or otherwise elected President, Chief Executive Officer, Senior Executive Vice President, Executive Vice President or designated an Executive Officer by resolution of the Board of Directors of the Bank, and "Signing Officer" shall mean any Senior Executive Officer, any Senior Vice President, the Treasurer, any Vice President, any Assistant Vice President, any person whose title includes the word "Officer" (e.g., Commercial Banking Officer, Personal Banking Officer, Trust Officer), or any other person whose title: has been or is hereafter designated by the Board of Directors as a title for an officer of the Bank, and such officers are hereby authorized to sign agreements, instruments and other documents on behalf of the Bank in accordance with the signing authorities conferred in Parts A, B and C of these resolutions; C. Signing Officers RESOLVED, that any Signing Officer, acting alone, may execute on behalf of the Bank., whether acting for its own accouj:ut or in a fiduciary or other representative capacity: [Governmental Reporting; Legal Proceedings) 16. Tax returns and all reports, applications and other filings made 'With any federal, state, local or foreign governmental department, agency, body or official. 2. On the date hereof:, the following person was a duly appointed, qualified and acting officer of the Bank, that her correct title appears beside her name, and that on said date she was duly authorized to act on behalf of the Bank as set forth in the foregoing; resolutions: Name Title Kristen K. Mahoney Assistant Vice President IN WITNESS WHEREOF, I have hereunto signed my name and affixed the seal of the Bank this 2:?"d day of June, 2023, [Seal] Clara S. Blanding, Assistant SecMary Wells Fargo Bank, National Association * * * Redacted [Indicates portions of the resolution which have been omitted because they are not relevant to the transaction for which this certificate has been requested.] #25131643 2 le CO r SEP 12 ZOZ', P -Y- 4i DATE ZONING -[e Ze,7 Lo?'le-3115-T STRUCTUPV1 'ELECTRICAL PLUMBING PAECHANICAL BLDG. Lu TATE AND CGI N ) C 0 rn5 ESo 0 C 3 o v c O v C OV u p N YN L N C1 fqp 0jr Eo - N t G V O 3 ° LL � g O o cL t y J ry c o via€� 0 Yam 0� g 0 x c d y O 'o W o a 0 c v N c c E Z m C E 2 T 2 oowa o t w U o 434 V O C t jS OTO N 3 V- O v ryry a � O C W a� � O ro 'E' L�� W W E N r t%1 G A o 3 c a v p N a a Z w � Q O C •Q V cc LL OC w E o `w � E o�R L vb m v roa N p �i t r N T C C ro c v c .a E? ."C+ > Z �'i a In � o +' y o N N N L � O� N i-,-98 ,a 3 V o.M 3 O ~ E V Q r✓N0 LL n Ye m G J c G c w w l� t7 ro >}pN v YO O`i'l7 2 O� 3 - �2 O d m �? S y Q m .40 QED 'O LL' ^ G 9e Or D O ia, N Q th W O Ci_ C o �a qa$ o E rn ¢ a c 4 i5c V a a0ansN� � � r N SEP ,Z e'j".3 L. Encon Services, Inc. Sign Design Calculations Job Description PREPARED BY: Encon Services, Inc. WELLS FARGO 143580 P.O. Box 3613 9899 NE 2ND AVE Apollo Beach, FL 33572 MIAMI SHORES FL 813-655-3373 WFR2-WCH-RR-FH I-H-10 Design per Florida Building Code, 7th Edition (2020) Section 16 Wind Load ASCE 7-16, Load Case: D + 0.6W Design Specifications Risk Category II Kzt 1 Exposure Factor C Kd 0.85 Kz 0.98 V 175 (mph) GCp-GCpi 1.1 Zone 4, H < 60 Feet Wind Pressure 71.8 (psf) Sign Information Height 0.83 (ft) Width 0.83 (ft) Thickness 0.25 (ft) Building Height 30 (ft) Wind Shear Force 8.94 (lb) Weight of Sign 7 (lb) Total Shear Force = 11.29 (lb) Total Tension Force = 29.69 (lb) Required Provided Fastener size (Nominal) 1/4 1/4 Minimum number of fasteners 3 3 Shear Force per fastener (lb) 3.8 170 Tension Force per fastener (lb) 9.9 230 Aaron Biedenbach, P.E. FL PE #52949, FL EB 9394 OH PE 60756, OC #01893 KY PE #20281, P #2463 IN PE #PE 19600332 FL CBC #060535, QB #22527 LICENSE #52949 STATE OF DATE SIGNED: 8/4/2023 Combination Tension and 0.07 <1 O.K. Sheer ratio THREADED ROD THROUGH WALL IS PREFERRED IN ALL INSTANCES. IF IT IS NOT POSSIBLE TO USE THREADED ROD, SEE CHART BELOW FOR APPROPRIATE ANCHOR SELECTION. SIZE AND NUMBER REQUIRED ARE NOTED IN THE CHART ABOVE. WALL STRUCTURE ANCHOR TYPE WOOD BLOCKING LAG BOLT (1 1/2" EMBEDMENT) THROUGH BLOCKING EIFS OVER 5/8" PLYWOOD LIBERTY TOGGLE BOLT OR THRU BOLT WITH SLEEVE HOLLOW CONCRETE BLOCK, BRICK SLEEVE ANCHOR (1-1/2" EMBEDMENT) SOLID CONCRETE WEDGE ANCHOR (2-1/2" EMBEDMENT) CMU, SOLID CONCRETE, BRICK HILTI HIT ROD W/HY-20 ADHESIVE (31/2" EMBEDMENT) MASONRY SCREW (2" EMBEDMENT) ALL ANCHORS SHALL BE CHOSEN AND PLACED IN ACCORDANCE WITH MANUFACTURERS INSTALLATION INSTRUCTIONS D L C� S EP 12 8/4/2023 WELLS FARGO 143580 9899 NE 2ND AVE MIAMI SHORES FL WFR2-WCH-RR-FHI-H-10 Calc //////////f//////f///////////////////////////////////////1f///'////,/%/��///,/////r/////,//✓////////,r/�f//i/f//////////////r//r///%f////////f/////////f/////f,///ffl 108.5" 2.5" -7 10" D I a Co -WT?::: � a Il �F - WFR2-WCH-RR-FHI-H-10 ELEVATION 511 yf SCALE: NTS r r ° s4b momm-ft Q.- —ELECTRICAL / DISCONNECT °• 49 15 15 18 17 WFR2-WCH-RR-FHI-H-10 LED LAYOUT SCALE: NTS WFR2-WCH-RR-FHI-H-10 MOUNTING and ELECTRICAL SCALE: NTS 41 18 18 Colors and materials MS Acrylic, Plaskolite Optix, Clear {u1 MI4 E) Acrylic, Plaskolite Optix, 2406LD, White F® 'i'ranslucent Vinyl, 3M 3630-S3, Cardinal Red t 't"r'anslucent Vinyl, 3M.3630-20, White yg Translucent Vinyl, 3M 3735-60, Diffuser WFR2-WCH-RR-FHI-H-10 VINYL LAYOUT SCALE: NTS ANCHOR LOCATION rn ELECTRICAL REQUIREMENTS: 1. SIGN TO BE CONSTRUCTED AND INSTALLED TO 2017 NEC 600 STANDARD 2. LISTING AND MARKING FOR SIGN SHALL BE IN ACCORDANCE WITH 600.3 AND 600.4 OF THE NEC. 3. A DEDICATED 20A CIRCUIT ON 20A OCPD REQUIRED AT FRONT OF THE OCCUPANCY FOR THE SIGN. NEC 600.5 4. SIGN SHALL HAVE A 20 AMP, 120 VOLT ELECTRICAL DISCONNECT ING MEANS FOR THE BRANCH CIRCUIT SUPPLYING THE SIGN PER NEC 600.6(A) 5. THE REQUIRED DISCONNECTING MEANS SHALL BE LOCATED AT THE POINT OF ENTRY OF THE CIRCUIT PROVIDING POWER TO THE SIGN ENCLOSURE. NEC 600.6(A)(1) 6. DISCONNECT SWITCH MUST BE IN A SEPARATE ENCLOSURE PRIOR TO SIGN 7. SIGN CIRCUIT SHALL BE CONTROLLED BYATIMER PER C405.2.5 FBC ENERGY CONSERVATION CODE 8. SIGN SHALL BE GROUNDED AND BONDED PER NEC 600.7. 9. THE INSTALLATION OF THE WIRING SHALL BE PER FBC 5405.4 AND DESIGNED TO UL 48 SIGN AREA: 8 SQ FT EwLEL I I ,AL INi VIEDYI' APPROVE FLORIDA BUILDING CODE 7TH EDITION (2020) SECTION 16 WIND LOAD ASCE 7-16 175 MPH WIND LOAD RISK CATEGORY II EXPOSURE C © ENCON SERVICES, INC. P.O. BOX 3613 APOLLO BEACH, FL 33572 Q 813-655-3373, FLEB #9394 ENCON@ME.COM LICENSE #52949 STATE OF ftORIOP AARON BIEDENBACH, PE 52949 DATE SIGNED: 8/4/2023 CUSTOMER -SITE ID: PROJECT NUMBER: DRAWN BY: DATE: REVISIONS: SCALE: FITTS WELLS FARGO SLZ 08/01 /2023 1. XX/XX/XX REV XX NTS CHECKED BY: DATE: 2. XX/XX/XX REV XX THE FITTS COMPANY XXX XX/XX/XXXX 3. XX/XX/XX REV XX SITE ADDRESS: WELLS FARGO 143580 PRODUCT NAME: INCORPORATED 55 SIRENS LN, GASTON, SC 29053 9899 NE 2ND AVE WFR2-WCH-RR-FHI-H-10 APPROVED BY: DATE: 4. XX/XX/XX REV XX PAGE: 803-356-5947 MIAMI SHORES FL XXX XX/XX/XXXX 5. Xx/xx/XX REV XX 1 OF 3 SEE CHART FOR ANCHORS BY WALL TYPE 5" ALUMINUM OR-/ NYLON SPACERS 18 GAUGE' WIRE CONDUIT) PENETRATION PRISM 12 NANO-_ WHITE 6500K 701269-6 W 12NJ-M B MINIMUM ONE- 0.25" WEEP HOLE PER STROKE ELECTRICAL-1 DISCONNECT SWITCH 'PLY POWER SUPPLY 1 SLOAN 12V 60C2 OR 60W3 SECTION AA POWER REQUIREMENTS SCALE.NTS .8 AMPS 120 VOLTS FITTS CUSTOMER -SITE ID: WELLS FARGO THE FITTS COMPANY SITE ADDRESS: WELLS FARGO 143580 INCORPORATED 55 SIRENS LN, GASTON, SC 29053 9899 NE 2ND AVE 803-356-5947 MIAMI SHORES FL .125" - VISIBLE PORTION OF J ACRYLIC LETTER FACE IS CUT ACCURATELY TO ARTWORK PROVIDED .5" ACRYLIC PLASKOLITE OPTIX 2406LD WHITE TRANSLUCENT J VINYL, 3M 3630-20 WHITE (APPLIED 1ST SURFACE) PRISM 12 NANO, WHITE 6500K 701269-6 W 12NJ-M B 2.5" 5" .375" .75" ALUMINUM- COIL L EXXXON RIEDO 375"t.375" PROJECT NUMBER: ac� ELECTRICAL J DISCONNECT 3M 5200 J J POLYURETHANE \ OPAQUE WHITE. `- #4 X 3/8" S.S. C.S SCREWS TRANSLUCENT ' VINYL 3M 3630-53 CARDINAL RED / r} �%��' �•"" (APPLIED 1ST SURFACEI TRANSLUCENT -� !'1 --✓ - VINYL 3M 3 Ud L--'Jnn 4 h DIFFUSER .75" ACRYLIC \_ `•�",Qil �,�//�/�� PLASKOLITE OPTIX CLEAR TRANSLUCENT VINYL 3M 3630-53 CARDINAL RED (APPLIED 2ND SURFACE) i APPIROV SECTION 1 DETAIL SCALE:NTS PRODUCT NAME: WFR2-WCH-RR-FHI-H-10 DRAWN BY: DATE: SLZ 08/01/2023 CHECKED BY: DATE: XXX XX/XX/XXXX APPROVED BY: DATE: XXX XX/XX/XXXX SIGN MOUNTING HEIGHT TO BE 30FT MAXIMUM ANCHOR TO BE THRU BOLTS IF POSSIBLE, ALTERNATE ANCHORS PER WALL TYPE SHOWN BELOW FOR USE IF THRU BOLTING IS NOT POSSIBLE ANCHOR SCHEDULE: 1l4" DIA. ANCHORS ANCHOR QUANTITY: AS SHOWN ON PAGE 1 WALL STRUCTURE ANCHOR TYPE WOOD BLOCKING LAG BOLT (1-1/2" EMBEDMENT) THRU BLOCKING EIFS OVER 5/8" PLYWOOD LIBERTY TOGGLE BOLT HOLLOW CONCRETE BLOCK, BRICK SLEEVE ANCHOR (1-112" EMBEDMENT) SOLID CONCRETE WEDGE ANCHOR (2-1/2" EMBEDMENT) CMU, SOLID CONCRETE, BRICK MASONRY SCREW (2" EMBEDMENT) HILTI HIT ROD W/ HIT-1 ADHESIVE (3 WEMBEDMENT) ANCHORS SHALL BE CHOSEN AND PLACED I -1 MANUFACTURERS INSTALLATION INSTRUC © ENCON SERVICES, INC. P.O. BOX 3613 APOLLO BEACH, FL 33572 Q 813-655-3373, FLEB #9394 ENCON@ME.COM REVISIONS: 1. XX/XX/XX REV XX 2. XX/XX/XX REV XX 3. XX/XX/XX REV XX 4. XX/XX/XX REV XX 5. XX/XX/XX REV XX SEP 12 2023 IUI LICENSE #52949 STATE OF F4 _5 _�_. `<Z/oNAL AARON BIEDENBACH, PE 52949 DATE SIGNED: 8/4/2023 SCALE: NTS PAGE: 2OF3 VA . 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J N Q w � Client#: 2836 FLOCE ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 11/28/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy()es) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Harmon Dennis Bradshaw, Inc. 334-273-7277 P.O. Box 241667 Montgomery, AL 36124 NAME: C Kristen Collum _ P o" o, Exci334 273-7277 _ vC, No): 334-273-9197 ADDRESS: kcollum@hdbinsurance.com _ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Monroe Guaranty Insurance Company 32506 INSURED Florida Certified Sign Erectors, LLC. 2824 Horace Shepard Drive Dothan, AL 36303 INSURER B : FCCI Insurance Company 10178 INSURER C INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAI' THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I L.TR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDA YY POLICY EXF+ MM/DD/YYY\I LIMITS A A X COMMERCIAL GENERAL LIABILITY J CLAIMS -MADE [X] OCCUR PD D_ed: $500 CPP10003586604 CPP10003470804 12/03/2023 12/03/2023 12/03/2024 12/03/202 EACH OCCURRENCE $1 000,000 PREM ES RENTED I Ea occurrence $100 000 X MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ _E A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY _ CA10000888507 12/03/2023 12/03/2024 Ea acc dentSINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ _ B UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE UMB10001984506 12/03/2023 12103/2024 EACH OCCURRENCE $1 OOO 000 AGGREGATE $1 00O 000 DIED I X RETENTION $$1 O,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE — $ E.L. DISEASE - POLICY LIMIT $ A A Installation Fltr L/R Equipment _ CPP10003470804 CPP10003470804 12/03/2023 12/03/2023 12/03/202 12/03/202 $100,000/$1,000 ded. $250,000/$1,000 ded. DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) David Hughes ES12000226 David Hughes CGC1529996 Miami Shores Village Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE Miami, FL 33138 AUTHORIZEDREPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S7856431M785314 KBC CERTIFICATE OF LIABILITY INSURANCE Date 8/22/2023 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. Holiday, FL 34691 rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. 1 (727) 938-5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 Insurer B: 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM/DD/YY) Policy Expiration Date(MM/DD/YY) Limits GENERAL LIABILITY Each occurrence Commercial General Liability Claims Made Occur Damage to rented premises (EA occurrence) $ Mad Exp Personal Adv Injury General aggregate limit applies per: Policy ❑ Project ❑ LOC General Aggregate Products -Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) $ Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Bodily Injury Hired Autos Non -Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Aggregate Occur ❑ Claims Made Deductible A Workers Compensation and X WC Statu- 1 I OTH- [EIR Employers' Liability WC 71949 01/01/2023 01/01/2024 tory Limits E.L. Each Accident $1,000,000 Any proprietor/partner/executive officer/member E.L. Disease - Ea Employee $1.000,000 excluded? NO If Yes, describe under special provisions below. E.L. Disease -Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 81-67-912 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Florida Certified Sign Erectors, LLC Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by emailing a request to certificates@lioninsurancecompany.com Project Name: ISSUE 08-22-23 (TD) Begin Date: 3 16 2018 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to BUILDING DEPARTMENT do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number ___.___._..__.._._ _.__.. ....__....__._._._..._.._...... _____._...___.._...___.............. ................. .............. _........-..._..__ 9899 NE 2ND AVE, Miami Shores, FL 33138 1132060134360 Contacts SOUTHTRUST BANK NATT ASSOC Owner Stephanie Kelleher Applicant P.O. BOX 2554, BIRMINGHAM, AL 35290 Mobile: 9547866142 kristen.mahoney@wellsfargo.com FLORIDA CERTIFIED SIGN ERECTORS LLC Contractor DAVID HUGHES 2824 HORACE SHEPARD DR, DOTHAN , AL 36303 Business: 8636038497 dhughes@fs-se.com Mobile: 8638995751 Ins aecdon Re uests: i Description: E03 INSTALL 1 ILLUMINATED WALL SIGN AND Valuation: $ 100.00 a 5 CONNECT TO EXISTING ELECTRIC Total Sq Feet: 29.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.30 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $10.00 Total : $123.90 Payments Date Paid Amt Paid Total Fees $123.90 Check # 13150 01/25/2024 $123.90 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. reg AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. i 4e' ' i nr_Q �sti I Ii Authorized Sigjfture: Owner / Applicant / Contractor / Agent Date January 25, 2024 Page 2 of 2 Miami Shores Village I -AL n A Building DepartmenLZ t,z.'� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 FBC�120:�-O BUILDING Master Permit No.5& _ % JC0__ 2' PERMIT APPLICATION Sub Permit No. ELC"�%--�/(�/J ❑BUILDING [0"/ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: C a C,q N F_ t9r—, d P"n City: Miami Shores County: Miami Dade Zip:��� Folio/Parcel#: i Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): !_ _ k. K\jjii4&21 OwcPhone#: Address-"-PCrtry_ 1Q( 0ce City: 0QjL%b0_d State: SSA Zip: �}� 4 Tenant/Lessee Name: Writs ----_--__ —Phone#:qSq-_M(_0- LOl t��) Email: OoLba)Y 4 a-) LI 1✓C (�Y►'� CONTRACTOR: Company Name: Address:3154 L�f-act Email: Qualifier Name: Phone#: State Certification or Registration #: � �10X1S`(YQr'] L__P Certificate of Competency #: DESIGNER: Architect/Engineer: an�rC'l Ir[�rn4�Ya^h Phone#: �I3 COSS ?Z�73 Address: n1 ZS ''�I 012) City: o y Ij�(h State :--JL_Zip: Value of Work for this Permit: $Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: CUDZZA-b c!62hoo Specify color of color thru tile: Submittal Fee 5 Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revi sed04/05/202 2) Permit Fee $ CCF $_ DCA Fee $ DBPR _ Training/Education Fee $ P&Z Review $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 2 • —t� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property Is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first Inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGAW The foregoing instrumen was acknowledged before me this da of20, by who Is pers nally known to me or who ha produc 14J �, as identification and who did take an oath. NOTARY PUBLIC: 17 Sign: Print; Seal: E L+�JENNIFER FRIDAY r- Commission Number 841977 My Commission �rM�►***���1��'1'�`�'���1�5��r4�r* ***rt�rr*r*�*rww»� APPROVED BY /`�$^/� z� Plans E (Revised04/05/2022) Signature CONTRACTOR The foregoing instrument was acknowledged before me this �ay of.yJ 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: a F;9; CANOACE I;�' ROJAS r Notary Public -State of Florida a Commission # HH 127635 xaminer Structural Review wtrrrrw�rssr*tr** Zoning Clerk