ELC-14-949Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-212176 Permit Number: ELC-5-14-949
Scheduled Inspection Date: March 12, 2015 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael
Owner: PROPERTIES LLC, SHORE SQUARE
Job Address: 9007-9029 BISCAYNE Boulevard 9007
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: ANCHOR SIGN, INC
comments
Inspection Type: Final
Work Classification: New
Phone Number (305)779-8040
Parcel Number 1132060110070
Phone: (800)213-3331
CONNECT 1 INTERNALLY ILLUMINATED FIRM WALL
SIGN TO THE EXISTING ELECTRICAL CIRCUIT ON THE INSPECTOR COMMENTS False
FRONT ELEVATION
Ea
Inspector Comments
Passed 843-576-3268 ELSIE
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 11, 2015 For Inspections please call: (305)762-4949 Page 4 of 32
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
7DS. 7
C 17 2014
B Y ;
0
Permit No. F7�k_C1 11-4 – I l., I
Master Permit No. s%,N J11-19 191
Permit Type: Electrical
JOB ADDRESS: 9007 Biscayne Boulevard, Miami Shores, FL 33138
City: Miami Shores County:
Miami Dade 7ip: 33138
Folio/Parcel#: 11-3206-011-0070
Is the Building Historically Designated: Yes NO
X Flood Zone: n/a
OWNER: Name (Fee Simple Titleholder): Shore Square Properties LLC Phone#: (954) 683-7657
Address: 696 NE 125th Street
City: Miami State. FL
Zip: 33161
Tenant/Lessee Name: The Mattress Firm
Phone#: (713) 923-1090
Email: keith.short@imcpropertymanagement.com
CONTRACTOR: Company Name: Anchor Sign, Inc.
Phone#: (843) 576-3268
Address: 2200 Discher Avenue
City: Charleston State: SC
Zip: 29405
Qualifier Name: David W. Jackson
Phone#: (800) 213-3331
State Certification or Registration #: ES0000291
Certificate of Competency #: n/a
Contact Phone#: (843) 576-3268 Email Address: dbrant@anchorsign.com
DESIGNER: Architect/Engineer: n/a
Phone#:
Value of Work for this Permit: $ 250 Square/Linear Footage of Work: 132.23 sq. ft.
Type of Work: ❑Address ❑Alteration ®/New ❑Repair/Replace ❑Demolition
Description of Work: Connect (1) internally -illuminated Mattress Firm wall sign to the existing electrical
circuit on the front elevation.
Submittal Fee $ Permit Fee $✓rG'n CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ 15 Z5 '
Bonding Company's Name (if applicable) n✓a
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) n/a
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 whit curs seven (7) days after the building permit is issu Intence such posted notice, the
inspection will notg5e oved and a reinspection fee will be charged.
X signature
Owner or Agent 4a)Dr
The foregoing ins ment was acknowledged before me this Id The foregoing instrument was acknowledged before me this
day of �, 20,LK by G! �day of 20 14, by David W. Jackson ,
who is personally known to me or who has produced who isonall�yo tome or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY P L NOTARY PUBLIC:
Sign: Sign:
Print: Print: r r i do
9 FF 2 2
My Commis p sPlr� July 2, 2017 My C mmi, xpues:
•/I I� T1-TMyFghft-- 3x17018 •• ems..-& MEGAN STARRICK
I�TARY PUSUC, STATE OF SOUTii CAMMA
APPROVED BY'n' 'f ` �l— > }° "C Plans Examiner P � � � ^' Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06110/2009)(Revised 3/15/09)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
FBC 20
MAY 0 9 2014
Permit No. L l
Master Permit No.
JOB ADDRESS: 9007 Biscayne Boulevard, Miami Shores, FL 33138
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-3206-011-0070
Is the Building Historically Designated: Yes
NO X Flood Zone: n/a
OWNER: Name (Fee Simple Titleholder): Shore Square Properties LLC Phone#: (954) 683-7657
696 NE 125th Street
City: Miami
State: FL
33161
Tenant/Lessee Name. The Mattress Firm Phone#: (713) 923-1090
Email: keith.short@imcpropertymanagement.com
CONTRACTOR: Company Name: Anchor Sign, Inc. Phone#: (843) 576-3268
Address: 2200 Discher Avenue
City: Charleston State: SC Zip: 29405
Qualifier Name: David W. Jackson Phone#: (800) 213-3331
State Certification or Registration #: ES0000291 Certificate of Competency #: n/a
Contact Phone#: (843) 576-3268 Email Address: dbrant@anchorsign.com
DESIGNER: Architect/Engineer: n/a Phone#:
Value of Work for this Permit: $ 250 Square/Linear Footage of Work: 132.23 aq. &
Type of Work: ❑Address ❑Alteration iNew ORepair/Replace ODemolition
Description of Work: Connect (1) internally -illuminated Mattress Firm wall sign to the existing electrical
circuit on the front elevation.
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable) n/a
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) n/a
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven 7 ays after the building permit is is In t sense of such posted notice, the
inspection will not be approved a are' ection fee will be charged.
Signature Signature
or Agent 0ontraor ,�,,11
The foregoing instrument was acknowledged before me this 28th The foregoing instrument was acknowledged before me this 5T4"
day of , / .20 ,d, by Yoram Izhak day of M 2p M-, by David W. Jackson
who is perso nall own to me or who has produced who isrsonally kno o me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission
GONZALEZ
Exores July 2, 2017
Baled Thm Troy Fdn InaMM OWM5 7019
Hesksk skskHsds=k=RBarkd«srh�H+Hsrkds$seak�k�+dsrkHiH+sk�Isdaskrkrkakds$sskH=H=HaHsskskds=kHsrkjkrkakrkakikskHrskskskds
APPROVED BY%7M '' Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign:
Print: Maureen Swint
My Commission Expires:
My Comm. Exp.
5.2-2023
Zoning
Clerk