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PLC-16-772Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Ilt Permit NO. PLC -3-16-772 Permit Type: Plumbing - Commercial Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 4129/2016 Expiration: 10/26/2016 Parcel Number Applicant 9050 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060100010 Block: Lot: PUBLIX SUPERMARKETS, INC Owner Information Address Phone Cell Contractor(s) MIGUEL LOPEZ JR INC Valuation: Total Sq Feet: $ 17,840.00 38 Type of Work: REPLACE TRENCH DRAIN 38 LF ASPHATL Type of Piping: Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $10.80 $8.03 $8.03 $3.60 $535.20 $9.00 $14.40 $589.06 Pay Date Pay Type Invoice # PLC -3-16-59126 03/23/2016 Check #: 28749 $ 50.00 $ 539.06 04/29/2016 Check #: 29175 $ 539.06 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Heater Water Service Final Water Main Lavatory Top Out Re Pipe Main Drain Underground Review Building Trench Review Plumbing 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 regulating construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. April 29, 2016 Authdrized Sit nature: Owner / Applicant / Contractor / Agent Building Department Copy Date April 29, 2016 1 Manny Lopez From: Ismael Naranjo <NaranjoI@miamishoresvillage.com> Sent: Friday, April 22, 2016 9:42 AM To: Manny Lopez Cc: Arlenis Silvera; Sindia Alvarez; BZ3 Subject: RE: Publix Address 9050 Biscayne Blvd Folio # 1132060100010 Application # PLC -3-16-772 Good morning Many, I will instruct the permit clerks to issue the permit..Please note that a final inspection will not be schedule until the expired permits are renew and closed. Thank you. From: Manny Lopez [mailto:manny@Iopezinc.com] Sent: Thursday, April 21, 2016 10:04 AM To: Ismael Naranjo Cc: Nelson Triana; Eduardo Lopez Subject: RE: Publix Address 9050 Biscayne Blvd Folio # 1132060100010 Application # PLC -3-16-772 Good Morning Ismael, The repair we are doing is in the middle of the entrance and exit by 6 Ave. The two old permits the companies that had pulled them do not exist anymore. we need to do the repair as soon as possible is there any way we can get our permit. Thank You. Manny Lopez Chief Permit Coordinator Cell: 786-942-0047 M' IIG't!`E`L` L O I P E I jL ine. ASPHALT MAINTENANCE ENGINEERING CONTRACTOR Licensed Dislrlbutor I REJuVA,�► The Global leader In Pavement Rejuvenation "horn Orlando to the Keys^ P.O. Box 669354, Miami, FL 33166 Office: 305-884-0767 / Fax: 305-884-0642 / Toll Free: 1-800-894-9234 manny(c�lopezinc.com • www.Iopezinc.com Like us on Facebook From: Ismael Naranjo [mailto:NaranjoI@miamishoresvillage.coml Sent: Thursday, April 14, 2016 1:05 PM To: Manny Lopez <manny@lopezinc.com> Subject: RE: Publix Address 9050 Biscayne Blvd Folio # 1132060100010 Application # PLC -3-16-772 1 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) 7624949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING LUMBING ❑ MECHANICAL El PUBLIC WORKS JOB ADDRESS: A050 Riccayne RIvri City: Miami Shores County: RECETV D MAR 2 3 2016 BY- FBC 201`~ S Master Permit No. PLC1 `0--2 Sub Permit No. ❑ REVISION ❑ EXTENSION ['RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Dade zip: 33138 Folio/Parcel#: 11-3206-010-0010 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): pU A Y. Phone#: �in3-i' 6£g—(1 ? Address: p� co -ct;i e_ n �..../ ,• City: La y f .1 Ci "'�' I( State: (-- C— `J Tenant/Lessee Name: _,b()x A O� f rr v-Email:'L�b-°r+ • f' lCL �I IC LIlib . CONTRACTOR: Company Name: Miguel Lopez jr Inc Address: 7711 NW 74 Ave Ott Phone#: zip: -. )s2 "3 3 Phone#: (786)942-0047 City: Medley Qualifier Name: State: Florida Miguel Lopez jr Zip: 33166 Phone#: (786)229-0804 State Certification or Registration Si: C V L d S -1 G ? V Certificate of Competency it: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 17,840.00 Square/Linear Footage of Work: 38LF 162 SF Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Replace Trench Drain 38 LF asphalt Patch 162 SF Specify color of color thru tile: S3 5 • 2 Submittal Fee Permit Fee $ CCF $ v Q . Scanning Fee �-- ` - Radon Fee $ S63 Technology Fee $ 1 0 Training/Education Fee $ ` <=.d �{ Structural Reviews $ 0 Bond $ X� TOTAL FEE NOW DUE $ 539 • nes )es co/cc $ gC DBPR $ Pi -03 Notary $ (Revised02/24/2014) $onding Company's Name (if applicable) Bonding Company's Address City State Zip 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 low 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 AGENT The foregoing instrument was acknowledged before me this Q -di day of �'J 'U ,201 ip by 0)1\12y -1-J.069 h is personally known to as me or who has produced r identification and who did take an oath. NOTARY PUBUC: Sign: Print: Seal: ;� JODI L. SLOAN r i * MY COMMISSION # FF 184644 EXPIRES: February 5, 2019 Eurded Nu Budget Notary Services APPROVED BY e 3-23- IP (Revised02/24/2014) Sign O The foregoing instrument was TP( nowledged before me this day off ,T , 20 \LQ , by t WZSif , who is personally known to has produced identification and who did take an oath. NOTARY PUBLIC: Plans Examiner Structural Review Clerk dWZUI D FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS uetaii oy miry Name Detail by Entity Name Florida Profit Corporation PUBLIX SUPER MARKETS, Filing Information Document Number FEI/EIN Number Date Filed State Status Last Event Event Date Filed Event Effective Date INC. 112252 59-0324412 12/27/1921 FL ACTIVE CORPORATE MERGER 04/29/2015 NONE Principal Address 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Changed: 03/24/2010 Mailing Address Licenses P 0 Box 32027 LAKELAND, FL 33802-2027 Changed: 04/22/2014 Registered Agent Name & Address ATTAWAY, JOHN A, JR. 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Name Changed: 07/14/2000 Address Changed: 04/27/2005 Officer/Director Detail Name & Address Title CEO CRENSHAW, WILLIAM E httn•//eearrh ci enhi7 nrn/Inns lin, Ir.nrnnrail nnCearrh/CnarrhRxi dtneatai19irule ei r,h,r, I ntifi,NamAR.riirartinnTrnce=InitialReearrhName(lr(ler=PI IRI I)MI IPPP KA 1 /d L/0/40.10 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Title SRVP ATTAWAY, JOHN AJR. 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Title CFOT PHILLIPS, DAVID P 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Title P JONES, RANDALL T 3300 PUBLIX CORPORATE PARKWAY LAKELAND, FL 33811-3311 Title VP CHAMBERLAIN, JEFFREY G 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Title VP DUNCAN, DAVE 3300 PUBLIX CORPORATE PKWY LAKELAND, FL 33811-3311 Annual Reports Report Year Filed Date 2013 04/02/2013 2014 04/22/2014 2015 02/23/2015 uetaii oy tnuty Name Document Images 04/29/2015 -- Merger View image in PDF format 04/29/2015 -- Merger View image in PDF format 04/29/2015 -- Merger View image in PDF format 02/23/2015 -- ANNUAL REPORT View image in PDF format 07/29/2014 -- Merger M View image in PDF format 04/22/2014 -- ANNUAL REPORT F View image in PDF format 09/04/2013 -- Merger a View image in PDF format 09/04/2013 -- Merger r View image in PDF format httn•//caarncinhi7nrn/Inns iiniK:nrnnratinnCoarrh/CuarrhRetc! 11 otaiI?inniiinihrnc=RntihiklamcRrtirnrtinnTvnn=lnitialReaarrhKIamct rrlcr=PI IRI IYRI!PRP IA 9/4 LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that PUBLIX SUPER MARKETS, INC., a Florida corporation ("Publix"), by and through it undersigned officer, having its mailing address at P. O. Box 407, Lakeland, Florida 33802-0407, pursuant to a proper Corporate Resolution, does hereby appoint ROBERT J. MCGARRITY, P.E., Director of Construction for Publix Super Markets, Inc., to do and execute all or any acts with respect to the permitting, notice of commencement, construction and occupancy of Publix stores under construction or to be constructed, or in connection with the remodeling of Publix stores, as fully as said corporation might or could do through its officers. IN WITNESS WHEREOF, the undersigned has caused the within to be duly executed by its proper officer and the seal of the corporation hereto affixed by proper authority of its Board of Directors. Two Witnesses: PUBLIX S -'•E} UIQ 2 _ids) 0. STATE OF FLORIDA COUNTY OF POLK The foregoing instrument was a By: ' .L. John A•: `Atta Jr., eni r Vice President, General Counsel,aud e b.. $4 ••-fit (Cg •ra Seal) tfl. v i . ._DEC;27,1921 ^; sem,.---.'SEAT:= STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 LOPEZ, MIGUEL JR MIGUEL LOPEZ JR INC 7711 NW74AVE MEDLEY FL 33166 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range From architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's initiatives, Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND ' PROFESSIONALs•REGULATION �• CGC060135 ?+s -4 .ISSUED 08/27/2014 CERTIFIED GENERAL CONTRAC'TOR - LOPEZ, MIGUEL-1A MIGUEL L'OPEZJRINC r� IS CERTIFIED under the provisions of Ch 499 FS.• J, Expfl Tan dati ..AUG 31 2016 _ — L1408270003601 r f KEN LAWSON, SECRETARY LICENSE NUMBER STATE OF FLORIDA - • DEPARTMENT OF BUSINESeAND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD • "'The GENERAL -CONTRACTOR . -- -- -Named below ISCERTIFIED '' --• ;.Under:the provisions of Chapter 489 FS._ Expiration date: AUG 31, 2016 -•— fir+ i,,r /,LOPEZ,=MIGUEL- JR MIGUEL-LOPEZ JR 7711, NW 74 AVE' _.,,,--=;„;,-77•11 ME�DLLEY rf. , -FL 33166• - ISSUED: 08/27/2014 ---. - . s.._ ,rte . 4 - - .- ---- • w ' . 4, "� '• `� ., \ t �... —.....N.' ,�— _, ,.. - -- '... ., . �.., ti .,., •+; '`�:,. �`'�.��• '�'�\1 fit` DISPLAY AS REQUIRED BY LAW SEQ a L1408270003601 • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 LOPEZ, MIGUEL JR MIGUEL LOPEZ JR INC 7711 NW 74 AVE MEDLEY FL 33166 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflortdalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL:REGULATION CUC057030 t ISSUED:; 08/27/2014 CERT_ UNDERGROUND & EXCAV CP1TR LOPEZ, MIGUEt ; •M} .. ;_- MIGUEL-LOPEZ,JR'SNC ‘-et.31" - IS CERTIFIED nder~the avis ns of°Ch.409 FS-`- ff E1p1ret011 date ;,AUG 3t, 2016 _'--",..,,•� "., L1400270004120 •-• - KEN LAWSON, SECRETARY • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER --1,' ,, .000057030'_r ' • _ '`. -.. �' .._ --f -The UNDERGROUND.UTILITY & EXCAVATION CO Named below IS'CERTIFIED ' 1> Under.the provisions oF•Chapter 489 FS. - -Expiration date:-AUG,31, 2016 - r _ .. • `\� 1, •`*\,• - :s-;\ • - N /.//,MIGUELLOPEZ JR INC 4.. 4. �r -77.11,NW 74 AVE. „c ,--MEDLEY-"..."---.FL 33166 • DISPLAYAS REQUIRED BY ISSUED: 08/27/2014 y .�. LAW SEO # L1408270004120 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOTA BILL - OO NOT PAY 2671163 BUSINESS NAME/LOCATION LOPEZ MIGUEL JR INC 7711 NW 74 AVE MEDLEY FL 33166 OWNER LOPEZ MIGUEL JR INC Worker(s) 2 RECEIPT NO. RENEWAL, 2800044 LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 SPECIALTY ENGINEERING CONTRACT BY TAx COLLECTOR CUC057030 S45.00 08/18/2015 ECHECK-15—.160088 • • This Local Begonia Tax Receipt only tmnraas payment -ill the Local Easiness Tax. The Receipt is not a license. permit, or a cs tirrcadon of the bolder's gadihcatiaes, to do business. Halder moat comply with any governmental or nongovernmental regulatory lavarequirementsa requirements which apply 10 the business. The RECEIPT NO. above must be displayed oe all commercial vehicles - Minni-slats Cade Sac Ila -271. For more iafonnatioa, visit y+ww.asiamidade.eovitaxcollecau 0003?. Local Business_ Tax Receipt Miami -Dade .County,, State of Florida THIS if NOTA BILL - OO NOT PAY 2090777 ' BUSINESS NAME/LOCATION LOPEZ MIGUEL JR INC 7711 NW 74 AVE MEDLEY FL 33166 OWNER t LOPEZ MIGUEL JR INC Worker(s) 1 RECEIPT NO. RENEWAL 2198562 LBT EXPIRES — SEPTEMBER 30, 2016 Must be displayed et place of business Pursuant to County Code Chapter 11.4 - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC060135 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 08/18/2015 ECHECK-15-160088 This Local Business Tax Receipt only eoarrrras papaw of the Local Business Tax. The Receipt is not a license. permit. 0,a certilicadoe of the bolder"suaiifcations. to da Swings& Holder mast comply with any govemmentat or noogoverameatai regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all conmmercial vehicles - Mind -Bade Code Sec le -276. For more information. visit www atiamidade.gavfascollector Parcel Owner Report Parcel Number: 1132060100010 dAS (() 9050 BISCAYNE Boulevard Miami Shores FL 33138 - Tax ID: 1132060100010 Owner Information PUBLIX SUPERMARKETS, INC Current Owner: Yes Company: PUBLIX SUPERMARKETS, INC Phone: (863)688-747_ Related Permits Commercial Construction Commercial Construction Commercial Construction Commercial Construction Electrical - Commercial Electrical - Commercial Electrical - Commercial Electrical - Commercial Electrical - Commercial Electrical - Commercial Imported Permit Imported Permit Imported Permit Imported Permit Imported Permit Imported Permit Mechanical - Commercial Mechanical - Commercial Mechanical - Commercial Mechanical - Commercial Paint Plumbing - Commercial Plumbing - Commercial Plumbing - Commercial Plumbing - Commercial Permit Number CC -10-12-1928 CC -12-15-3052 CC -3-06-669 CC -6-08-1003 ELC-3-13-440 ELC-2-13-257 ELC-3-06-670 ELC-9-13-2143 ELC-6-08-1004 ELC-9-13-2137 EL2003-76 EL2002-260 BP2002-1883 EL2002-365 BP2002-1168 EL2002-54 MC -2-13-256 MC -8-13-1844 MC -6-13-1315 MC -9-13-2041 PT -4-12-581 PLC -2-13-261 PLC -8-06-2117 PLC -9-13-2180 PLC -2-13-260 Application Date Expiration Date Status 10/15/2012 12/09/2015 03/15/2006 06/02/2008 03/05/2013 02/08/2013 03/15/2006 09/23/2013 06/02/2008 09/20/2013 03/24/2003 08/07/2002 11/01/2002 11/01/2002 06/28/2002 02/12/2002 02/08/2013 08/13/2013 06/11/2013 09/10/2013 04/04/2012 02/08/2013 08/10/2006 09/26/2013 02/08/2013 01/01/2999 09/04/2016 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 07/21/2003 01/01/2999 01/01/2999 07/29/2003 08/11/2002 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 01/01/2999 CLOSED APPLIED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED EXPIRED CLOSED CLOSED EXPIRED EXPIRED CLOSED APPLIED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED Related Code Cases Case Number Case Status Ordinance Violation CASE-2-13-109033ase Closed Case Date 02/12/2013 Compliance Date 3/8/2013 Wednesday, March 23, 2016 Page 1 of 1 Zvi / ,5?) 4-v4— pvirk (eAyfi 7eCdr� -71— riz- iz e( t7CPi C*)