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ELC-19-1051Permit No.: ELC-05-19-1051 Miami Shores Village Permit Type: EWdrical - Commercial 10050 NE 2 Ave Miami Shores FL 33138 lt�' Work Classification: Low Voltage 305-795-2204 f Permit Status: Approved Issue Date:OSr,/17/2019 I Expiration: 11/13/2019 Location Address Parcel Number 9050 BISCAYNE BLVD, Miami Shores, FL 33138 1132060100010 Contacts Inspection Requests: Description: UPGRADE ANALOG CCN SYSTEM TO IP NETWORK Valuation: $ 80,656.85 Inspe tion R9 CCN SYSTEM (VIDEO CAMERAS) LOW VOLTAGE CAT 5E LOW VOLTAGE WIRE RUNS. Total Sq Feet: 0.00 Fees Amount PUBLIX SUPERMARKETS, INC Owner ADT SECURITY SERVICES Contractor PUBLIX SUPERMARKETS, INC ROBERT BULL P 0 BOX 407, LAKELAND, FL 338020407 3970 S PIPKIN RD, LAKELAND, FL 33811 Other: 863688747 Business: 9543149340 Education Surcharge Mobile: 8632269331 Inspection Requests: Description: UPGRADE ANALOG CCN SYSTEM TO IP NETWORK Valuation: $ 80,656.85 Inspe tion R9 CCN SYSTEM (VIDEO CAMERAS) LOW VOLTAGE CAT 5E LOW VOLTAGE WIRE RUNS. Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $48.60 DBPR Fee $36.30 DCA Fee $24.20 Education Surcharge $16.20 Permit Fee $2,369.71 Scanning Fee $9.00 Technology Fee $60.49 Total: $2,614.50 Building Department Copy Payments Date Paid Amt Paid Total Fees $2,614.50 Credit Card 05/10/2019 $50.00 Credit Card 05/17/2019 $2,564.50 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 q�rtify thpt all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an oning. Futhermore, I authorize the above named contractor to do the work stated. ) Auth 'red Signature: Owner / Applicant / Contractor / Agent Date May 17, 2019 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 ❑ BUILDING ❑■ ELECTRIC ❑ ROOFING F-IPLUMBING ❑ MECHANICAL PUBLIC WORKS JOB ADDRESS: 9050 Biscayne Blvd. Publix 0794 jM to Zp13 :y ( - FBC 20 (7 Master Permit No.E�L- 1 V I Sub Permit No. ❑ REVISION ❑ EXTENSION RENEWAL CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: 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): NORTHERN TRUST BANK ETAL TRS % PUBLIX SUPERMARKET INC phone#: 1-866-528-7698 Address: PO BOX 32025 City: LAKELAND State: Florida zip: 33802 Tenant/Lessee Name: PUBLIX SUPERMARKET INC Phone#:1-866-528-7698 Email: C LAM bNtrA G9 AIDT, C O M CONTRACTOR: Company Name: ADt LLC dba ADT Security Services Phone#: 863-226-9331 Address: 3970 South Pipkin Road City: Lakeland State: Florida zip: 33811 Qualifier Name: Robert Bull Phone#: 863-226-9331 State Certification or Registration #: EF20001044 Certificate of Competency #: DESIGNER: Architect/Engineer: N/A Phone#: Address: City: State: Zip: Value of Work for this Permit: $ I?i 0. 656, 8S Square/Linear Footage of Work: Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Upgrade Analog CCN system to IP Network CCTV System (Video Cameras) Low Voltage Cat5e Low Voltage wire runs. Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 on 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 *,Qey— Signatures OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of LA()OCAI—N 20 A , by 15 day of F'C (30�_ 20 1 °1 by a11Ltfi?P� S� ,who s personally known �oe�As (�b�1 who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and w did tak an oath. NOTARY PUBLIC: NOTARY PUBLI Sign: Sign: Print: ra nnecupr Print:IN Go Seal: Seal: MY C MISSION # FF992050 DIANA SHECKLER OrEXPIRES M8y 12, 2020 w * Commisslon # GG 230606 407 �Ob-0103 FlorklrNow 8*Mw,«�n Explres June 19, 2022 APPROVED BY S[ f3 �� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 5/10/2019 Property Search Application - Miarn -Dade Countv J`FF14`E O� THE PROPER I Y ArPRAISER U EV Summary Report Property Information Folio: 11-3206-010-0010 Property Address: 9050 BISCAYNE BLVD Miami Shores, FL 33138-3222 Owner NORTHERN TRUST BANK ETAL TRS % PUBLIX SUPERMARKET INC Mailing Address PO BOX 32025 LAKELAND, FL 33802-2025 PA Primary Zone 6200 COMMERCIAL - ARTERIAL Primary Land Use 1411 SUPERMARKET: RETAIL OUTLET Beds / Baths / Half 0 / 0 / 0 Floors 2 Living Units 0 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 63,776 Sq. Ft Lot Size 223,898 Sq. Ft Year Built 2001 Assessment Information Year 2018 2017 2016 Land Value $4,030,164 $4,030,164 $4,030,164 Building Value $4,803,886 $4,214,836 $4,214,836 XF Value $0 $0 $0 Market Value $8,834,050 $8,245,000 $8,245,000 Assessed Value $8,834,050 $8,245,000 $8,245,000 Generated On: 5/10/2019 Taxable Value Information 2018 2017 2016 County Exemption Value Note: Not all benefits are applicable to all Taxable Values (i.e. County, School $0 $0 $0 Taxable Value $8,834,050 $8,245,000 $8,245,000 School Board Sales Information Exemption Value $0 $0 $0 Taxable Value $8,834,050 $8,245,000 $8,245,000 City Exemption Value $0 $0 $0 Taxable Value $8,834,050 $8,245,000 $8,245,000 Regional Exemption Value $0 $0 $0 Taxable Value $8,834,050 $8,245,000 $8,245,000 Benefits Information Benefit Type 2018 2017 2016 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Sales Information Previous Sale Price OR Book -Page Qualification Description Short Legal Description 6 53 42 5.14 AC M/L SHORES CENTER PB 49-42 TR A LESS BEG 52.07FTSWLY OF X OF S/L NE 92ND ST & WLY R/W/L BISC BLVD CONT SWLY140.15FT 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://www.rniamidade.gov/info/disclaimer.asp Version: CERTIFICATE, OF SECRETARY (AUTHORITY OF DIRECTOR OF CONSTRUCTION) THE UNDERSIGNED, being the Secretary ot'PUBLIX SUPER MARKETS, INC., a Florida corporation (the -Corporation")., hereby certifies, on behalf of' the (..'orporation and its subsidiaries, that MIKHAEL.H. SER, P.E., as the [.)irector of Construction of the Corporation, is authorized to do all acts and execute all documents (including., without limitation, contract documents, permit applications, and notice of' commencement documents) with respect to the construction. alteration, and installation ot'improvements and equipment for facilities owned,, leased. or otherwise controlled by the Corporation, on behalf of the Corporation, as tLilly as the Corporation might or could do through its officers. VN DATFD this day of'November. 2018. John A. Attaw'RIN11, ry 4.t t********* I N A 1CORPUR DEC. 2T, 1921 SEAL STATE OF 1-1,0RIDA 0 R I C01 INTY Of`1101.1( The foregoing instrument was signed. scaled. and acknowledged before [Tie this day of November. 2018. by, John A. Attaway. Jr., as Secretary of' Publix Super Markets, Inc.. a Florida corporation, oil behalf of'the corporation. He is personally known to Ile. - - - - - -------- - ------------ Notary Public, State and County Aforesaid Printed Name: AA !N� BRENDA ADriNs My Commission Expires: *- * CWMISSIon 0 GG 238473 TIM EMIN 16, 2072 Commission Number: v (Notary Seal) ADT LLC dba ADT Security Services 3970 South Pipkin Road, Lakeland FI. 33811-1422 863-583-3343 Rmix CAA SI A Scope of Work Installation of the CCTV IP or Analog upgrade at Publix Purpose: To Upgrade the existing CCTV IP system or Analog System. ADT will Add/Move/Remove CCTV components to the existing CCTV IP system or Analog System (Video Surveillance system). - Low Voltage All cameras that are mounted on a drop ceiling will have a mounting bracket attached to the ceiling grid. All cameras mounted on a pipe will have safety wire ran through the pipe and attached to the camera and bar joust for support & safety. The basic installation process of all cabling provided and installed by ADT LLC.AII cable that is used for camera installation is a 24 AWG Category 5e Unshielded Twisted Pair Non -Plenum or Siamese coax with 16-2 Power wire Non Plenum. We use (UL Listed) Non -Plenum cable that is installed in open ceiling areas or mounted on wire hangers above a drop ceiling or along the walls with wall mount ties or J hooks. We use Costar Direct IP Cameras or Costar Analog Cameras. When installing all cable drops down a wall or through stet 4, frame work we use a 2" plastic grommet or mud ring to protect the cable L_.i from any damage. When installing cable through a firewall we use a 2" FS2BO <: Fire stop sleeve and pack with AD fire stop silicone caulk. When installing cabl4ng � C_1 in red iron, rafters or beams we use 10" tie straps to bundle and secure all c►le. LLi trunks. All of our cabling is installed away from any other service cables, FAC= Ducting, Plumbing or Fire Sprinkler Piping. All Cat5e cable is terminated to the-' IP rack in the Server Room or on the IT rack in the back of the store by DSD. All Siamese wire is terminated to 24v Power Supplies and Terminated to the DVR with a BNC connector. If there are any questions please contact ADT representative Chris LaMonica at: 863-226-9331 : clamonica@adt.com