ELC-17-154 Permit No. ELC-1-17-154
��sKO1s y� Miami Shores Village Permit Type:Electrical-Commercial
10050 N.E.2nd Avenue NE
F n,. Per It
Work Classification:Temp for Test
Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
�ORtOp
Issue Date: 1/20/2017 Expiration: 07/19/2017
Project Address Parcel Number Applicant
9501 NE 2 Avenue 1132060133920
Miami Shores, FL 33138- Block: Lot: DVS LLC
Owner Information Address Phone Cell
DVS LLC 9400 NE 2 Avenue (305)756-3711
MIAMI FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 100.00
INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384
_r..., m. Total Sq Feet: 0
Type of Work:TEMPORARY FOR TEST Available Inspections:
Additional Info:TEMPORARY FOR TEST Inspection Type:
Classification:Commercial Final
Scanning: 1 Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# ELC-1-17-62670
DBPR Fee $2.00
DCA Fee $2.00 01/20/2017 Check#: 1736 $ 108.60 $0.00
Education Surcharge $0.20
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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 AFF AV I certi that a the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a Tonin Futhe ,I uthorize the above-named contractor to do the work stated.
G4 U l January 20, 2017
tu
Authorized.Signare:Owner / Appli nt / Contractor / Agent Date
Building Department Copy
January 20, 2017 1
r Miami Shores a Villa C`'EXVED
C/ g
Building Department JAN 2p 2017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: �—�1�__
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20TH
BUILDING Master Permit No. 16-1530
PERMIT APPLICATION Sub Permit No.PA C' 5q
❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9517 NE 2 Ave
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-013-3920 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):DVS LLC Phone#:
Address:201 NE 95 ST
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Industrial Electrical Systems Corp. Phone#: 305 388-4648
Address: 14050 SW 84 St Suite 206
City: Miami State: FL Zip: 33183
Qualifier Name: Nestor I. Corvea Phone#: 305 388-4648
State Certification or Registration#: EC 13002182 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Temporary for test.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ l mO 1,0'40� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ v
(Revised02/24/2014) `�—
t
Bonding 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 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 (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will nelf app a an a reinspe ' n fee will be charged.
Sig ture Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_jq,`�day of 20 ,by 19th day of January 20 17 by
P✓2�A e Clow 11JPkNho is personally known to CQkc,IL A who is personally known to
,rhe or who has produced as moor who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: Y'o;; FRANCISCO P MORALES
Francisco P. MOr�IeS °= Notary Public-State of Florida
Print: Print:
' � � 767
ELIZABETH ELORRIAGA
Fc'c' ' My Corm.Exp.November 17,2017
Seal: MY COMMISSION 0 FF953536 Seal: Bonded Thru National Assocation-Florida
EXPIRES January 25.2020
140 I"R o,bt ilow~& Service earn
#s#*************s**s#s*##s**s**##****sssss##*s###*ss#*####*****ass###ss#s#sssss*#**********s#*ss##s***#*****
APPROVED BY ', I lr •/ 7 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
15NoREs Miami Shores Village
Building Department
,.,, 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
�l RIDA Fax: (305) 756.8972
AFFIDAVIT FOR 30 DAY TEMPORARY-ELECTRIC SERVICE
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY
TERMINATION UNLESS APPLICATION IS RENEWED.
It is understood that the temporary-electrical approval by the Miami Shores Village, Building Department given
in connection with the building being constructed under:
Building Permit N: 16-1530 Electrical Permit,N:
At Address: 9517 NE 2 Ave Miami Shores, FL
For Owners: ovs LLC , and is being given only for
construction purpose or for testing the following equipment in said
structure:_ VJt C �l�h�,_l-t5tA`r � c C7 , Sc�s b-6 e6%.c.i� (`Ti c -
The owner does herby agree to assume the respo"onsibifity of maintaining U installation in such manner that
there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said
structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further
inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of
Occupancy or Completion is obtained.
The undersigned also understands that the temporary electric approval is subject to rescission and
(,ancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of
ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of
Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your
being,unable to obtain future Temporary for Test permits.
I, �}'�ey'e2 (,at 062 � 1, , being first duly sworn, depose and say that I am the owner of the
above des ' ed d that I agree that the structure covered in this agreement shall not be occupied
e i i ntractor has tained approval of final inspections and/or obtained a Certificate of
Occ ancy o omp tion. Note: allure to comply with the provisions of this affidavit will result in your
b ' g una e o or
ELIZABETH R ��
Sign atur o wn MyISS10811 f Notary
EXPIRES January 5.21=11
I, Nestor I. Corvea , being duly ' . ' ' hl e Ele LES
the above-described property and that the electrical installations as now existing Ilt.410 qe� 9s1R@{� �ia°� .
if to or ry servic/� is connected. Notary Public State of Florida
�/ 6 �C/ Nestor I.Corvea p� ate_ Commission#FF 39767
2017
Signature of Electri al Contractor Signature of Ivtiw�gondedThruNationalAssocation-Florida
I,� r1 `L being first duly sworn,•depose and say that I am the Building Contractor
of the above described pro erty and that I will not permit occupancy of this building until final inspections have
been called for by the contracto s and sub-contractors concerned and final approval by the inspection division
obtained and that I have the u ority insofar as the owner of said property is concerned to prohibit occupancy
unti in I inspectio a o tained and/or a Certificate of Occupancy or Completion is issued.
; �►'"' ;; ELIZABETH ELOR
MY COMMISSION#
gnature of Building ContractorEXPIRES January 2 I u e of Notary
(40l)3W-O'b3 Fkxd~a Swv"Oar
Signature of Inspector Signature of Notary