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EL-14-2572Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231308 Scheduled Inspection Date: March 31, 2015 Inspector: Devaney, Michael Owner: MARVIN R LIST & MARIA T MANERBA, MAD\/IAI D 1 ICT Q IiAADIA T MAAICDQA Job Address: 9929 NE 4 Avenue Road Miami Shores, FL 33138 - Project: <NONE> Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP junamg ueparltment comments INTERIOR REMODEL. HIGH HAT IN THE ENTIRE HOUSE. ADD OUTLETS IN DINING, FAMILY AND LIVING ROOM. ADD SMOKE DETECTORS. Permit Number: EL -11-14-2572 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (305)858-0204 Parcel Number 1132060171280 INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid Phone: 305/228-1384 March 30, 2016 For Inspections please call: (305)762-4949 Page 23 of 27 NN" 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) 76L4949 BUILDING PERMIT APPLICATION IND 74 FBC 20 Permit Type: Electrical � C EWED NOV 21 2014 BY, Permit No. �� '�� Master Permit No. RC -8-14-1843 OWNER: Name (Fee Simple Titleholder): Marvin R. List & Maria T. Manerba Phone#: Address: 9929 PIE 4 AVE ROAD City: Miami Shores State: Florida Zip: 33138 Tenant/L.essee Name: Phone#: Email: JOBADDRESS:992_9 NE 4 AVE ROAD City: Miami Shores County: Miami Dade Zip: 33138 Folio/ParceW 11-3206-017-1280 Is the Building Historically Designated: Yes NO x Flood Zone: CONTRACTOR: Company Name: Industrial Electrical Systems Corp Phone#: 305 228-1384 Address: 10257 NW 9th St Cir 205 City: _ Miami State: FL Zip: 33172 Qualifier Name: Nestor I. Cornea Phone#: 305 228-1384 State Certification or Registration #: EC13 002182 Certificate of Competency #: Contact Phone#: 305 228-1384 EmailAddless: iesflorida@comcast.net DESIGNER: Architect/Engineer: Phone#: Value of Work for this permit: $ 4,000.00 Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew ORepair/Replace UDemolition Description of Work: Interior Remodeling According to approved plans. Submittal Fee $ - � Permit Fee $ ;Z2, ",,,P CCF' `C CO/CC $ Scanning Fee $ 9 Radon Fee $ �'� _ $ • '�(� DBPR $ � � Bond Notary $ . Truining/Education Fee $ 0 2Technology Fee $ 3 ` a(�l Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 q '_� o 16� Vp -I ,tell 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 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 properly 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 n be�Tproved and a reinspec on fee will be charged. Signature � Signature� Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 20th day of , 2ft- by (t�) T'-- U6T , day of November , 20 -14, by Nestor I Corvea 9 who is personally known to me or who has produced JLkLR_ who is personally known to me or who has produced Ll C"001 As identification and who did take an oath. NOTARY PUBLIC• N Public Florida g� OF 1 E)q*" 09103,20,4 8 My Commission Expires: as identific th b;; • FRANCISCO P. NOTARY PUBLIC: :A ao: MORALES *_ Notary Public - State of Florida Commission #FF 39767 MyComm.Exp.November17,2017 Sign' ' Bonded Thru National Assocation - Florida Print: Francisco P. Morales My Commission Expires: 11/17/2017 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(ReAsed 06/1W009)(Revised 3/15/09) STATE OF FLORIDA ° DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD we 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CORVEA,NESTOR I INDUSTRIAL ELECTRICAL SYSTEMS CORP 10257 NW 9TH ST CIR # 205 MIAMI FL 33172 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 remotions that impact you, subscribe to department newsletters and seam 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 (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND 2 PROFESSIONAL REGULATION EC13002182 ISSUED 08/10/2014 CERTIFIED ELECTRICAL CONTRACTOR CORVEA, NESTOR I INDUSTRIAL ELECTRICAL_ SYSTEMS CORP IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31. 2016 11408100003048 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER 4s. The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 CORVEA, NESTOR I INDUSTRIAL ELECTRICAL, SYSTEMS CORP 10257 NW 9TH ST CIR # 206 MIAMI FL 33172 ISSUED. 08/10/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408100003048 004+09 Local Business Tax Receipt Miami -Dade County, State of Florida- -THIS I8 NOTA BILL 00 NOT PAY 6115851 BUC- Cy d NAME/LOCATION RECEIPT NO. INDUSTRIAL ELECTRICAL SYSTEM CORP (RENEWAL 10257 NW 9 ST CIR 205 6378780 MIAMI FL 33172 EXPIRES SEPTEMBER 30, 2415 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED INDUSTRIAL ELECTRICAL SYSTEM CORP 188 ELECTRICAL CONTRACTOR BY TAX COLLECTOR Worker(s) 1 EC73002182 $75,00 07/30/2014 CHECK21-14--039228 This Local Business Tax Receipt only cmdirms payment of the Local Business Tax. The Receipt is not a license, permit are certification of the holder's qualifications, to do business. Holder must comply with any governmantal ar nongaaornmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed an all conmtercial vehicles - Miami4ade Code Sac Ile -278, Formate information, visit wmw.miamidade novhaxoolleatar ,. CERTIFICATE OF UABILITY LIABILITYINSU DICEam 11!2012014 PRODUCER Serial # B2835 OVERSEAS INSURANCE AGENCY P. O. BOT[ 162936 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGIM UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL W.i BELOW. MIAMI, FLORIDA 33116 INSURERS AFFORDING COVERAGE VISURED INDUSTRIAL, ELECTRICAL. SYSTEMS CORP msuRERA: GRANADA INSURANCE CO_..__. 10257 N.W. 9 ST CIRCLE #205 R4SuRER B:_ -- 1 tliRER C: MIM FL.OWA 33172 INSURER D: t sNSc E: - S 11000,000 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW)THSTANDING ANY RECRAREMENT, 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, EXCLUIS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOW14 MAY HAVE BEEN REDUCED BY PAID CLAIMS. NMI TwEOF POLICYWAMER Fd1CYEXPi1ATIDR EFFEC79VE 1LTO —� GENERAL LIABILM j t EACH Oma S 11000,000 A X,C MCu Crows MADE ®ocCUR JOINFL00045331 05/12/15 05!12/14 i FIRE DAn(My —ta) s_ MED EXP(Any ares) _100.000 $ v 5.600. M a ADV WXMY $ 2,000A80 -250 OED GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMRTAPPLIES PER: PRODUCTS - COMPnP AGG $ 2,0001000 j7PO LOC A MO I.E LIAMLrIT ANYAUTO COMBMdED SINGLE LMuriT (Eeami * $ - $ _� ALL OWNED AUTOS SCHEDULED AUTOS j BODILY OLMY I (P -P—) $ HIREDAUTos 1 &�I ) y 1 DAMAGE $ LIARRM I AUTO ONLY. EAACCIOMT_ j $._-------.,_._.-- --- S AW AUTO ! I OTHER THAN EA ACC AUTO ONLY: AGG S -W(C�M LIARRAY jOCCUR CLAIMS MAW EACH OCCURRIME ' AGGRE0015 $ S T S S DEDUCTIBLE � RETENTION $ ' WOMUM IMAM � T LJMITS E.L. EACHA=EW $ - i j i E L DISERBE - EA ESE OYES $ S Lei DISEASE - POLICY t MST { OTIM 1 MMM OF ADDED BY f$PELtAIPROVISION Description of Operation Electrical Miring: EC 13002182 As Qualifier Nestor I. Corvea W VILLAGE OF MIAMI SHORES 10050 NE 2ND AVE MIAMI SHORES, FL. 33138 FAX: 305 756-8972 SWWW ANYOFTHEAWO OMCREMPOLICIE11 W CARCELIM BeFo Tm zKPm1m DATE THEREOF, THE [M MIG Bim VWLL ENDBAVOR TO IL 10 DAYS WR rM NOTICE TO TM CotTOWATE HOLDER KW= TO TM LEFT, BUT FAILURE TO DO 80 SHALL DOSE W 08L]"'RON OR LIAHM_ W OF ANY IW UPON THE MOS IIS AMM OR 0 ACCO D® CERTIFICATE OF LIABILITY INSURANCE 11.20-^ 014 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDTTIONALINSURED, the pollcy(les) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditionsof the policy, certain policies may require an endorsement. A statenventon this certificate does not conferrights to the certificate holder In lieu of such endorsement($). PRODUCER PAYCHEX INSURANCE AGENCY INC 210705 P:()- F:(888)443-6112 P 0 BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONE (Aic N' (Aac,Na: (888)443-611 ADDRESS: PRODUCER CUSTOMER ID r: INSURERS) AFFORDING COVERAGE NAIC F INSURED INDUSTRIAL ELECTRICAL SYSTEMS CORP 10257 N.W. 9TH STREET CIR. APT. 205 MIAMI FL 33172 INSURER A : Twin City Fire Ins Co INSURER 0' INSURERC` INSURER D INSURER E INSURER F ; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ron LTR I TYPE OF WSURANOEWWSR POLICY NUMBER POLICY EF (MMIDD/YYYY) LImLTs GENERAL IJaetutr EACH OCCURRENCE I.$ 'Pli iMN1 LPIIIEREMISES Ea occurw% $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE U OCCUR MED EXP (Any one I>sraon) S PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ L AGGREGATE UMR APPAS PER: PRODUCTS - COMP/OP AMS POLICY LJ Ni LJ Loc $ AUTOMOBILE LIABUJTY COMBINED SINGLE LIMIT $ (lie accident) ANY AUTO BODILY INJURY (Par pwoon) $ ALL OWNED AUTOS BODILY INJURY (Per aoafdmrt) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per aceiderM $ $ NON -OWNED AUTOS s UMBRELLA UAB u OCCUR EACH OCCURRENCE s EXCESS UAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ !r $ RETENTION s A WORKERS C.OMPENSATMN AND EMPLOYERS' UABB,nY YIN. ANY PROPRIEfORIPARTNEFUEXECUTPA-- OFFlCERIMEMBEREXCLUDED7 iMyyaass clary In N14 MIA, 76 WEG F06188 01/24/14 01 /2 4 / 15 X WC ATO 0TH I E:L_ EACH ACCIDENT $ 1,000,000 E.L. DISEASE'- EA EMPLOYE 0 1 0 0 0 0 0 0 under DESC��IPN OF OPERATIONS below ELL DISEASE - POLICY LIMIT s 1,000,000 DPt�N OF OPERATIONS / LOCAT�NS 1 V (Amefi ACRD 101. A&Btioiml Remwl® 8chedWa. H more space � requ4+adi • Those usual to the Insured's Operations: EC 13002182 As Qualifier Nestor I. Corvea Village of Miami 10050 NE 2ndAVe Miami Shores, FL. Fax: 305 756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Shores BEFORE THE 0MRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 33138 A 01988-2009 ACORD CORPORATION. AN dahts reserved. ACORD 25 (2009/09) The ACORD name and. logo are reg(stered marks of ACORD