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DEMO-15-1321 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-237830 Permit Number: DEMO-6-15-1321 Scheduled Inspection Date: June 29, 2015 Permit Type: Demolition Inspector: Devaney, Michael Inspection Type: Final Owner: WONG, BRIAN & MARILYN Work Classification: Electric Job Address: 1236 NE 93 Street Miami Shores, FL 33138- Phone Number (305)442-8884 Parcel Number 1132050270180 Project: <NONE> Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP Phone: 305/228-1384 Building Department Comments ELECTRICAL WORK AS PER PLANS DEMOLITION AND Infractio Passed Comments UPDATING GFI'S INSPECTOR COMMENTS False Inspector Comments Passed Failed ' Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 26, 2015 For Inspections please call: (305)762-4949 Page 24 of 28 Y v Per�1t � 321 5+�°77ES Miami Shores h4 Village e41, Y �Qtt[IC�I 10050 N.E.2nd Avenue NEs Miami Shores,FL 33138-0000 !l , APPR3V�� E Phone: (305)795-2204 . r;• Expiration: 12108/2015 Project Address Parcel Number Applicant 1236 NE 93 Street 1132050270180 BRIAN&MARILYN WONG Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell BRIAN&MARILYN WONG 1236 NE 93 Street (305)442-8884 MIAMI SHORES FL 33138- 1236 NE 93 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 800.00 INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384 _... ,, Total Sq Feet: 00 Type of Demo:Electric Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-6-15-55796 CCF $0.00 06/11/2015 Credit Card $64.60 $50.00 DBPR Fee $0.00 DBPR Fee $2.00 06/02/2015 Credit Card $50.00 $0.00 DCA Fee $2.00 DCA Fee $0.00 Education Surcharge $0.20 Education Surcharge $0.00 Permit Fee $100.00 Permit Fee-Additions/Alterations $0.00 Scanning Fee $9.00 Scanning Fee $0.00 Technology Fee $0.00 Technology Fee $0.80 Total: $114.60 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 P 9 b P 9 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 informati is curate nd hat all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-n ed r t e work stated. June 11, 2015 Authorized Signature:Owner / Applicant a -or A nt Date June 11,2015 1 �TA- EAt4321 v. ye°SE �S y Miami Shores Village i �rmfr ypu.,64- !lit bn � y 10050 N.E.2nd Avenue NE yyH tlf� fd �f3t � Miami Shores, FL 3313&0000 p `` i ;N Phone: (305)795-2204 � � t AW ©. Expiration: 12/08/2015 Project Address Parcel Number Applicant 1236 NE 93 Street 1132050270180 BRIAN&MARILYN WONG Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell BRIAN&MARILYN WONG 1236 NE 93 Street (305)442-8884 MIAMI SHORES FL 33138- 1236 NE 93 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 800.00 INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384 Total Sq Feet: 00 Type of Demo:Electric Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 =j Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-6-15-55796 CCF $0.00 DBPR Fee $0.00 06/11/2015 Credit Card $64.60 $50.00 DBPR Fee $2.00 06/02/2015 Credit Card $50.00 $0.00 DCA Fee $2.00 DCA Fee $0.00 Education Surcharge $0.20 Education Surcharge $0.00 Permit Fee $100.00 Permit Fee-Additions/Alterations $0.00 Scanning Fee $9.00 Scanning Fee $0.00 Technology Fee $0.00 Technology Fee $0.80 Total: $114.60 Building Department Copy June 11,2015 2 6z' lCrl& Miami Shores Village REC...VED Building Department JUN 0 2 2015 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 (D BUILDING SD 35 Master Permit No � PERMIT APPLICATION Sub Permit Nzw ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1236 NE 93 STREET City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3205-027-0180 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Brian W Wong / Marilyn C Wong Phone#: Address: 1236 NE 93 STREET City: MIAMI SHORES State: FLORIDA Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Industrial Electrical Systems,Corp. Phone#: 305-228-1384 Address: 10257 NW 9th Street Cir#205 Miami Florida Ci State: Zip: 33172 City: Qualifier Name: Nestor I.Corvea Phone#: 305-228-1384 State Certification or Registration#: EC13002182 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 800.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑X Demolition Description of Work: Electrical Dem i' Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBP R Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ caq• GO (Revised02/24/2014) 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 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 Signature OWNER or OENT CONTRACTOR The foregoing instrument/was acknowledged before me this The foregoing instrument was acknowledged before me this / _day of Wl'u- 20 S by 28th day of May p20 15 by "1?rM, �jt�J►'�� _,who is p s nal wn to Nestor I Corvea 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 who did t FRANCISCO P. MORALES NOTARY PUBLIC: NOTARY PUBLIC: '`E: Nfty N gc-def FNldde Commission#►FF 39787 My Cwfift Exp.November 17,2017 Sign: Sign: Bonded iteNdWWAssocoon-FWde Prin : Print: Francisco P.Morales Seal: II"Pd k-SW of Florida w Seal: • Comb"•FF 197443 My CWA.Expka Feb 9.2019 ''''•ell a011dld 101M el Notary Assn n' ************ ******* ** * ** * * ** * * ****************************************************************** APPROVED B �� J`Lr�-B Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ACORD. CERTIFICATE OF LIABILITY INSURANCEDx-mom' mn 05/28/2015 PRo xxm Serial#B2823 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION OVERSEAS INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O.BOX 162936 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MIAMI,FLORIDA 33116 INSURERS AFFORDING COVERAGE INSURED INDUSTRIAL ELECTRICAL SYSTEMS CORP INSURERA: ARCH SPECIALTY INSURANCE COMPANY 10257 N.W.9 ST CIRCLE 0205 MIAMI, FLORIDA 33172 INSURER C:_ �— INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T R18R AM— TYPE OF R18WtANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPStATION LMBTS ORAL LIABILITY EACH OCCURRENCE f 11000,000 A X COMMERCIAL GENERAL LIAsam AGL002536200 05/12/15 05/12/16 f FIRE DAMAGE(Any one fire) f 100.000 CLAIMS MADE OCCUR MED EXP paean) f 5.000. -250 DED I PERSONAL a ADV INJURY f 2,000,000 rx GENERAL AGGREGATE f . 2,000,000'L AGGREGATE LIMIT APPLIES PHI PRODUCTS-OOMPiOP AGG f 2,000,000 POLICY PRO,- LOC _-- AUT0110BILE LIABILITY I COMBINED SINGLE LIMIT ANY AUTO (Ea aoddwd) f ALLOVVNED AUT03 BODILY INJURY f SCHEDULED AUTOS (Per P—) HIRED AUTOS GODLY INJURY : NON- VNED AUTOS ) �_--- PROPERTY DAMAGE f (Per acdllerd) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT f ANY AUTO OTHER THAN .EA ACC f AUTO ONLY: AGD f EXCOM LIABILITY EACH OCCURRENCE f OCCUR CLAW MADE AGGREGATE ^� f DEDUCTIBLE f RETENTION ; OTHf VIORKERB COW434SATM AND I ARM ER EMPLOYERS'LIABILITY I E.L.EACH ACCIDENT —_ _ E.L.DISEASE-EA EMPLOYEE f E.L.DISEASE-POLICY LIMIT f OTHM 1 D118CRIPTION OF OPERATIDNBA OCA ADDED BY ENDORSEIENTMPECIAL PRON1810N8 Description of Operation Electrical Wiring: EC 13002182 As Qualifier Nestor 1.Corvea CERTIFICATE HOLDER 1 X ADDITIONAL MMED•INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION VILLAGE OF MIAMI SHORES DATE THEREOFTHE WWW RISINIFR Y"LL ENDEAVOR TO MAIL 10 DAYS wwTTEN 10050 NE 2ND AVE NOTICE TO THE C19tTIPICATE HOLDER NAMED TO THE LEFT,Our FAILURE TO DO so SHALL MIAMI SHORES, FL. 33138 IMS NO OBLIGATION oR LIABILITY OF ANY lam UPON THE INSURER.ITS AGENTS aR FAX: 305 756-8972 r111A ATME ACORD 25-5(7197) a ACORD CORPORATION 1988