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DEMO-15-2048 s; Perr'l4. 131 E = "5-2448 ,SNORE,r Ly Miami Shores Village Perrr►ffTve:�err�olitio 1, 10050 N.E.2nd Avenue NE r � tu�c Cffi€srr. Eie<:�iC Miami Shores, FL 33138-0000 , — „m 'errxit Altus: tieN es,w Phone: (305)795-2204O D '°4oittDA is ©ate:9131201Expiration: 03/01/2016 Project Address Parcel Number Applicant 1420 NE 103 Street 1132050310030 Miami Shores, FL Block: Lot: MARC AND ANNE LITZENBERG Owner Information _ Address Phone Cell MARC AND ANNE LITZENBERG 1420 NE 103 Street MIAMI SHORES FL 33138- 1420 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 AAA-ON TIME ELECTRIC, INC. 305-308-7333 Total Sq Feet: 0 Type of Demo:Electric Available Inspections: Additional Info:COMPLETE DEMOLITION Inspection Type: Classification:Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# DEMO-8-15-56707 DBPR Fee $2.00 DCA Fee $2.00 09/03/2015 Credit Card $ 108.60 $0.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING, MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information fist�todo at all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-namee work stated. September 03, 2015 Authorized Signature:Owner / Applicant acto / Agent Date Building Department Copy September 03,2015 1 AC�� i -LIABILITY _ 08/20115ancecy THIS CERTIFICATE-SSSUED_AS_AAAITE_OF INFORMATION ! 3801 SW 107 Avenue ! ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami,FL 33165 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Al7ER TtiE CQVER. AFFO DED Phone (305)226-390 -3997 BY THE PQUCIES BELONt/. _ i Ph0 _ _ Fax (305)226 - --•— _ -- INSURERS AFFORDING COVERAGE _ NAIC INSURED PSG Plumbing Service, Inc. — _- i INsuRER a..Sc?ttsdale Insurance Com an _---j 'L�!_ - 41297 3892 NW 125 Street +uvsut3�► �_Infinity Auto insurance Co_mpany� — j 7gg -"� Opalocka,FL 33054 ;_INSURER c: Ascendant Commercial Insurance Co. i 1139$ -- �_-_ INSURER D; COVERAGES i INSURER E - - r------_ El _1E .-------- - —._-.-- ------- I UVStX2ER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSIj{tEpNgj„iED ABOVE FOR T}IE pOLICy pER10D INDICA rEp• Ajp7Ay(Tj�$TANDMIG - I ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT yy�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. - _ —_— 1 Lhk]]ADO L I - I -------_�_..--_--- -- iLTR 1_I,_ -- TYPE . INSURANCE _._— pOUCY NUMBER f PO Y EFFECTIVE`POLICY EVIPATION! 4 GENERALUABIUTY i —•--- -�- _�M OA�Nuupplyy}--! LIMITS ` + r------- ---------�_...___ COMMERCIAL GENERAL LIABILRY i i EACH OCCURRENCE 3,000,000; CPSi$54001 DAt�ii`4GE r f l_ CLAIMS MADE ,�, OCCUR 0$/22/15 I 08/22116 t PREMLSEs Ef a 000We J -' ---300,000; .A ill i MED EXP(Any one person) 5,ODQi -: --- ----' { LPERSONAL&ADV INJURY j 1,000,000'• i GENERAL AGGREGATE -_�.-- G-WLAGGREGATELIMITAPPLIESPER:? 1 - -- ---- _-__..._-�__ 3.000,000; L_`^` POLICY i j PROJECT , I i PRODUCTS-COMPIOP AGG I �] LOC i AUTOMOBILE LIABILITY ...... ANY AUTOj509-55946 6827-001 07109/15 i COMBINED SINGLE LIMIT { Ir ALL OWNED AUTOS ! 07/0911000,000 /16 L(Ea accident) w- g ( '.; SCHEDULED AUTOS -- BODILY INJURY HIREDAUTOS i 1 ;(Per person) NOM OWNED AUTOS I BODILY INJURY Comp$500.00 Ded_ I(Per accident) _- Coll $500.00 Dedy PROPERTY DAMAGt _-- — -' GARAGE LIABILITY _ C 01' ANY AUTO i - i AUTO ONLY-EA ACCIDENT ----- -i 1 i OTHER THAN EA ACC - -1--• —- AUTO ONLY: i EXCESSIUMBRELLA LIABILITY ! -"- - AGG _ !CPS1 ir'' OCCUR CLAIMS MADE 854001 08/22/15 pgy16-- f EACH OCcuRRENCE i 2,000,0_00.00! i _ =AGGREGATE 2,000,000^0 r i DEDUCTIBLE - i... RETENTION EMPLOYERS'LIABILITY Vt1C�i6349 0 -.T '--`-^ t -- t s 11/18/14 '_� __�r-^---...--� , C ANY PROPRIETOR f PARTNER f EXECUTNE I 11118/15 I WCC TAT�- j DTH- OFFICER f MEMBER EXCLUDED? _II�IITS E.L.EACH ACCIDENT r If yes,describe under N SPECIAL PROVfSIONS below 1 E•L_DISEASE-EA EMPLOYEE, 1,000,000 ' ; OTHER ' ;--- ._ -- - — — - L - -- - --- �-E-'- , DISEASE-POLICY LIMIT � .. 1,000,000 `DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PRgYISK)NS Plumbing Contractor-CG2033 Blanket Additional Insured-Included/CG2404 Waiver of Subrogation-Blanket coverage l 'included per written agreement; GLS-295s Primary and Noncontributo Wording—included ! Designated Construction Project(s)General Aggregate Limit--••Included as applicable to CG 20 33;CG25U3 CERTIFICATE HOLDER -- ------•--_-_.. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE 1SSUING INSURER WILL ENDEAVOR TO MAIL ? Miami Shores Village Building Dep _30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED To i 10050 NE 2 Ave [ Th LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY E Miami Shone,Fl 33138 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. I Fax 305-756-8972 AUTHORIZED REPRESENTATIVE-. .-- �. - - _ -- ®ACORD CORPORATION 1988 Miami Shores Village ECRIVI, Building Department AUG 18 015 10050 NX.Znd Avenue,Miami Mores,Florida 33138 Tel:(305)795-2204 fax,(305)756-8972 INSPECTION UNE PHONE rNt,IMSER:(305)782 9 FOC 2014 BUILDING Master Permit -62— PERMIT 2-PERMIT APPLIt ` "ION Sub Permit +I)eMQ l5-ZO QBUILDINCs i12fKECtRIC 0 ROOFING REVISION Q EXTENSION EIRENEWAL PLUMBIN I I OPUBLIC c RKS E]CHAKEOF OCANCELLATION p SHOP CONTRACTOR DRAWINGS Noy ADDRESS, %rib JiL., !fes ZJW Designated-tree N Occupancy Type: Load. Construction"Type: Flood Zone., 8FE. FEE. OWNER:Name(fee Simple Titleholder): done#: Address: City: State: Zips Te t e. Phone#; Emailt P y V ` COM"RACTO `.men an Nara : Address ' ' City: ?" State: CtualifSer Marne; 2,& rA ^jPhone#: Stag Certification or Reaixtratian#. FF � Certifite of Competency# DESIGNEW Archltett/Engineery 1. Phone; Address; City: State: Zip: Value of Work for this "nit:$ g2 r' C;� squareAhwar Footage of Works Type of work: © Addition Q Alteration 0 New Repair/Replace of tion Description ref:.: � � �-' Spec*I:wr of cokw wu dre: Sufee S Pernnit Fee$ 10'69"0U CCI"S O/t Scanning Fee hdon fee$ DRPR$ Notary Tela $ TrainkWEducation Fee$ Double Fee S structural aeries$ Bond TOTAL I:EE N GINE Ine�risecZl24120Aa1 E onding Comparlys Name(if.applicable) dingCompany's Address city State Zip Mortgage LentWx N (if applicable} Mortgage LendeesAtIdress city state Application is hereby made to obtain a permit to do the work and installations as indicated, l 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,MLM.HEATERS,TANKS,AIR CGA t3ttit3NERS,ETC,.... OWNER'S AFFIDAVIT: t certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws r0tulating construction and zoniot. OWARNING 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.0 ,vatice to Apoko a candkion to the issuanceof a building permit with air estimated value exceeding$2&V,the applicant must promise in gleed fir a of the notice of commencement and construction lien low brochure will a delivered to the person whose propeny is su t, Aho,a cerli*d copy of the recorded notice of commencement must be pasted at the,fab site for the fkai rs seen!7)days after the building permit is issuedin the absence of such posted patice, the inspection wr7l not be a reins ion fee will be charged� Signature Sllllmsture-7�2_ � OWNER or AGENT CONTRACTOR The foregoing irrstr tmentwas owl before me this LE u nt wa3 nowledged before me this day a 2Q J 5 . Zt} by �� 11JO ;4 z who is personally known wd1 personet�p� � n to me or who has produced as me or who has produced as identification and who did take an oath. identMcati n and who did take an oath, NOTARY POSUC NOTARY SLIC Sign. ;�� Signa Print: C'� I' k Print {y Sear: Seal; Notary Pubic State of Florida oF' 24, Notaty PUNM State of Florida Michael Ruiz Jose L Saladin My commhabn EE 126297 ?��•ssses t s� 1i11��� M#ss #s+►+rr�wFMs•stsse*.atst' • �t~�Wla *�M+4*fit rRi+i:ae#r• APPROVED$Y _ �....,�. Plans Examiner II Zoning Structural Review Clerk iRevs �f�aal RICK SCOTT, GOVERNOR :., KEN LAwwN, ECtTAR�f� STATE OF FLOMDA DEPARTMENT OF BUSINESS AND PROFE WNAL e ELECTRICAL CONTRACTORS LICENSM 8OApa EC132 he ELECTRICAL CONTRACTOR OR ,141med below IS CERTIFIED finder the provisions of Chapter 489 FS. � XpirettQndate: AUG 31, 2016 KATAN, ROBERT 651 N W 100 TORR. MIAMI F:.380 4 . t ISSUED' 06W=14 DISPLAY AS REQUIRED BY LAW+ =Q# L14000MOIT45 i 2 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-242855 Permit Number: DEMO-8-15-2048 Scheduled Inspection Date: September 08, 2015 Permit Type: Demolition Inspector: Devaney, Michael Inspection Type: Final Owner: LITZENBERG, MARC AND ANNE Work Classification: Electric Job Address: 1420 NE 103 Street Miami Shores, FL Phone Number Parcel Number 1132050310030 Project: <NONE> Contractor: AAA-ON TIME ELECTRIC, INC. Phone: 305-308-7333 Building Department Comments Infractio Passed Comments COMPLETE DEMOLITION INSPECTOR COMMENTS False Inspector Comments Passed ' Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 04, 2015 For Inspections please call: (305)762-4949 Page 25 of 33