EL-15-212 Perftt Na EG 45-212
Miami Shores VillageP�r�7"�-El rtoa 'ReSldentt al
10050 N.E.2nd Avenue NE � wh*� "'taswCe don N@W
"n.m Miami Shores,FL 33138-0000 Pe rrl t",
ktJS:APPROVED
ywe a Phone: (305)795-2204
F`RtDA Expiration: 10/03/2015
F. Is$u�nate:41612015 p�
Project Address Parcel Number Applicant
680 NE 97 Street 1132060171610
Miami Shores, FL Block: Lot: ROSALINE FRAME
Owner Information Address Phone Cell
[ ROSALINE FRAME 680 NE 97 ST
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone $ 3,000.00 3
Valuation: i;
INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384 Total Sq Feet: 500 ',
i;
Type of Work:NEW PANEL AND LAYOUT AT CONVERTED G Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Final
Scanning:1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Underground
W.W.
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# EL-1-15-54317
DBPR Fee $3.38 04/06/2015 Check#:295478 $239.56 $0.00
DCA Fee $3.38
Education Surcharge $0.60
Permit Fee-Additions/Alterations $225.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $239.56
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 AF AV . I certi that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction zo ng. uthermore,I authorize the above-named contractor to do the work stated.
April 06, 2015
Aut orized i ature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 06, 2015 1
E:3-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-227407 Permit Number: EL-1-15-212
Inspection Date: January 26, 2016 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: FRAME, ROSALINE Work Classification: New
Job Address:680 NE 97 Street
Miami Shores, FL Phone Number (305)302-1784
Parcel Number 1132060171610
Project: <NONE>
Contractor: ALES GROUP ELECTRICAL CONTRACTORS Phone: (305)219-4806
Building Department Comments
NEW PANEL AND LAYOUT AT CONVERTED GARAGE. infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
January 26,2016 Page 1 of 1
Miami Shores Village AUG ' 0i I
Buildin,g 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 ��
FBC 20(
BUILDING Master Permit No �q _ ( �33
PERMIT APPLICATION Sub Permit No. r Q(::� - 9 ) _
❑BUILDING UdELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKSCFtaANGE OF ❑CANCELLATION ❑ SHOP
� NTRACTOR DRAWINGS
JOB ADDRESS: r �<'4 f-'e Q
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#: L 2. ' (-, " 8 l� - t 1 0 Is the Building Historically Designated:Yes NO a�
Occupancy Type: Load: Construction Type: Flood Zone:NQ BFE: FFE:
OWNER:Name(Fee Simple Titleholder): �\' d����1Phone#:
Address: 6,8 ® lV E l 7`4 S r /
City:AdJAf41 S /�1� —State: FL0rz-1P4 Zip: 3 /315
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 14 LE5 6220L/P ELe'c, G®/.rT Phone#: 796 60 76,
Address: 8 Y& S W 70 A16
City: / -/fAA/ / State:, FL®�/oft
Qualifier Name: /22/e-/®A/ L®j� �7E Phone#:786—-92—
State
9Z
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State Zip:
Value of Work for this Permit:$ ac?rr Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ®New ❑ /Re lace
Re air
p p ❑ Demolition
Description of Work: r1oAl � AIE W
Specify color of color thru tile: 6 C) .
Submittal Fee$ Permit Fee$ ��° c�lmc&F ���� 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)
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 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 t
OWN orAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of -PAJGQ O� =,20 �by day of TU11 20 1%." by
,�� VRwho�gispersona�lly`known to 0e% LOI(1-ft44— who is personally known to
me or who has produced t yV — VA I"a?�— me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
1;PY PyB,
Seal: sq�°r �^ Notary Public State of Florida Seal: ?eq ADRIANA GIHARDI
Sindia Alvarez MY COMMISSION ti EE 867174
c` My Commission FF 156750 7'•.... EXPIRES:January 22,2017
ov p�P Expires 09103/2016 p,F; Bonded Thru Notary Public Underwriters
APPROVED B Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
` Miami Shores Village
BuildingDepartment �c� �
p JAN 2 9 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
�
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 10
BUILDING Master Permit No. R--i+ L4- I3bG
PERMIT APPLICATION Sub Permit NotI I`5- ?1112—
F-]BUILDING
2—
❑BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
LQ
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: 1S313's
Folio/Parcel#: I ' '3Z-QC* • O Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): R® tea@ Phone#: `30'x'`33''-9 O63
Address: 690 N'E R+ S I
q ' 3313
City: S\AD�eS State: Zip:
t
Tenant/Lessee Name: �_VpIN Phone#:
Email: � �e f OS akxv 1► ® f' WL
CONTRACTOR:Company Name: /' 7 .S Phone#:.�1�'T-,(a
Address: lJ t'L e
City:-a2-zA State: ,a Zip:
Qualifier Name: C9 Phone#:
State Certification or Registration Certificat f Competency#:
DESIGNE rchitec Engineer: M Dow- l- CA,MPr ` Phone#:
Address: `''/q- `1 '1 9r , ; Ity: N fAcv%1 KA-^L S State: ` Zip:
Value of Work for this Permit:$ 9-S-00.LF0 Square/Linear Footage of Work: 5d® S )-
Type of Work: ❑ Addition TSi"Alterration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: M6'— w'T- Aef- 4-OW AAII,cv 6t A'?A4'9
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ J45 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)
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 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
O R or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z—day of 20 J . by A1 day of Ala qq ,20 by
/2Qc��l`/i ��G�{?l z<' ,who-ids personally known to ,who is personally known to
me or who has produced z- 6 G�`]7 yA7�as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Notary Public State
oanna M Feliciano Pii
Seal: My Commission FF 082753 Seal: /11/-7 /�; Notary Public-State of Florida
'�ovwo ExPrras 01/12/2018 `= Commission#FF 39767
M Comm.Exp.November 17 2017
' e oF'p��p`• Y P
Bonded Thru National Assocation-Florida
Gist,
APPROVED BY f/r 9 Jb,t� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
�� ► ® r DATE IMM/DD/YYYY)
A R� CERTIFICATE OF LIABILITY INSURANCE 1 01-21-2015
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 CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERiS),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONALINSURED,the policy(les)must be endorsed. If SUBROGATIONIS WAIVED,subject to
the terms and conditions of the policy,certain poWes may require an endorsement. A statementon this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER NAME: AX
PAYCHEX INSURANCE AGENCY INC PHONE.
210705 P: () - F: (888)443-6112 IA/c No Ext: '(A/C,No): (888)443-61I
P 0 BOX 33015 ADDRESS:
SAN ANTONIO TX 78265 CUSTOMS ID#:
INSURERS)AFFORDING COVERAGE NAIC P
INSURED INSURER A: Twin City Fire Ins Co
INDUSTRIAL ELECTRICAL SYSTEMS CORP INSURER B
10257 N.W. 9TH STREET CIR. APT. 205 INSURERC:
MIAMI FL 33172 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE SR WVD POLICY NUMBER IMM/DDIYYYY) I (MMIDDIYYYY) LIM=
GENERAL UABILRY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $
CLAIMS-MADE U OCCUR I MED EXP(Any one person) 8
PERSONAL&ADV INJURY $
(GENERAL AGGREGATE IS
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 118
POLICYL_J PRO LOC Is
C _JAUTOMOBILE LUUHUTY COMBINED SINGLE LIMIT $
(Ea a=derd)
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED AUTOS BODILY INJURY(Per accident) 8
SCHEDULED AUTOS PROPERTY DAMAGE
HIRED AUTOS (Per aeeldant) 8
NON-OWNED AUTOS 8
8
UMBRELLA UAB U OCCUR EACH OCCURRENCE $
EXCESS LUUi CUUMS-MADE AGGREGATE 8
DEDUCTIBLE $
RETENTION 9
=,: 8
WORKERS COMPENSATION WC S7ATU OTH-
AND EMPLOYERS,LIABILnY X TO Y LIMI S I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE�Y N El.EACH ACCIDENT $ 11000, 000
A OFFICERIMEMBER EXCLUDED) u N/^- 76 WEG F06188 01/24/15 01/2 4/16
(Mandatary in NMI E.L.DISEASE'-EA EMPLOY 9 1, 0 0 , 0 0 0
if UrKler
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 0 1, 000, 000
DESCWMN OF OPERATIONS I LOCATIONS I VALES(Attach ACOW 101.A"dorml Remake Sclaile.H mme spars Is rs**64
Those usual to the Insured' s Operations:
EC 13002182 As Qualifier Nestor I . Corvea
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Village of Miami Shores BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE
10050 NE 2 ndAV e DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores, FL. 33138 AUTIM ENTATIVE
Fax: 305 756-8972 0-T'
®1988-2009 ACORD CORPORATION. Ali rights reserved.
ACORD 25(2009/09) The ACORD name and..logo are registered marks of ACORD