DEMO-16-1154 Miami Shores Village
10050 N.E.2nd Avenue NE w= 4'
Miami Shores,FL 33138-0000
Phone: (305)795-2204
F=
Expiratlon: 10/30/2016
Project Address Parcel Number Applicant
347 NE 98 Street 1132060135621
ARTHUR BAKER
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ARTHUR BAKER 347 NE 98 Street (917)345-4387
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
PINAR ELECTRIC CONRACTOR CORF 305-500-9669 Total Sq Feet: 800
Type of Demo:Electric Available Inspections:
Additional Info:INTERIOR DEMOLITION FOR FUTURE INT. Inspection Type:
Classification:Residential Final
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# DEMO-4-16-59584
DBPR Fee $2.00
DCA Fee $2.00 05/03/2016 Cash $58.60 $SO.QO
Education Surcharge $0.20 04/28/2016 Credit Card $50.00 $0.00
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 is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futherm I authorize the above-named contractor to do the work stated.
May 03,2016
Autho ed u :Owner / Applicant / Contractor / Agent Date
Building D artment Copy
May 03,2016 1
Miami Shores Villages<�
Building Department APR 28 i6
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 F
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 14
BUILDING Master Permit No. E)5&k0 16— 153
PERMIT APPLI ATION Sub Permit No. � O 16-- 4155`
BUILDING ELECTRIC (-1 ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL (PUBLIC WORKS F-1 CHANGE OF ❑ CANCELLATION EISHOP
�,/'%') 9 CONTRACTOR DRAWINGS
-3 / U
JOB ADDRESS: ET (-19
City: Miami Shores County Miami Dade Zio• 33'''6 8
Folio/Parcel#: 11-32-C)6 -013-567-1 is the Building Historically Designated:Yes NO
Occupancy Type:-�Load: Construction Type: L/—13
''-13 'Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):,a V-14 f- R 8'1<1512. Phone#:ql q -3'Y5 - q,�,9
Addre��ss// L4 'CCPO P_ ' qg 5 T
City: t'L(CX M 1 State: Zip: 33)3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: //)����G'}'Y(�L HO /04- Phone#: '19 2_� 091 Z--
Address:'-14116 OW /D-L 4042- /O 2-
City: IQ R..41 State: Zip: 33 r-4 Q'
Qualifier Name: IQ N 0 R 6 S 01-+'G+ Phone#:,3 0 Se-1 g q '4 q
State Certification or Registration#:F C 13 Q Q 5 4-11'2— Certificate of Competency M
DESIGNER:Architect/Engineer: Ce S C1 P- . 64�)O Phone#•,3 OS q LId 44 7 c+
Address_4Ab4. r- A-MPo '�al, j " G-'r City:62r 6g6State:z&_Zip: 32t1115
Value of Work for this Permit:$ 1 1®00.01, Square/Linear Footage of Work: 6z) O
Type of Work: ❑ Addition r_1Alteration ❑ New ElRepair/Replace Demolition
Description of Work: 1 n4, Y i o it 04 J 'fin jl r i L jo Fo✓ f-,j UV e in P
d2e� 17-x ) i ►�+-�.
Specify color of color thru tile:
Submittal Fee$ • Permit Fee$ IV01'Q Z> CCF$ 0 CO/CC$
Scanning Fee$ CZ)- Radon Fee$ '2 r t10 DBPR$ 2— Notary$S3 __
Technology Fee$ cam® Training/Education Fee$ Q ' 2-0 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 willnot be approved and reinspection fee will be charged.
Kle�_
Signature Signature
OWNER or AGENT CONTRA R
The foregoing instrument was acknowledged before me this The foregoing instrument was a nowledged before me this
day of 10WVAok .20 by 24 day of 0644M t. 20 1 (* ,by
4106-t0t, • ,who Is personally knowp to rte, IPFVfteE^c ,who is personally known to
me or who has produced ,+e{tlu,1� as me or who has produced M6 o/Z"fin as
identification and who did take an`� P� S�C �®i®,�� identification and who did take an oath`o.®`���R�. �oti
`� .r �QOM\SSION�i' i .�� • 0��26,2�O'�
NOTARY PUBLIC: a :�o X26,20 9 •, �_ NOTARY PUBLIC: :g kG 0 Fs••
Sign: y .� EE860600 a Sign: �Oy• Q
•
Print: �0 Print: !-4,P�G�
Seal: rrr��slf!!{{{�,����� �S�AB!!!1{{itll\
Seal:
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APPROVED BY rid.?-� �1�/fe Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
EC13005412
The ELECTRICAL CONTRACTORZt
Named below IS CERTIFIED `
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2016
ORTA,ANDRES WARD �•
PINAR ELECTRIC MDJPY1 ,
4910 NW 102 AVENUI
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DATE(MM/DD/YY)
CERTIFICATE OF LIABILITY INSURANCE I 12/28/15
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER Excellence Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3801 SW 107 Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Miami,FL 33165 ALTER THE COVERAGE AFFORDED BY THE POLICIES f @ELOW.
Phone (305)226-3900 Fax (305)226-3997 INSURERS AFFORDING COVERAGE NAIC#
INSURER A' Granada Insurance C 4
INSURED Pinar Electric,MD INC INSURER B: Norm�!r�dy lnf�uranqe_qomp�Lr��...... --I-3-8-70
4910 NW 102 Ave #102 INSURER C:
Doral,FL 33178- INSURER D:
INSURER
COVERAGES INSURER F:
THE POLICIES OF INSURANCE LISTED 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.
POLICY EXPIRATION
POLICY EFFECTIVE
INSR ADIM NUMBER DATE(MMA)DrfY) DATE(MMIDOrMfy
LTR I TYPE OF INSURANCE POLICY
GENERAL LIABILITY EACH OCCURRENCE 11000,000
W b-AYAO-E-TOWERT95---
j COMMERCIAL GENERAL LIABILITY 0185FL00001837-0 08/09/15 08/09116 PREMISES fEawqqqLq-,nqq) 100,000
EJEI CLAIMS MADE W,� OCCUR MED EXP(Any one person) ___5,000
A F- PERSONAL&ADV INJURY 1,000,000
GENERAL AGGREGATE 2,000,000
PRODUCTS-COMP/OP AGG 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY D PROJECT El Loc 1$500 Ded Prop.Damage
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO Eaaccident)_
ALL OWNED AUTOS BODILY INJURY
B SCHEDULED AUTOS Per person)
HIRED AUTOS BODILY INJURY
NON OWNED AUTOS (Per accident)
_7
PROPERTY DAMAGE
(Per accident
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT
ANY AUTO OTHER THAN EAACC
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE
OCCUR CI CLAIMS MADE AGGREGATE—_.—__...
DEDUCTIBLE
RETENTION $
WORKERS- &CWOENSA�611WAi-D WCSTATU-
11/15/16 j 91H
EMPLOYERS'LIABILITY NHFL0044242015 11/15/15 1013njmms��iL-------------------
B !ANY PROPRIETOR/PARTNER I EXECUTIVE E.L.EACH ACCIDENT 1,000,010011
.I
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 1,000,0001
If yes,describe under E.L.DISEASE-POLICY LIMIT 10-0, 00001
SF�(�IALPR
OTHER
DESCRIPTK3N OF OPERATIONS J LOCATIONS!VEHICLES I—EXC-LU-SIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
License#EC 13005412
1
CERTIFICATE HOLDER CANCELLATION____
-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Miami Shores Village 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY i
10050 NE 2nd.Avenue OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
Miami Shores,Florida 33138-0000 —AZTHORaD REPRESENTATIVE
Fax 305-756-8972
CORPORATION 1988
ACORD 25(2001/08)OF