EL-14-2641 ?c ILI -2h Yb
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)796-2204 Fax: (305)756-8972
Inspection Number: INSP-224482 Permit Number: EL-12-14-2641
Scheduled Inspection Date:January 1 2016
s� ry �, Permit Type: Electrical- Residential
Inspector Devaney, Michael
Inspection Type: Final
�I
Owner Work Classification: Addition/Alteration
j Job Address:102 NW 108 Street
Miami Shores, FL 33168-4313 Phone Number
I
Parcel Number 1121360100010
Project: <NONE>
Contractor. INDUSTRIAL ELECTRICAL SYSTEM CORP Phone:306f228-1384
Building Department Comments
NEW BATHROOM, NEW CLOSET AND NEW MASTER Infractio Passed Comments
BEDROOM. INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
For Inspections please call: (305)762-4949
� January 11,2016 Page 1 of 34
kms Miami Shores Village
4 10050 N.E.2nd Avenue NW
■• Miami Shores,FL 33138-0000 � �
*' Phone: (305)795-2204 , , r ff£ 3
r .,r
F Expiration: 03/1212016
Project Address Parcel Number Applicant
102 NW 108 Street 1121360100010
DOUBLE TT LLC
Miami Shores, FL 33168-4313 Block: Lot:
Owner information Address Phone Cell
DOUBLE TT LLC P.O.BOX 90393
KEY BISCAYNE FL 33149-
P.O.BOX 90393
KEY BISCAYNE FL 33149-
Contractor(s) Phone Cell Phone Valuation: $ 3,000.00
INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384 VF Total Sq Feet: 0
Type of Work:NEW BATHROOM,NEW CLOSET AND NEW MA 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-12-14-53771
DBPR Fee $2.25 09/14/2015 Credit Card $112.30 $50.00
DCA Fee $2.25
Education Surcharge $0.60 12/04/2014 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $162.30
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,D ORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing info ati is rate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the abov na r ctor to do the work stated.
September 14, 2015
Authorized Signature:Owner / Applicant Co or Agent Date
Building Department Copy
September 14,2015 1
Miami Shores Village
DEC 4 2014
Building 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 tk3 t�
BUILDING Master Permit No. W L O
PERMIT APPLICATION I' sub Permit No.
'E�_--114- 2.(( 1
F-1 BUILDING ;K ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING ❑ MECHANICAL r-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10 Z ),\U.) or z-r
City: Miami Shores County: Miami Dade Zip: e33 l69
Folio/Parcel#: // 2-/36 Dl 0 �%/O Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Z`` V�� 7i 2Z d Phone#:
Address: /JoA-
X� 2,
City: /"/ /a� � State: � ✓
Zip: 32
Tenant/Lessee Name: Phone#:
\ Email:
CONTRACTOR:Company Name: �� Phone#:
Address:
City: /�l�m L State: Zip:
-1-9f 72
Qualifier Name: k_� e z• �,rye�c Phone#: -12✓
State Certification or Registration#: l.. r ®�� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ®0D®W Square/Linear Footage of Work:
Type of Work: W Addition ❑ Alteration ❑ New ❑ Repair/Replace J ❑ Demolition
Description of Work: )41CA AC 0/)
Specify color of color tthru tile:
Submittal Fee$�fcV uU Permit Fee$/ !�d14p CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Tiaining/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Rev1sed02/24/2014)
r
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
n r r Signature
4
Sigatu e g
OW r A CONTRACTOR
The foregoing instrument was acknowledged before me this The 2 foregoing instrument was acknowledged before me this
of kOeA/e6� 4' 20 l7� b
day of .�.er� 0�.J b /?y da y y
B-,j-2J1 z ,who is personally known to 7v&A ID4 ' CMtIEA who is personally known to
me or who has produced as _Me or who has produced as
identification and who did take an oath. identification and who did take an, .,, FRANCISCO P. MORALES
NOTARY PUBLIC• NOTARY PUBLIC: Notary Public-State of Florida
�: `" Commission#FF 39767
My Comm.Exp.November 17,2017
9onded Thru National Assocatlon-Florida
Sign: Sign* �4 �/
Print: a Print. ��AAA'I t ZD ' �%DAe,4 L&S
AUKIANA KAMBE Seal:
Sea
MY• '"c MY COMMISSION#EE136658
EXPIRES October 09,2015
(407j 3598-D153 Fbrldallotary$eiv�e.com
APPROVED BY R4P-6-?G Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
41940 STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395
�
NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
,I
CORVEA, NESTOR I j
INDUSTRIAL ELECTRICAL SYSTEMS CORP
10257 NW 9TH ST CIR #205
MIAMI FL 33172
Congratulations! With this license you become one of the nearly
one mil#ian Fhxidians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses rangeSTATE OF FLORIDA
from architects to yacht brokers,from boxers to baiteque restaurants, DEPARTMENT OF BUSINESS AND
and they keep Florida's economy strong. "��:. PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order to EC13002182 ISSUED: 08/10/2014
serve you better. For information about our services,please log onto
wnww myftoridalicense.com. There you can find more information CERTIFIED ELECTRICAL CONTRACTOR
about our divisions and thegulatiots that impact you,subscribe CORVEA,NESTOR I
to department newsletters and more about the Department's INDUSTRIAL ELECTRICAL SYSTEMS CORP
initiatives.
Our mission at the Department is:License Efficiently,Regulate Fairly.
We constantly strive to sere you better so that you can serve your
customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS.
and congratulations on your new license! E>wketio,date:AUG 31.2DIS L1408100003048
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
EC13=182
The ELECTRICAL CONTRACTOR
Named below IS CERTIFIED �`�� ,
vM
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2016
y,e
CORVEA, NESTOR I •
INDUSTRIAL ELECTRICAL:S''YSTEMS CORP
10257 NW 9TH ST CIRR'2'tl5
MIAMI FL 33172
ISSUED: 0811012014 DISPLAY AS REQUIRED BY LAW SEQ 0 L1408100003048
Local Business Tux Receipt
Miami—Dade County, State of Florida-, m
THIS IS NC)TABILL DO NOT PAY
6115851 \ LBT
all "MmMA"ON RRC 110rNO. EXPIRES
INIXMIAL ELECTRICAL.SYSTEM CORP AgNOWAi. SEPTEMBER 30, 2015
10257 NW 9 ST CIR 205 8378780 Must be displayed at plow of business
MIAMI EL 33172 pursuant to County Code
Chapter 8A-Art.9&10
O INEIRINDUSTRIAL
GEC.TYPO 96 ELECTRICAL CONTRACTOR PAVMENT REC MVMD
BUSNESS
INDUSTaIAI.ELECTRICAL SYSTEM CORP BY TAX COLLECTOR
Worker(s) 1 EC13002182 $75,00 07/30/2014
CHECK21---14-039228
This Late!Business Tarr Recelit ooty aoaHrois payment o!tim Local Susbas Tar.The Receipt Is no a If
pera�t,,er a aerd6e�&q tlm lder's lificatlow,to do bmiaeae.Mahar mmt loagtly Wo any govarsatal
or ata►ragalatory laws sad req�reomaN.biab apply to the�eipess
TW RECEIPT N&Om mum be displayed an all GW=WW eabiabs-Mbu 4bft Cade Sec 8a-276.
For mom bdunuation,*it mmmiamidade.avitax
�!00M. CERTIFICATE OF UABILIW INSURANCELCL 1112012014
PRODUCat Serial#82835 THIS CERTIFICATE M ISSUED AS A MATTER TER OP RIFORMATION
OVERSEAS INSURANCE AGENCY ONLY AND COIF NO ROM UPON THE CERTWICATE
HOLDIR THIS OffEND OR
P.0.13OX 162938 TM COVERAGE AFFORDED BY DOES �POLICES BELOW
Mme,FLORIDA 33116
INSURERS AFFORD COVERAGE
INDUSTRIAL ELECTRICAL SYSTEMS CORP aaram- GRANADA INSURANCE CO
10257 KW.9 ST CIRCLE#205 RIsLRERS
MIA IK FLORIDA 33172 Lac
MUM&.
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSLREp NAMED ABOVE FOR THE POLICY PERIOD SATED.NOIVVMWANDING
ANY RSWREMENT.TERM OR t0010lTiON 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,EXCLUSKM AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA8iA3.
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CERTIFICATE HOUR 1 X AmnxmL LAStt CANCELLATION
SHOUWAM(WTMAOMCRBCIUMPOUCMWCANCOUM THE4XMATLON
VILLAGE OF MIAMI SHORES DATE Tom;TLS IS LALL �TO w' 10 DAYS vmrm
10050 NE 2ND AVE MUM TO TW�T�ATH SAT
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MIAMI SHORES, FL. 33138 arm w MUM=OR OF MY mm Upm 7m .rrs A OR
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FAX: 305 756-8972 a� ATRfE
ACORD 254(7M 0 ACORD CORPORATION 1888
A� 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 CERTIFICATEOF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IYSURERM).AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holler Is an ADDITIONALIYSURED,the pok*Res)must 1e endorsed. If SUBROGATIONIS WAIVED,wA*ct to
the terms and conditlons of the policy,certain pow may require an endorsenvent. A summvent on this cerdlicate does not confw d0m to the
certificate bolder in Nou of swdl endorsement(s).
PRODUC rt
PAYCHEX INSURANCE AGENCY INC PHON, FAX
210705 P: 0 - F: (888)443-6112 (AIC,NW: (888)443-617
P O BOX 33015 aDDIrM
PRODUCIPI
SAN ANTONIO TX 78265 D*
1NSUIIEFRSI AFFORDING COVERAGE NAIC d
MUIRED INSUR M A: Twin City Fire Ins Co
INDUSTRIAL ELECTRICAL SYSTEMS CORP MUM RI
10257 N.W. 9TH STREET CIR. APT. 205 INSURER o`
MIAMI FL 33172 INSURER D
INSURER E
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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.
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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 ATI
Fax: 305 756-8972 74-dzo�✓
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