EL-15-2482 Inspection Worksheet ® �
Miami Shores Village
4
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-248859 Permit Number: EL-9-15-2482
Scheduled Inspection Date: December 07,2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: , Work Classification: Alteration
Job Address:40 NW 111 Street
Miami Shores, FL 33168-4322 Phone Number (786)251-2263
Parcel Number 1121360030360
Project: <NONE>
Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP Phone: 3061228-1384
Building Department Comments
REMODELING, KITCHEN, 2 BATHROOMS Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed EP 2
Failed
� s
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 04,2015 For Inspections please call: (305)762-4949 Page 24 of 28
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Miami Shores Village �177f� Eie4Tl# ( r�ian�li
10050 N.E.2nd Avenue NW
Miami Shores,FL 3313&0000
SO PROVED-
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F x�` Phone: (305)795-2204
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issuebads. Expiration: 04/03/2016
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Project Address Parcel Number Applicant
40 NW 111 Street 1121360030360
Miami Shores, FL 33168-4322 Block: Lot: 4040 GROUP CORP
Owner Information Address Phone Cell
4040 GROUP CORP 40 NW 111 Street (786)251-2263
MIAMI SHORES FL 33168-
9660 SW 72 Street
MIAMI FL 33173-
Contractor(s) Phone Cell Phone Valuation: $ 750.00
INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384
Total Sq Feet: 0
Type of Work:REMODELING,KITCHEN,2 BATHROOMS Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Review Electrical
Scanning:3
Fees Due L$242.36
nt Pay Date Pay Type Amt Paid Amt Due
CCF 0.60 Invoice# EL-9-15-57252
DBPR Fee3.3 110/06/2015 Check#:1014 $ 192.36 $50.00
DCA Fee 3.36
Education Surcharge0.20 09/30/2015 Check#:1011 $50.00 $0.00
Permit Fee-Additions/Alteratio5.00
Scanning Fee9.00
Technology Fee0.60
Total:
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,state s or specifications submitted to the prop r authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by eith r yself, my agent, servants, or employes.I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,D O S,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing informa'on curate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-na ntractor to do the work stated.
October 06, 2015
Authorized Signature:Owner / Applicant / ontr ctor / Agent Date
Building Department Copy
October 06,2015 1
SEPS
Miami Shores Village
Building Department
100S0 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-3972 -
INSPECTION LINE PHONE NUMBER.(305)762-49=
rw.: ;pot
BUILDING Master Permit No.gx�-,-;ve
PERMIT APPLICATION sub Permit No.
FIB ILDING '(ELECTRICEj ROOFING F-] REVISION L] EXTENSION F-]RENEWAL
PLUMBING M MECHANICAL PUBLIC WORKS F-] CHANGE OF CANCELLATION F-] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: S1,
City: Miami Shores County: Miami Dade Zip: 35 1�D E)
Folio/Parcel#: I I- 2 1 - S�O- 0 0-6 -- 02)40 Is the Building Historically Designated:Yes_NO X
Occupancy Type:SF P- Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 4V , q() &I —Phone#:I g(f,
Address: 9�00 EVNI k�t
City:—M i 0 ry)I State: L Zip:
Tenant/Lessee Name: NIA Phone#:
Email:.
V
CONTRACTOR:Company Name:
U
Phone#:
2.5
Address: -7
City: t -State: F& Zip: 5Qualifier Name: k1C.9 7bk COWe,17, Phone#: ,305
State Certification or Registration#: 'EG /0 t)0 2- -Certificate of Competency#:
DESIG NER:Architect/Engineer: do S-e-, A . lb, It d c) -Phone#: 8p'5-uxV5-H655
Address;_4L1LJL+ ,SV4 -1 ( Ave-, Sy&C, tC)3 —City: Micimi —State:.Pt- zip:
Value of Work for this Permit:$ 76D P�L? Square/Linear Footage of Work:
Type of Work: El 'Addition El All
New 21 Repair/Repla4e 14 Demolition
Description of Work: bib� oq , Wilc� tn. 2 oath s ,
K U
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ 'Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
�-L v
' 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 installatidn 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.
Signat a Signature
WNER or AGE CONTRACTOR
The foregoing instrume t as acknowl dged before me this The foregoing instruments wasacknowledgedbefore me this
dayf _ 20 by day of G 20 by
41
who Ipprso,lly known to � .who is personally known to
me or who has produced �d CG as me or who has produced as
i'
identification and who id take an oath. identification and who did take n oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: - �`�� Sign: (p 7�
Print: Print: ��41C/ ;i. J® �J° I Q MORALES
a°•••"•.'� •�: 0 ery C- e of Florida
FERWOEE
Seal: * * MY COMMISSION#FF 063324 Seal:
EXPIRES:October 15,2017 Commission#FF 39787
°P\O� BondedThruBudgetNotaryServices p�oFR`oP� My Comm.Exp.November 17,2017
OFF,,
Bonded Thru National Assocatlon•Florida
APPROVED BY �/� l �r16 plans Examiner Zoning
r
Structural Review Clerk
(Revised02/24/2014)
` MIAMFQAD
MIAMI-DADE COUNTY -STATE OF FLORIDA N/A October 06,2015
om LOCAL BUSINESS TAX RENEWAL
• 6115851 2015 -2016 APPLICATION RECEIPT:6378780
STATE#EC13002182
DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:10/01/2007
INDUSTRIAL ELECTRICAL SYSTEM CORP SEC TYPE OF BUSINESS
BUSINESS LOCATION: ELEC ELECTRICAL CONTRACTOR
10257 NW 9 ST CIR 205 1
MIAMI,FL 33172
OWNER/CORR APPLICATION DETAILS
INDUSTRIAL ELECTRICAL SYSTEM CORP FEE AMOUNT
PHONE# 305-228-1384 Receipt Fee 30.00
UMSA Fee 30.00
10257 NW 9 ST CIR 205 Beacon Council Fee 15.00
MIAMI,FL 33172 Bingo Permit Fee 0.00
Nightclub Permit Fee 0.00
Multi-Municipal Contractor Fee 0.00
Restricted Contractor Fee 0.00
Library Fee 0.00
NAICS CODE: 23821 Transfer Fee 0.00
Doing Business without a License Penalty 0.00
Late Penalty 0.00
Collection Cost 0.00
NSF Fee 0.00
Prior Years Due 0.00
Amount Recently Paid
TOTAL AMOUNT DUE: 0.00
.................................................................................................................................................................................................................................................................................................................
If no longer in business,please notify us in writing. To pay online go to www.miamidade.gov/taxcollector
Review and correct the information shown on this application. To pay by mail, make check payable to:
Miami-Dade County Tax Collector
A 25%penalty will be assessed to anyone found operating Business Tax
without a paid local business tax, in addition to any other 200 NW 2nd Avenue
penalty provided by law or ordinance(Sec 8A-176(2)). Miami FL 33128
To pay in person go to:
A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue
Receipt may also be required. (305)270-4949,fax(305)372-6368
A service fee of not less than$25.00 up to a minimum of 5%
will be charged for all returned checks.
+ RETAIN FOR YOUR RECORDS +
.................................................................................................................................................................................................................................................................................................................
MIAMI-DADE COUNTY- + DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 06,2015
STATE OF FLORIDA
LOCAL BUSINESS TAX RENEWAL
201812016 APPLICATION I VIII IIIIIIIIIIDIIIIII�DIII III I I IIII�II I 8 ATIE#EC130 2182
6115851 5
BUSINESS LOCATION: lu'
10257 NW 9 ST CIR 205
MIAMI,FL 33172 BUS.COMMENCEMENT DATE:10/01/2007
SEC TYPE OF BUSINESS
OWNER/CORR ELEC ELECTRICAL CONTRACTOR
INDUSTRIAL ELECTRICAL SYSTEM CORP 1
APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION
OR OCCUPATION DESCRIBED HEREON.I HAVE BEEN INFORMED F ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT.
I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT.
INDUSTRIAL ELECTRICAL SYSTEM CORP
NESTOR I CORVEA PRES
10257 NW 9 ST CIR 205 SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE
MIAMI,FL 33172 Please pay only one amount.The amounts due after Sept 30th include penalties
per FS 205.053.
If Received By Oct 31,2015 Nov 30,2015 Dec 31,2015 Jan 31,2016
Please Pay $0.00 $0.00 $0.00 $0.00
7000000000000000000000006378780201600000007500000000000007