ELC-17-1846Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-286277
Permit Number: ELC-7-17-1846
Scheduled Inspection Date: January 17, 2018
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Garner Building
Miami Shores, FL 33138-0000
Project: BARRY UNIVERSITY
Contractor: MAJESTY ELECTRIC SERVICES CORP
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1121360000050-25
Phone: (786)402-9150
Building Department Comments
REPLACE DISCONNECTING IN THE ELEVATOR
MACHINE ROOM
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
786-402-9150
RAFAEL DIAZ
l � Jap-�lS
January 16, 2018
For Inspections please call: (305)762-4949
Page 6 of 41
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. E LC 7-17-1846
Permit Type: Electrical - Commercial
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 8/14/2017
Expiration: 02/10/2018
Parcel Number
Applicant
11300 NE 2 Avenue Number: Garner Buildin 1121360000050-25
Miami Shores, FL 33138-0000 Block: Lot:
BARRY UNIVERSITY INC
Owner Information
Address
11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
11300 NE 2 Avenue
MIAMI SHORES FL 33161-6628
Phone
Cell
Contractor(s) Phone
MAJESTY ELECTRIC SERVICES CORI (786)402-9150
Cell Phone
Valuation:
Total Sq Feet:
$ 2,000.00
0
Type of Work: REPLACE DISCONNECTING IN THE ELEVAT
Additional Info: REPLACE DISCONNECTING IN THE ELEVAT
Classification: Commercial
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.25
$0.40
$150.00
$3.00
$1.60
$160.70
Pay Date Pay Type Amt Paid Amt Due
Invoice # ELC-7-17-64622
08/14/2017 Check #: 1110 $ 110.70 $ 50.00
07/19/2017 Check* 1102 $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W. W.
Underground
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 zo, ing. Futhermore, I authorize the above-named contractor to do the work stated.
August 14, 2017
Autho ''gnaturo:Owner / Applicant / Contractor / Agent
Buildin • "' epartment Copy
Date
August 14, 2017
1
BUILDING
PERMIT APPLICATION
El BUILDING ELECTRIC
❑PLUMBING ❑ MECHANICAL
JOB ADDRESS: 1 CX.)
City:
Miami Shores Village
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
Master Permit No.
ItitzdtElisif19
Ji 1i941NP
(7 cilzo
FBC 20
fAe ►q-i3C4co
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION
❑ PUBLIC WORKS D CHANGE OF ❑ CANCELLATION
CONTRACTOR
1
ED RENEWAL
❑ SHOP
DRAWINGS
Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: %l 2_/ 34 ad Q OU S0' Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type:
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Dkf" r `'( (J I Vt j2- S T7'l Phone#:
Address: 113 C O '4 2 A v EN U C
City: m 1/ M 1 S i�i� �2,F5 State: i L
Tenant/Lessee Name: Phone#:
Email:
zip: 331 6 I
CONTRACTOR: Company Name: 1-4 4 0 sr J -Z.-(- rii re Ce., 40ipPhone#: 7K6- ({O2- 7/ O
Address: //e-4-0 /7!442/9`7,ZS4dOei./ /3 11 via/7 //v. /ZZ /j//%.4 i'
City:State: Zip: ` ,2c>/ ef-
Qualifier Name: //9/�c/ ,1 V l/� Phone#: 3 ex -'a2-17/ 2
State Certification or Registration #: Certificate of Competency #: O/C oe-, /
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for thls Permit: $ 2( el c' c, Square/Linear Footage of Work:
Type of Work: ❑ Ad ition ❑ Alteration ❑ New p Repair/Replace ❑ Demolition /
Description of Work: KP f//k---4VDisc c3 'C 7; C % 4,trA C' c ft- zi /4T /1 "inch
(Jo
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ / .4--e, 14 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ ((�
TOTAL FEE NOW DUE $ I 1 v ` 0
(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
OWNER or AGENT
The foregotrument was acknowledged
fore me this
7 day of , 20 17 , by
NibiN fi /LAy , who i
meter who has produced as
identification and who did take an oath.
NOTARY PU : IC:
Sign:
Print:
S
APPROVED BY
(Revised02/24/2014)
The foregoing instrumFnt was acknowledged before me this
day of CA) , 20 1 . by
aiFae ( 1,11 , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
1 Py Plans Examiner
1.,61
riILLrI.r.
Structural Review
•.•�'iir .n. . ELIZABETH BARILARI
� Notary Public - State of Florida
• Commission 4 GG 088970
My Comm. Expires May 14, 2021
Bonded through National Notary Assn.
Zoning
Clerk
1JCla11 ►,y ,�,�►.l,ly IN Li11e
Detail by Entity Name
Florida Not For Profit Corporation
BARRY UNIVERSITY, INC.
Filing Information
Document Number 711458
FEI/EIN Number 59-0624364
Date Filed 09/08/1966
State FL
Status ACTIVE
Last Event AMENDED AND RESTATED ARTICLES
Event Date Filed 03/27/2009
Event Effective Date NONE
Principal Address
11300 N.E. SECOND AVENUE
ROOM 105 FARRELL HALL
MIAMI, FL 33161
Changed: 02/08/2012
Mailing Address
11300 N.E. SECOND AVENUE
ROOM 105, FARRELL HALL
MIAMI, FL 33161
Changed: 01/31/2011
Registered Agent Name & Address
Dudgeon, David
11300 NE SECOND AVE
LaVoie Hall
#209
MIAMI, FL 33161
Name Changed: 03/31/2014
Address Changed: 03/31/2014
Officer/Director Detail
Name & Address
Title S
DUDGEON, DAVID
11300 NE SECOND AVE
MIAMI, FL 33161
Title T
Rosenthal, Susan
Page 1 of 3
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L.J LII uy i_;isu�y i�uurc
11300 N.E. SECOND AVENUE
MIAMI, FL 33161
Title D
Busse!, John
11300 NE SECOND AVE
MIAMI, FL 33161
Title PD
BEVILACQUA, SISTER LINDA
11300 NE SECOND AVE
MIAMI, FL 33161
Title VP
Murray, John
11300 N.E. SECOND AVENUE
MIAMI, FL 33161
Annual Reports
Report Year
2015
2016
2016
Filed Date
04/23/2015
04/29/2016
10/18/2016
Document Images
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01/23/2015 -::: ANN UAL REPORT
03/31/2014 ANNUAL RPORT
04/01/2013 -• ANNUAL REPORT
02/00/2012 -- ANNUAL REPORT
41/31/20-11 ._ ANNUAL_ ROPORT
01/29/2010 -- ANNUAL REPORT
0.3/27/2009. _ Amended widRestatpd__Ar cic s
03/19/2009 ANNUAL REPORT
05/23/2008
02/05/2007 -- ANNUAL. REPORT
02!10/2006 ANNUAL_ REPORT
0;5/02/2005: - ANNUAL REPORT
06/08/2004 c.1.,, ii ci.._Re stns AF Ides
02/28/2004 -•- ANNUAL REPORT
01/23/200 -ANNUAL REPORT
05/13/2002 ANNUAL RE= p01::f T
Q5/10/2001 ANNUAL. REPORT
05/09/2000 ANNUAL REPORT
05/11/1999 -- ANNUAL REPORT
05/19/1998 •- ANNUAL. REPORT
03/14/1997 ANNUAL REPORT
L
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
County of Miami -Dade
The foregoing was acknowledge before me this 0' day of AU GMT . , 20 17 .
who is personally known to me or has produced
By.7-bo kugaiiay
Notary:
SEAL:
eTi7, ,w w «w .
i otary Public State 01 Florida
. Jeffry J Yao
My Commission FF 188481
4q dr Expires 11/12/2018
as identification.
Majesty Electric
Service Corp.
Date: 8-10-2017
State of Florida
County of Dade
Before me this day personally appeared Rafael Guia who, being duly
sworn, deposes and says:
That he or she ill be the only person working on the project located at
11300 N.E. 2JAve, Miami, Fl 33161
Contractnature
Sworn to (or affirmed) and subscribed before me this /0 day of
/9i() sr- o/7 .
Personally Know
,01,,,,,,,,,,pr Produced Identification
.COSTO yi, ,e of Identification Produced
-.Kw ., . *
��'�`A�`it6lril
ype o
Qd$IPhone 786-402-9150 gRy,��O11870 Hialeah Gardens Blvd Unit 129-122
License No. CCO1E000164 Hialeah Gardens FI 33018