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EL-19-2078Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1paf2uaE Issue Date:11/21/2019 Parcel Number 64 NW 111TH ST, Miami Shores, FL 33168 1121360030380 Contacts Permit No.: EL-09-19-2078 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Expiration: 05/19/2020 Barry University Inc. Owner 11300 NE 2 AVE LAVOIE BLDG 2ND FL RM 204, MIAMI SHORES, FL 331E HIGHLINE ELECTRIC Contractor RAUL HERNANDEZ 205 BRISTOL CT, TAVENIER, FL 33070 Mobile: 30SS253797 Description: INSTALL 1 NEW 1 TON MINI SPLIT LVaLluation: $ 1,300.00 Inspection Requests: 305-762-4949 Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.10 Building Department Copy Payments Date Paid Amt Paid Total Fees $111.10 Check # 37597 11/21/2019 $111.10 Amount Due: $0.00 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 accur and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above name ntra for to do the work stated. Authorized Signature: Owner / Applicant / Contractor �� 2I Date November 21, 2019 Page 2 of 2 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 BUILDING PERMIT APPLICATION ❑BUILDING rM-1 ELECTRIC ❑ ROOFING RECEIVED SEP 0 6 1019 LAh FBC 201--�y Master Permit No. Sub Permit No.E L' j ! (go -7t3 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 64 NW 4Fr STREET City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -2136-003-0380 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): BARRY UNIVERSITY Phone#: 305-318-6886 Address:11300 NE 2ND AVENUE City: MIAMI SHORES State: FL Zip: 33161 Tenant/Lessee Name: Email Phone#: CONTRACTOR: Company Name: Highline Electric Phone#: 786-269-1100 Address: 205 Bristol Ct City. Tavenier State: FL Zip: 33070 Qualifier Name: Raul D. Hernandez Phone#: 305-525-3797 State Certification or Registration #: EC13004606 Certificate of Competency #: DESIGNER: Architect/Engineer: Address: e#: City: State: Zip: Value of Work for this Permit: $ 1,300 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration FER New ❑ Repair/Replace ❑ Demolition Description of Work: PROVIDE NEW POWER SUPPLY TO MINI SPLIT BEING INSTALLED. Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 approyed and a reinspection fee will be charged. ER or AGENT Th foregoing i s p6nneent was acknowledged before me this day of �-�1' 20 �"1 . by IW N("% who is personally known to Mr,pr who has produced as Sign The foregoing instrument was acknowledged before me this 22th day of July , 20 19 by Raul D. Hernandez who is personally known to me or who has produced identification and who did take an oath. Oro.. y►�! AMINE T�'�ii�� identification and who did take an oath. � ••., jOSS104; •• /,�'�IOTARY PUBLIC: NO RY PUBLIC: •Ud 17 -po /FF954799 OQ gn: 9�. F ge Vaz ez Pri I �i •'•: m ^`:�' 6 ' Pr' Seal: /111/ h4.C..11.1.1.1.0'\\W\` Seal: � [y APPROVED BY 1046", Plans Examiner ;ip•�'"•w4: JORGE VAZQUEZ My COMMISSION # GG001355 =; "•%{oi^.� EXPIRES June 13, 2020 as Zoning Structural Review (Revised02/24/2014) Clerk 2018 / 2019 MONROE COUNTY BUSINESS TA 20R9CEIPT EXPIRES SEPTEMBER 30, RECEIPT# 30140-123560 Business Name: HIGHLINE ELECTRIC COMPANY CTY JORGE VAZQUEZ Business Location: K� LARGO, FL 33037 Owner Name: Mailing Address: Business Phone: 786-269-110000NTRACTOR (ELECTRICAL ) 205 gRISTOL CT Business Type: TAVERNIER,FL 33070 Employees 4 STATE LICENSE: EC13004606 Penalty Prior Years Collection Cost Total Paid Tax Amount Transfer Fee Sub -Total 0.00 0.00 20.00 0.00 20.00 20.00 0.00 Paid 402-17-00000318 08/09/2018 20.00 A TAX. LY THIS BECOMES A TAX RECEIPT PO Box 1129, Key West CFL 33041, Tax'eCtor YOU MUSTTHIS ISNME T ALL WHEN VALIDATED COUNTY AND/OR MUNICIPALITY PLANNING AND ZONING REQUIREMENTS. MONROE COUNTY BUSINESS TAX RECEIPT P.O. Box 1129, Key West, FL 33041-1129 EXPIRES SEPTEMBER 30, 2019 Business Name: HIGHLINE ELECTRIC COMPANY RECEIPT# 30140-123560MO CTY Business Location: KEY LARGO, FL 33037 Owner Name: JORGE VAZQUEZ Mailing Address: Business Phone: 786-269-1100 205 BRISTOL CT Business Type: CONTRACTOR (ELECTRICAL) TAVERNIER,FL 33070 Employees 4 STATE LICENSE:EC130046n6 Tax Amount Transfer Fee Sub -Total Penalty Prior Years Collection Cost Total Pdid 20.001 0.001 20.001 0,00 0.00 0.00 20,00 Paid 402-17-00000318 08/09/2018 20.00 I ° + f • - ,sue # '� it C g � n � ter`' �F_ �� . � M A ��' f �: �-'fi��'y _ poi • ! ° ° . Y�"`# �, �r �afilk rs2��",'Te ° *� ° ii) •1r OL A IFE lo '• ! •1.. �I,,: Will � , �.��,1,�:'.. !`. � `�► .r�� K`• � sad aq�lr� f :�.►w z •s M .� ❑ ❑ 'OL. HIGHLINE ELECTRIC CO. 205 BRISTOL CT. TAVERNIER FL 33070 Phone (786) 269-1100 Email: jlvhunter@gmail.com BILL TO: DEBONAIR MECHANICAL ATTN: LORN TUCKER ESTIMATE DATE: July 15, 2019 INVOICE # 2019-255 FOR: BARRY UNIVERSITY DESCRIPTION, HOURS RATE AMOUNT PROVIDE NEW POWER SUPPLY TO MINI SPLIT BEING INSTALLED. PROVIDE ELECTRICAL PERMIT, PERMIT TO BE RUN BY DEBONAIR. $ 1,300.00 SUBTOTAL A payment in the amount of 50% of the estimates cost of the job is due TAX RATE before comencment of the work with the balance due upon completion, SALES TAX in the event of nonpayment, customer shall be responsible for all cost OTHER of collection and attorneys fees. TOTAL $ 1,300.00 - $ 1,300.00 Estimate good for 30 days from date of this document. THANK YOU FOR YOUR BUSINESS! H IG H E-1 ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY)0712412019 THIS CERTIFICATE IS 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 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 954-565-1117 TCC Associates, Inc. PO Box 11975 Fort Lauderdale, FL 33339-1975 Thomas C Cundy, Jr. C ACT Thomas C Cundy, Jr. PHONE 954-565-1117 FAX 954-565-1131 (AIC, No, Ext): (A1C, No): U)DMSS: INSURERS AFFORDING COVERAGE NAIC tl INSURER A: Associated Industries Ins Co 23140 INSURED I 2205��istol Electric Company Tavernier, FL 33070 INSURERS: Mapfre Insurance Company 34932 INSURER C National Union Fire Ins Co 02351 INSURER D INSURER E INSURER F OVERAGES CERTIFICATE NUMBER' REVISION NUMBER: C 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. INSR TYPE OF INSURANCE ADOL SUB POLICY NUMBER POI ICY EFFDDIMY) PO(MMLICY EXYLTR LIMITS B X COMMERCIAL GENERAL LIABILITY CLAMS -MADE FX] OCCUR CP0324304 01/01/2019 01/0112020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO kENTED PREMISES (Ea $ 100,000 MED EXP (Any one erson 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY j9&- LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP A 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS W Ep AIR ONLY L AUTOS ONLY ED (Ea accciCBIdentSINGLELIMIT) $ BODILY INJURY Per personl $ BODILY INJURY Per accident $ PPe .CcRden[ AMAGE $ CUMBRELLA X LIAB EXCESS LIAB X - OCCUR CLAIMS -MADE EBU011922172 03I06/2019 01I0112020 EACH OCCURRENCE $ 4,000,nnn AGGREGATE $ 4'000'000 DED RETENTION$ Prod/Comp $ 4,000,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRILTOR/PARTNEREXECUTlVE Y❑ �FFICER/M�M@�R EXCLUDED? (Mandatory n ) fps , describe under DCRIPTION OF OPERATIONS below A NIA AWC1129800 05/27/2019 05/27/2020 X PERTUTE OTH- E L EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE 500,000 $ E.L. DISEASE -POLICY LIMIT 500,000 DESCRIPTION OFF OPERATIONS 1 LOCATIONS! VEHICLES ((AACOR�D-�1001Additional Remarks Schedule, maybe attached K more space is required) MIASH02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village Building Department AUTHORIZED REPR�ESENiTATIVE N.E. 2nd Avenue Miami Miami, FL 33138 ACORD 25 (2016/03) W IV00-[V IO M%.VIVJ VRr VR/1I1V1Y. nu 11911W ICJrI YCU. The ACORD name and logo are registered marks of ACORD HIGHLINE ELECTRIC CO. 205 BRISTOL CT. TAVERNIER FL 33070 Phone (786) 269-1100 Email: jlvhunter@gmail.com BILL TO: DEBONAIR MECHANICAL ATTN: LORN TUCKER ESTIMATE DATE: July 15, 2019 INVOICE # 2019-255 FOR: BARRY UNIVERSITY DESCRIPTION HOURS RATE AMOUNT PROVIDE NEW POWER SUPPLY TO MINI SPLIT BEING INSTALLED. PROVIDE ELECTRICAL PERMIT, PERMIT TO BE RUN BY DEBONAIR. $ 1,300.00 SUBTOTAL A payment in the amount of 50% of the estimates cost of the job is due TAX RATE before comencment of the work with the balance due upon completion, SALES TAX in the event of nonpayment, customer shall be responsible for all cost OTHER :)f collection and attorneys fees. TOTAL $ 1,300.00 - $ 1,300.00 Estimate good for 30 days from date of this document. THANK YOU FOR YOUR BUSINESSI