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ELC-19-1715Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 -P(YfUWE Issue Date: 09/06/2019 Location Address Parcel Number 602 NE 96TH ST, Miami Shores, FL 33138 1132060141410 Contacts Permit No.: ELC-07-19-1716 Permit Type: Electrical - Commercial Work Classification: Alteration Permit Status: Approved Expiration: 03/04/2020 MIAMI SHORES PRESBYTERIAN CHURCH Owner WAVE LINK CORP. OF PUERTO RICO Contractor CHURCH JOSEBARRETO 602 NE 96 ST, MIAMI, FL 331382742 87961 OLD HWY, ISLAMORADA, FL 33036 Other: 3057549541 Business: 5617776037 Description: SPRINT (M103XC065) ADDING ANTENNA Valuation: $ 13,000.00 Requests: Inspection 305-4949 EQUIPMENT TO EXISTING TELECOM FACILITY Total Sq Feet: 0.00 Fees Amount Payments Date Paid Amt Paid Total Fees Total: Amount Due: Building Department Copy 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 regu ti g,construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date September 06, 2019 Page 2 of 2 Miami Shores Village 1jUF6-ff1VWv 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 BUILDING Master Permit No. O-C'0� - ( °i PERMIT APPLICATION Sub Permit No.11—C`04 ❑BUILDING M ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 602 NE 96th ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-014-1410 Is the Building Historically Designated: Yes NO X Occupancy Type: 6800 Load: Construction Type: II-B Flood Zone: No BFE: NA FFE: NA OWNER: Name (Fee Simple Titleholder): Northeast Presbyterian Church phone#: 305-815-5014 Address: 602 NE 96 ST City: Miami State: FL Zip: 33138 Tenant/Lessee Name: Sprint Phone#: 941-320-6843 Email: cmiller@trunorthe.com CONTRACTOR: Company Name: Wave Link Corp. of Puerto Rico Phone#: 561-777-6037 Address: 87961 Old Highway City: Islamorada State: FL Zip: 33036 Qualifier Name: Jose Isidro Barreto Phone#: 561-777-6037 State Certification or Registration #: EC13007738 Certificate of Competency #: DESIGNER: Architect/Engineer: Morrison Hershfield Phone#: 954-577-4655 Address: 2 S University Drive, Suite 245 city. Plantation State: FL Zip: 33324 Value of Work for this Permit: $ 13,000.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition Description of work: Sprint (M103XC065) adding antenna equipment to existing telecom facility. Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) NA Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City NA 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: 1 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 Signature /4"�Zt� OWN R or NT CONTRACTOR The foregoing instrument was acknowledged before me this o271+ day of m 4y 20 11 by -raomA5 T, ►h K o who is personally known to me or who has produced 1AVCKS7 6.l C'ENS as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this I day of�- , 20 1Q by AMP r, t "J�1?" -�TZ� , who iss personally known to me or who has produced A6736)-11/4 - 75-d -IV-as identification and who did take an oath. NOTARY PUBLIC: Sign: C5-z—�� g Z Sign: Print: �5 E✓ IV I-, S/1.109TR0 : Print: _ (y.` Seal: 1rRY otr e, STEVEN L. SILVESTRO Seal: �pr'ofJ+., JOSSiE ACOSTA MY COMMISSION 8 FF 982378 :s 0 rotary Public - State of Florida a; Commissior, aGG 194C7e ''.Fan' v'�o� EXPIRES: August 13.2020 My Comm. Expires Mar 11.2022 oaf f jQ boded Thru Budget Newry Serviees Bonded through National Notary Assr. APPROVED BY 00%1 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) LETTER OF AUTHORIZATION TO MIAMI SHORES VILLAGE: APPLICATION FOR ZONING/USE/BUILDING PERMIT The undersigned Jose Isidro Barreto authorized representative of Wave Link Corp, of Puerto Rico (EC13007738) of the below described Property ("Qualifier"), does/do hereby appoint Milena Vasco of Morrison Hershfield, as agent for the purpose of consummating any application necessary to ensure its ability to use and/or construct improvements to the Property leased or licensed to it for the purpose of constructing a wireless communications facility. I understand that the application may be denied, modified or approved with conditions and that those conditions or modifications must be complied with prior to issuance of building permits. GC hereby authorizes the employees of the Miami Shores Village to enter upon the Property during normal business hours as necessary to inspect the Property for the purpose of processing this application. Property Located at: 602 NE 96t' ST ("Property") Assessor's Parcel Number: 11-3206-014-1410 Qualifier's Name (print): Jose Isidro Barreto Signature: Title: The foregoi g instrument acknowledged before me this _ day of /7 2019, by 1('��p `� �a�� who is personally known tom or who has produced P�ci—%5—a51—D as identification and who did take an oath. NOTAR PUBLIC: Sign: '+° ,y Wary .ilek Stateof:I Print: '� �. yr.GG �sn°' MyCOM, eaMrcsMarll.. Bondea thrweh %r oral \Ota Site Cascade ID #: M103XCO65 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. X COPY OF QUALIFIER'S STATE LICENCES B. X COPY OF LOCAL BUSINESS TAX RECEIPT C. x COPY OF LIABILITY INSURANCE* D. x COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: Wave Link Corp. of Puerto Rico BUSINESS ADDRESS: 87961 Old Hwy. CITY Is lamorada STATE FL ZIP 33036 BUSINESS PHONE: ( FAX NUMBER ( ) CELL PHONE (786 ) 427-7576 QUALIFIER'S NAME: Jose I. Barreto QUALIFIER'S LIC NUMBER: EC13007738 RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY bFloddpr a V STATE OF FLORIDA DEPARTMENT OF BUSINES—S-�N.:R-OFESSIONAL REGULATION ELECTRICAL CQ� - Y _��E' NG BOARD C CD ` T ' �f � 1��4 � R jc� (ERE 1�-IS CEr I `D UNDER THE THE ELECTRI PROVIS O.N Of C 7A E�F ., 1`D TATUTES r c.d1ti°a Bps rtes, Aiation�-91 A- EXPIRATIOMID 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. 2018 / 2019 MONROE COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30, 2019 RECEIPT# 30140-96401 Business Name: WAVE LINK CORP OF PUERTO RICO Owner Name: GABRIELA GUZMAN Business Location: IS CTY Mailing Address: ISCTY FL 33036 87961 OLD HWY Business Phone: 786-427-7576 ISLAMORADA, FL 33036 Business Type: CONTRACTOR (GENERAL / ELECTRICAL) Employees 6 STATE LICENSE: CGC1511713 / EC13007738 Tax Amount Transfer Fee Sub -Total Penalty Prior Years Collection Cost Total Paid 25.00 0.00 25.00 0.00 1 0.00 1 0.00 25.00 Paid 000-17-00027067 08/28/2018 25.00 THIS BECOMES A TAX RECEIPT Danise D. Henriquez, CFC, Tax Collector THIS IS ONLY A TAX. WHEN VALIDATED PO Box 1129, Key West, FL 33041 YOU MUST MEET ALL 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: WAVE LINK CORP OF PUERTO RICO RECEIPT# 30140-96401 MO CTY Business Location: ISLAMORADA, FL 33036 Owner Name: GABRIELA GUZMAN Mailing Address: Business Phone: 786-427-7576 87961 OLD HWY Business Type: CONTRACTOR (GENERAL / ELECTRICAL) ISLAMORADA, FL 33036 Employees 6 STATE LICENSE: CGC1511713 / Tax Amount Transfer Fee Sub -Total Penalty Prior Years Collection Cost Total Paid 25.00 0.00 25.00 0.00 0.00 0.00 25.00 Paid 000-17-00027067 08/28/2018 25.00 CERTIFICATE OF LIABILITY INSURANCE Date 7/17/2019 Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. Holiday, FL 34691 rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. (727) 938-5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 InsurerB: 2739 U.S. Highway 19 N. Holiday, FL 34691 InsurerC: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date Policy Expiration Date Limits (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence Commercial General Liability Claims Made ❑ Occur Damage to rented premises (EA occurrence) $ Med Exp Personal Adv Injury General aggregate limit applies per: Policy ❑Project ❑ LOC General Aggregate Products - Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Bodily Injury Hired Autos Non -Owned Autos (Per Accident) Property Damage � (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Occur ❑ Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2019 01/01/2020 X WC Statu- I OTH- Employers' Liability tory Limits ER E.L. Each Accident $1,000,000 Any proprietor/partner/executive officer/member E.L. Disease - Ea Employee $1,000,000 excluded? NO If Yes, describe under special provisions below. E.L. Disease -Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 43-65-173 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Wave Link Corp. Of Puerto Rico dba Wave Link Corp. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or email certificates@lioninsurancecompany.com Project Name: 633 NE 16TFH ST., MIAMI SHORES, FL ISSUE 07-17-19 (SS) Begin Date: 9 30 2010 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE Should any of the above described policies be cancelled before the expiration date thereof, the issuing BUILDING DEPARTMENT insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138