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ELC-11-54Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NS P- 154809 Scheduled Inspection Date: February 09, 2011 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138- Permit Number: ELC -1 -11-54 Project: BARRY UNIVERSITY Contractor: MOODY ELECTRIC INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 Phone: (305)758 -2000 Building Department Comments NEW RECEPTACLES & DATA FOR MASS COMMUNICATIONS SYSTEM. Passed C7 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments t'e/fi / February 08, 2011 For Inspections please call: (305)762 -4949 Page 7 of 26 1. Cor Jesu Chapel 2. Thompson Hall 3. Library 4. Broad Center 5. Pelican Theatre 6. Fine Arts Quadrangle 7. O'Laughlin Hall 8. Natural & Health Sciences Bldg 9. Adrian Hall 10. Wiegand Center \ \ I \ c \._szc. fi c N C 11. Posner Hall ( Wiegand Annex) 12. Kelley House 13. Farrell Hall 14. LaVoie Hall 15. Weber Hall 16. Browne Hall 17. Sage Hall 18. Dunspaugh House 19. Dalton House 20. Renee Mottrarn Doss Hall 21. Flood Hall 22. Powers Building 23. Andreas Building 24. Lehman Hall 25. Garner Building 26. R. Kirk Landon Student Union 27. Health and Sports Center 28. John and Neta Kolasa Hall 29. Benicasa Hall 30. Center for Community Health and Minority Medicine 31. Alumni House 32. 11600 Building 33. Holly House Apts 34. Hopper Building 35. Villa 36. ACE \c c� -��r 'tom Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 MCMETM3 JAN 1 1 2010 BY: BUILDING Permit No. Ec.Lj ( "Sy PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) vN1\k'L ty Phone # Owner's Address t ddress 11300 E ' AVaith.,16 33 City(A N\M t State ��- Zip J� 1( t Tenant/Lessee Name Phone # Email Job Address (where the work is being done) } y W ► ''6 16 G (AIMg J A S NOTI C'Al lot City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name W OLY rca(i'lC E 4.NG s Contractor's Address 661 }t W 90Th ct e6G'r Phone # Z.000 City tAt AMl State Ft. Zip 331 S 0 Qualifier Name -179400 .1 fl )0x Phone # 'jU 5-1S r-,ZCXo State Certificate or Registration No. ) 0 9 Certificate of Competency No. Contact Phone 3O _-7cg ZOCIO E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ / / 7-5T Square / Linear Footage Of Work: Type of Work: ❑Addition [Alteration ['New ❑ Repair/Replace ❑ Demolition Describe Work: * * * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** Submittal Fee Permit Fee $ h1 /' Z f CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side -* Bonding Company's Name (if applicable) Donding Company's Address City State ki 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 re- inspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of V P'v . , 20 1) , by Q 1:70% A2W. , day of �� , 20/ , by .%� 11 .�1 /�� , who is personally known to me or who has produced who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission E APPROVED BY // ✓ ��l Plans Examiner Engineer (Revised 07 /10 /07XRevised 06/10/2009) Sign: hi Print: My Comm F•■ DIY COMMISSION t DD 979267 es. EXPIRES: May 11, 2014 .0 Bonded Thru Nobly Pubs Underwrites Zoning Clerk checked Jan 05 11 09:35a Moody Electric Inc 305- 754 -1333 p.2 OP ID: GC A..°RO- CERTIFICATE OF LIABILITY INSURANCE DATE(MMID/10 12/09/10 lTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS l 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(ies) must 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 561- 3924300 Workers Compensation Group 561- 361 -1132 P 0 Box 410 Boca Raton, FL 33429 -0410 Workers Compensation Group NAMNT CT Greg Carignan PHONE 561 - 392 -3300 FAX /AIC, No. EMI: 1 (ac, No): 561 - 361 -1132 E-MAIL ADDRESS: carts @workerscompgroup.com CUSTOMEERRID#:MOODY -1 )NSURER(S) AFFORDING COVERAGE INsuRERA,Bridgefield Employers Ins NAIC 8 INSURED Moody Electric, Inc 669 Northwest 90th Street Miami, FL 33150 INSURER s INSURER C : AMER 0 : EACH OCCURRENCE INSURER E : INSURER F : • • 11-1I8 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 QTR TYPE OF INSURANCE ADDL RUSH POLICY NUMBER POLICY EPP ..,i YYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY —1 CLAIMS -MADE L OCCUR EACH OCCURRENCE $ DAMAUE TUliENTED PREMISES (Ea occurrence) $ MW EXP Any one person) $ PERSONAL & AOV INJURY $ APPLIES PER' n LOC GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT POLICY n 'EC, PRODUCTS • • COMP/OP AGG 5 —1 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON - OWNED AUTOS COMBINED SINGLE LIMIT (Ea accdent) $ „ BODILY INJURY (Por person) $ BODILY INJURY (Per maxima) 5 PROPERTY DAMAGE (Per accident) $ $ 5 UMBRELLA uAe EXCESS LIAB r_ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ 5 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory to NH) It yes, escribe under DESCRIPTION OF OPERATIONS Y I N N / A 830 -29673 01/01/11 01/01/12 WC STATU• r I TH- TTORY LIMITS „(�,_LE„_ E.L. EACH ACCIDENT $ 500,000 below E.L. DISEASE • EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 600,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES Attach ACRD Additional Remarks Barmaids It mom space Is required) 8127 /07- increase EL Limits to $500,000/$500 000/$5 101. 0,000 r-mz rmtr•Arc u.., e.ce CANCELLATION MIAMIS3 Village of Miami Shores 10050 NE 2nd Ave. Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) 01988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Jan 05 11 09:35a Moody Electric Inc 305- 754 -1333 p.l CERTIFICATE OF LIABILITY INSURANCE PRODUCER InSource, Inc. 9500 South Dadeland Blvd., #400 P.O. Box 561567 Miami FL 33256 -1567 Phone:305- 670 -6111 Fax:305 -670 -9699 INSURED M600�dy_Ell$cs iieetInc. Miami WFL 33150 DATE IMNWD/YYYY) OP ID J2 MOODY -1 12/2210 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A FCCI Insurance Company 10178 INSURER B: FCCI Commercial Ins. Co. 33472 INSURER C: INSURER D: INSURER E: COVERAGES VILLMIO D THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POUCIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PERIOD INDICATED. THIS CERTIFICATE MAY EXCLUSIONS AND CONDITIONS IRAYTIO } NOTWITHSTANDING BE ISSUED OR OF SUCH LIMITS IINSR LEER') LTR LEER') TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDI TT VE A QENERALL.IABILITY X COMMERCIAL GENERAL UABIUTY CPP00056946 12/31/10 EACH OCCURRENCE $ 1000000 12/31/11 UAMACit 1U RkN 1tU PRENllSES(Eaocarence) $100000 MED EXP (Any one person) $ 5000 J CLAIMS MADE Ill OCCUR PERSONAL &ADVINJURY S 1000000 ,u GENERAL AGGREGATE $ 2000000 PRODUCTS • COMP /OP AGO $ 200 0 000 GENL AGGRE��GATE UMIT APPLIES PER T POLICY I� 1 ECT n LOC B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CA00067796 12/31/10 12/31/11 COMBINED SINGLE UMIT (EaacddenU $ 1000000 X _ — X X BODILY INJURY (Par parson) BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Per accident) GARAGEUABILITY .1 ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN FA ACC $ AUTO ONLY: AGG $ EXCESS X] X / UMBRELLA LIABILITY OCCUR [ 1 CLAIMS MADE DEDUCTIBLE I RETENTION $ 10000 UMB00047875 12/31/10 12/31/11 EACH OCCURRENCE $ 200000 0 AGGREGATE $ 2000000 - $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETCR/PARTNERJEXECUTIV j OFFICER/MEMBER EXCLUDED? L J (Mandatory In NH) It yea, describe under SPECIAL PROVISIONS below WU S 1 ATU- OTH- TORY LIMITS I I ER E.L. EACH ACCIDENT $ 51. DISEASE - EA EMPLOYEE $ E L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS t VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS *10 days notice of cancellation applies for non - payment of premium. Village of Miami Shores R VILLMIO D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALT. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 26 (2009!01) _211DA ACaRO a.a,.crv,cA o - r D rase e The ACORD name and logo are registered marks of ACORD NOTICE. OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. 112(�(U�o STATE OF FLORIDA COUNTY OF MIAMI -DADE: THE UNDERSIGNED nereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 111111111111111111111111111111111111111111111 c :FN 2011 R nt307n,ft.2 OR Bit 27542 Ps 3045; (1s) RECORDED 01/05/2011 09:57 :29 HARVEY RUVINf CLERK OF COURT MIAMI -DACE COUNTY, FLORIDA LAST PAGE 1. Legal description of property and street/address: 1(' Oc. ) 1 fn AinI 54-10e& ,L 33I 3 8" 2. Description of improvement: 1/01-74-1.4-441-010 eF MASS AiNtninuOGRODA1 O ysrZ -- 7+7A --LABS 3. Owner(s) name and address: 'a6CULI I%)J/O $ / J //3X)1 )J, Z tAVe Y1 Jam) Interest in property: Name and address of tee simple titleholder. 4. Contractor's name and address: f eOlki el 1 G 4 Am) q Si MIAMI 33 ISO 5. Surety: (Payment bond required by owner fro Name and address: Amount of bond $ 6. Lender's name and address: ntractor, if any) STATE OFF BY CERTIFY Meet this Is a true copy of the origin! filed In This office on n'sy of 7. Persons within the state of Florida designated by 0 provided by Section 713.13(1)(a)7., Florida St. - es, Name and address: 8. In addition to himself, Owners designates the f (lowing person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a differen coed) Signature of Owner Print Owner's Name EDWARD ft-Cry) Sworn to and subscribed before me tnis oay of 1 1L . 2DL Notary Pubiir ! v 1 Pant (votaries Narne My commission expire: MARY PAT BFI ...Llcv. ill, .i. .w,,, EXPIRES: May 11, 2014 Bon118(1TianN+ yPublicUndemr rs Prepared by