The URL can be used to link to this page

ELC-11-1684Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164398 Scheduled Inspection Date: September 19, 2011 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Health & Sports Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: OUTLOOK INTERNATIONAL Permit Number: ELC -9 -11 -1684 Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -23 Phone: (305)374 -1005 Building Department Comments REMOVING REGULAR TOGGLE SWITCHES AND INSTALLING NEW OCCUPANCY SENSOR SWITCHES. Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. ;'0720 // September 16, 2011 For Inspections please call: (305)762 -4949 Page 36 of 48 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 °L\i k5 11-'—AA\ INSPECTION'S PHONE NUMBER: (305) Tel: (305) 795.2204 Fax: (305) 756.8972 12.4949 Permit No. LUC, 1 t IC IN BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical Master Permit No. OWNER: Name (Fee Simple Titleholder 111.A JefS �+ Phone #: Address: 11:00 N % AY City: M t A b fL. State: \ �, Zip: 3--3 1 Co 1 Tenant/Lessee Name: N/14 Phone #: Email: JOB ADDRESS: i I' 0 0' 6 ZuNcl AV -, A S C City: Miami Shores County: Miami Dade Zip: 3 / Folio/Parcel #: 1 1` 2 1 ✓' L— 000 — 0() 5 b Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: cir10 0 J ..fin 'Wna �`ia�/�� Phone #: 7 (C .2e% 35 T9._ Address: /736 Jc�pcR ,e/ ti-E) • # City: /t(( 71 State: 1C r Zip:33I Z Qualifier Name: &iO _ (A-71 Phone #: 7g6 JJG 35g! State Certification or Registration #: eetez / / .2 Certificate of Competency #: ©5 e> c) o �: Zf / 7 Contact Phone #: GD 6 ,42 CC‘ 35 2' 4' Email Address: Wa h iG.e /f1 D G /fl . C. DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Z-1° 50 C ° Square/Linear Footage of Work: Type of Work: Address UAlteration New ARepair/Replace ODemolition Description of Work: 442,Q ViecaliLtA > .€ "fp r5 (€ D- c. kes 1 Si`a /J d K j * * * * * * * * * * * * * *** * * * *** * * ** * * * **** * * * ** Fees * * ***** ** * *** * * * * * * * * * * * ***** ** * * ** r *** *** Submittal Fee $ Permit Fee $5�" CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1CQD' Cie 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 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 approves d a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 1Z day of SO'. , 20 1) , by 3e.m,Cj ' vitnios who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * ** APPROVED BY tractor The foregoing instrument was acknowledged before me this day of , 20 ®( , by C'ri° 61— who is personally known to me or who has produced as identification and who did take an oath. Sign: P •i My Co 4.NliEL REGIS No lry Public, State of Florida Rffitomm. Expires Nov. 30. 2014 No. 00389723 Bonded Thru Public Underwriters *********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ,y 5 Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Zoning Clerk A ° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 09/08/2011 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 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 305 - 233 -0855 305 - 235 -8606 NCAAMe%Cr KINO MCGREGOR ALL AMERICAN INSURANCE ASSOCIATES a"g,"lN . Ext): 305 - 233 -0855 d, No 305- 235 -8606 9036 SW 152ND MIAMI FL, 33132 ADDRESS• PRODUCER CUSTOMER ID #: 03/15/11 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Scottsdale Insurance 41297 OUTLOOK INTERNATIONAL, INC. INSURERB: Progressive Express 10193 1730 BISCAYNE BLVD SUITE 201 INSURER C: Bridgefield Insurance Company 011812 MIAMI FL, 33132 INSURERD: INSURER E : L AGGREGATE UMIT APPLIES PER: "At it 11 A wrc■ INSURER F : POLICY JEC LOC • THIS INDICATED. CERTIFICATE EXCLUSIONS n. N71V1e n ur nfnsaGR: IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER (MIM)DD YEFF (MGM DD Y) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CPS 1307583 03/15/11 03/15/12 EACH OCCURRENCE $ 1 .000.000 $ 50.000 1 DAMAGE TO RENTED PREMISES (Ea occurrence) CLAIMS -MADE I 1 I OCCUR MED EXP (Any one nelson) $ 5,400 PERSONAL a ADV INJURY $1.000.000 $ 2,000.000 $1,000,000 GENERAL AGGREGATE L AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/OP AGO POLICY JEC LOC B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 04337897 -1 03/04/11 03/04/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ 1 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) ✓ $ $ — UMBRELLA LWB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ — AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? n (Mandatory In NH) f yes deSCt be under O SGRIPTION OF OPERATIONS below N IA 05210980420000 03/28/11 03/28/12 WC STATU- OTH- TORY UMITS I ER EL EACH ACCIDENT $ 100,000 E.L DISEASE - EA EMPLOYEE $ 500,000 E.L DISEASE - POLICY LIMIT $ 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, timers space Is required) ..r.TU- .....rte ..w. ��ma CANCELLATION Miami Shores Village Building Department 1005 NE 2 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. AUTOO D REPRESENTATIVE KINO MCGREGOR Ail ©1988.2009 ! ORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD