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ELC-11-2374Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 168259 ( --- I '1191-- Permit Number: ELC -12 -11 -2374 Scheduled Inspection Date: January 03, 2012 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Wiegand & Annex Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: DIGITAL VIDEO SYSTEMS Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -09 Building Department Comments ELECTRICAL LOW VOLTAGE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 7 ,e'7`z.-- December 30, 2011 For Inspections please call: (305)762 -4949 Page 13 of 19 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 BUILDING Permit No. PERMIT APPLICATION Master Permit No.' FBC 20 CrYLeaniCilL Permit Typett__ OWNER: Name (Fee Simple Titleholder): &Clef L91 J X 5 Phone#: Address: 113 00 /U. IF. OZ/t, City: /2q t State: Flo r2i AA DEC 222611 L BY: Zip: 331 h 1 Tenant/Lessee Name: Phone#: Email: / A 0 / 1 441 6 rr �- �•� JOB ADDRESS: W I e G J e 4 c ue S 4OS — Low Jee.-;e7aekil City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 0)1 I V, cL Q ® Sy ri e ` 3'. Phone #: °SS ' - qql 0 Address: e; 0 - jceC•P4-4 4� (/ (4../q 7 City: v/YMa4r State: 1 li°rJ_to9 Qualifier Name: Phone #: 3Q.a. 'f 7- o2b. State Certification or Registration #: Certificate of Competency #: Contact Phone#: %4/4734) iy,:iz iIJ Email Address: Ai IMAISAAYV212 P414010 I— a2.,A— - DESIGNER: Architect/Engineer: Phone #: Zip: 3 3 C°'LS Value of Work for this Permit: $ (c71 C)0° Square/Linear Footage of Work: ❑New *Repair/Replace ❑Demolition Type of Work: ❑Addition ❑Alteration Description of Work: X11/ CC Pr-vi e �0c atS�e��P ®s 4641e,/e4414A, 011 el0 iota- ce_ -ice ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * ****+x***s:*+x**a:a *** ****** ****+x************ Submittal Fee $ Permit Fee $ 8 / G 6 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) ! - /4 Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Lender's Address City State Zip r 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 CONIMTIONERS, 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 occ, rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approve a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of �. ' 4 20 6l , by 1 1A �� 044184 1 ' , wh*o is pm )nal .yL. wn to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp * * * * * * ** * * * * * * ** **** , #ice :N 12,2014 FI.NooryDisoomtAssoo.Co. Contractor The foregoing instrument was acknowled day of beC 62-2- , 20 1 ± , by who is personally known to me or who has produced at as identification and who di take an oath. NOTARY PUBLIC: Sign: Print: °'''"'-e- `Melanie James COMMISSION #EE14'..::1 p e ` ' E X P I R E S : NOV. 18, _ : 5 www.AARONN07ARY.com My Commission Expires: ** ** ********** * * * * * * * * ** * * * * * * *** * * * ** * ** **** * * * * * * * * ** * * * * * * ** * * * * * * * * * ** * ** VG // APPROVED BY Or9/2-- k 7f,! Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk BUSINESS TAX RECEIPT (954) 602 -3040 PHONE (954) 602 -3470 FAX LICENSE NO 08000416 DIGITAL VIDEO SYSTEM 3270 EXECUT IVE WAY MIRAMAR FL 33025 BEGINNING 10/01/2011 ENDING 09/30/2012 NAME & LOCATION OF LICENSEE DIGITAL VIDEO SYSTEM 3270 EXECUTIVE WAY MIRAMAR FL 33025 CONTACT PERSON: DAVID HESS DESCRIPTION wfo- CONTRACTORS- SPECIALT t ME12CH- WHLSALE /STOCK <$90, 000 FIRE INSPECT ..50 00 SQ . FT . FIRE INSPECT -EA .ADD'L 1000SQFT SPRINKLER SYSTEM FIRE ALARM HAZ /MAT FLAME /COMMIS /CI,S/ 1A &1B PRINT DATE: 10/04/2011 ** RESTRICTIONS ** MAIL & PHONE ONIX NO EMPLOYEES AT HOME NO WORK ON PREMISES NO CLIENTS Ni HOME NO DELIVERIES TO HOME HOME USED FOR OFFICE ONLY PHONE: (201) 859- 43.77 ** BUSINESS TAX RECEIPT MUST BE DISPLAYED ** ** RgsTRICTIQNS Y.1�QME•BASEP B1 S1NESSES ** 90/TO BEVd SAG 9817176EZb56 WIT TtOZ /6Z /It CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DO YY) 12/28/2011 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 T115 COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OP 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), (ODUCER TxlANTZC RISK MANAGEMENT CORP 850 Waterloo Road, Suite 240 olumbia MD 21045 ■SURED taritime Mobile Communications, TALC. BOA Digital Video Systems 'O Box 547 (ontvale 147 07645 JONTACT Kimberly J)aME: Calhoun PHONE (410)480 -4400 (AJO.Nn.PxI, Ac oRIESSt kcalhouneatlanti +frisk . cam IFAX (410)465 -0754 LAIC, No): INSURER(S) AFFORDING COVERAGE INSungRAMassachu setts Bay Insuranc Co INSURER a ;The 1 anover American Ins Co . INSURER C The Hanover Insurance Group INSURER D IZI1rich American ins Co of 111 INSURER E : INSURER F NAIC # :OVERAGES CERTIFICATE NUMBER:11 -12 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�CL�AI�M-S. TYPE OF INSURANCE IN Sj vD POUCY NUMBER M UCY gPF IV rom-riml REVISION NUMBER: C GENERAL LABILITY X COMMERCIAL. GENERAL LIABILrn' CLAIMS -MADE FI OCCUR X XCC Not ExCluderd GEN'L AGGREGATE LIMIT APPLIES PER POLICY I 14eFRo' 1 "-1 LOC AUTOMOBILE UAOILITY X ANY AUTO ALL OWNED AUTOS X HIRED AUTOS X UMBRELLA LAB EXCESS UAB N SCHEDULED AUTOS X NON•OWNED AUTOS rawI3035a502 7/23/2011 7/23/2012 M304033002 7/23/2011 1/23/2012 X OCCUR CLAIMS -MADE D QED I X J RETENT ON E 0 X 0NQ3133874302 WORKERS COMPENSATION AND EMPLOYERS' LABILITY ANY PROPF00TOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) I( (tendril* under DESCRIPTION OF OPERATIONS below YIN L3 NIA IC379763 -01 7/23/2011 7/23/2012 LIMITS EACH OCCURRENCE P:.MIS4 i1 =- u;me MED EXP (Any one Admen) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMPrOP AGG • 1,000,000 5 500,000 5,000 0 1,000,000 0 2,000,000 2,000,000 COi+lI�INEDi;1NGLE LTMrr tae gcridnntl 5 BODILY INJURY (Per person) ; 1,000,000 $ BODILY INJURY (Per =Went) 5 PRR I -65 RTY E (Per octal nt) 5 — 7/23/2011 7/23/2012 EACH OCCURRENCE AGGREGATE S 5 5 5 5,000,000 5,000,000 1 41°1 E. I .L.EACHA 5 1,000,000 E.L. DISEASE - EA EMPLOYEE 5 1,000,000 EL, ISEASE•POLICYUMI'C 5 1,000,000 DESCRIPTION OF OPERATIONS J LOCATIONS / VEHICLES (Attach ACORD 101, AddlEonel Remarks Schedule, If more Yeace N required) If required by written Contrast, 'Village of Miami Shores is named as Additional Insured on all policies except Workers Compensation, subject to policy provisions. CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10050 NE 2nd Avenue Miami, FL 33138 ACORD 25 (2010105) 50/1,0 3JVd SHOLD THE ABOVE DESCRIBED THEREOF, NOTICE WILL CANCELLED WILL BEEDU A VERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE David Saul/MAC ©1988 -20'10 ACORD CORPORATION. All rights reserved. TNA of AR1l nc.... - an.i I..wn ore. rnnictarori mark* of Ortniort SNI 9811,6EZ1,56 LZ :TT TTOZ /6Z /TT �S t 145'tiV.fYS iaLG tY..l^,. 1 4,+a•>.n � '�.rk saw it > 'b •'•tPS'n 1 a 6 n n o. ", k 41 410"•.. ikY 90/60 39Vd SAQ 98171766Z796 LZ :TT TTGZ /6Z /TT