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CC-12-863
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 176143 Permit Number: CC -5 -12 -863 Scheduled Inspection Date: August 01, 2012 Inspector: Bruhn, Norman Owner: CHURCH, Job Address: 602 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: AEROTECH SERVICES INC Permit Type: Commercial Construction Inspection Type: Final Building Work Classification: Alteration Phone Number (305)754 -9541 Parcel Number 1132060141410 Phone: (239)673 -6166 Building Department Comments REMOVE AND REPLACE EXISTING ANTENNAS FOR METRO PCS Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 176059. Provide fire final NB July 31, 2012 For Inspections please call: (305)762 -4949 Page 17 of 30 Miami Shores Village gilding Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 'S PHONE MMUS: (305) 762.4949 D G Permit No. @%C..) I ∎ PERMIT APPLICATION Master Permit No. la MAY 152.612 FBCZO Permit Ir3.pUILDPI. R $ 1 FING OWNER: Name (Fee Simple Titleholder): Address: t,pp N City: t,� i'c1; Vii. -cc State: Tenant/Lessee Name: PLR t 8'0 Q Email- - `3 Phone#: JOB ADDRESS: 1909, : 0\14> City: Miami Shores County: Folio/Parcel#: 11 5{{ri„ 12 O11-k `-k i 0 Ls the Building Historically meted: Yes Miami Dade Zip: `-S, l cA NO Flood Zone: CONTRACTOR Company Name: ^^\C,c -(i-k-P C,�, Se \NCQ D \nt, Phone#: .Z;21- A.61 —l) \ (c I ? Address: 1tbl E \ 2\Cc,,4x� City: l aC State: PhneoZip 2 # ^ n 1 \040 Qualifier ` cheke,k C.-SS State Certification or Registration #:CESC, NS 1 0.0(00 Certificate of Competency #: Contact Phone#: 44 et ir Srcl 01 1 fai-C6LI;z6L9 03�iddress: IALQ±"klUe@ Fas-I -Troke }"%Q rn1 +. COPY) DESIGNER: Architect/Engineer: )(.a.rvt.A Phone# Alti 61S1-417S F Value of Work for this P j S9 , C)-C' SgaareJLinear Footage of W Type of Work: °Addition ©Alteration °Newepair/Replace Description of Work: C Qxxa )- 4- ('.i °Demolition Submittal Fee $ Permit Fee $ /Q,°ccs COICCs Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Train Double Fee $ Structural RevIew $ ion Fee $ Technology Fee $ Braiding CompaufsName (if Company's ,ll tdraltgage ' 's Name fff appficable) City Tap Qq�' tit; ]hez kmade to obtain a ale fie V:01(011:' karala leedifY tad TEO Welk ri has reammaneed prior ID ibe INSIENCe of a permit anti that an work mall Im performed W malt The samdards of all laws regalating in This Et tee a separwe permit mot be seamed for EllECTIRICAL WOW., PLUMBING, ® 'S W fiat all the ` A; - i *g inforrmiden is =mote and that an wok will be dune in Wand& Y ?? s Itglablingconaniettan :E9I9 4 t'9'!R "WARNINIG TO ! u YOUR FAILURE TO RECORD A NOTICE OF CO t1i, A 0 I MAY T IN YOUR PANG TWICE BAR IMPROVEMENTS TO YOM PROPERTY,. IF YOU INTEND TO OBTAMT EINANCZNG, CONSULT mull YOUR i ;'0 I1 : OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF N> e to JApprictott Asap to the £ the bantam of a inatung permit with an estimated P exceetrtog + j, i that a - &velour real d w d to the wawa whose propeny is =Wed ottoolonent. , o =pried zilopy tithe moozded notice ofc ommeneerneot matt he prated at ejoh e , for the fropeettota which ow= seven f7 lap ape, teboarang poroth is issoetl. n the absence te siza pined Thrace, the &gnat= The +'V! -Y - -A �`� lae{ before= -- 9 day Q029~6 .20 >..2, by J°avrci f chen , * is personally known ID-theyr NVIO produced As identification and w10 take an NOTARY Swam L ' — t31,id C e-- � 20V by WO c iP\ -1e^ -s who 1:15 Meer who implode:cad take iuiask NOTARYPTIOLle Prim S71ve /(-41ge,‹ NOTARY PUMICWATE -u rvORIDA .•`"'{N Sylvia Halter )Comdussion # EE098053 {,;' Expires: JUNE 08, 2015 NDING Co. INC. My iul{. iiss un 7714 Plans Examiner Strucatrid Roview ry ODITI aryland rambdiaitinkrarpitin County My Commission Expires Januar 22, 2014 Zemin Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. X COPY OF QUALIFIER'S STATE LIC CARD B. X COPY OF LOCAL BUSINESS TAX RECEIPT C. ..\Q COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. X COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION (\%e,-e c BUSINESS NAME: d SE C\ hciu0 j `aQ BUSINESS ADDRESS: \) 6-1 a 1 a Pi aCt, CITY CC C STATE (.. ZIP CODE 3 S9 9 BUSINESS PHONE: ('°t) C-f1?) Colo FAX NUMBER ( Z-59 (d1 CELL PHONE ( (0-- QUALIFIER'S NAME: MO(Q.. C eSS QUALIFIER'S LIC NUMBER: C---6C, F 1 a to (p 0 E -MAIL ADDRESS (IF APPLICABLE): c\atieleh cue - 2chsys , C Om Created on 3119109 BY MLDV! RV 3129109 LDY L101115,13006 SS ASR CH P 0 SOX- I+ COat \Pe CO114y LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2011 - 2012 Tax Co ` t ©r ACCOUNT NUMBER: 1103669 ofa Lotion _._. 0 720 NE 25TH AVE STE 32 GAPE CORAL FL 33909 ._ AEROTECH SERVICES INC HESS MICHAEL J PO BOX 100846 CAPE CORAL FL 33910 ACCOUNT EXPIRES SEPTEMBER 30, 2012 May engage in the business of: CERTIFIED GENERAL CONTRACTOR THIS LOCAL BUSINESS TAX RECEIPT 1S NON REGULATORY THIS IS NOT A BILL DO NOT PAY PAID 298978 -1 -1 09/22/2011 09:53 BXM1 $50.00 4-03Te!Lu•PN • Tax Co tor ACCOUNT NUMBER: 1103670 e of fAo�`a LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2011 - 2012 Location 710 720 NE 25TH AVE STE 32 CAPE CORAL FL 33909 AEROTECH SERVICES INC KVIDT JEREMY R PO BOX 100846 CAPE CORAL FL 33909 ACCOUNT EXPIRES SEPTEMBER 30, 2012 May engage in the business of: ELECTRICAL CONTRACTOR THIS LOCAL BUSINESS TAX RECEIPT 1S NON REGULATORY THIS IS NOT A BILL - DO NOT PAY PAID 298900 -1 -1 09/21 /2011 09 :15 MW R1 $50.00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED 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. MOTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSURANCE DATE (MMIDDIYYYY) 4/19/2012 CERTIFICATE OF LIABILITY SUER S Vn THIS CERTIFICATE 1S 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREDS), 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. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER SOUTH FLORIDA CASUALTY 415 North 4th Street Lantana, FL 33462 CONTACT NAME PHONE , ExO: (561) 533 -6144 I FAX No): (561) 533 -6170 ADDRESS: Elaine@ south£loridacasualty.com PRODUCER CUSTOMER ID $: INSURER(S) AFFORDING COVERAGE NAIC# INSURED rC >teCh Services Inc. P.O. Box 100846 Cape Coral, FL 33910 INSURER A: Scottsdale Insurance Company 41297 INSURER B: The Travelers 27998 INSURER C: $ INSURER D: X, INSURER E: $ INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED 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. MOTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MISR LTR TYPE OF INSURANCE ADDL MSR SUER S Vn POLICY NUMBER POLICY EFF (MIWDDNYYY) POLICY EXP (MM/DD/YYYY) UMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY [] OCCUR CPS1516093 03/08/12 03/08/13 EACH OCCURRENCE $ 1,000,000 X, DAMAGE TO %NMI) PREMISES (Ea occurrence) $ 100,000 ICLAIMS -MADE MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ $ 2,000,000 2,000,000 GENII AGGREGATE OMIT APPUES PER POLICY n JE [) LOC PRODUCTS - COMP /OP AGG $ B AUTOMOBILE LIABILITY ANYAUTO ALLOWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA- 8018P726 03/12/12 03/12/13 COMBINED SINGLE UMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per nodded) $ X X 0 $ A X UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS-MADE XBS0020650 03/08/12 03/08/13 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIErORIPARTNERIEXECU IVE 11 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, desnibe under DESCRIPTION OF OPERATIONS below N!A WC STATU- IOTH- TORY LIMITS ER EL EACH ACCIDENT $ EL DISEASE- EA EMPLOYEE $ E.L DISEASE - POUCY LIMIT $ A Installation Floater CPS1357502 03/08/12 03/08/13 $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional RemaiksSchedde,if morespaoe Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, FL 33138 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE 54itht,Iva ACORD25 (2009/09) © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A pi CERTIFICATE OF LIABILITY INSURANCE DMEMM /0rn 12 THIS CERTIFICATE 15 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 15 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 Main Street America MGA, Inc. 21977 East Wallis Drive Porter TX 77365 TACT Certificate Department PHONE (281) 999 -5544 I FAX (281)577 -2678 ADD :certs @hapeo.com INSURERS) AFFORDING COVERAGE NANO # INSURERA UlliCO Casualty Company LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Harbor America Coastal, Inc. Aerotech Services, Inc. Bus: (239) 673 -6166 Fax: (239) 673 -6167 1107 SE 12th Place Cape Coral FL 33990 INSURERB: INSURER C : INSURERD: $ INSURERE: $ INSURER F : COVERAGES CERTIFICATE NUMBER•CL1232909307 ISION NUMBER: 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER J MIM/DD ) (M D/Y ) UNITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE I OCCUR MED EXP (My one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPUES PER: 7 POLICY n PRCOT n LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OPINED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 1 RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) K describe under DESCRIPTION OF OPERATIONS below Y I N N / A WCB- 113000 -03 4/1/2012 4/1/2013 x I TORY LIMITS 1 1 O E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Workers' Compensation coverage is extended to all payroll active employees of Harbor America Coastal, Inc. leased to Aerotech Services, Inc. Insured is afforded Workers' Compensation & Employers Liability as a co- employer under the policy for employees leased from Harbor America Coastal, Inc. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Bldg Dept 10050 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 Rick Walker /ASHW1 4f,v ACORD 25 (2010105) INS028 rminrn 01 © 1988-2010 ACORD CORPORATION. All rights reserved. Tho At flPfl namn and Inn^ arc ranlcharorl marlrc of Amon NOTICE OF COMMENCEMENT <\ A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION • PERMIT NO. TAX FOLIO NO. 11- 3206 - 014 -1410 STATE OF FLORIDA COUNTY OF MIAMI -DADE THE UNDERSIGNED hereby gives notice that improvement 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. 111111 11111 11111 11111 11111 11111 111E11111111 C4714 21-1 128033009` 3 OR Bk 28104 Ps 2591; (1a5) RECORDED 05/09/2012 12:30:01 HARVEY RUVII'fr CLERK OF COURT MIAMI —DADE COUNTY? FLORIDA LAST PAGE I. Legal description of property and street address: 602 NE 96th Street Miami Shores, FL 33138 2. General description of improvement remove and replace existing antennas 3. Owner(s) name and address: Metro PCS 1000 Sawgrass Corporate Pkwy #400 Sunrise, FL 33323 Interest in property: leasehold Name and address of fee simple titleholder (if other than owner): ?j -( 3}- Pr s 9,{ -Q r', n C+ Vw fth ioork r\f ais St. i^licar U..tri— 3'13S Aerotech 720 NE 25th Ave #32 Cape Coral, FL 33909 4. Contractor's name, address, and phone number: 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond: $ 6. Lender's name, address, and phone number: N/A N/A 7. Persons within the State of Rorie designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(I)(a)7 Florida Statutes: Name, address, and phone number N/A 8. In addition to himself or herself, Owner designates the following person(s) to receive a copy of the Lienor s Notice as provided in Section 713.13(I)(b), Florida Statutes: Name, address, and phone number N/A 9. Expiration date of the Notice of Commencement (the expiration date is I year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 7t3, PART 1, SECTION 713.13, FLORIDA. STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE MENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. �.�� v °'F C Signature owner or� sy� reed Officer/Director /Partner /Manager Signatory's Title/Office A � l , �I�, 1<..SJ M P ( Print Name The faregoin4 in tris admowl jded before me this day of r 1 , 20 ft, , by 014 M as iii a )1 CV (type of authority, e.g. officer, trustee, attorney in fact) for / 24 6-172-0 G) (name of party on behalf of whom instrument was executed). dentification Type of Identification Produced: Print, Type, or Stamp Commissioned Name sTA i� i� � �FDADE VERIFICATION PURSUANT TO SECTION 92-525, FLORIDA STATUTES HEREBY CER77FY that this is a true copy of th Signature •f Notary Public — State of Florida Under penalties of perjury,1 declare that I have read the foregoing and that ;It e of Natural Person Signing Above HEAD s tER SMOLLETT -nc MY COMMISSION # DD850734 EXPIRES February 03, 2013 407) 998 -0103 FicrtaaPfrmySe+vi;e.com Turn Over for In Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 CC- Sto3 Inspection Number: INSP - 173599 Permit Number: ELC -5 -12 -864 Scheduled Inspection Date: July 18, 2012 Inspector: Devaney, Michael Owner: CHURCH, Job Address: 602 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: AEROTECH SERVICES INC Permit Type: Electrical - Commercial Inspection TypeR%ttgir Work Classification: Addition /Alteration Phone Number (305)754 -9541 Parcel Number 1132060141410 Phone: (239)673 -6166 Building Department Comments ELECTRICAL WORK FOR REMOVE AND REPLACE EXISTING ANTENNAS FOR METRO PCS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments /141P'. /8 r July 17, 2012 For Inspections please call: (305)762 -4949 Page 9 of 29 Mi Buil 10050 N.E:fi Tei: (3 INSPECTIO. BUILDING PERMIT APPLICATION F'BC 20 i Shores Village ing Department. Avenue, Miami Shores, Florida 33138 ) 795.2204 Fax: (305) 756.8972 S PHONE NUMBER (305) 762.4949 Permit No. 1 Master Permit No. La MAY 152612 il Permit Type: Electrical OWNER: Name (Fee Simple Titleholder):1� le ( 4V Add.: o . Ni otsi city:; NiNO,Ci1 , k � f � a . state: Tenant/Lessee Name: frn12,110 qt.S Rmail: JOB ADDRESS: t 9O ,, 1V l °t{ I s la ' Ci ty: M ian�hores County: Folio/Parcel#: 1 a gO1-9 ' 014 1 9 l Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: \. City. �" n3 b Qualifier Name: '" e; e XYML° F— -�U PhonePhone* �' k , Ob State Certification or Registration #: • —1 Certificate of Competency Contact Phone#: J0 T K.ell..@if cc-Le e. WYYI DESIGNER: Architect/Engineer. 1 C1:,a' 1.A. P.►1 r YTh Pho Value of Work for this Permit: $ 2 j ems' �' "' / Square/ Linear Footage of World Type of Work: °Address -�,�" °Alteration °New �,.—Repair/Replace °Demolition Description Work: ti `i- t.) Q_ (VON' Sl DA - Phone#: -Ix f3S Miami Dade Zip: ej r3 NO Flood Zone: ** ***Fees Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ T Ed Doable Fee $ Structural'R /® CCF $ CO/CC $ DBPR $ Bond $ ion Fee $ Technology Fee $ TOTAL FEE NOW DUE $ i?.'r9:Atals @6; thexEatorsE s Wen 's"' - Magna Lemlef's Address City S Zip A COMMglatta gaits ppliartian is lambs ��qy,�,,,, q'+yyam�.,�, ti @aim a t R o do ,, @p �q installations as �y.� ... { q. the Rai Ham. or Hffi $ do Ula. 01 a and t2 am wifl 'o t» '.Y 7LI4YlBi.. � CE nanstrudion Oils @staL,v rEe3irar@ immierstand Uinta =plum pemit MUSLIM =mud for NUIECTRICAL WORK, 1411114OUNG, , WHIM MRS, 11 Va .!11 :.(01 MUMS, MENEMS,,TANKSamii AIR CONIDITTIONIMS,BFC.-- .1m 1 : a the Rowing infinumfita is =untie and Ilna ,d Asatk a iinam te `tai Fi�akUtia i . "WARNING TO O % V$. #!; FAILURE TO °R vie «'° t o NOTKE OF COMMENCEMENT MAY RDWULT IN YOUR PANG TWICE TOR P TO YOU 1'1? 't 1 IF YOU INTEND TO OBTAIN RECORDINGYt I° NOTI OF 6 IA to lipprwanr its 7Q ' <tlFOatf@ ltFt6. to the issuance ea an caimated wake weerring the mat psonize ff good lJFBSf glea m atop *the notice 44zonenneneneret a : - t! {t.:;. law IdFifillll tre me he a3`iGtL.dlwed go the pen= w a.s jet r asuchssent Also. of ecorronencement anus .he,postalsa she jnb Ate feg. ghe fps - g pwatt as balsa In the atm= of eniTh peesed minx, glae acme -r#L' [ uraI x aggeoneda zd loner f }sE Ln[se. IL`,..111J OatmerarAgeni / `' t;@t��A .,E�, E� Q C� 6 i L Qvo, a4L( A + a ),4, ;47 instrument was etheryieleited &fere zim Ibis a7 t* The - jestoneeet was 11,b >a V I'd i 'fit-he , (`- , 1 `ae0" Ak -1 ,t whois aiti' . vita Ins produced 'as3Y) �, i6':9 i3AY. O, 11120 trr peationed As iderdriantion ar liL7 late an aaik 6, and admiral :,$ 'ai& Saw blyeansmisfonfaphem r 1J�1 /%✓f t1 C -STATE OF FLORIDA ,i'*ISl4, Sylvia Halter 1.,;,.� I Commission # EE098053 'tiorgw„„.$ Expires: JUNE 08, 2015 BONDED THAU ATLANTIC BONDING CO, MC. 4 .-4-7, 'Y /.Plans?- roramirer Stractura) Review f, Aif.. • r Chat Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. _COPY OF QUALIFIER'S STATE LIC CARD B. X COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. X COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 — COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: l\ S€X\J 1 QLD \AC BUSINESS ADDRESS: WY), SE 1 � ' P, CITY ` C of\ STATE — ZIP CODE ‘SS F g Q BUSINESS PHONE: (2 (61 " (cal FAX NUMBER (ZzF col kczn CELL PHONE ( �� QUALIFIER'S NAME: , ' \C\3\ (k QUALIFIER'S LIC NUMBER: EC 13o-0 Lt E-MAIL ADDRESS (IF APPLICABLE): ,..\e @) Q e .4-es .}1 1 sv S . c c m Created on 3119139 BY WOV 1 RV 3I26189 MLDV STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 KVIDT, JEREMY RYAN AEROTECH SERVICES INC. 5970 SW 1ST COURT CAPE CORAL FL 33914 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487 -1395 -STATE DE FLORIDA _.. AC# 6 0 7 l 4 43 DEPARTMENT OF 'BUSINESS AND PROFESSIONAL REGULATION EC13004687 05/12/11 107067728 CERTIFIED ELECTRICAL CONTRACTOR KVIDT, JEREMY RYAN AEROTECH SERVICES INC. IS CERTIFIED under the proc,iatone of Ch.4 8.9 F9 Expiration dater AUG - =3i, 2012 W.1051200485 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL, REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ# L11051200485 DATE BATCH NUMBER LICENSE NBR 05/12 /2011 107067728 EC13004687 ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2012 KVIDT, JEREMY RYAN AEROTECH SERVICES INC. 5970 SW 1ST COURT CAPE CORAL FL 33914 RICE :SCOTT` GOVERNOR DISPLAY AS REQUIRED BY LAIN KEN LAWSON SECRETARY \Pec` LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2011 - 2012 Tax Co ` , for ACCOUNT NUMBER: 1103669 443 of SOka Location 710720 NE 25TH AVE STE 32 CAPE CORAL FL 33909 AEROTECH SERVICES INC HESS MICHAEL J PO BOX 100846 CAPE CORAL FL 33910 y flax Co for ACCOUNT NUMBER: 1103670 4teof Pia ACCOUNT EXPIRES SEPTEMBER 30, 2012 May engage in the business of: CERTIFIED GENERAL CONTRACTOR THIS LOCAL BUSINESS TAX RECEIPT 1S NON REGULATORY THIS IS NOT A BILL DO NOT PAY PAID 298978 -1 -1 09/22/2011 09:53 BXM1 $50.00 vj-cr4 le4udp!SII- LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2011 - 2012 Location 710 720 NE 25T1-I AVE STE 32 L FL 33909 AEROTECH SERVICES IN KVIDT JEREMY R PO BOX 100846 CAPE CORAL FL 33909 ACCOUNT EXPIRES SEPTEMBER 30, 2012 May engage In the business of: ELECTRICAL CONTRACTOR THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY THIS IS NOT A BILL - DO NOT PAY PAID 298900 -1 -1 09/21 /2011 09 :15 MW R1 $50.00 CERTIFICATE Of LIABILITY INSURANCE DATE (MALD rYYYY) 4/19/2012 THIS CERTIFICATE IS ISSUED AS A MATTER Cr MIRNAWATION CE RTINCATE DOES NOT AFRITMATIVELY OR NEGATIVELY BEI.ON. DINE CERTIFICATE OF TRANCE DC NOT FLEPRESOITATIVE OR PRODUCER AND THE CERTWICATE Y AND COWERS N0 RIGHTS UPON THE CER1WICATE HOLDER. INS EICTEND OR ALTER THE COVERALE AFFORLED BY THE PCSMIES A CONTRACT BETWEEN THE ISSIANG INSURERS), AUTHORIZED IMPORTANT: if dm certificate holder Is an ADDITIONAL INIMRED, the po1cy(tes) Heart be endorsed. If SUNLOGATION IS WAIVED, subject to the terms and condithms of the poNcY, cerhain pandas tnay remdre an endosseartint. Astatement on this certificate does not confer dglds to the car bidder in Nu of such s). PRODLOM SOUTH FLORIDA CASUALTY 415 North 4th Street Lantana, FL 33462 -CONTACT NAME (ANe.Eap: (561) 533 -6144 i ot, twy (561) 533 -6170 momemBlaine@southfloridacasualty.cam CUSTOMER ID*: AFFORDING COVERAGE NAIL# INSURED Aerotech Services Inc. P.O. Box 100846 Cape Coral, FL 33910 INSURER A: Scottsdale Insurance Company 41297 INSURER a: The Travelers 27998 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFiCATENUMBER: REVISION M EER: THIS IS TO CERTIFY TI4AT THE FIXICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS NAMED ABOVE FOR THE POLICY PERiOD INDICATED. NOTIACCHSTMINNG ANY REQUIREMENT. TERM OR OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VN#CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE AFFORDED BY THE POLICIES DESCRII3ED HEREIN IS SUBJECT TO ALL TIE TERMS. EXCLUSIONS AND CONDITIONS Cr SUCH POUCHES. LIMITS SH0M8 MAY HAVE BEEN DEDUCED BY PAID CLAIMS. IM TYPEOFTMUMMX is GENERAL UALVUTY A SuBR POLICYT:FF PIIUCY E3IP X COMMERCIAL GENERAL. EMBODY lCLAIMS-MADE D OCCIM GBN1A TE�LMITAPPLIESPN3t POUCY 1 (` 1cr j Iwc AUFOMOOLE LIAMUTY B x ANYAUTO AU.OINNED AUTOS SCHEDUUSTAUTOS FARED AUTO M3NiROODAUTO8 03/08/12 03/08/13 LSSTS EACH OCCURRENCE $ 1, 000,000 LEVAAGE To RtNTL:U Pty (Fa saaara ce) MED SW (Anyaroperamr) PERSONAL RADII INJURY s 100,000 $ 5,000 s 1,000,000 GENERA! ANTE PRODUCTS - C AGG s 2,000,000 $ 2,000,000 BA- 8018P726 03/12/12 03/12/13 GOMMNEO LDMT (E) $ $ 1,000,000 BODILY INJURY (Per person) $ BODILYINJL8tY (Per a s PROPERTY DAM** (P » a $ $ LANIREU A Ld1B 2E DLCE8S LIAR A DES E IX I OCCUR Y, RETENTION s WORKERSCOMPENSATION ANDENKMERGUMUW ANY PRDPRETomPARTNIEFMECIMVE (Mandakey InMI) Iysa,desa be under DESCRIPTION OF OPERATIONS below XBS00k0650 03/08/12 03/08/13 EACH OCCURRENCE AGGREGATE s 5,000,000 $ 5,000,000 $ s YIINN NIA I I TSI 1ER E.L. EACH ACCIDENT $ El - EAEMPLOYEE s EL OFSEAEIE _ POLICY UNIT Lt A Installation Floater CPS1357502 03/08/12 03/08/13 $500,000 DEsmsFnION OF OPERATIONS /LOCATEMs IvemlE8 (AttaMACORD 10L. Remedsbdre U, I7 amrespem b required) CERTIFICATE HOLDER CANCELLATION I Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF TIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIE EXPIRATION DATE THBREF, NOTICE W1.L BE DEUVERED IN ACCORDANCE HRH THE POLICY PROVISIONS. AUTHORIZED iTATTVE HdAvoil ACORD25 (2009/09) The ACORD name 01988 -2009 ACORDCORPORATION.AR Tights reserved. and logo are registered marks of ACORD A °® CERTIFICATE OF LIABILITY INSURANCE 14� E011MDii ) THIS CERTIFICATE IS ISSUED AS A MATTER OF 1 - • CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA BELOW. THIS CERTIFICATE OF INSURANCE DOES REPRESENTATIVE OR PRODUCER, AND THE ' . • i:' TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS = Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES • CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED HOLDER IMPORTANT: If the ate holder Is an ADDITIONAL the tom hums and conditions of the policy, certain polfcdas certificate holder In lieu of such endorsement(s). INSURED, the poIlcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject t0 require an endorsement. A statement on this certMcate does not confer rights to the PRODUCER Main Street America 1GA, Inc. 21977 mast X1118 Drive Porter TX 77365 CONTACT Certificate Department (281) 999 -5544 1 Futikt hift (281.)577 2678 E Ammiimmcertenhapeo.com URa is COVERAGE NAM 0 mummeA Casualty Company INSURED Harbor America Coastal, Inc. Aerotech Services, Inc. INSUIIFItS: INSURER C: Bus :(239)673 -6166 Fax:(239)673 -61 1107 SE 12th Place INGLIRER It : OISURERE: pe Coral FL 33990 INSURER F: COVERAGES CERTIFICATE NUMBEkCL1232909307 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR OF INSURANCE Elf NUM POUCY CpYYTYPE LIMITS QI3(ERAL LIA8U ITY CIMAMEitcAt UN/1M EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea oarsrenc $ 1 CLAIMS -MAC ❑ OCCUR MED EXP (Any one person) $ PERSCMAL B AO/ INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APP�UES I POLICY' LPI ! PER I LOC PRODUCTS - COMPRP AGG $ $ AUTOMOBILE — LIABILITY ANY AUTO Au. AUTO HIRED AUTOS — SCHEMED AUTOS Amos SINGLE LIMIT $ .Y INJURY (Per person) $ BODILY INJURY (Perm:Went) $ (Per acdslenli $ $ UMBRELLA UAB EXCESS LIAR _ OCCUR GAS EACH OCCURRENCE $ AGGREGATE $ DEO 1 I RETENTION$ $ p' WORKERS COMPENSATION AM/ EMPLOYERS' LIABILITY YtN N t A 1- 0 -03 4,1,2012 4/1/2013 WC STATU- X !TORY wars I I FR EL EACH ACCIDENT $ 1,000,000 $ 1,000,000 ANY PROPm Ws. Mandatory In NH) EXCLUDED? DES( RI OF OPERATIONS betkm EL DID - EA EMPLOYEE EL DISEASE - POUCY UIBr $ 1,000 , 000 DE PTION O F OPERATIM ILOCATI0NSt V E H I C L E S ( A tt a c h A C O R D 101, Ramie SvImdule, Wmam e Is required) Workers' Compensation coverage is to all payroll active employees of Harbor America Coastal, Inc.. leased to Aerotech Services, Inc. is afforded Workers' Compensation & Employers Liability as a co- employer under the policy for empl leased from Harbor America Coastal, Inc. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Bldg Dept 10050 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NO1ICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISION AUTHORIZED REPRESENTATIVE Rick Walker /ASHW1 ie'ir/'' m ACORD 25 (2010105) I SO2Srxnrsnim ®1988 -2010 ACORD CORPORATION. Al rights reserved. Tim scrum m�r inns am i ni f m i rnarire of A VIRO • Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 MIAMI SHORES VILLAGE NOTICE TO BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER THE FLORIDA BUILDING CODE I (We) have been retained by MetroPCS Florida, LLC . to perform special inspector services under the Florida Building Code at the FL- 616 , SW6 -144 project on the below listed structures as of 04-26-12 (date). I am a registered architect or professional engineer licensed in the State of Florida. PROCESS NUMBERS: ❑ SPECIAL INSPECTOR FOR PILING, FBC 1822.1.20 (R4404.6.1.20) ❑ SPECIAL INSPECTOR FOR TRUSSES >35' LONG OR 6' HIGH 2319.17.2.4.2 (R4409.6.17.2.4.2) ❑ SPECIAL INSPECTOR FOR REINFORCED MASONRY, FBC 2122.4 (R4407.5.4) ❑ SPECIAL INSPECTOR FOR STEEL CONNECTIONS, FBC 2218.2 (R4408.5.2) ❑ SPECIAL INSPECTOR FOR SOIL COMPACTION, FBC 1820.3.1 (R4404.4.3.1) ❑ SPECIAL INSPECTOR FOR PRECAST UNITS & ATTACHMENTS, FBC 1927.12 (R4405.9.12) ❑ SPECIAL INSPECTOR FOR Antenna Upgrade Note: Only the marked boxes apply. The following individual(s) employed by this firm or me are authorized representatives to perform inspection * 1. Lks Vc0wk C 2. 3. 4. *Special Inspectors utilizing authorized representatives shall insure the authorized representative is qualified by education or licensure to perform the duties assigned by the Special Inspector. The qualifications shall include licensure as a professional engineer or architect; graduation from an engineering education program in civil or structural engineering; graduation from an architectural education program; successful completion of the NCEES Fundamental Examination; or registration as building inspector or general contractor. I, (we) will notify Miami Shores Village Building Department of any changes regarding authorized personnel performing inspection services I, (we) understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Village Building Department Inspector. All mandatory inspections, as required by the Florida Building Code, must be performed by the County. The Village building inspections must be called for on all mandatory inspections. Inspections performed by the Special Inspector hired by the Owner are in addition to the mandatory inspections performed by the Department. Further, upon completion of the work under each Building Permit I will submit to the Building Inspector at the time of final inspectimfilei bbiviplet professiq ` jucigtriOtR subst at*corOricee` Sigma nd 't ealed inspection log form and a sealed statement indicating that, to the best of my knowledge, belief and /portions of the project outlined above meet the intent of the Florida Building Code and are in oved plans. Engineer /Architect �o. 72397 TE O DATE°, 'Z. IONAG flip/ n rari t ds� Created on 6/10/2009 NameMaria Martin PE #72397 plan Address1920 Wekiva Way, Suite 200 West Palm Beach FL 33411 PhoneNo. 561 845 0665 �-u■u ' X1201 20.0& 7 NOTE: ALL SHEET MUST BE REVIEWED MIAMI -DADE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT Herbert S. Soffit Permitting and Inspection Center 11805 SW 26th Street (Coral Way) • Miami, Florida 33175 -2474 • (786) 315 -2100 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI -DADE FIRE RESCUE AND /OR DEPARMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT MUNICIPAL PROCESS NUMBER HERE LOCATION OF IMPROVEMENTS (P�ROVVIDE Job Address �b05.. rA E (I l51 Stiff CONTRACTOR INFORMATION !� Contractor No CG C � i 1�(y CP Folio \ \ ®3 ':A. . D 1 4 \ A 1 1D Last four (4) digits of Qualifier No. Ci 456- , Lot Block Contractor Name ri f'o'R ch U ) 1 Qualifier Name P1.1 IC, RS Subdivision Address \10'1 5E j a-'''''° 1\ . Metes and bounds C'V►A l State— Zip 3 D TYPE OF IMPROVEMENTS [ i New Construction on Vacant Land [ 1 Alteration Interior 1 At Alteration Exterior 1 1 Relocation of Structure [ 1 Enclosure E ) Repair [ 1 Repair Due to Fire [ 1 Demolith 1 [ Shy Only 1 1 Addition Attached [ ] Addition Detached [ 1 Re -Roof [ 1 Foundation Only Current use of property teIet om Description of Work remove and replace antennas Sq. Ft. 49 Units Floors Value of Work $5.000 w 'a [ A MBLD* Category 10 REVIEW STATUS 1 1 Chg. Contractor [ 1 Re -Issue [ 1 Re -Stamp [ ] Revision [ 1 Not Applicable for Are I m w % Owner Address E 1 MELE City State Zip [ 1 MLPG Phone 1 1 MMEC Last four (4) digits of Owner's Social Security No. [ x] FIRE PERSON TO PICK UP PLANS Name Tyrone Ruiz or Heather /John Smo[[ett ARCHITECT / ENGINEER Owner VOY S. WS b)+-ef ),rn Address heather @fasttracpermit.com Address e City State Zip City State phone 954- 275 -8990 or 954- 868 -3869 _Zip Phono FIRE SPECIAL. REQUEST PLAN REVIEW (SRI) l am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at the rate of $190 for the first hour and $65 per each additional hour in addition to the review fees. Minimum charge one -hour. 1• Request Date: 2nd Request Date: 3id Request Date: DERM OPTIONAL PLAN REVIEW (OPR) I am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline. Additional review fees may apply. 1E1 Request Date: ltd Request Date: 3'd Request: Date: 123_01 -182 12/09 0 6 417064 011 sector \FL -616 \CAD \Cover.0W0 T -1 8 6 metroPCS FLORIDA, LLC. 1000 SAWGRASS CORPORATE PAR<WAY, S.,ITE 400 FT. LA.,DERDALE, FL. 33323 MIAMI SHORES PRESBYTERIAN CHURCH (SFL -616, SW6 144) 602 \I- 96T SIRE-T N AM S OR- S, L 33138 LAT T„D- 25 °51'48.96 " \, LONG T-„D= 80 °11'05.28 "W VICINITY MAP FROM METROPCS OFFICE: TAKE 1 -95 SOUTH TO THE NE 95TH STREET EXIT. GO EAST ON NE 957H STREET TO NE 6TH AVE. GO NORTH ON NE 6TH AVE TO NE 96TH STREET. CHURCH /STEEPLE IS ON THE SOUTHEAST CORNER. DRIVING DIRECTIONS balranmt ol4brvke, b HimtlW *T fa'Ne aped pwpae mM chant lam .0, it aas , P.Iforaft. ,,Th& Raw, of aM *,tN, by Ubn. m ,, =lent wen.n eRt.� amwraotan as moat.. by Nog xan As�nem ond bc, aM0 Ue WOmt .14 to VOTO,Man old — Assoc... be THIS IS AN APPLICATION FOR AN: UNMANNED WIRELESS DATA FACILITY CONSISTING OF ANTENNA & COAXIAL CABLE UPGRADES. (3) EXISTING ANTENNAS TO BE REMOVED AND REPLACED WITH (6) NEW ANTENNAS. PROJECT DESCRIPTION ALL WORK AND MATERIALS SHALL BE PERFORMED AND INSTALLED IN ACCORDANCE WITH THE CURRENT EDITIONS OF THE FOLLOWING CODES AS ADOPTED BY THE LOCAL GOVERNING AUTHORITIES. NOTHING IN THESE PLANS IS TO BE CONSTRUED TO PERMIT WORK NOT CONFORMING TO THESE CODES. 1. 2010 FLORIDA BUILDING CODE 2. NATIONAL ELECTRIC CODE (NEC) WITH LOCAL AMENDMENTS LATEST ED. 3. ANSI/TIARA APPLICABLE STANDARDS 4. LIFE SAFETY CODE NFPA -101 -2006 5. FLORIDA FIRE PREVENTION CODE 2007 6. AMERICAN INSTITUTE OF STEEL CONSTRUCTION SPECIRCATIONS (AISC) 7. UNDERWRITERS LABORATORIES (U.L) APPROVED ELECTRICAL PRODUCTS 8. LOCH. BUILDING CODE 9. CITY/COUNTY ORDINANCES CODE COMPLIANCE APPLICANT /LESSEE MDCMC NAME: METROPCS PROJECT MANAGER: MIKE JULIAN PHONE: (954) 839 -2641 PROPERTY INFORMATION OWNER: MIAMI SHORES PRESBYTERIAN CHURCH 602 NE 96TH STREET MIAMI SHORES, FL 33138 CONTACT: SID REESE (305) 331 -4729 HANDICAP REQUIREMENTS: FACILITY IS UNMANNED AND NOT FOR HUMAN HABITATION. JURISDICTION: MIAMI —DADE COUNTY PROJECT INFORMATION EQUIPMENT LOCATION: ❑ OUTDOOR ® INDOOR ❑ GUY TOWER ❑ SELF SUPPORT TOWER ❑ MONOPOLE FA ROOF TOP ❑ NEW TOWER ❑ OTHER PROJECT SUMMARY CIVIL ENGINEER: KIMLEY —HORN AND ASSOCIATES, INC. 1920 WEKIVA WAY, SUITE 200 WEST PALM BEACH, FL 33411 (561) 845 -0665 STRUCTURAL ENGINEER: N/A ELECTRICAL ENGINEER: N/A SURVEYOR: N/A TOWER ENGINEER: N/A PROJECT TEAM SHEET DESCRIPTION REV. T -1 COVER SHEET 0 C -1 SITE PLAN 0 C -2 TOWER ELEVATION AND RFDS 0 EV.: =DATE: DESCRIPTION: d ®GEC S®A g ti ° A1� 1° 2012 No. 72397 ¢2 1 . STATE OF ).AN ' PIREPARED BY:' itK}mley —Horn i /Wand Associates, Inc. © 2012 KIMLEY —HORN AND ASSOCIATES, INC. 1920 WEKIVA WAY, SUITE 200 WEST PALM BEACH, FLORIDA 33411 (561) 845 -0665 FBPE CA00000696 DRAWN BY: =CHK.: APV.: MM LF LR I—LIC E DAVID STEWE: ART PE 31180 KEVIN M. SCHANEN PE 60251 LEO REPETT1 PE 57573 MARIA VICTORIA MARTIN PE 72397 HEET TITLE COVER SHEET HEET NUMBER REVISION• T -1 0 KHA Job #: 041417064 SHEET INDEX ISSUED FOR: SIX SECTOR UPGRADE DATE: MARCH 2012 metroPCS FLORIDA, LLC. 1000 SAWGRASS CORPORATE PARKWAY, SUITE 400 FF. LAUDERDALE, FL. 33323 = PROJECT INFORMATION: MIAMI SHORES PRESB. CH. SFL -616, SW6_144 602 NE 96TH STREET MIAMI SHORES, FL 33138 MIAMI —DADE COUNTY = CURRENT ISSUE DATE: 19 MARCH 2012 — ISSUED FOR: SIX SECTOR UPGRADE EV.: =DATE: DESCRIPTION: d ®GEC S®A g ti ° A1� 1° 2012 No. 72397 ¢2 1 . STATE OF ).AN ' PIREPARED BY:' itK}mley —Horn i /Wand Associates, Inc. © 2012 KIMLEY —HORN AND ASSOCIATES, INC. 1920 WEKIVA WAY, SUITE 200 WEST PALM BEACH, FLORIDA 33411 (561) 845 -0665 FBPE CA00000696 DRAWN BY: =CHK.: APV.: MM LF LR I—LIC E DAVID STEWE: ART PE 31180 KEVIN M. SCHANEN PE 60251 LEO REPETT1 PE 57573 MARIA VICTORIA MARTIN PE 72397 HEET TITLE COVER SHEET HEET NUMBER REVISION• T -1 0 KHA Job #: 041417064 Apr 18, 2012 3:58pm by: morio.mortln 9 9 0 0 3 \WPB_CM \CELL SITES \MetroPCS \0 IS 0 POI OUTLINE OF EXISTING CONCRETE TOWER EXISTING EQUIPMENT ROOM WITHIN CONCRETE TOWER ELEV. 40' -0" A.G.L. 4TH FLOOR OF TOWER EXISTING METROPCS ENODE FIBER BOX EXISTING COAXIAL CABLE ENTRY PORT A. be EXISTING EQUIPMENT ROOM ACCESS HATCH EXISTING OVERALL SITE PLAN 0 2 4 SCALE AS SHOWN NOTE' SITE PLAN BASED ON FIELD OBSERVATIONS CONTRACTOR SHALL VERIFY ALL DIMENSIONS snaww cmminp ° "°f"* —`e m m 1 Pace of 00 00, ,eU 0, 0n 0 Eae t Itatt.7 to ItinOtry-Horo d ,. loos EXISTING ROOF ACCESS HATCH EQUIPMENT ACCESS TO ROOM S13K. WAT DATE EXISTING HVAC EXISTING METROPCS PPC CABINET APPROVED -i� A pr t d�aapp UI �t r us"'4a d,0 XISTING INTERIOR ROOM L-- I II / 1 L I // �i LL _� L- ENLARGED EXISTING LAYOUT N.T.S LEGEND EXISTING METROPCS PPC CABINET OA EXISTING 4.05 RADIO CABINET 35.4 "WIDE x 40 "DEEP x 72 °TALL TO REMAIN © EXISTING BATTERY CABINET TO REMAIN © EXISTING LTE CABINET TO REMAIN metroPCS FLORIDA, LLC. 1000 SAWGRASS CORPORATE PARKWAY, SUITE 400 FT. LAUDERDALE, FL. 33323 = PROJECT INFORMATION: MIAMI SHORES PRESB. CH. SFL -616, SW6_144 602 NE 96TH STREET MIAMI SHORES, FL 33138 MIAMI —DADE COUNTY = CURRENT ISSUE DATE: 19 MARCH 2012 = ISSUED FOR: SIX SECTOR UPGRADE = REV.: =DATE: -DESCRIPTION: °a° ° °y.�t. "® °°L, E N s 9 ®• N®. 72597 \* * APR ° E 2iu i2 STATE OF '�`C t3 F? q <� e ,'��yy'��r��c�...aa ; e C'''',.‘ — 1ffis8 priElFWEV BY: ,.Kimley © WEST —Horn and Associates, Inc. 2012 KIMLEY -HORN AND ASSOCIATES, INC 1920 WEKIVA WAY, SUITE 200 PALM BEACH, FLORIDA 33411 (561) 845 -0665 FBPE CA00000696 DRAWN BY: =CHK.: APV.: MM [1_ LF 1 LR (CSR EN U DAVID STEWE: ART PE 31180 KEVIN M. SCHANEN PE 60251 LEO REPETTI PE 57573 MARIA VICTORIA MARTIN PE 72397 HEET TITLE SITE PLAN HEET NUMBER REVISION C -1 0 KHA Job #. 041417064 a 8 6 fe 12 01 as 6 TRUE NORTH 350° 0° SECTOR 1 290° SECTOR 6 1111411WA 270 °; 230° SECTOR 5 180° SECTOR 4 60° SECTOR 2 90° 120° SECTOR 3 CONTRACTOR SHALL USE SURVEY INFORMATION TO ALIGN ORIENTATION OF ANTENNA SUPPORT STRUCTURE(S) WITH BEARINGS SHOWN IN DIAGRAM ABOVE. COAXIAL CABLE COLOR CODE SECTOR 1: RX — RED TX /RX — RED & WHITE SECTOR 2: RX — BLUE TX /RX — BLUE & WHITE SECTOR 3: RX — GREEN TX /RX — GREEN & WHITE SECTOR 4: RX — RED TX /RX — RED & WHITE SECTOR 5: RX — BLUE TX /RX — BLUE & WHITE SECTOR 6: RX — GREEN TX /RX — GREEN & WHITE ANTENNA ORIENTATION DIAGRAM N.T.S. ANTENNA SECTOR (SW6 -144) AZIMUTH IN DEGREES ELECTRICAL DOWN TILT MECHANICAL DOWN TILT ANTENNA MAKE /MODEL /QUANTITY COMPOSITION CABLES LENGTH SIZE QTY. SECTOR 1 350° 4° 0° (1) ANDREW SBH -3DA 100'± 7/8 "0 2 SECTOR 2 60° 4° 0° (1) ANDREW SBH -3DA 100'± 7/8 "0 2 SECTOR 3 120° 4° 0° (1) ANDREW SBH -3DA 100'± 7 /8 "o 2 SECTOR 4 180° 3° 0° (1) ANDREW SBH -3DA 100'± 7/8 "4 2 SECTOR 5 230° 3° 0° (1) ANDREW SBH -3DA 100'± 7/8 "0 2 SECTOR 6 290° 4° 0° (1) ANDREW SBH -3DA 100'± 7/8 "4 2 Wa Warmest .m. a.. es as a ntaa bomb. w as *pass and :� 1.Aa�.tt a by withart M shalt be *itt .1 Wyly to to Kb H"'' pW Am"aebttn. 1. gyp• NOTE: ALL COAX CABLE LENGTHS ARE APPROXIMATE, CONTRACTOR TO VERIFY EXACT LENGTH IN THE FIELD PRIOR TO CONSTRUCTION. RF TO ADJUST EDT ON ALL ANTENNAS. ELEV. 160' -0" ELEV. 150' -0" EXISTING METROPCS ANTENNAS ELEV. 112' -0 "± ELEV. 100' -0" ELEV. 95-0" ELEV. 80' -0" ELEV. 75-0" ELEV. 60' -0" ELEV. 30' -0" ELEV. 20' -0" ELEV. 10' -0" ELEV. O' -0" (3) EXISTING METROPCS ANTENNAS TO BE REMOVED AND REPLACED WITH (6) NEW ANTENNAS. EXISTING MOUNTS TO REMAIN. NEW MOUNTS TO MATCH EXISTING. EXISTING ANTENNAS �J L� CHURCH ELEVATION N.T.S EXISTING ANTENNAS metro PCS FLORIDA, LLC. 1000 SAWGRASS CORPORATE PARKWAY, SUITE 400 FT. LAUDERDALE, FL 33323 = PROJECT INFORMATION: MIAMI SHORES PRESB. CH. SFL -616, SW6_144 602 NE 96TH STREET MIAMI SHORES, FL 33138 MIAMI —DADE COUNTY = CURRENT ISSUE DATE. 19 MARCH 2012 = ISSUED FOR: SIX SECTOR UPGRADE = REV.: =DATE: DESCRIPTION: ..�Awp�l �:m �! I iii',, " g lye y y, {Tl :. T k.�i '�9 ,/> No. 72397 APR 11. 71'2 STATE OF ice I CANIIS I41"' RE,D .BYty'' , 0 WEST Kimley —Horn Tland Associates, Inc. 2012 KINLEY —HORN AND ASSOCIATES. INC 1920 WEKIVA WAY, SUITE 200 PALM BEACH, FLORIDA 33411 (561) 845 -0665 FSPE CA00000696 PRAWN BY: =CHK.: APV.: MM [i_ LF LR (CR ENSU DAVID STEWE: ART PE 31180 KEVIN M. SCHANEN PE 60251 LEO REPETTI PE 57573 MARIA VICTORIA MARTIN PE 72397 HEET TITLE• TOWER ELEVATION AND RFDS HEET NUMBER REVISION* -2 0 KHA Job #: 041417064 ,L/2 £7/2 &sc./7 1.)ACtl,' • • -•••• •••• Process No: Project Name: 4bkess: foo?-- Doi Appris. DPP W 1111 11111 • 110111111111111111 Not Applicable Disopp ot Applicable • CC,12.4ib Miami Shores Village APPROVED ZONING DEPT BLDG DEPT BY DATE SUBJECT TO COMPUANCE WITH ALL FEDERAL STATE AND COI INTY RULES AND REGULATIONS 2 ,2 x',.4r—lyeeptkr •