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ELC-11-2157Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 - L-05(p Inspection Number: INSP - 1.6908 Permit Number: ELC -11 -11 -2157 Inspection Date: March 13, 20 2 Inspector: Devaney, Michael Owner: , BARRY UNIVE - SITY Job Address: 11300 NE 2 Ave ue Benincasa Hall Miami Shores, -L 33138 -0000 Project: BARRY UNIVER ITY Contractor: MR1 ELECTRIC CORP Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -34 Phone: (305)261 -6000 Building Department Comments PROVIDE POWER FOR 4 VERTICAL PTAC UNITS Inspector Comments , F1'e___ 7e--- Passed IM Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For Inspections please call: (305)762 -4949 March 13, 2012 Page 1 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 114\ 11-- INSPECTION'S PHONE NUMBER: (305) 762.4949 B DING Permit No. PERMIT APPLICATION FBC 20 Permit Type: Electrical NOV ?Oil B Master Permit No. e - le - Atom suat rust -4- 11 (vgq) OWNER: Name (Fee Simple Titleholder): BAR►1H O4eUE12.4 Phone #: 30S- 89q Address: 113oiv NE 214D Ave,lde 1 City: MIAMI SNoeF,.1' I State: Ft zip: 3316 Tenant/Lessee Name: Email: Phone #: JOB ADDRESS: 14445 NW1; I I S lt 51 -Krty( City: Miami Shorts County:. Miami Dade Zip: 3510,1 Folio/Parcel #: Is the Building Historically 7esignated: Yes NO Flood Zone: CONTRACTOR: Company Name: fig i i 61 tGi C- Phone #: 30S ^ 2-19 1 — 400 Address: 5 14 2— 9 , 1 - I .I1 ( 3v�Ti; Zple4 City: i1 ''A r', . State: ' Ft Zip: 33 14 q Qualifier Name: R Q ke, ct )0t r z.. Phone #: 3cS - 2 v 1 - 40. 00 State Certification or Registra ion #: GQ 130 OZG Sc., Certificate of Competency #: Contact Phone #: I Email Address: DESIGNER: Architect/ Engineer: Ike. Erde. ;Agetit&e.i UL tS /T - Phone#: 3o V"- 90r.- 46S'L_ Value of Work for this Permit: $ r 5-00 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ONew ORepair/Replace ❑Demolition Description of Work: .i7r® i ?owe,- Li vQ AO 1 i, u'M\ 1 * * * ** ,* * * * * *1** * * * * * * * * * * * * * * * * * * * *** * *x Fees * * **x * ***** ****** * * **x*x * * ** *** * * * * **** * ** Submittal Fee $ Permit Fee $ /1 ' C e"P CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 Applic4Ton is hereby made tobtgi atp t id i the work and installations as indicated. I certify that no work or installation has commented prior to the iss ce 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 AF A 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. " t'v114A "WARNING -TO OWNER: YOUR FAILURE TO RECORD 12A` - °N� TICE 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." k /'s 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 afier the building permit is issued. In the absence of such posted notice, the inspection will not be approved nspection fee will be charged. Signature Octeutut,6) Owner or Agent I Contractor The foregoing instrument was acknowledged before me this I sr The foregoing instrument was acknowledged before me this j1 day of NMI a , 20 i% , by 1 Ch 6D V./AR C , day of 1■10417044.. , 20 t t , by T— J are2,- 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. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ^ u Sign :. Print: Print: My Commission Expires My Co • 0" . 1 ceigekrimew cly COMMISSION u DO 757331 EXPIRES: March 14, 2012 •• Bonded linn Nome Put& underoters "1 II 11 APPROVED BY `�� .„92., ZA 6' Plans Examiner ' Zoning Structural Review Clerk (Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) DBPR - ALVAREZ, AEL A; Doing Business As: MR1 CORPORATION, Electrical... Page 1 of 1 8:37.:24 AM 11/21/2011 Licensee Details Licensee Inform = tion Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications ALVAREZ, RAFAEL A (Primary Name) MR1 CORPORATION (DBA Name) 16525 SW 76 STREET MIAMI Florida 33193 DADE Electrical Contractor Cert Electrical EC13002656 Current,Active 02/22/2005 08/31/2012 Qualification Effective View Related License Information View License Complaint Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 :: CaII.Centeradbpr.state,fl.us :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copvrinht 2007 -2010 State of Florida, Privacv Statement Under Flori Ida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public- records request, do not send electronic mall to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions regarding DBPR's ADA web accessibility, please contact our Web Master at webmasterOdbar.state.fi.us. https: / /www.myflorid license.com/LicenseDetail.asp?SID=&id=7C1F1FE926E528F8DD... 11/21/2011 On, AWRIJ CERTIFICATE OF LIABILITY INSURANCE `.,. ---- DATE DD 02/09/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE 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 ho der 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 requre an endorsement. A statement on this certt lcate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER WELLS FARGO INS. SERV. USA -CH, NC 6100 FAIRVIEW ROAD, SUITE 800 PO BOX 220748 CHARLOTTE, NC 26222 c TEACT (/ CCI O. Ex0.. 1 iM". Na icskss INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: HARTFORD FIRE INSURANCE COMPAN LIABIUTY COMMERCIAL GENERAL LIABILITY INSURED 3348 STRATEGIC OUTSOURCING, PO BOX 241448 CHARLOTTE, NC 2224 INC. INSURER B: INSURER C: INSURER D: $ INSURER E $ INSURER F: $ COVERAGES CERTIFICATE NUMBER: 2,979 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POL IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING A REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF UCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TYPE OF INSURANCE at. tRND POLICY NUMBER / igvYMA t % LIMITS GENERAL LIABIUTY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ Ktati ) $ MED EXP (My one parson) $ 1 CLAIMS mar* ❑ OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ GEN'L AGGREGATE OMIT APPLIES PER: —1 POLICY n JEC ❑ LOC $ AUTOMOBILE r— _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS AUTOS NON-OWNED FaMBISED SINGLE LIMIT $ BODILY INJURY (Per fin) $ BODILY INJURY (Per saxdenl) $ PRtO ?AMAGE 1 $ $— UMBRELLA LUAB EXCESS UAB _ OCCUR CLANS MADE EACH OCCURRENCE $ AGGREGATE $ $ QED 1 J RETENTION $ WORKERS COMPENSATION A AND EMPLOYERS•UABIUTY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ 1T a r II I�H) DESCRIPTION OF OPERATIONS Flaw NIA 22WBRJ79226 03/01/2011 03/01/2012 X ITMEPA 1 Pa EL EACH ACCIDENT $ 1,000,0C E.L. DISEASE - EA EMPLOYEE $ 1 ,000,OC EL DISEASE - POLICY LIMIT $ 1 ,000,OC DESCRIPTION OF OPERATIONS /LOCATIONSMEHICLES LIMITED TO EMPLOYEES LEASED JOB: BARRY UNIVERSITY FAX: 305- 261 -6674 FAX: 305- (Attach ACORD 101, Additional Remarks Schedu e, if more space Is required) TO MR1 CORPORATION BY STRATEGIC OUTSOURCING, INC. 756 -8972 CERTIFICATE HOLDER CANCELLATION Certificate ID 2,979 MIAMI SHORES VILLAGE BUILDING DEPT. 10050 NE 2ND AVENUE MIAMI, 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 (2010105) ®1988 -2010 ACORD CORPORATION. All rights reser The ACORD name and logo are registered marks of ACORD DATE (}/IMIDDIYYYYJ CER IFICATE OF LIABILITY INSURANCE OP ID >�. 09/13/11 THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFI TIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF I URANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUC AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate ho r is an ADDITIONAL INSURED, the poIcy(les) must he endorsed. If SUBROGATION IS WAIVE , su6ject to the terms and conditions of the , certain policies may require an endorsement A statement on this certiflcate does not confer rights to the certificate holder In lieu of such a rsement(s). ' RODUCER BROWN & BROWN OF FIRIDA INC 14900 NW 79th Court Suite #200 Miami Lakes FL 33016 -5869 Phone:305- 364 -7800 Fax:305- 714 -4401 1 Corp ratio 7422l 8W 7th St eet, Suite-6 201 CAIN Haul NAME: FAX raPHONJ WC. Nor t ' Ext): I ADDRESS: — — — - — - PRODUCER CUSTOMER ID #: MR1C0 -1 INSURERS) AFFORDING COVERAGE NAM 0 INSURERA: *FCCI Insurance Company* i 10178 INSURER B : INSURER C INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tISR gUBR POLICY-TPOLICYEXP i MTS. TYPE OF INSURANCE 1N WV POUCY NUMBER (MMIDDIYYYY) i (MM1DDNYYYY) `? ( I Z ! t EACH OCCURRENCE 1 s 1, 000,000 GENERAL LIABILITY I ( DAB "Abt 1 U KtN I tt3 — A FX COMMERCIAL GENERAL LIABILITY 1 i iCPP0005309 09/01/ 11109 /01/121 PREhtiSES(Eaocwrrence) S 100,000 LIMED ExP (Any one person) ( 5,000 . CLAIMS -MADE X ' OCCUR I i 1 I ( I PERSONAL BADVINJURY y s 1,000,000 i I 1 . 1 GEN'L AGGREGATE LIMIT APPLIES PER:'. 1 X 1 POLICY ; -: JEC I 1 LOC AUTOMOBILE LIABILITY A ANY AUTO 1 1 ALL OWNEDAUTOS 1- _ 1 X ! SCHEDULED AUTOS I X j HIREOAUTOS 4 X j NON -OWNED AUTOS j UMBRELLA UAB 1 OCCUR ? i 1 EXCESS LIAR CLAIMS -PAAOE F- --I-- i DEDUCTIBLE 1 RETENTION S I, WORKERS COMPENSATION 1 AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIV I OFFICER/MEMBER EXCLUDED? I (Mandatory In NH) DzSCRIPTION OF OPERATIONS be'a"r: CA0006320 GENERAL AGGREGATE _I s 2 , 000 , 0_00 I PRODUCTS - COMP/OP AID S 2,000,000 I$ COMBS ED SINGLE LIMIT 15 300,000 09/01/11109/01/121 —� 1LYNjNJURY(Perpffisonl S BODILY INJURY (Per acc'dent)4S -- __ i PROPERTY DAMAGE S (Per accident) `S LS YINf N I A EACH OCCURRENCE $ l AGGREGATE ;$ ___________ 1. WC STATU- t 0TH-! TCRYL$MITS i . —. ?_ ER L_. —.. - E.L. EACH ACCIDENT S rE.L. DISEASE - EA EMPLOYE S E.L. DISEASE - POLICY OMIT I S DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD 104, Additional Remarks Schedule. If mare apace Is r�l ) Iii QUALIFIER NAME RAFAEL ALVAREZ QUALIFIER LICENSE EC13002656 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE MIAMI FL 33138 ACORD 25 (2009109) SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOOTIGE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR$ZED REPRESENTATIVE © 1988-2009 ACORk CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD