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ELC-12-2304Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 182527 Permit Number: ELC -12 -12 -2304 Scheduled Inspection Date: December 17, 2012 Inspector: Devaney, Michael Owner: DAVIES, JOHN Job Address: 1041 NE 94 Street Miami Shores, FL Project: <NONE> Contractor: LANGER ELECTRIC COMPANY Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050120080 Phone: (786)251 -8585 Building Department Comments INSTALL 7 LED LANDSCAPE LIGHT CONDUIT FOR SPEAKERS AND TIME CLOCK. Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments December 14, 2012 For Inspections please call: (305)762 -4949 Page 33 of 41 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 i i'L -7ANi5 BU DING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 1041 NE 94 ST City: Miami Shores FBC 20 ID Permit No. r - of 3 Master Permit No. Folio/Parcel #: 11 32050120080 County: Miami Dade zip: 33138 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER: Name (Fee Simple Titleholder): MIAMI CTRY DAY SCHOOL INC Address: 601 NE 107 ST City: MIAMI State: FL Tenant/Lessee Name: Phone #: (305) 758 -5569 zip: 33238 Phone #: Email: CONTRACTOR: Company Name: LANGER ELECTRIC COMPANY Address: 6500 NW 21st AVENUE, SUITEI City: FORT LAUDERDALE Qualifier Name: ROGER LANGER Phone #: 954.984.8489 State Certification or Registration #: EC0000099 Certificate of Competency #: Contact Phone#: 954.984.8489 Email Address: info @langerelectric.com DESIGNER: Architect/Engineer: Phone #: 954.984.8489 State: FL zip: 33309 Phone #: Value of Work for this Permit: $ 2400.00 Square/Linear Footage of Work: Type of Work: Address OAlteration ❑New ❑Repair/Replace ❑Demolition Description of Work: Install (7) LED landscape lights, conduit for speakers & (1) time clock Submittal Fee $50 Scanning Fee $ Notary $ Double Fee $ * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * **** * * * * * *** x***** ********* Permit Fee $ /1.? CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Structural Review $ Technology Fee $ 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of c) > mencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue l. rn the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature / ! Signature Owner or Agent The fore of u g ins meent was ac. , owledged before me this day of'tt!' by M' ci� �j0 who is personknown tom r who has produced As identification and who did take an oath. NOT ' UBLIC: Sign: Print: My Commissi ULiANA CUEVAS Notary Public - State at Fcdda Commission # DD 881908 My Comm. Expires Apr 20. 2013 • ' ar. Nr?t ?onai Notary Assn. Contractor The foregoing instrument was acknowledged before me this 5 day of DECEMBER 20 /2 , by Roger Langer who is personally_ known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: •• T. B. PLYLER J. Ex qug E6,2015 Sign: Print: TB PLY 'ER::„, My Commission Expires: ,1u t-r /toy Z€2( * * * * * * * * * ** c *?$* 42k*** * * * * * ** , .:. ***************************** ***** ********* *** ********** **** ; APPROVED BY .�'� Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Miami-Dade County. Real Estate Tax Information http://egvsys.miamidade.gov:1608/wwwserv/ggvt/txcaw01.dia?foli... Show Me: I RqyatyTems Search : Select Item.....) Detail Tax Information: Real Estate Tax Info 2012 Taxes Prior Years Taxes Due 2012 Ad Valorem 2012 Non-Ad Valorem 2012 Back Assessments 2012 Enterprise Folio 2012 listorical Abatements 2013 Quarterly Payments 2012 Tax Notice/MemoranduM 52002 6a44-Dede County A8 rights maned. Real Estate Tax Information Today's Date: 12/05/2012 Last Update: 12/03/2012 Tax Year: 2012 Folio Number: 11 32050120080 MIAMI SHORES Owner's Name: MIAMI CTRY DAY SCHOOL INC Property Address: 1041 NE 94 ST Mailing Information: MIAMI CTRY DR1' SCHOOL INC 801 NE 107 ST MIAMI FL 33238 Legal Description: KIRBYS ADD TO MIAMI SHORES PB 41-44 LOT 8 LOT 505 515 VALUE To view 2012 Tax Notice/Memorandum click here 2012 Taxes are In paid status, Amounts due are subject to change without notice. Contact Information E-Mail: proptaxn, miamidade.gov (305) 270-4916 Downtown Office: 140 W Flagler St, Room 101 Miami, FL 33130 Office Hours: Mon - Fri 8:00 AM - 4:30 PM Related Links: Tax Collector Property Florida State Dept of EMMA, 12iggegyTeyBome 1 Real Estate Tax Info 121117Lar 1Flor Year% I 20120833AL15I02011 29.12J 820kooeoomon10 2012 Enterprise Fold I 2212JE8tai 124119illi,20d. 2212zr MIIMI2S22.800113 I UMW 011, 688 I r81811.1.1 P12010 Dfroct10v 1 Biwa I Pisch■mer E-mail your comments, questions and suggestions toWebmastr 1 of 1 12/5/2012 12:48 PM Miami COUNTRY DAY SCHOOL December 6, 2012 RE: 1041 N.E. 94 St, Miami Shores, FI. 33138 To Whom It May Concern: Mr. Gary Butts, Chief Operating Officer is an authorized signer on behalf of the corporation, Miami Country Day School, Inc., owner of the above addressed property. Sincerely, Anne Paulk, President Board of Trustees Miami Country Day School, Inc. t�-' tco Ill x V,QA v■ot1,\A 6\,-owt(-1-6 liAsz a�,..Ya. L��NA CUEVAS 3 1 Notary Public - State of Florida g' a Commission # DD 881908 '' ✓':¢' My Comm. Expires Apr 20, 2013 Bonded Through National Notary Assn. 601 Northeast 107 Street 1 Miami, Florida 33161 1 305.759.2843 1 Fax 305.759.4871 1 www.miamicountryday.org Every Student. Every Day. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 LANGER, ROGER E LANGER ELECTRIC COMPANY 6500 NW 21ST AVENUE SUITE 1 FORT LAUDERDALE FL 33309 (850) 487 -1395 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 bette 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 learn 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 EC000009 a 128033830 RACTOR CERTIx`T? gyration' date:': provisions of ::c) $,89 Fs 14 <L12080802012 IS DOCUMENT 14 ORCD BACKGROUND MICRDPRINTIING LINEMARKT' PATENTED PAP' °E OF:::;FLORI BUSINESS AND PROFESSIONAL J Gi7LATION CTRIC CONTRACTORS .LICENSING BOLD ocutit L12080802012 LICENSE NBJ 0:8/08`;/2012 28033830.... c000009.,' The ELECTRICAL co Named:;. below IS CERTIF2 D Under the provisions of "Chapter Expiration date: AUG :31, 2014, ;; LANGER, RUDER LANGER ELECTRIC COMPANY 6500 NW 21ST AVENUE SUITE 1 FORT T AUDERDALE FL ' RICK SCOTT fIfiPl AY AS RF(J!!IRF11 RY I AW KEN LAWSON SECRETARY` 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000 VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013 DBA: Business Name: LANGER ELECTRIC COMPANY Owner Name: LANGER, ROGER E. Business Location: 6500 NW 21 AVE 1 FT LAUDERDALE Business Phone: Rooms Seats Employees 20 Receipt #:E EC RICAL /ALARMS /CONTRA Business Type: (CERT ELECTRICAL CONTRAC Business Opened:o9 /06/2007 StatelCountylCert/Reg:EC0000099 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 54.00 0.00 0.00 0.00 0.00 0.00 54.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: LANGER, ROGER E. 6500 NW 21 AVE STE #1 FORT LAUDERDALE, FL This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and /or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 33309 2012 - 2013 Receipt #04A- 11- 00012590 Paid 08/14/2012 54.00 LANGE -2 OP ID: J3 �" INSURANCE DATE (MM /DD/YYYY) 03107/12 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 - '=LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED PRESENTATIVE 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 954 - 776 -2222 Brown & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 954- 776 -4446 P.O. Box 5727 Ft. Lauderdale, FL 33310 -5727 Andrew Noye, CIC, CRIS CONTACT NAME: PHONE FAX (A/C. No. Exth (NC, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hanover American Insurance Co+ 36064 INSURED Langer Electric Company dba Langer Electrical Services Co 6500 NW 21st Ave, Suite #1 Fort Lauderdale, FL 33309 INSURER S: *Hanover Insurance Co.+ 22292 INSURER C :*FFVA Mutual Insurance Co.+ 10385 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ 5,000 COVERAGES CERTIFICATE NUMBER: REVISION 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. INSR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POUCY EXP (MM/DD/YYYY) LIMITS A - -- GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ZZJ765636502 03/10/12 03/10/13 EACH OCCURRENCE $ 1,000,000 DAMAGES (RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES 'E& PER: LOC Emp Ben. $ 1,000,000 B AUTOMOBILE X _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS ANO O -SWNED AHJ947590200 03/10/12 03/10/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESS LIAR X OCCUR CLAIMS -MADE UHJ765636002 03/10/12 03/10/13 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENT ON $ -0- $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N / A WC84000183242012A 01/01/12 01/01/13 X WC STATU- TORY LIMITS X OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A Equipment Floater ZZJ65636502 03/10/12 03/10/13 Leased / Rented Eq 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMI -1 Miami Shores Building & Zoning g g 10050 NE 2nd Ave Miami Shores, FL 33128 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 (2010/05) © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EXISTING PANEL NEW TIME CLOCK Project: MIAMI COUNTRY DAY SCHOOL 3/4" PVC CO DU1T ITH THREE 112 PROTECTED BY . A 20 AMP I3REAKER EVE LED 6W LANDSCAPE LIGHTS EMPTY CON'DHIT AND TWO BOXES ES FOR FUTURE SPED E S ^,IH V C[ WI rl-I ALL FEDERAL Larger Elec :trio; E C. 40 io tai). Roger L TF7e torte ,trig ire s rumq, t'Aeas- ackknowldged ` before Fre this cia r. of C- ZO tZ tit MIAMI COUNTRY DAY SCHOOL HEAD MASTER' S HOUSE 1041 NE 94T11 STREET MIAMI SHOI ES0; -FL 33138 P ersonally knoirn or pr o du c 2d .identification.. Type of ident f cation. produc ed: Date: Lnescription For: B Drag