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EL-14-2075Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220185 Scheduled Inspection Date: October 06, 2014 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 64 NW 111 Street Miami Shores, FL 33168 - Project: <NONE> Contractor: TRI -CITY ELECTRIC CO INC Building Department Comments INSTALL 6 NEW LED SECURITY LIGHTS Permit Number: ELC-9-14-2075 Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1121360030380 INSPECTOR COMMENTS False Inspector Comments Passed 21 Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Phone: (305)642-5428 October 03, 2014 For Inspections please call: (305)762-4949 Page 7 of 17 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 �0 C IVFD SEP 2 4 2014 _Y: FBC 2010 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. FIC-C-114®7-0-ls ❑BUILDING [RELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL E] PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION SHOP 1�l K ►'�Y 1 CONTRACTOR DRAWINGS JOB ADDRESS: LvI I rh 6t(t)f7t City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: i_ — [ 3 M'039® Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: q FFE: a OWNER: Name (Fee Simple Titleholder) (W I An I yllfrS itQ Phone#: �. 1�• -L S Address: 42)W ` 0cl N(-, City: Ut C. ry i State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Tri -City Electric Co., Inc. Phone#: 305-642-5428 Address: 625 N.W. 16th -Ave. City. MiamiState FL Zip: 33125 Qualifier Name: D.R. Borden Jr. Phone#: 305-642-5428 State Certification or Registration #. EC0000136 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: J1x)6 (-&�E Ifl7'�f L f'i {L�Il_11 C Specify color of color thru tile: Submittal Fee!' Permit Fee $�1cs A �' CCF $ CO/CC $ Scanning Fee $ `_a �—%� Radon Fee $ cxy DBPR $ a , a Notary $ 99 Technology Fee $ " �® Training/Education Fee $ G ` Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ (Z TOTAL FEE NOW DUE $ \, I - -:;V Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zi 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 approved and a reinspection fee will be charged. Signature—LALYM OWNER or AGENT The foregoing instrument �was . aackknnlowledged before me this CrID -day of -E4 `-- 20 by A" NrowtuAll who is p�onally k_ no_n�p me or who has produced identification and who did take an oath. NOTARY PUBLIC: as Signature ONTRACTOR The foregoing instrument was acknowledged before me this 'C day of 20by who +Lersonallytknow)nt me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: i it > �N sS211dX3 , '� "YP% JEFFRY J. YAO eal: a`q P�Al % ®ARBARA9tiARCZ j a"M # NO18Sid M00 AN MY COMMISSION # EE36829 *; € MY COMMISSIOid $ FF 002878 r .',�.- EXPIRES: Aprfl 4, 2017 ®dA 'f Al33gf mom' °��oc�3` EXPIiYF�: Nov®Ita 12, 2014IRP•� be` Bonded Thru Nary Publb Undervmtere 1.8p0.3NOTABY FI. NotayD Awn CO. ,,, �k�kA�Me APPROVED BY0/4£/L-- , 4( f �� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RICK SCOTT; GOVERNOR KEN ----- ,SECRETARY STATE OF FLORIDA DE BUSINESS AND P O E$SIONAL REGULATION ELECTRICAL C®TRACTORS LICENSING BOARD - { The ELECTEICAL CONTRACTOR ` A MMIK Naxned'fv�15 CERTIFIED �.. under a `p�ovis ons of C'ba{ -ter X89. 5. , Ex gra o; dale AUG 31L - D Clf'BLEG R -3 s r �y Y ISSUED: 06/03/2014 DISPLAY AS REQUIRED BYLAW SEQ# L1406030001106 . li. R CERTIFICATE OF LIABILITY INSURANCE `•� DATE (MM/DDIYYYY) 6/24/2014 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(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 Keen Battle Mead � Company 7850 Northwest 146th Street Suite 200 Miami Lakes FL 33016 CONTACT NAME: Cynthia Hernandez PHOA/CNE (305) 558-1101C No: (305)822-4722 E-MAIL ADDRESS: chernandez@kbmco.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Indemnity 5658 INSURED Tri -City Electric Co., Inc. 625 NW 16th Ave Miami FL 33125-4611 INSURERB:Travelers Indemnity Co of Amer 25666 INSURERC:Travelers Prop Cas Co of Amer 25674 INSURER 0Brid efield Employers Ins Co 10701 INSURERE:Underwriters at Lloyds 15792 INSURER F: COVERAGES CERTIFICATE NUMBER:14/15 GL/AL/WC/UMB 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 LTR rypE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA TO RENTED PREMISES Ea occurrence $ 300,000 A CLAIMS -MADE Fx_] OCCUR C03664P993TIA14 /1/2014 /1/2015 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 X Blnkt Contractual & XCU X Broad Form Prop Damage GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICYX PRO LOC $ AUTOMOBILE LIABILITY SINGLE LIMIT COMBINEDEa accident $ 1,000,000 B X ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS T8103664P993TIA14 /1/2014 /1/2015 X X NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Medical payments $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE DED I X RETENTION$ 10,00 $ UP3664P993TIL14 /1/2014 /1/2015 D WORKERS COMPENSATIONX TTWC STATU- OTH- AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 11000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 83045364 /1/2014 /1/2015 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below E Professional Liability ANE106826414 /1/2014 /1/2015 Each Occurrence 500,000 Aggregate 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) License # EC0000136 I It NULUI Miami Shores Village Building Department 10050 N.E. 2nd Ave Miami Shores, FL 33138 ACORD 25 (2010/05) IN302.5 oninnai ni 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 Perez/JMT - a ©1988-2010 ACORD CORPORATION. All rights reserved. Tho Arr)Pr1 nnmo =nrl Innn aro ronictororl markc of Ar:r)I ESTABLISHED 1946 CONSTRUCTION (305) 642-7822 1-800-480-8646 SERVICE (305) 642-5428 1-800-480-8642 FIRE SERVICE (305) 541-3254 1-800-480-8642 EXPOSITION/ EVENT SERVICES (305) 691-4900 Fax: (305) 693-3546 DATA AND COMMUNICATIONS SOLUTIONS (305) 642-7822 NECK ./Aft IRM TRI -CITY ELECTRIC CO., INC. June 3, 2014 Barry University 11600 NE Second Avenue Miami Shores, FL 33161 Attn: Gene Wojtynek Re: Barry University Security LED lights 64 NW llla' Street Dear Mr. Wojtynek: We are pleased to offer our electrical quotation for the above-mentioned, subject to the following qualifications and exceptions: We are to furnish and install six (6) new LED security flood lights around reference above house. Proposal includes: 1. All applicable taxes. 2. Power branch wiring and conduit. 3. New LED lights. 4. Permit fee budget. Proposal excludes: 1. Patching, repairing, and painting of walls and ceilings. 2. Any utility companies charges. Our quote is as follows: Labor 16hrs x $65.00 each................................$1,040.00 LED Lights 6 x $150.00 each..............................$900.00 Material pipe and wires.....................................$224.00 Sub Total ................................................... $2,164.00 Permit fee budget............................................$400.00 Total......................................................... $2,564.00 If you should have any questions regarding this quote, please do not hesitate to contact our office. Sincerely, TRI -CITY EIACTRIC CO. INC. Ra ae O. Fuentes Service Manager Acceptance to Proceed: By: Date: The above quote is valid for fourteen (14) days due to rapidly escalating material cost. If approved in beyond (14) days, we will re-evaluate this quote to ensure that costs have not changed. In this quotation, we have attempted to foresee all costs arising from the direct and indirect impact. DarryUniversity 11300 N. E. 2ND AVENUE MIAMI SHORES, fl 33161-6695 PHONE (305) 899-4910 V E Tri -City Electric Co Inc N 625 NW 16th Ave D Miami FL 33125-4611 O R SHIP & BILL TO SAME AS PURCHASER UNLESS INDICATED BELOW DELIVER: Barry University 11300 NE 2nd Ave. Miami Shores FL 33161 This order is subieot to the TAr nC anti C.nnditinnc nn tha ravAm,- ciria WORK ORDER NO DATE DATEREQUIRED BILL TO DEPARTMENT TERMS Aug 28, 2014 JBILLTONAME/LOCATION Sep 27, 2014 Net 45 Days ITEM NO. QUANTITY AND UNIT STOCK NUMBER DESCRIPTION UNIT PRICE DISC, % EXTENDED PRICE 1 1 JB LED Lights Furnish and install siz 2,564.0000 2,564.00 (6)new LED security flood lights at 64 NW 111 th Street Price includes taxes, power branch wiring and conduit, new LED lights, and permit fee allowance as per proposal dated June 3, 2014 All work governed by Terms and Conditions of Continuing Services Agreement dated April 7, 2014 10-64602-910100 Matt Cameron Housing & Residence Life TOTAL - /'_ I.A., AM{?UNT I 2,564.40 ORIGINALs aw;,at� i..,.%,% BY 'V,� TAA EXEMPT NO. 85-8012620764C-7 I)irorinr rn£ Purrha cines