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DEMO-13-1006Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 3 Inspection Number: INSP-191138 Scheduled Inspection Date: June 25, 2013 Inspector: Devaney, Michael Owner: , Job Address: 9475 NE 2 Avenue Miami Shores, FL 33138 - Project: Contractor: <NONE> ECOLECTRIC COMPANY 5uuamg Department comments ELECTRICAL DEMOLITON UNDER DRIVE-THRU Passed Failed Correction Needed 0 Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. -lo3tr Permit Number: DEMO -5-13-1006 Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number Parcel Number INSPECTOR COMMENTS False Inspector Comments 1132060133760 Phone: (305)482-1788 June 25, 2013 For Inspections please call: (305)762-4949 Page 8 of 30 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 APPLICATION Permit Type: Electrical JOB ADDRESS: 9499 NE 2nd Avenue NE FBC 20 0 Permit No. Master Permit No. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-3760 Is the Building Historically Designated: Yes NO X Flood Zone; OWNER: Name (Fee Simple Address: 101 Tyron Street City: Charlotte Bank of America 81 State: North Carolina Zip: Tenant/Lessee Name: Ems. patdcia.l.ramos@bankofamedca.com 3- 1 Com% CC -13-638 33138 t55-8176 28256 CONTRACTOR: Company Name: Ecolectric Company Phone#: 305-482-1788 Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration #: EC -13001535 & EC -13003659 Certificate of Competency #: Contact Phone#: 305482-1788 Email Address. cliffjunkins@ecolectdc.us DESIGNER: Architect/Engineer: Phone#: _ Value of Work for this Permit: $ r� Square/Linear Footage of Work: _ Type of Work: ❑Address OAlteration ONew. E39cpair/Replace Description of Work: Electrical Demolition under Submittal Fee $ Permit Fee $ 1 m CCF $ CO/CC Scanning Fee $ Radon Fee $ DBPR $ Bond $. Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE ❑Demolition 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 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 WOR K, 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 bedo a in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TORECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTO Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding promise in good faith that a copy of the notice of commencement and construction lien law brochure will whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement mu for the first inspection which occurs seven (7) days after the building permit is issued. In the absence inspection will not be approved and a reinspection fee will be charged. r � Signature _-* . SIGN HERE Sianatw;eO Owner or Agent Contracts The foregoing instrument was acknowledged before me this The foregoing instrument was acknowl day of 20 L, by L& , f t day of A 20 L, by C1 who is p y kn to me or who has produced who is personally known to me or who As identification and who did take an oath. as identifica v NOTARY PUBL . N UBLIC: r v sG I Sign: Sign: a Print: print: oQ`O ops"4p6 Notary Public State of Florida My Commission Expires: + Nicole Glass My Commission Ex d1 c� My Commission EE032687 Expires 10/05/2014 sYdra: ah+ksYahkoF�sYdnY&�Y�k9e�td::Yhat�Yrka4sYs�odoskt�e�lyda�ra49r3.dz�nYrdroYdr��kdr�Y�sY�troY&rk9ck�Y&d:9t�Y&dcottYdFdteY&d2ar�k�r7edn4decYsk�TnY��Ys4 APPROVED BY Plans Examiner Structural Review (Revised 3/12/2012XIIevised 07/14/07XRevised 06/10/2009)(Revised 3/15/09) U00, the applicant must delivered to the person be posted at the job site such posted notice, the before me this_2� I Vt yck R. u 61S produced he..�dlaks an oath. Zoning Letter of Authorization Project Name: FL7-988 / Miami Shores — Shores Village 9499 NE 2nd ,Avenue Miami Shores, FL Project: Drive In Canopy Ceiling Restoration and Site Lighting Replacement May 1, 2013 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 The undersigned on behalf of Bank of America, N.A., owner of the property known as Miami Shores —:Shores Village located at 9499 Northeast 2nd Avenue, Miami Shores, Fl. (the "Property"'), hereby authorizes Alan Duryea of Lincoln Harris to act as Hank of America's agent for the purpose of executing and filing any applications or documents in connection with obtaining any permits or development approvals for the Project. If there are questions or comments concerning this document do not hesitate to contact me. Sincerely, c a Henry L. Hutson Vice President 980.387.2808 STATE OF19/ft� COUNTY OF Im The foregoing instrument was acknowledged before me this May , 2013, by Henry L. Hutson as Vice President of Bank of America, N.A. a national association, on behalf of the association. He is persopally to me or has produced as Iden ' � $'n. • j J P ' ted Name Jaid ffiC61/ Notary Public _ Mal wamm-m-wil ------ fAic#6152826 STATE CW FLOM DA 695169 !¢ 4ijv*TA8U—Q*rWpAy evemum I REM31AL IDWLEcru 12458 SW i 641, TION /- SEWL1206050124, vste6' LJLrJvzt ULAFF L; -,;- WW_, ROBERT SW 114TH C7 H. FL 3311� ECOLCOM-01 SSIMEON 14� RE', CERTIFICATE OF `LIABILITY INSURANCE °"21� 13"" 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 pollcy(ies) must be endorsed. N SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certiflcate does not confer rights to the certificate holder in lieu of such endoreemsnt(s). PRODUCER CONTACT NM Collinsworth, Alter, Fowler & French, LLC 8000 Governors Square Blvd Suite 301 Miami Lakes, FL 33016 PHONE _7 F a AIG No): (306) 362-2443 ADDRESS, GLOO132882 3/1/2013 INSU S AFFORDING COVERAGE MAIC 0 INSURERA : FCCI Commercial Insurance Co 33472 PREMISES Ea occurrence $ 300,000 INSURED INSURERS: INSURERC: Ecolectric Company INSURER D: 12450 SW 117th Court Miami, FL 33186 INSURERE; INSURER F : AUTOMOBILE X X COVERAGES CERTIFICATE NUMBER- REVISIAN NUMRFR! 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 CONTRACTOR 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. L1R TYPE OF INSURANCEPMDLPOCYEV THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SUBR POLICY NUMBER POLICYEFFMMD MMID LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 0*4 #AIW GLOO132882 3/1/2013 311/2014 EACH OCCURRENCE $ 1'0m,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5r PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,0001000 GEML AGGREGATE LIMIT APPLIES PER: POLICY X PET LOC PRODUCTS - COMPIOP AGG $ 2,OW,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS AUTO USD HIRED AUTOSX NON-OWNEDpeAUTracdderd CA00207022 3/112013 3/1/2014 COINED SINGLE LIMIT 19000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accIdent) $ DAMAGE $ $ UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTNE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 001WC13A68287 311/2013 311/2014 O STATU OTFl- X T Y L I' ER EL EACH ACCIDENT $ 1,0001000 EL DISEASE - EA EMPLOYE $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1'000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rernaft Schedule, N more space Is required) CERTIFICATE HOLDER CANCELLATInN ACORD 26 (2010/06) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Miami S THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DepartmentsVillage Build10050 ACCORDANCE WITH THE POLICY PROVISIONS. NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 0*4 #AIW ACORD 26 (2010/06) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD