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ELC-15-1700 (2) Permit NO. ELC-7-15-1700 Miami Shores Village Permit Type:Electrical-Commercial .� 10050 N.E.2nd Avenue NE e r m i work Classification: LOW Voltage •'• Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 Issue Date:7/10/2015 Expiration: 01/06/2016 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Health & Sport 1121360010160-23 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone $ 22,400.00 Valuation: CONTROLS SYSTEMS CONTRACTINC (786)472-3499 Total Sq Feet: 0 Type of Work:ENERGY MANAGEMENT SYSTEM INSTALLATI Available Inspections: Additional Info: Inspection Type: Classification:Commercial Review Electrical Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $13.80 invoice# ELC-7-15-56266 DBPR Fee $10.89 07/08/2015 Credit Card $50.00 $737.58 DCA Fee $10.89 Education Surcharge $4.60 07/10/2015 Check#:3427 $737.58 $0.00 Permit Fee $726.00 Scanning Fee $3.00 Technology Fee $18.40 Total: $787.58 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict con ity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume ponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PL ING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni hermore,I authorize the above-named contractor to do the work stated. July 10,2015 Authorize ignature:Owner / Applicant / Contractor / Agent ate Building Department Copy July 10,2015 1 �V R Miami Shores Village �, �• JUL 0 2015 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 C,TN FBC 201 BUILDING Master Permit No.MC-7-14-1502 PERMIT APPLICATION Sub Permit No.I`LL' 1 '5— ❑BUILDING FE-1 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING [:] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION SHOP CONTRACTOR DRAWINGS JOBADDRESS: 11300 NE 2ND AVE SUITE HEALTH AND SPORTS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:1121360010160-23 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):BARRY UNIVERSITY Phone#: Address: City: State Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: CONTROLS SYSTEMS CONTRACTING Phone#: 786-472-3499 Address: 7330 S. WATERWAY DR City: MIAMI State: FLORIDA Zip: 33155 Qualifier Name: GONZALO FERNANDEZ Phone#: 305-322-2489 State Certification or Registration#: EC 13006661 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$22,400 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of work: ENERGY MANAGMENT SYSTEM INSTALLATION 8 RTU'S AND 20 VAV'S Specify color of color thru tile: Submittal Fee$ CK) Permit Fee$ 7 CCF$ (, Q CO/CC$ Scanning Fee$ Radon Fee$ G- L DBPR$ v v Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 13041ing 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 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT C ACTOR The(foregoing instrument was acknowledged before me this The foregoing instrum was cknowledged before me this 0 day of/"t 0',/ 20 ,by C� l day of I�l� 20��.by ,Sen who' persoAknowno G0ti n iF who is Cersonally known me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: \\`\`�� �S ////// NOTARY PURL C: SIP � •••••••••••Q� // Sign: •�yG2B?o�fo: Sign:/ • on Print: �'L/�.7 A� — '• "'S Print: cd Z .�s AW., ''•. ROXANA FERNMIDEZ Seal: 9�'. O 7 Seal: +?' �-_ ii'�}i•';�cl ..•QO\�A� a•, ,�; EXPIRE5MY SJune 3F2018� ATE Ck` 0� ;Rd� Q".•'- Bonded Thru Notary Public underwriters lllllllllN ############################################################################################################ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STAT FE� A orEta E?F BUSINESS AND PF21�SIC7tdAiGULA"tIC3N ECt3i}t36661 `a t'=.< d204 CEFMFI ,E s`,"-TOR CDIVTI`tL?LS SYS, � TANG,INC. t$COR MJ�D under the provisions of Ch.489 FS. Hanan dM AUG 31,2016 X150 1251 Local Business,Tax Receipt Miami—:Dade County, State of Florida -THIS 13-NOT A BILL-DONOT PAY LBT 5402342 BUSINESS NAMEROCATION RECEIPT No. EXPIRES CONTROLS SYSTEMS NEW BUSINESS SEPTEMBER 2x15 CONTRACTING INC 7466576 17053 NW 79 AVE Must be displayed at place of business DORAL. FL 33126 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS CONTROLS SYSTEMS 196 ELECTRICAL PAYMENT RECEIVED CONTRACTING INC BY TAX COLLECTOR CONTRACTOR 45.00 05113/2015 Worker(s) 1 EC13006661 0221-15-005686 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt Is not a ficomm, permit,or a certification of the holder's goallfications,to do business.Holder mast comply With any governmental of nongovernmental rogalatorylaws and requirements which apply to the business. The RECEIPT N0.above must he displayed as all commercial vehicles-Miami_B d#Code See ea-275. Muac1 sFor more Information,visit W".miamidade aov/laxeo I,Le E t ACCWOCERTIFICATE OF LIABILITY INSURANCE i DATE(Ml1q/DDiYYYY) I 06/29/15 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. ff 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(.). —— PRODUCER CONTACT NAME: JULIO JIMENEZ Jimenez&Co.,Inc. PHONE 305 264-9900 FAX 305 264-5382 8000 Coral Way tA/C do.EXU—(olio )Im---------- a-JN°�. � 0�----- EMAIL _ADPJ3€SS: 1 @I enezandcompany.com Miami,FL 33155 1 INSURERS)AFFORDING COVERAGE NAIC @ Phone (305)264-9900 Fax (305)264-5382 INSURER A: SCOTTSDALE INSURANCE_COMPANY INSURED INSURER B: PROGRESSIVE INSURANCE COMPANY CONTROLS SYSTEMS CONTRACTING INC INSURER_C: GUARANTEE INSURANCE COMPANY 1705 NW 79 AVE INSURER D: ESSEX INSURANCE COMPANY DORAL,FL 33126 INSURER E: ----- 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._ LTR TYPE OF INSURANCE IVS - D UBR —— — — POLICY EFF POLICY EXP ----- POLICY NUMBER MM/DD/YYYY MMIDDNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000.00 PRE ASEE(_Ea 000_urrenceL $ A ❑ ❑ CLAIMS-MADE © OCCUR Y CPS2075102 I MED EXP(Any one person) $ 5,000.00 11/15/2014 11/15/2015 ❑ PERSONAL BADV INJURY $ 1,000,000.00 ❑ -- GENERAL AGGREGATE s 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG $ 1,000,000.00 D POLICY ❑ PRO- JECT ❑ LOC I _ $ AUTOMOBILE LIABILnYCOMBINED SINGLE LIMIT Ea accident 1,000,000.00 D ANY AUTO BODILY INJURY(Per person) $ AUL OS SCHEDULED 01912479-2 I BODILY INJURY Per accldenl $ B ❑ Auros ❑O AUTOS Y 10/24/2014 10/24/2015 � ( Q HIRED AUTOSR1NON-OWNEDI PROPERTY DAMAGE AUTOS Per accident)__ $ ❑ O ___ __ ____ _ _�� _ $_ _ ❑ UMBRELLA LIAR ©OCCUR EAi CH OCCURRENCE $ 2,0 0,000.00 D EXCESS UAB ❑CLAIMS-MADE MAPXS00004336 02/11/2015 02/11/2016 AGGREGATE $ 2,000,000.00 ❑ DED ❑ RETENTION$ I $ WORKERS COMPENSATIONI ©WC STATU• OTH- AND EMPLOYERS'LIABILITY Y/N I TORY LIMlll'S_❑ ANY PROPRIETOR/PARTNERIEXECUTIVE WCP100639505GIC E.L.EACH ACCIDENT $ 1,000,000.00 C OFFICER/MEMBER EXCLUDED? N/A 05/10/2015 05/10/2016 -- (Mandatory In NH) If C] E.L.DISEASE•EA EMPLOYE $ 1,000,000.00 es,descdbe under -- ---- DESCRIPTION OF OPERATIONS below_ I E.L.DISEASE•POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) LICENSE NO.EC13006661 • I CERTIFICATE HOLDER CANCELLATION SHOULD ANY TH ABOYE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPI O DA E THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDAN THE POLICY PROVISIONS. ! — � MIAMI SHORES,FL 33138 AUTHOR' D R R SEN ATIVE 305-795-2204 988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)OF ACORD name and logo are registered marks of ACORD