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ELC-15-2776 Inspection Worksheet Miami Shores Village /� 10050 N.E.2nd Avenue Miami Shores,FL 0—C I F`— Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-255067 Permit Number: ELC-10-15-2776 Scheduled Inspection Date: March 31,2016 Permit Type: Electrical-Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: ,BARRY UNIVERSITY Work Classification: Repair Job Address:11300 NE 2 Avenue Wiegand&Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211 Building Department Comments INSTALL EXISTING CIRCUITS FOR CAFE IN LOBBY OF Infractio Passed Comments EXISTING BUILDING INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP 246974. Fire alarm pull station 1E and horn strobe not readily accessible. Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid March 30,2016 For Inspections please call: (305)762-4949 Page 7 of 34 Inspection Worksheet Miami Shores Village LD G ' (6 r ZY 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-255067 Permit Number: ELC-10-15-2776 Scheduled Inspection Date: March 31,2016 Permit Type: Electrical-Commercial Inspector: Devaney, Michael Inspection Type: Final Owner. ,BARRY UNIVERSITY Work Classification: Repair Job Address:11300 NE 2 Avenue Wiegand$Annex Miami Shores,FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: LONGMAN ELECTRIC INC Phone: (305)758-1211 Building Department Comments INSTALL EXISTING CIRCUITS FOR CAFE IN LOBBY OF lnfractio Passed Comments EXISTING BUILDING INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP 246974. Fire alarm pull station and horn strobe not readily accessible. Failed Correction � - Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid March 30,2016 For Inspections please call: (305)762-4949 Page 7 of 34 h Miami Shores Village € 10050 N.E.2nd Avenue NE ; Miami Shores,FL 33138-0000 , Phone: (305)795-2204 � Expiration: 05/02/2016 N Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Wlegand &Anr 1121360010160-08 BARRY UNIVERSITY INC Mlaml 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 $ 2,160.00 Valuation: LONGMAN ELECTRICINC WMT F (305)758-1211 cTTTY� Total Sq Feet: 0 Type of Work:INSTALL EXISTING CIRCUITS FOR CAFE Available Inspections: Additional Info: . Inspection Type: Classification:Commercial Final Scanning:3 Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# ELC-10-15-57616 DBPR Fee $2.25 10/30/2015 Credit Card $50.00 $112.30 DCA Fee $2.25 Education Surcharge $0.60 11/04/2015 Credit Card $112.30 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $162.30 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 conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS 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 a z ning. Futhermore I authorize the above-named contractor to do the work stated. November 04,2016 Authorized Signa e:Owner / Applicant / CoOtractor / Agent Date Building Department Copy November 04,2015 1 r �15 Miami Shores Village rBY: c,� D b BuildingDepartment OCT 3 2015 U0/l p 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tei:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 5�f!( FBC 201 ( BUILDING (waster Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING PLECTRIC ❑ ROOFING ❑ REVISION [] EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS [] CHANGE OF [:]CANCELLATION ❑ SHOP �f CONTRACTOR DRAWINGS JOB ADDRESS: //j Oe xle ��0 � 4e //:s(JA41 City Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ��v Phone#: Address: //6"40 AO'," 2*D City: &AV x;410 -f State: �G ZIp: .�.�A�� Tenant/Lessee Name: ',014e,6J 0 1x1f,4,11-rr1 Phone#:-00 '✓�� Email: ��5/® /o/��® C►= l//��. �O� CONTRACTOR:Com any Name: QWWW—&145eI-Ale' Phone#: ✓ z ' Address: L�U ` City: IvAefW1 -S/��1T®�G� State: �� Zip: .*01.. 40 Qualifier Name• 1W 1e11�/W1--4- L.®,d0/W/f/l Phone#• - State Certification or Registration#: eC13040 3 '7/9 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: / City: State: Zip: Value of Work for this Permit:$ x® Square/Linea;Repair/Replace of Work: Type of Work: El Addition F_] Alteration ❑ New ❑ Demolition Description of Work: T-&5�1 / LXo �A) S r>'��> 4?k G eft �¢�✓ Le b y of e m s , Specify color of color thru tile: Submittal Fee$ Permit Fee$ /.!`� °04P CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/EduceMon Fee$ Double Fee$ Structural Reviews$ Bond$ x TOTAL FEE NOW DUE$ I (ReviseM2/24/2014) 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 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 inspection fee will be charged 4Signature Signature Owner or Agent Contractor The foreg i /t was acknowledged before this"2 The foreg ' g instrument was acknowledged before me this day of�Q �. ,by—5i>4'Av G � o', day of ems' 201 I !%e./ Gtr4,L,��✓ who is personally known to me or who has produced who' �: as me or who has produced d As identification and who did take an oath. tification and who did take an oath. NOTARYPUBLIC: NOTARY PUBLIC:� 1j �T�foiFo Sign Sign: Punt' --�`�'� r N i �'— Print My Co7.z."710., Expires: _ IFFY/ '�c� My Co 0 5 ' NO"Public Pew a Florida �',�rr��I �`` MY Commissbn FF 0=21 APPROVED BYPlans Examiner Zoning Structural Review Clerk (Revised 3/1=012XRevised 07/10/07)Wwised 0611=MXRevised 3/15/09) t . � _._._..._.._. .__ ......__........__............__....._..._..... __..__._...__ .- - RICK SCOTF,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CWrRACTORS LICENSING BOARD EC13003-113 I The ELECTRICAL CONTRACTOR ; Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2018 LONGMAN, MICHAEL W LONGMAN ELECTRIC 844 NF.-98TH A?IfAAAi SHQRS�°"'" :: 138 MUM. OM 2014 DISPLAYAS REQUIRED BY LAW SEQ a L1407240001832 Local 'untie * Rooelpt ml , emi Qade C53urity� Arte � Ftoric{a THIS I NOTA�'J R - O'NOTpIIY 6137004 a arat�aly aa. E,1CP� i j t wwuu + t C c "EMSIOR=300»0110' - MUitbeftp*edai*m**fbUWfteft�- MINE MIJ111 t Fl 33162 Pumam m CduMyr Code' j arOA-AR.9&10 OWN6it, SM T"M OF BUMAM III tONG1NArt;E1EMC INC 196 ELECTRicAL coW"ACTQg,, ey T OR fCUD03713 Wwker(s) 1 $75.00 00/15/2015 MWCA1zD-15-5141053 nk lmad Bashm aTax �t Paq tlMl�Idem 9x Tax.The Reost�Is rm a Iiaem% Itadb Ora 1 lewp9 wh tire gmemnow Tde BECBP?N0.eAwra¢ M oa ell aa �votes-19�i-0ada P.e�aB�so 8a-,�8. Farmene � I I I r , co CERTIFICATE OF LIABILITY INSURANCE 1 0812412015 DATE '") 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(8),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the p~las)must be endorsed. If SUBROGATION IS WANED,subject to to tens and conditions of to policy,certain policies may require an endorser ent. A sfaternant on this certificate does not confer rights to the certificate holder in IMu of such endomerre s PRODUCER Pontell Insurance and Financial Group,Inc. PHONE � �IFAX 407888-13M 1484 Tuskawilla Road E reAIL eiti!@Forftlllftsurance.com Oviedo,FL 32765 License#:D051255 '� s AFFORDING COVERAGE NAIc s wauRERA: NatlomNlde Insurance Company of America 25463 - - INSURED wsumRB: P Longman Electric Inc INC: 844 NE 98th St IND: Miami Shores,FL 33138 wIRAIME: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-1461506 REVISION NUMBER: 1S 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 INSURANCEPOLICY NUMBER AWL SUDR POLICY EFF POLICyfyyyj Y EXP limns VAIDrA X coMae:gaL GENERAL LIABILITY ACP5905107300 0910712015 09107/2016 EACH OCCURRENCE $ 2,000,000 RENTED - CLAIMS-MADE a OCCUR7 000iffrenow $ 100.000 MED EXP Arty aye person) $ 5,000 PERSONAL a ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES FFR GENERALAGGREGATE $ 2,000,000 X POLICY0 J� [—]LOC PRODUCTS-COMPIOPAGG $ 2.000.000 $ OTHER B AUTOMOBILE LIABILITY 03264540-0 09107/2015 M0712016 M N SINGLE LIMIT $ 1,09Q1000 a d ern ANY AUTO BODILY INJURY(Per WSW) $ ALLOYYNED SCHEDULED BODILY INJURY(Per exhlent) $ AUTOS X AUTOS VNm $ HIRED AUTO AUTOS PROPERLY DAMAGE $ ummJ.LA LIAR EACH OCCURRENCE $ EXCE88 LIAB CLAIM&MADE AGGREGATE $ DED RETENTION$ $ WORIMIS OETRH AND EMPLOYERS'LIABILITY Y/N ATUTE ANY PROPRIETORIPARTNER/EXECUTIVEE-1 N/A EL EACH ACCIDENT $ OFFlCERNAMER EXCLUDED? (Manddery In NH) E.L.DISEASE-EA EMPLOYE15 $ Nye d P nONnntda EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATION3 belay DESCRIP TION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101.Additional Ranaft schedule,stay be aft B nwe apace Is requhad) EC 13003713 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE MagRATiON DATE THEREOF,NOTICE WILL BE DELIVERED IN P-305-795-2207 ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave AUTHo�Eo parr Miami Shores,FL 33138 EMC m 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD Printed by EMC on August 24,2016 at 09:23AM JRC DATE(hWDINYYYY) T�'•e`+�'+P CERTIFICATE OF LIABILITY INSURANCE R001 15/5/2015 THIS CERTIFICATEIS 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(les)must be endorsed. If SUBROGATIONIS WANED,subject to the terns 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 endomement(s). PAYCHEX INSURANCE AGENCY INC QVC.No.E* (ArC.rwr. (888) 443-6112 210705 P: F: (888) 443-6112 B, PO BOX 33015 9M1RER(S)AFFCRDINOCOVERAGE t SAN ANTONIO TX 78265 WWRERA: Twin City Fire Ins Co 29459 MMUMM DOWRERB 045LHW R C: LONGMAN ELECTRIC INC NSURERD: 844 NE 98TH ST 94SUFIME: MIAMI FL 33138 HNKIRERF: 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. kin 17PB0FOOMAWCE ADDL SURR POLWYAWAIRM POLCPEFF POLICTAMP Laoms LrR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g CLAIMS-MADE❑OCCUR DAMAGE TO RENTED $ PREMISES araarence MED EXP(Arty are Pelson) PERSONAL&ADV INJURY GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY JJEECTT❑LOC PRODUCTS-COMP/OPAOO OTHER: AUTOMOBILE LIABILnY COMBINED SINGLE LIMIT(Ea soddent) Lg ANY AUTO BODILY KIURY(Per Person) ALL OWNED SCHEDULED BODILY INJURY(Pa aa*nt) AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTYDAMAGE AUTOS (Pff ) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ WOOMCOAVOMMV X ANPA3fiWTA LMRUn7 STATUTE ER ANY PROMETORJPARTNERIEXECUnVE Y1 N E L EACH ACCIDENT 1, 000, 0 0 0 OMCERIA03UM EXCLUDED! A ( y&A" N/A 76 WEG IX1296 05/01/2015 05/01/2016 DISEASE-EA EMPLOYEE $1, 000,000 IfSCRI OF OPERATIONS below i I-DISEASE-POLICY LIMIT 61,000, 000 I I T DfSCRaPT/OMOFOPFRATIONS/LOCATE/V6BCLE8(ACORD 101,�disorml Remarks Sah&ft may be aged H mom epee la regWraM Those usual to the Insured's Operations. LIC# EC13003713 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village AUTHOIM REPRESENTATIVE 10050 NE 2ND AVEC_ MIAMI SHORES, FL 33138 ®1888 2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are regishwed marks of ACORD yt Ica0OrFIC- E opy Gmtkvered f mw ,i. MPH) ��ry (42"N) 1 —1 _ U— FLOOR PLANa SCALE:11,C=r-W Ocl s 15 vinu ;.. ..• ..: •.: •.• : : ..• APPROVED RY DATE 70N1NG DEPT -- • •.. • • • -f7_DG DEPT ..• • . • • 44 �� J �L 3 !3 "{. CT TO COMPLIANCE WITH ALL FEDERAL """JT'r RUI_FS AND REGULATIONS • • • • • • • e • • G.. + • •• •• • • • •• •• L C.- is 2-7-_7_�