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ELC-16-2375 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-266699 Permit Number: ELC-8-16-2375 Inspection Date: September 06,2016 Permit Type: Electrical - Commercial Inspector: Devaney, Michael Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: New Job Address: 11300 NE 2 Avenue Health &Sports Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-23 Project: <NONE> Contractor: TRI-CITY ELECTRIC CO INC Phone: (305)642-5428 Building Department Comments ELECTRIC FOR NEW SCOREBOARD (BASKETBALL Infractio Passed Comments GYM) INSPECTOR COMMENTS False Inspector Comments Passed E�/ Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 September 06,2016 Page 1 of 1 WN ir sK� Miami Shores Village s Pertj*.T)" Efer! 10050 N.E.2nd Avenue NE 4 ' '�+�Ci{+ .5� Miami Shores,FL 33138-0000 : �t�ct. tato 'A , — m Phone: (305)795-2204 , 2t? ° �� Expiration: 25/2017 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 Celt 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 Valuation: $ 1,500.00 TRI-CITY ELECTRIC CO INC (305)642-5428 (305)642-7822 ...., .. ._,,... ... ._,.a, m _.,..... __.. , _ __ Total Sq Feet: 0 Type of Work:ELECTRIC FOR NEW SCOREBOARD(BASKET Available Inspections: Additional Info: Inspection Type: Classification:Commercial Final Scanning:3 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoice# ELC-8-16-61097 $2.25 08/29/2016 Check#:4367 $ 110.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 08/24/2016 Check#:4361 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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 and zoning. Futhermore,I authorize he above-nam d contractor to do the work stated. August 29,2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 29,2016 1 C-4 -IT A G 2 4 ZM, Miami Shores Village 5BY: Building epartment 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949J FBC 20 NA-( BUILDING Master Permit No. 239 PERMIT APPLICATION Sub Permit No. (BUILDING ❑ELECTRIC F-1 ROOFING n REVISION [--j EXTENSION ❑RENEWAL ❑PLUMBING F-1 MECHANICAL F--j PUBLIC WORKS F--j CHANGE OF F-1 CANCELLATION [--j SHOP CONTRACTOR DRAWINGS JOB ADDRESS, C— City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: I I— Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone:—BFE:—FFE: OWNER:Name(Fee Simple Titleholder):'lacrA Col Phone#: Address:113M R-E, g�xa A-4t, I City: KA,artk- State: Zip, Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name n-(-jiQ fk6f-i IC'- coouc-- Phonek Address: Las tju--) lwu City. miomi State: Zip: Qualifier Name: -h-R. 60rdeA Jr. Phone#: M5 MIMI State Certification or Registration#:ECAMM 1 3u 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- F Addition EJ Alteration E-1 New ❑ Repair/Replace F—IDemolition t Description of Work- BCL� Af- Mw �LVQrr -baske,16MA M Specify color of color thru tile: Submittal Fee Permit Fee CCF$ CO/CC$ 0 A2 2 Scanning Fee$ 0, Radon Fee DBPR 2 - E; Notary jo Technology Fee Training/Education Fee$ (0 - 40 Double Fee$ Structural Reviews 2 Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) f A • Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage tender'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..... OWNEWS•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. 1 "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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will b harged. SignatureSignature i OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2,21K day of \.1 " 120 11 by X2-6 day of_ ;:� .20 k(O by SUSAN kSki Q ./ ,who is persona�ll rknown to V[� ,Q,,{)_, who is person1ally known to moor who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY BUQ NOTARY PUBLIC: e._ Sign: Sign: /� j n : Print: t___i rkA k_4 L kftc f S k/4 J YaoCINDY L.DRISKA jConunion FF 188ae1 Seal: NOTARY PUBLIC �0' Expkes t ti12t2o16 STATE OF FLORIDA Comm#FF006051 APPROVED BY � �, Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY � STATE O'F FLORIDA DEPARTMENT OF BUSINESS A!ND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC00001 B6 - ' TheELECTRICAL CONTRACTOR Named-below3lS CERTIFIED Under tt a prow islonsrof Chapter4,89 FS. Ex Dation date AUG 3 I,2016- - BORDEN, DIS LARD-,R-JR pip. TRI-CITY-8CECTRIC CONCa 1362/DEER9iVG BAX�F� T Y UNIT 903 y r � rY p if - ISSUED: 06/03/2014 DISPLAY AS REQUIRED BY LAWN SEQ# L1406030001106 i • r.......... I 000538 1,Gil4 lr'.D dr �r, rr,r,{u.v7nntyrr r 5 SSt( 6arI tef of�1d xr a�+ 'ilVI ��a'4' t2r t t W t+� tiz 5yaA{,yptrp '—THI$r'�3 NdT'A�SIU, rlb (] P a{s 4�(i Jr5r6 - ,ti�+ rV."2 266510 o , hti€ Yd ) I 411l BII1§04kSS11'A Ofs}�IlOIU •rye r yy� �•'t•7� R�L ({�/��' 4 rtt:,•t r it '., PIP.'E��'yt� IICI 4 11 �L�C RI� NW-16A YU.�1NC �r, r ,rr. N�VQpL .,yir "i7 � r� Yr �V�ir�o1'6 r 6z5: V � lv;jd MIAMI PL,33125 ��1�st����Ijsbl�yed atl�lpp�'tif bl�s(netis i ,, 'P9r�UantttiC'iiupt�'Cole,': � . i j: CF,a�te�'8A•�.gtt S gt,''10 � OWNRFI SEC.TYPE OF BUSINESS TRI CITY ELECTRIC'I CO INC PAYMENT RECEIVED. 196 ELEGIRICAL CONTRACTOR Workers) 40 •E1;0000136 BY TAX COLLECTbR $135.00109/22/2015 CHECK21-15-135514 This Local Business Tax Receipt only cppftrms Mound:of the Lodal Business Tax.The Recec8difipt is not a license, permit;of a ronentcahad of the holder s gUalificetions,to dd,�usln o..Holder must comply wlfh any governmental or hopgov rnmental tegplatory laws gpd.requirements Whic 000 io the business;. The RECEI�f N0,above must be dig 11 404 on all commercial vehicles—MiaMl Dade Code$ec 8a-278. For more information,visit www.miamidede aoyNaxcolicctor Ii i • DATE(MM/DDNYYY) A�RE® CERTIFICATE OF LIABILITY INSURANCE 7/29/2016 `i HIS 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(les)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 CCOONTE CT Gri.sel Prego Keen Battle Mead & Company PHONE (305)558-1101 FAX (305)822-4722 _(A/C No)_-_ - - - - 7850 Northwest 146th Street ADDESS:9prego@kbmco.com Suite 200 INSURER(S)AFFORDING COVERAGE _ NAIC_# Miami Lakes FL 33016 INSURERA:Travelers Indemnity 25682 INSURED INSURERS Travelers Indemnity Co of.Amer Tri-City Electric Co., Inc. INSURER CTravelers Prop Cas Co of Amer 05590__ 625 NW 16th Ave INSURER D 33ri.d afield Employers Ins Co INSUREREUnderwriters at Miami FL 33125-4611 1 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 TRI CITY MAST 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 REDU CED BY PAID CLAIMS. INSR TYPE OF INSURANCE DD POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE T RENTED 300,000 PREMISES Ea occurrence $ X Blkt Contractual & XCU C03664P993TIA16 7/1/2016 7/1/2017 MED EXP(Any one person) $ 10,000 X Broad Form Prop Damage PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]JE O LOC PRODUCTS-COMP/OPAGG $_ 2 r 000,000 OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accid�t $ 1,000,000 _ _ _ B XANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED DT8103664P993TIA16 7/1/2016 7/1/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON�OVVNED PROPERTY DAMAGE $ AUTOS Peraccident _ Medical payments $ 5,000 X UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB I L CLAIMS-MADE AGGREGATE_____ $ ____5,Q",_000 DED X RETENTION$ 10,000 CUP3664P993TIL16 7/1/2016 7/1/2017 $ WORKERS COMPENSATION XI PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTEANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,0001 000 OFFICER/MEMBER EXCLUDED? N/A -- - - - D (Mandatory in NH) 083045364 7/1/2016 7/1/2017 E.L.DISEASE-EA EMPLOYE $_- 1,0001000 If yes,desaibe under _ -- - - - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 E Professional Liability A1TE706826416 7/1/2016 7/1/2017 Each Occurrence $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Electrical contractor number EC0000136. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Alex Perez/BECKY <--- — ----�J—' ' ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSD25 r7o14o1n DISPLAY &SIGNAL LAYOUT BARRY UNIVERSITY POWERAND SIGNAL DISTRIBUTION SYSTEM LEGEND REFERENCE DRAWING 33877T78.SHEET 200 SASKETTI ALL COMPONENT IDENTIFICATION LEGEND 1t=NE2NDAVENUE Hm7HaBPORTBrawETER wrAB cacouBlrowcmrc• ,fAnRAelwRa aas411nr w1a411m,r MIAIO BIIORE8.R81181 vASTAamea vnao®nau�ar � PONm,nftmA•m oa,nanees ��, 8U•4RTALAPPROVK wwfm4a1�1weR a-ffamm m,alm,oca wcma.am. p.wBomn pa�vBwm,xwnu ❑umwmas•meoaasuum Bfct�,rof-a ����vwl,a euararea caamlm are: 'AU 2 4 2016 PkTa*�5t�i • • •••s•• ------------------------------------- YAw01&KAYILfYQiON IIrAVINJARY 018RAY LOCATON SKWAL LAYOUT VIEW • 5.' 18480°:WN3C41BiA122Ntle06 / —-__- ` ' REAR V 00.1748003k 8822PAAA120,lYNBDOUBLE BONUST.Ol w2I i , :••, ••• CONNECTION DETAIL--l' T480MS0202R4V-tA@2 i ••••• i 0.40889 P lw • TRUSS „�V4LrLorAT® "'mI � • N0RT0 PLRtw \ TO PKPTAIL IRPWRCORD M /FMTYP.Wr TO DVN.m 018P1I.Y8 Q pp_ 701.01 1 ' I I •••••• ••• S'1 • •i•', AMMV 7ET�Y i A 1 I I TRUSS 120 VAC DUPLEXCIRCMT. 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