ELC-16-2376 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 I /„ _ 2 3 q5
inspection Number: INSP-266700 Permit Number: ELC-8-16-2376
Inspection Date: September 06,2016 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael Inspection Type: Final
Owner: , BARRY UNIVERSITY Work Classification: Low Voltage
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
LOW VOLTAGE FOR SCOREBOARD(BASKETBALL Infractio Passed comments
GYM) INSPECTOR COMMENTS False
Inspector C is
Passed
Failed El
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
PeA N&ELC-84 x2376
a go t� Miami Shores Village PRO erCl$t
ol
10050 N.E.2nd Avenue NE AA,5
Miami Shores,FL 33138-0000p }�
Phone: (305)795-2204
Perrtt 5tat�°APF' Et
F 61
Expiration: 02/2512017
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
TRI-CITY ELECTRIC CO INC Valuation: $ 700.00
(305)642-5428 (305)642-7822
__._ _... . _.. .... __..... __... _,....�,,._.__ _...... Total Sq Feet: 0
Type of Work:LOW VOLTAGE FOR SCOREBOARD(BASKETS Available Inspections:
Additional Info: Inspection Type:
Classification:Commercial Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# ELC-8-16-61098
$2.25 08/29/2016 Check M 4367 $ 109.10 $50.00
DCA Fee $2.25
Education Surcharge $0.20 08/24/2016 Check#:4362 $50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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 authori the above- med contractor to do the work stated.
� August 29, 2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
August 29,2016 1
RD
Miami Shores Village AUG2 4 2016
G
Building Department 513Y:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 _-T44
INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC6 —
BUILDING Master Permit No. 11E_v� L�-
PERMIT APPLICATION Sub Permit No. tZS-C kC
F__j BUILDING F]ELECTRIC ❑ ROOFING F-1 REVISION 0 EXTENSION [:]RENEWAL
F-IPLUMBING F-1 MECHANICAL E]PUBLIC WORKS F-1 CHANGE OF F-1 CANCELLATION F_-j SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:- IWD 4E DIA Nt�, — +A 5 C—
City: 11 Miami Shores County: Miami Dade Zip:
Folio/Parcel#: I-wtroc&-C� Is the Building Historically Designated:Yes_NO
Occupancy Type:_Load. Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder) Phone#:
Address: I 13W NM
City: mi oxy�' —State: Zip:
Tenant/Lessee Name: Phone#-
Email:
Phone#: M UQQ Lal-qg
CONTRACTOR:Company Name. n-c(�4
Address:W5 NO 164h "b '_
City: M I ojA:u ----State: Zip: 2a)Q6
Qualifier Name: I> elk) 'Tr- Phone#: 2W 4q'D -)&QQ
State Certification or Registration#: fcQW_C;i NP Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ WO,159 Square/Linear Footage of Work:
Type of Work: 0 Addition 0 Alteration El New ❑ Repair/Replace F-1 Demolition
Description of Work: L_" 5cprzbmir�, ho,04etbaa 9wry%
Specify color of color thru tile:
��T') , o� —PermkFee$ CO/CC$
Submittal Fee$. CCF
Scanning Fee$ —Radon Fee$ S DSPR$ Notary
Technology Fee Training/Education Fee$ 2Ci Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 0
(RevisedO2/2412014)
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 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 FXILURE 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 on 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,o 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 AAA 4A Signature g g tore
OWNERorAGENT CONTI&CTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z day of U 20 1b by c� day_of,p ;S-L" ,20 (�o by
N �iV who is personally known tomJY1 . ,who is personally known to
me or who has produced as me or who has produced � �° tt+� as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
.....Sign: . _.. Sign:
ISKA
Print: 1(1 y
NotarLl�=2'ate of Florida
JeffrSeal: a STATE OF FLORIDA
er my Comn"W o a 10:481 3 Comm#FF00605'1
"'�'4c 141 Expires 4/8/2017
:*v**�s*�***��*rr***sxe*ew*�*e*e**�:****:*�«*a�******w*r*s*+*+*#rr*t��s***x�+�ra>k�x�e�*t�**�***e�*:*r:*«s#*::*x**•
APPROVED BYa/�/ tans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)