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ELC-15-1766Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 l Li -1 g'F Inspection Number: INSP-239120 Permit Number: ELC-7-15-1766 Scheduled Inspection Date: August 12, 2015 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Wiegand & Annex Miami Shores, FL 33138-0000 Project: BARRY UNIVERSITY Contractor: DADE ELECTRIC SERVICE INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1121360010160-09 Phone: (305)887-4645 Building Department Comments FIRE ALARM Infractio Passed Comments INSPECTOR COMMENTS False Passed i/ Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments August 11, 2015 For Inspections please call: (305)762-4949 Page 17 of 36 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. E L C-7 -15 -1766 Permit Type: Electrical - Commercial Worts Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 7/28/2015 Expiration: 01/24/2016 Parcel Number Applicant 11300 NE 2 Avenue Number: Wiegand & Anr 1121360010160-09 Miami Shores, FL 33138-0000 Block: Lot: BARRY UNIVERSITY INC 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) DADE ELECTRIC SERVICE INC Phone (305)887-4645 CeII Phone Type of Work: FIRE ALARM Additional Info: Classification: Commercial Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.25 $0.40 $150.00 $3.00 $1.60 $160.70 Pay Date Pay Type Invoice # ELC-7-15-56345 07/28/2015 Credit Card 07/15/2015 Credit Card Amt Paid Amt Due $ 110.70 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Review Electrical W. W. Underground 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 AFF constructi VIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating oning. F rm re, I orize the above-named contractor to do the work stated. Author ed Signature: Owner / Applicant Building Department Copy / Contractor / Agent July 28, 2015 Date July 28, 2015 1 Miami Shores Village 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 BUILDING PERMIT APPLICATION BUILDING 0 ELECTRIC ROOFING maize- 414z6.0 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS S FBC 20(-{ Master Permit No. CC -9-14-1992 jl REVISION Sub Permit No. 1✓ L O ec ❑ CHANGE OF CONTRACTOR ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: BARRY UNIVERSITY (WIEGAND HALL - ANNEX) 11300 NE 2ND AVE City: Miami Shores County: Folio/Parcel#:11-2136-000-0050 Occupancy Type: Load: Construction Type: Miami Dade Zip: 3 3161 Is the Building Historically Designated: Yes NO OWNER: Name (Fee Simple Titleholder): BARRY UNIVERSITY Address: 11300 NE 2ND AVE Flood Zone: BFE: FFE: Phone#: 305-899-3000 City: MIAMI SHORES State: FLORIDA Zip: 33161 Tenant/Lessee Name: Email: bf@barry.edu Phone#: CONTRACTOR: Company Name: DADE ELECTRIC SERVICE, INC Address: 8191 NW 91ST TERRACE. SUITE 9 Phone#: 305-8874645 City: MEDLEYState: FLORIDA Zip: 33166 Qualifier Name: RICHARD M. WHITE State Certification or Registration #: EC0000946 DESIGNER: Architect/Engineer: MC HARRY Phone#: 305-8874645 Certificate of Competency #: Phone#: 305445-3765 Address:2780 SW DOUGLAS ROAD. SUITE 302 City: MIAMI Value of Work for this Permit: $ 1,500.00 Type of Work: ❑ Addition ❑■ Alteration Description of Work: 'Ft z.__ NAS State: FL Zip: 33133 Square/Linear Footage of Work: n New ❑ Repair/Replace [1 Demolition Specify color orrfcolorthru tile: Submittal Fee $� Uvll(rt - w Permit Fee $ /‚5'i /...4-40"lead2 CCF $ 1.20 Scanning Fee $ j. 0 0 Radon Fee $ 9.23 DBPR $ 2. 6 Technology Fee $ ) • b b Training/Education Fee $ D • 40 Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ t 1 Q . 'TLJ Bonding Company's Name (if applicable) N/A Bonding Company's Address N/A City N/A State N/A Zip N/A Mortgage Lender's Name (if applicable) N/A Mortgage Lender's Address N/A City N/A State N/A Zip N/A 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 OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this /5. day of� Nr -Z1/, 20 / 67 by 10TH day of JULY 20 15 by G'04'0,��ede,e7 ✓, who is personally known to RICHARD M. WHITE , who is personally known to me or who has produced as me or who has produced N/A identification and who did take an oath. identification and w Signature CONTRACTOR NOTARY PUBLIC: SI Print: Seal: \\P\S TARP/F :*= *********************** APPROVED BY (Revised02/24/2014) ;ob6UC, STAR 4llllllllllN *****************************************iii******************************* NOTARY PUB Sign: Print: AL Seal: as Notary Public State of Florida Albert Mendez "' My Commission EE 850325 7 // ' Plans Examiner Structural Review Zoning Clerk DEC -22-2015 11:40 From: LICENSE NUMBER EC0000946 To:3057568972 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS Expiration date AUG 31, 2016 WHITE. RICHARD M DADE ELECTRIC SERVICE INC 8191 N W 91 TER #9 MEDLEY FL 33166 iSSuEO o5I29!2ot4 DISPLAY AS REQUIRED BY LAW 550 u L 14C579CCO30 f3 DEC -22-2015 11:40 From: 000362 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY 909227 BUSINESS NAME/LOCATION DADE ELECTRIC SERVICE INC 8191 NW 91 TERR 9 MEDLEY FL 33166 OWNER DADE ELECTRIC SERVICE INC Worker(s) 20 RECEIPT NO. RENEWAL 909227 To:3057568972 Page:4/5 LBT � J EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR EC0000946 PAYMENT RECEIvEO BY TAX COLLECTOR $75.00 07/20/2015 CHECK21-15-099036 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is nota license, permit or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO, above must be displayed an all commercial vehicles — Miami—Dade Coda Sec 8a-278. For more information, visit yyyyW.miamidade.aoxltotcall or • DEC -22-2015 11:39 From: To :3057568972 Page: 2/5 ,Jo- ?� 3-' DADEEC/1 OP ID: AM A�O/?�- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/Dnmw) 11/02/2015 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. 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 FILER INSURANCE, INC. 9440 S.W. 77 Avenue Miami„ FL 33156 Keith R. Miller CONTACT NAME= Amy Mencia PHttAIGNE No. ERtI 305-270-2169 (Fa FAX ° No): 305-270-2195 E-MAIL ADDRESS: amenciat fiierins com INSURER(S) AFFORDING COVERAGE NAM 0 INSURER A : Massachusetts Bay Ins. Co. 22306 INSURED Dade Electric Service, Inc- 8191 NW 91 Terr #9 Medley, FL 33166 INSURER B ;Hanover American Ins. Co. 22292 INSURER C : Bridgefield Employers Ins. Co. 10701 INSURER 0 : S 1,000,000 INSURER E ; INSURER F : X OCCUR E CERTIFICA 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. JNSR LTR TYPE OF INSURANCE ADDL. I<iSB EUBN WYE? pOl„ICY NUMBER POLICY EFF (MMroomW) POLICI—EXP (MM/DDlYYYT) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE X OCCUR ZDJ8478444 11/01/2016 11/01/2016 DAMA PREMISES 3 300,000 (Ea MED EXP (Any one person) a 5,000 PERSONAL*AIN INJURY 3 1,000,000 GEN1- AGGREGATE UNIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY ©� JET LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER S B AUTOMOBILE LIABILITY COMBINED$INGLE LIMN (Ea accoent) s 1,OOD,000 X ANY AUTO ALL OWNED — SCHEDULED AZJ8488258 11/01/2015 11/01/2016 BODILY INJURY (Per person) S AUTOS_ AUTOS NON -OWNED ED BODILY INJURY (Par accident) S HIRED AUTOS A— PSI OPERTY DAMAGE (Per accident) y - S X UMBRELLA LIAR E ccFys X OccuR EACH OCCURRENCE S 1,000,000 8 UM) CLAIMS -MADE UHJ8478443 11/01/2015 11/01/2016 AGGREGATE 1 DEO RETENT ONS S WORKERS COMPENSATION AND EMPLOYERS• UAMILITY Y 1N pER X STATUTE ERS C ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED'?.. N I A 0830-46420 11/01/2015 11/01/2016 EL EACH ACCIDENT 5 1,000,000 (MYyan66datory In NH) IeeDESCRIPTIIONN OFOPERATIONS E L, DISEASE - EA EMPLOYEE s 1,000,000 Ooe below E L DISEASE - POLICY LIMIT 3 1,000,000 DESCRIPTION OF OPERATIONS, LOCATONB 1 VEHICLES (ACORD 101, Addltlon1l Remarltg Schedule, may be attached IT more space Is Yaqui ed) Electrical Contractor License #: EC0000946 r`Ce?ICI! ATc uril neo _ CELLATION VILLA04 Miami Shores Village Bldg Dept 10050 N. E. 2 Avenue Miami Shores„ FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Aymara Mencia A269211 41988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD