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ELC-16-2110Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Cc 16-210q Inspection Number: INSP-270938 Permit Number: ELC-7-16-2110 Scheduled Inspection Date: November 10, 2016 Inspector: Devaney, Michael Owner: CHURCH, MIAMI SHORES DCCCQVTCDIA1.l Job Address: 602 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: MASTEC NETWORK SOLUTIONS, LLC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Low Voltage Phone Number (305)751-5917 Parcel Number 1132060141410 Phone: (561)962-9807 Building Department Comments LOW VOLTAGE PERMIT TO SWAP EXISTING AT&T ANTENNAS. Infractio Passed Comments INSPECTOR COMMENTS False Passed C� Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments MAIL BOX > YOU CAN FINE PERMIT & PAPER WORK FOR INSPECTION BRIAN 410-533-2268 November 09, 2016 For Inspections please call: (305)762-4949 Page 32 of 34 I Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. ELC-7-16-2110 Permit Type: Electrical - Commercial Work Classification: Low Voltage Permit Status: APPROVED Issue Date: 8/3/2016 Expiration: 01/30/2017 Parcel Number Applicant 602 NE 96 Street Miami Shores, FL 1132060141410 Block: Lot: MIAMI SHORES PRESBYTERIAN Owner Information Address Phone Cell MIAMI SHORES PRESBYTERIAN 601 NE 96 ST MIAMI 38 FL 33138-2741 (305)751-5917 Contractor(s) Phone MASTEC NETWORK SOLUTIONS, LL( (561)962-9807 Cell Phone Valuation: Total Sq Feet: $ 1,500.00 50 Type of Work: LOW VOLTAGE PERMIT TO SWAP EXISTING Additional Info: Classification: Residential Scanning: 1 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-7-16-60762 08/03/2016 Credit Card 07/26/2016 Credit Card Amt Paid Amt Due $ 110.70 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical 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 - c rate and construction and zoning. Futhermore, I authorize the abs' a o actor work will be done in compliance with all applicable laws regulating stated. August 03, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 03, 2016 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 ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 602 NE 96 STREET, RECEIVED J,L262016 (---1 Sib FBC 20 Master Permit No. 00_1C- (09 Sub Permit No.13....Q1 G-2110 ❑ REVISION ❑ CHANGE OF CONTRACTOR ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Folio/Parcel#: 11-3206-014-1410 Occupancy Type: Load: Miami Dade Zip: Is the Building Historically Designated: Yes NO X Construction Type: ALTERATION Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): MIAMI SHORES PRESBYTERIAN CHURCH phone#: 305 754 9541 Address: 602 NE 96 STREET City: MIAMI SHORES State: FL Tenant/Lessee Name: AT&T MOBILITY Email: CIO ROREY.WANLISS@MASTEC.COM Zip: 33138 Phone#: 954 994 4449 CONTRACTOR: Company Name: MASTEC NETWORK SOLUTIONS Address: 6100 BROKEN SOUND PKWY Phone#: 561 962 9807 City: BOCA RATON State: FLZip: 33487 Qualifier Name: BRADLEY CONN Phone#: 561 961 9801 State Certification or Registration #: EC13006418 Certificate of Competency #: DESIGNER: Architect/Engineer: CALTROP TELECOM Phone#: Address: 3400 LAKESIDE DRIVE City: MIRAMAR State: FL Value of Work for this Permit: e/$ 0 quare/Linear Footage of Work: 50 Zip: 33027 Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: LOW VOLTAGE PERMIT TO SWAP EXISTING AT&T ANTENNAS Specify color of color thru tile: Submittal Fee $ % - CO Permit Fee $ /3-0, C' CCF $ 2U CO/CC $ rd Scanning Fee $ 3 - oz, Radon Fee $ 2 DBPR $ Notary $ (19 Technology Fee $ 1 - GG Structural Reviews $ F (Revised02/24/2014) Training/Education Fee $ b• 1/4 -IG Double Fee $ 0 Bond $ TOTAL FEE NOW DUE $ / 1 0 . "•-O Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N/A 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. Signatu • 1� OWNER or AGENT The foregoing instrument was acknowledged before me this 12,1LL day of TC,(1 y , 20 lip , by I? s� , who is personally known to me or who has produced f jLyt_SCI jC as identification and who did take an oath. NOTARY PUBLIC: Sign: �Cc jijQ1 Print: Seal: r. • . ;, EMYPCROEMS:MIDIOemN bIe720119 Bonded Thru Notary Public Underwrihra ONTRACTOR The foregoing instru ent was acknowledged before me this 025 day of StA.K.I , 20 ►(p , by 3YLtd 1e9 ('on V1 , who is personally known to me or who has produced ({ viV I IIet?yl. seas identification and who did take an oath. NOTARY PUBLIC: Sign: IN�`�"�' Sign: // '',,�� ,� .- Print:l/`r`V `CjGt2 Nlcdl( Mb Seal: *************************************************************** MONIQUE NICOLI NOBLE MY COMMISSION #FFOBO936 'gra ' EXPIRES January 5, 2018 01,40414‘11,6" Abp* * *+rKltaaah xiiIewlr taapa* * * 4 * * * * * * * * * * * APPROVED BY 4 .. ) Yee4 y/( Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami Shores Viiiage Building Department CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. �OPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: /77a-5- v -‹-c BUSINESS ADDRESS: 610 a e -v CITY ' 'c.-- 2 STATE ZIP 33(4)/5' BUSINESS2 - G PHONE: (��i / ) ��j 9�Y7 FAX NUMBER ( ) CELL PHONE ( ) QUALIFIER'S NAME: A QUALIFIER'S LIC NUMBER: � /3 (la STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CONN, BRADLEY FRED MASTEC NETWORK SOLUTIONS, LLC 317 BLACK FOREST DRIVE CLAYTON NC 27527 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. (850) 487-1395 'w3 STATE OF FLORIDA t DEPARTMENT OF BUSINESS AND '' PROFESSIONAL REGULATION EC13006418 ISSUED: 08/05/2015 CERTIFIED ELECTRICAL CONTRACTOR CONN, BRADLEY FRED MASTEC NETWORK SOLUTIONS, LLC Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch 489 FS and congratulations on your new license! Expiration date AUG 31. 2016 L1508050000537 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON. SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER EC13006418 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 CONN, BRADLEY FRED MASTEC NETWORK SOLUTIONS, LLC 806 S DOUGLAS RD 11TH FLOOR CORAL GABLES FL 33134 iSSIiFn nMmfinnis fICPi AV AS RPflI IIRFII RY I MA/ CP/114 i'�nQncnnnn;z7 ANNE M. GANNON CONSTITUTIONAL TAX COLLECTOR Serving Palm Beach County Serving you. P.O. Box 3353, West Palm Beach, FL 33402-3353 www.pbctax.com Tel: (561) 355-2264 "'LOCATED Ar 6100 BROKEN SOUND PKWY NW STE 6 BOCA RATON, FL 33487-2713 recelpted by the Tax Collector's Office. MASTEC NETWORK SOLUTIONS LLC MASTEC NETWORK SOLUTIONS LLC 6100 BROKEN SOUND PKWY STE 6 BOCA RATON, FL 33487 IuIIn�IIIIInIIIuIIilnuI STATE OF FLORIDA PALM BEACH COUNTY 63-201 2015/2016 LOCAL BUSINESS TAX RECEIPT .4 LBTR Number: 2015083753 EXPIRES: SEPTEMBER 30, 2016 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. TYPE OF BUSINESS OWNER CERTIFICATION # RECEIPT #/DATE PAID AMT PAID BILL 6 23-0169 ELECTRICAL CONTRACTOR CONN BRADLEY FRED EC13006418 816.4654 - 10/20/15 $30.50 640195211 recelpted by the Tax Collector's Office. MASTEC NETWORK SOLUTIONS LLC MASTEC NETWORK SOLUTIONS LLC 6100 BROKEN SOUND PKWY STE 6 BOCA RATON, FL 33487 IuIIn�IIIIInIIIuIIilnuI STATE OF FLORIDA PALM BEACH COUNTY 63-201 2015/2016 LOCAL BUSINESS TAX RECEIPT .4 LBTR Number: 2015083753 EXPIRES: SEPTEMBER 30, 2016 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public.