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.