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EL-18-3041issue ?at'e:11/20/2018,, Permit NO.: EL-10.18-3041 Permii type: Electrical -Residential Work,Ctossiftcatfon: Alteration Permit Status: Approved Expiration: 04/01/2019 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 53 NW 97TH ST, Miami Shores, FL 33150 Contacts MATHEW DATES 53 97 Description: 60 AMP TELSA CHARGER INSTALLATION Fees Amount Application Fee - Other CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: $50.00 $0.60 $2.00 $2.00 $0.20 $50.00 $9.00 $2.50 $116.30 Parcel Number ELEKRON ELECTRIC INC RODRIGO MORENO Business: 7864235230 Valuation: $ 897.00 Total Sq Feet: 0.00 Contractor lucia@elekronelectric.com Inspection Requests: 30S 762-4949 Payments Total Fees Credit Card Credit Card Amount Due: Date Paid 10/03/2018 11/20/2018 Amt Paid $116.30 $50.00 $66.30 $0.00 Building Department Copy 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 FFID .� I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating •nsfru� • :nd zoning. Futhermore, I authorize the above named contractor to do the work stated. Authi' Signature: Owner / Applicant / Contractor / Agent Date November 20, 2018 Page 2 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2ndAve, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-001796-2018 Permit Number: EL-10-18-3041 Scheduled Inspection Date: November 21, 2018 Inspector: DeVaney, Michael Owner: MATHEW DATES Address: Project: 53 NW 97TH ST Miami Shores, FL 33150 Contractor: ELEKRON ELECTRIC INC RODRIGO MORENO Permit Type: Electrical - Residential Inspection Type: Electrical Final Work Classification: Alteration Phone Number: Parcel Number: 1131010330280 Phone Number: 7864235230 Building Department Comments 60 AMP TELSA CHARGER INSTALLATION Checklist Item General Comments Passed False Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments / /is'I'/8 November 20, 2018 For Inspections please call: 305-762-4949 Page 5 of 28 BUILDING PERMIT APPLICATION BUILDING Q ELECTRIC 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 ❑ ROOFING Master Permit No. Sub Permit No. REc>�� CT BY: FBC 20)7 ("" �L\8 -304) n REVISION ❑ EXTENSION ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR 53 NW 97 Street JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 11-3101-033-0280 Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: Matthew C Dates OWNER: Name (Fee Simple Titleholder): Phone#: Address: 53 NW 97 Street Miami Shores FL City: State: Tenant/Lessee Name: Phone#: Email: RENEWAL ❑ SHOP DRAWINGS 33150 NO X FFE: 33150 Zip: Elekron Electric Inc (786) 423-5230 CONTRACTOR: Company Name: Phone#: 3641 SW 25 Terrace Address: Miami FL 33133 City: State: Zip: Rodrigo Moreno (786) 423-5230 Qualifier Name: Phone#: E R 13014704 11E000549 State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 897 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition 60 Amp Tesla Charger Description of Work: Specify color of color thru tile: Submittal Fee $ -S3 pa; d Permit Fee $ /,S d'< da CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2Oo'' day of S.CQKrnI2(✓ ,20 _‘C by ZO�h day of 5 0-Kol 19'i.✓ ,20 Ir ,by ('nG V' w �C1 , who is personally known to • (Lct) 11.9 0 (Y) GU (010, who is personally known to as me or who has produced me or who has produced D. L. identification and who did take an oath. NOTARY PUBLIC: PP/q tl (I ICncwn as identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: Seal: LUC G �C,>1�QcG ############ APPROVED BY Lucia Vanessa Fanseae NOTARY PUBLIC STATE OF FLORIDA Cann* FF922816 Print: Seal: %t 7 — -r/ fans Examiner GuctU., fin Cc Gt Ludy Vanessa Fans.a. NOTARY PUBLIC STATE OF FLORIDA Conn* FF922816 rAtO ############### Zoning (Revised02/24/2014) Structural Review Clerk PROPOSED WORK 200 Amp Existing Exterior Electrical Panel 60 Amp rated Tesla Charger PERMIT JLlb-3041 M ami Shcres Vill.- c e APPPO\'ED BY DATE TONING DEPT c D E. SEUD DEPT SUBJECT CO CCAIP1FNCE WI rri ALL FEUERAL STATE ANv Cr.UN i-f riUL-S AND REGULATIONS Matt Dates 53 NW 97th ST •• ••• • • • • • •• • • • • • • • • • •• ••• •• • • • •• • ••• Miami Shores, FL 3315a • • • • • • • • ••• •• • •• • •• • • • • • • • • • • • • • • • • • ••• • . • • • • • ••• • • • • ••• • • • •• •• •• • • • • •• •• •••• •• •• • • •• , • • • • • • •• • • • ••• •• • • • • ••• •• ••• •• • • ••• • • • 3/4" PVC Conduit (2) #6 THHN Wire (1) #10 THHN Ground Wire Lucia Vanessa Fonseca NOTARY PUBLIC STATE OF FLORIDA Canal FF922816 Expires 9/30/2019 Elekron Electric Inc. 3641 SW 25 Terrace Miami, FL 33133 Qualifier: Rodrigo Moreno (786) 918-6018 3va x 1,671 Sq. FT. 5,013 Sm. Appliance & Laundry 4,500W Dryer 5,000W Range 13,700W Microwave 1,700W Refrigerator 1,392W Dishwasher 1,188W Water Heater 4,500W Testa - New Load 11,500W Total 48,493W First 10 KVA @ 100% 10,000W Remaining 38,493 @ 40% 15,397W A/C Heater 4,800W Pool Pump 2,760W Sprinkler Pump 2,016W Total 34,973W 34,973W/240V = 146 Amps Existing Service 200 Amps Load Calculation Matt Dates 53 NW 97th St Miami Shores, FL 33150 Elekron Electric Inc 3641 SW 25 Terrace Miami, FL 33133 Qualifier: Rodrigo Moreno (786) 918-6018 Lucia Vanessa Fonseca NOTARY PUBLIC STATE OF FLORIDA Comn FF922816 Expires 9/330/2019 • • • • • ..• . tl..:i.. . .. .... • • • • • . . . . . . . .. . • . .... .... . . .... • • • • . .... • .• • • • • •• . . ...... ••. • •• • • ... .. . • • • • . •.. RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND=rePROFESSIONAL REGULATION E 5 EKROSW NtLECTRIC; 84€1t2'TER t LICENSE-NUr iB`ER: ER;1 014704 EXPIRATIONtDATE, AC GIST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. ()cal BusinessTax Receipt. #darn; -Dade County, State of Florida -THIS PS NOT 4; Bltl. -.DO NOT PAY? 69404 NAME/LOCA°T ON ELEKRON ELECTRIC113(.. OPERATING IN DADE COUNTY MIAMI FL 33999 OWNER LEKRC 'ELECTTRI Wo'kfrt`s j This Canal Rusiitass,T prtaut Of -raihsation er nengevettttaetttal rtgtl .,The RECEIPT NO. atrere rstst, EEC., TYPE OE BUBMIES£ 4f ELECTRIC A_ CON rt,A. -EXPIRES SEPTEMBER 30, 2019 Must .b.:ilisplasttsi hi pktce of i/usinlass Pursuant to' Cou n v CotUi Cha'ptsi- Bit - Art: 4 Et" le PAYMENT- RECEIVED BY TAX COLLECTOR $75.00 07/16 231E CR E D=TC 4RD-- 18-455146 sohms payment et the Eadal &esaasss Ta><. The Receipt is next a liegesa . gtnsliiiczttintss, to dl btesiaass. Reidat most ccmplr with any gasiritiittental gei vemenaa uhf cit only to cite b�aBptass:= d en>Ii tOrItRit a@ 414Ricla5EARMi..t C 'lion, visit vYTY4t`.,Itits'tt#filiAt1i CERTIFICATE OF LIABILITY INSURANCE DATE (MMtED/YYYY) 08/16/2018 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 endarsernent(s). PRODUCER E & L Insurance Services 1241 SW 27th Ave. Miami, FL 33135 CONTACT NAME: ENRIQUE RUIZ NE (A//c No. Exit: (305) 541-1002 {a1c, No): (305) 541-0250 EMAIL C ADDRESS: eruiz eandlinsurance.com INSURER(S) AFFORDING COVERAGE NAIC I/ INSURER A: SCOTTSDALE INSURANCE COMPANY INSURED ELEKRON ELECTRIC, INC 3641 SW 25 Terrace Miami FL 33133 INSURER B : INFINITY INSURER C: BERKSHIRE HATHAWAY GUARD INSURER D : INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION N THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI-IE 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, INSRR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL. GENERAL LIABILITY N N CPS3084692 07/31/18 07/31/19 EACH OCCURRENCE $ 1,000,000.00 CLAIMS -MADE X OCCUR DAMAGE TO REt41 E0 PREMISES (Ea occurrence) $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL a ADV INJURY $ 1,000,000,00 GEN'L X AGGREGATE LIMIT APPLIES POLICY PRO- 1 OTHER: PER: GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 1,000,000.00 BI/PD/P&Al DED $ 0 B AUTOMOBILE ,.�_ LIABILITY X SCHEDULED AUTOS NON -OWNED AUTOS N N 509-80001-8225-001 09/19/2017 09/19/2018 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 250,000.00 BODILY INJURY (Per accident) $ 500,000.00 PROPERTY DAMAGE (Per accident) $ 100,000.00 $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N/ A N ELWC901837-1 07/14/2018 07/14/2019 X STATUTE OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Electrician CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Avenue Miami Shores, FL 33138 i SHOULD ANY OF THE ABOVE DESCRIBED THE EXPIRATION DATE THE ACCORDANCE WIT HE POLIC POLICIES BE CANCELLED BEFORE F, NOTICE WIL DELIVERED IN PROVISIONS. AUTHORIZED REP SENTATIVE _ , ACORD 25 (2014/01) 0 1988-20i4 ACORD CO . AII rights reserved. The ACORD name and logo are registered marks of ACORD