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PL-17-2116Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-8-17-2116 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: APPROVED Issue Date: 8/30/2017 Expiration: 02/26/2018 Parcel Number Applicant 601 GRAND CONCOURSE Miami Shores, FL 1132060172140 Block: Lot: CARLOS FELIPE LEMOS Owner Information Address Phone CeII CARLOS FELIPE LEMOS 601 GRAND Concourse MIAMI SHORES FL 33138- 601 GRAND Concourse MIAMI SHORES FL 33138- Contractor(s) FLORIDA POWER HOUSE, INC Phone (305)256-0241 CeII Phone Valuation: Total Sq Feet: $ 1,000.00 10 Type of Work: GAS PIPING Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $159.10 Pay Date Pay Type Invoice # PL-8-17-64947 08/30/2017 Credit Card 08/21/2017 Credit Card Amt Paid Amt Due $ 109.10 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Press Test Review Plumbing 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 authorize the above -named cont or to do the work stated. August 30, 2017 Authorized Signature: Owner / Applicant ,F . ontractor / Agent ate Building Department Cop August 30, 2017 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 ❑ ROOFING ❑PUBLIC WORKS JOB ADDRESS: h/ r//Ari ( 2C,dizsf City: Miami Shor County: Folio/Parcel#: //' 32DI' - D/'--.e/T40 Occupancy Type: load: Construction Type: RECEI VE.O 4421 ?oil FBC 20 Master Permit No. ‘Z - /'T1—i/ ,3 Sub Permit No. ? `'1 a 1 I `p ❑ REVISION ❑ EXTENSION RENEWAL ❑ CHANGE OF. ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Dade Zip: ifi/g0 Is the Building Historically Designated: Yes NO it Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholdr): (i 2t S AOC Phone#: Address: A/1A 61)0 et,dzd'F State: 72 City: t41// 4P-r-e-g Tenant/lessee Name: Phone#: Email: Zip: lfg/30 CONTRACTOR: Company Name: 40;/46049 ) 3 ? E Address: /d130O &J City: State: Qualifier (came: qi.,///e.goL10 State Certification or Registration 4:. 1- ,e;2 lo44P DESIGNER: Architect/Engineer: Address: dDO Type of Work: ❑ Addition ❑ Alteration Description of Work I AS • f Phone#: C 10 s)09 rn - 0.210 Zip: L /y(CJ , / // Phone#: �305 .a5 -OZY Certificate of Competency #: Value of Work for this Permit: $ Phone#: city: State: Zip: Square/Linear Footage of Work: 10 D New ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ / 1d ---- CCF $ CO/CC $ Scanning Fee $ Radon Fee $ OBPR $ Notary $ Technology Fee $ Training/Educadon Fee $ Double Fee $ Structural Reviews $ Bond $ 1 TOTAL FEE NOW DUE $ 109 • (0 (Revised02/24/2014) • V7- 4 114 F 4 • z Bonding Company's Name (if applicable) Bonding Company's Address City State Tap 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. 1 certify that no work orinstallation has commenced prior to the issuance of a permit and that all work wdl 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 o building permit with an estimated value exceeding .52500, 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 th absence of such posted notice, the inspection will not be approved and a reinsp , . fee will be chorged. Signature OWN Ste. r AGENT The foregoing instrument was acnowledged before me this —day o s Signature CONTRACTOR The fore : oin . instrum t was acknowledged before me this U JS , 20 [7 , by . ay of wJ 4 20 % 7 , by a who is personaNy known to i I .. ✓►^-O _�4T�L6e who is personally known to me or who has produced -----I''. as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY IC Sign: Print: Seal: APPROVED BY (Revised02/24/2014) COMMISSION f FF155425 EXPIRES August 21, 2018 WWW.AARONNOTARY.COM Sign: Print: Seal: Plans Examiner Structural Review Capera COMMISSION it FF155425 EXPIRES August 27, 2018 ' WWW.AAROIINOTARY.COM Zoning Clerk CERTIFICATE OF LIABILITY INSURANCE DATE (MtlNDDIYYYII) 08I21/2017 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTIND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(8), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT. If the certifkate holder 16 an ADDITIONAL INSURED, the poilcy(les) must be andaned. 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 Estrella 0176 B219 South Dixie Hwy Miami INSURED Florida Power House Inc 12300 SW 117 Ct Miami FL 33143 kZr. Blb)ana Martorell r _ .. , 30. 644-9301 . 305 64,1-9388 INSURER(S) AFFORDING COVERAGE INSURER A : GRANADA INSURANCE COMPANY INEUR®Re; PROGRESSIVE COMMERCIAL INSURER C INSURER D : NAIL f 1NSUROR E r FL 33188- ,)USURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAmert 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 70 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I�Y wen - ASUMDI aU A 0 COMMERCIAL GENERAL LIABILITY 1 CLAGAS.AIADE a OCCUR GEM AGGREGATE LIMIT APPLES PER: R_PouCi JJEL'r ❑ LOC OTHER AUTOMOIU}t LIAau.nv ANYAUTO ALL OWNED AVMs HIRED AUTOS UMBRELLA LIAR ExQBO$ UAe X SCHEDULED AUTOS NONONNED AUTOS TYPE OF INSURANCE NUMeeR . •h. 0185FL00015272 02596067-1 OCCUR CLAIMS.AIADE oeo 1 1 REMNN„4N: COMPEANIAAND rAlpLoyERs• TTON LIAeNER YIJ ANY P enst meeft excLucR�pmyM (Mya�n me 0.upED7 A+ 2 Aivicabb under PTCN OF PPERATIq s Leroy Nrw 08/26/2016 oZoL7Nly 0E1/26/2017 UMPre EACH OCCURRENCE WAAGE TO PREMISES oo urrOgpgt MED E(P (P,b one perm) PERSONAL 6 ADv INJURY GENERAL AGGREGATE PRODUCTS•COMP/m.AOO s 1,000,000.00 s 1,000,000.00 s 5,000,00 $ 1,000,000.00 3 2.000,000,00 s INCLUDED S 08/09/2016 08/09/2017 COMDINED LEANeided) LEUMW ROPILY INJURY Pet person) 6 300,000.00 f IrOQ[LY INJURY (Per aooldaN) (Paraaolerrprt PIP 10000 0 DEDUC EACN OCCURRENCE S S E AGGREGATE S E.L. EACH ACCIDENT s EI AS-SAEMPL.OYE EL. Di86AGE - POUCY LIMIT DESCRIPTION OF OPERATtON81 LOCAT10Na 1 VEHtcLES (ACoRG 701, Additional Ra,neft geNNIyra,,®y W agechaa a PAo:a apaoa la muds* MACHINERY OR EQUIPMENT INSTALLATION AND SERVICING CERTIFICATE HOLDIrR Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores FL 33138 ACORD 25 (2014/01) $ $ CANCELLATION SHOULD ANY OF THR ASOVE DESCRIBED POlJC p.$ RE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 9E DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 198$,2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Local Business Tax, Receipt. Miami -Dade County, Mate of RondaTHIS IS NOT A BILL - NOT PAY 6977;86 eus',cESS NAME/LOCATION FLORIDA POWER HOUSE INC 12300 SW 117 Cr MIAMI FL 33186 WIMPY NO. RENEWAL 7232794 OWNER .EEC. TyPs OF BU81NGBQ FLORIDA POWER HOUSE INC 205 LPG INSTALLER C/O GUILLERMO HERNANDEZ PRES LP027608 1I EXPIRES SEPTEMBER 30, 2017 •Must be displayed it place Of budnese 'Pureuent to County Coda Chapter 8A - An. 9 & 10 • PAYMENT REC!IVID ay TAX CtNsaCTOR 5100,00 09/23/2016 CREDiTCARD--16-056644 This laoal BusinasTIx Nocapt oelytu 'ale of the looui Bucio�s Tu. Ms Racetlpt is not a (lmlYe, permit or a oerd6ealon ditto boldeesquIUURc3tton to do booboos. Holderm t aoraply wit ally p.er�el or usagarernmeawrepu[sroty ism sod reduiteaiento triblah apply Mtge pi>olosss. Tat RECHFr tt0. abate muds displayed au all commetsiii veMctes-INaa l•.Dade Cede Sec Bs-Dt For mot• intonnalioa, rislt sovetuaisuibiladayhaxiiegroggt Local Business Tax Receipt Miami-Dade.County, State of Florida -TWlS IS NOT A B LL-DO NOT PAY 59953(14 • Bu6lNEnt NiAmeR.00ATION FLORIDA POWER HOUSE INC OPERATING IN DADE COUNTY MIAMI A. 33999 OWNER FLORIDA POWER HOUSE ii�IC Employee(s) 0 ItiCNIP•C NO., RENEWAL 8255251 `ate � Iltit ) • EXPIRES SEPTEMBER 30, 2017 Must be dlsplsYed at place of buueinaes Pursuant to .County Code Chapter SA - Arc 9 & 10 6EC. TYPN OF eUWWNENS 220 TANGIBLE PERSONAL PROP DLR PAYMENT e i W VID IVY TAX COLLECTOR $75,00 09/23/2016 CREDTTCARD-16-056644 • This Loael Buslue &Tuxle air nano, of the Local Bodeen Slut The Receipt is sots Hoeosa Oral,. or a osettdorele a attbeloidais to de aware s. adder west candy rage anypedal:meter or metlosataatirbel regulatory tees, s airerpdreareareVittiaft applym an bebedeess, Tina RECEIPT/10. aboaa must be deployed ea aD eonaeertiiatvefdcias -gB l-Dads Code &o Ba•,2* • Forum! Iaforbedop,rie4 Florida Department of Agriculture and Consumer Services, P.O. Box 6700 Tallahassee, Florida 32399-6700 License Number: 27606 Business Mailing Address Licensed Location Address FLORIDA POWER HOUSE, INC 12300 SW 117TH CT 12300 SW 117TH CT MIAMI, FL 33186-3919 FLORIDA POWER HOUSE, INC 12300 SW 117TH CT MIAMI, FL 33186-3919 The liquefiedpetroieum gas license at the bottom of this formic Valid ONLY for the compahyloc.atetrat the address -- on the license. Each business location of a company must be licensed. All LP Gas licenses must be renewed annually. Any license allowed to expire shall become inoperative because of failure to renew. The fee for restoration of a license is equal to the original license fee and must be paid before the licensee may resume operations. IN THE EVENT OF AN OWNERSHIP CHANGE AT THIS BUSINESS LOCATION: This license may be transferred to any person, firm or corporation for the remainder of the current license year upon written request to the department by the original license holder. License transfers must be approved by the departmAlt licensing requirements must be met by the transferee and a transfer fee of $50 will apply. To apply for a transfer, contact the Bureau of LP Gas Inspections at (850) 921-1600. Pursuant to Chapter 527, Florida Statutes, LP Gas licensees must present proof of licensure to any consumer, owner, or end user upon request when engaged in the business of servicing, testing, repairing, maintaining or installing LP Gas systems and/or equipment. For future correspondence, please make any needed corrections or changes to your business mailing address and/or your licensed location address and return the UPPER PORTION with corrections to: POST UCENSE CONSPICUOUSLY Florida Department of Agriculture and Consumer Services P.O. Box 6700 Tallahassee, Florida 32399-6700 Cut Here Department of Agriculture and Consumer Services Division of Consumer Services Bureau of Liquefied Petroleum Gas Inspection (850)921-1600' Tallahassee, Florida Moline Number. 27606 Expiration Date• August 31, 2018 Date of Issue: September 1; 2017 License Fee: $200.00 Type and Class: • 0408 Liquefied Petroleum Gas License SPECIALTY INSTALLER C APPLIANCES, EQUIPMENT AND PIPING ' GOOD FOR ONE LOCATION ONLY , ANY CHANGE OF OWNERSHIP OR SALE OF THIS BUSINESS` RENDERS THIS UCENSE INVAUD This license is issued under authority of Section 527.02, Florida Statutes, to: • FLORIDA POWER HOUSE, INC 12300 SW 117TH CT MIAMI, FL 331864919 ADA H. PUTN COMMISSIONER OF AGRICULTURE Florida Department'of Agriculture and Consumer Services . Division of Consumer Services 2005 Apalachee Parkway Tallahassee, Florida 32399-6500 Master Qualifier Mailing Address Licensed Location Address GUILLERMO HERNANDEZ FLORIDA POWER HOUSE, INC 12300 SW 117TH CT MIAMI, FL 33186-3919 Certificate Number FLORIDA POWER HOUSE, INC 12300 SW 117TH CT • MIAMI, FL 33186-3919 License Number 24066 27606 This Master Qualifier Certificate is issued pursuant to Chapter 527, Florida Statutes. This certificate is valid only for the person and licensed holder listed. Any„changes to the Master Qualifier status (such as transfer or teri rination of einplayrrtent)-muttbe_reporled:to the Burg -au -of LP.--Gas_tnspection ... _.. at (850) 921-1600 immediately. The Master Qualifier Certificate is valid only through the date noted on the Certificate. A notice of renewal will be sent to you in advance of your expiration date. A Master Qualifier Certificate may be renewed if certification of a minimum of 16 (sixteen) hours continuing education is provided along with the renewal form. If training cannot be documented, an examination must be taken. If there are any errors on the certificate, please submit all changes in writing to: Florida Department of Agriculture and Consumer Services Division of Consumer Services 2005 Apalachee Parkway Tallahassee, Florida 32399-6500 Cut Here State of Florida Department of Agriculture and Consumer Services Dvision of Conet mer`Services Bureau of Liquefied Petroleum Gas Inspection (850) 921-1600 Tallahassee, Florida Certificate No: Exam Date: Issue Date: Expiration Date: Exam: MASTER QUALIFIER CERTIFICATE (NON -DESIGNATED) This Certificate is issued under authority of Section 527.02, Florida Statutes, to: GUILLERMO HERNANDEZ Vaud For License Number: 27606 FLORIDA POWER HOUSE, INC 12300 SW 117TH CT MIAMI, FL 33186-3919 24066 February 18, 2009 January 18, 2015 January 17, 2018 0803 ‘3,fraCOMMISIONER OF AGRICULTURE ACaRE, CERTIFICATE OF LIABILITY INSURANCE `...,►--- DATE(MM/DD/YYYY) 8/18/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE EXTEND OR ALTER THE COVERAGE AFFORDED HOLDER. THIS BY THE POLICIES AUTHORIZED A CONTRACT BETWEEN THE ISSUING INSURER(S), IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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, SUNZ Insurance Solutions, LLC ID: (Harbor) c/o Harbor America 21977 E. Wallis Dr. Porter, TX 77365 war Ashley Warren FAX PHONE (A/c, No): (281) 577-2678 N gym. (281) 577-1080 E-MAIL ADDRESS: ashleywtamemins.com INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A: SUNZ Insurance Company 34762 INSURED Harbor America Florida, Inc.; Harbor America West, Inc; Harbor America Central; Union Strategic Alliance, Inc.; * See Description of Operations 21977 E. Wallis Dr. Porter TX 77365 INSURER 8 : INSURER C: INSURERD: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 37293917 REVISION NUMBER: 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. INBR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS ' COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES O- JET PER: PRODUCTS- COMP/OP AGG $ $ AUTOMOBILE _ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per acddent) $ PROPERTY DAMAGE (Per acddent) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCPE00000156 05 WCPE00000156 04 4/1/2017 4/1/2016 4/1/2018 4/1/2017 ,/ STATUTE ERH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Coverage provided for all leased employees but not subcontractors of: Florida Power House, Inc. Location Effective: 4/24/2017 RE: LPG 27606 ' Harbor America Coastal, Inc.:Harbor America Southwest, Inc.;Harbor America East, Inc. CERTIFICATE HOLDER CANCELLATION 393453 Miami Shore Village g Building Department 10050 NE 2nd Ave Miami Shores FL 33138 I 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 Glen J Distefano ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 37293917 I Harbor I Harbor America Florida, Inc PEO 156 MASTER CERT I Ashley Warren 1 8/18/2017 12:03:31 PM (CDT) I Page 1 of 1 NAME: Wr"r�powER��4 bon't a left In the dark SE o Gn-kos Ie/4aS GAS DROP TEST PL - 2i16 El. n-1310 DATE: /0M3/(90/7 ADDRESS: 60/ U,pAAA doretwAieu DlGeUa.frtUhnu Start Time: (3.. (�U End Time: q r. ! 5 )1-r1 Starting Pressure: (f7l n. W C Ending Pressure: (0 4, we TEST DETAILS: W dd pre.Sburt State License #: I•G - ' 6e6 Qualifier: Gu f le o ndez Technician: ...J Signature tfist Mama Capera ,•, . COMMISSION I FF155425 EXPIRES: August 27, 2018 � trac A0 ARY.COM Florida Power House -12300 SW 117th Court - Miami, FL. 33186 - ph (305) 256-0241- fx (786) 362-7179