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ELC-06-22-1507Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: ELC-06-22-1507 Permit Type: Electrical - Commercial Work Classification: Repair Permit Status: Approved Issue Date: 12/1912022 1 Expiration:06/19/2023 Location Address Parcel Number 11300 NE 2ND AVE, Miami Shores, FL 33161 1121360000050 Contacts BARRY UNIVERSITY Owner ELECTRIC AVENUE INC Contractor LANDON BUILDING CARLOS DE JESUS 11300 NE 2 AVE LANDON BDLG, MIAMI SHORES, 33161 11621 SW 22 CT, Davie, FL 33325 Business: 3058993995 jyao@barry.edu Home: 9544458108 electrician@yourservicefast.com Description: INSTALLATION OF TWO (2) EV CHARGERS, PANEL, Valuation: $ 15,940.00 Inspection Requests: SINGLE PHASE FOUR AMP CIRCUITS. TAP FROM FPL TRANSFORMER - LANDON BUILDING Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $9.60 DBPR Fee $7.17 DCA Fee $4.78 Education Surcharge $4.80 Permit Fee $428.20 Scanning Fee $9.00 Structural Review ($60) $60.00 Structural Review ($60) $60.00 Technology Fee $47.82 Total: $681.37 Payments Date Paid Amt Paid Total Fees $681.37 Credit Card 06/14/2022 $50.00 Credit Card 12/19/2022 $631.37 Amount Due: $0.60 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. AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws cons in and onin hermore, I authorize the above named contractor to do the work stated. �9L-� Authorized Signature: Owner Appli nt l Contractor / Agent Date December 19, 2022 Page 2 of 2 Miami Shores Village RRcFrvnn; Building Department JUv 4 z `\ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 �� -- " INSPECTION LINE PHONE NUMBER: (305) 762.4949 FBC Z/o�ao� � BUILDING Master Permit No. EL_l_—V1y ,—� i�T1 U PERMIT APPLICATION Sub Permit No. [-]BUILDING ❑■ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Landon building City: Miami Shores County Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes_ NO Occupancy Type: Load: Construction Type:__ Flood Zone:___ BFE: FFE: OWNER: Name (Fee Simple Titleholder): BarryUniversity 11300 NE 2nd Ave City: Miami Shores Tenant/Lessee Name: Email: lyao@barry.edu State: FL CONTRACTOR: Company Name: Electric Avenue Inc. Address: 11621 SW 22Ct City: Davie State: FL Qualifier Name: Carlos A. De Jesus State Certification or Registration M EC13001809 Certificate of Competency #: DESIGNER: Architect/Engineer. _ ph ..- Value of Work for this Permit: $ 15,940.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace Description of Work: installation of Two (2) EV Chargers ,Panel, Single phase four 40amp circuits. Tap from FPL transformer. 305.899.3995 Zip: 33161 t. 954-445-8108 Zip: 33325 t: 954-445-8108 rte: _ Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee$ 9.0 Permit Fee$ /� O CCF$ "1•(Py CO/Cc $0_ Scanning Fee $ 0' Vr{y Radon Fee $. 4 •2;� DBPR $ �1�_ Notary $ _ Technology Fee $ T1, 937__ Tralning/Education Fee S • g V Double Fee $ _ Structural Reviews $ 120 . a _ Bond $ TOTAL FEE NOW DUE $ _ (Revlsed02/24/70141 Bonding Company's Name (if applicable) Bonding Company's Address city State Mortgage Lender's Name (if applicable) Mortgage Lenders 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 low 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 Signature OWNER or AGENT The foregoing Instrument was acknowledged before me this day of fi % 20 . by "). r who Is personally known tg me or who has produced CONTRACTOR The foregoing instrument was acknowledged before me this /'�� � _dayof NOVEM869— 20�,by ��5 A. Df 11:Aho is personalty known to me or who has produced ti� LCPtit,SP as identification and who did take an oath. identification and did take an oath. NOTARY PYBUC: Ii NOTARY P BLIC:/� as nmr. ... ..:. Print: '�pp,,a� JEFFRYJ.YA0 . " Seal: NMary p4ta Stab ofFkdit Canmissiwl i GG 249916 Katherine De Jeans e Expir" NOVerober f2, 2022 a 41Y conm. w HH maw .'•�a:�?� BadtlThNTIgF*lf I 800a0-7019 +a n� EXpves 12A36r2= i iiii MiHiiiiiiiiiigititiii • i• //��• �p ♦Hglii Mi APPROVED BY _ ' 7ZPlans Examiner /_ Viler' �l "4-111 �i'� Zoning 2 '� Structural Review Clerk (Revhatla7J36/iD14) � N ' 1 ��� Florida Power A /\ and Light^,^,:- ` L� 9:1 F TPIr AVENUE CITY EV READY SET GO! COPY -ECEIVETr JUN 4 ZZ BY:---' Primary: 7.2kw x 4 (plugs) = 28.8Kw /830 = 35amps x 1.25 = 50amps OCP Secondary: 7.2kw x 4 (plugs) = 28.8Kw /360 = 80amps x 1.25 = 100amps OCP Florida Power and 1. 120/208v Three phase Nema3r Panel 150amp Main Breaker. 3 # 1/0 Copper One # 6 Ground No Neutral. 4.Existing MSB 2000amps 277/480v 50amp 3pole Breaker EV TX 3# 4 cu 1# 6 Gr w If Light-%z / x xx ELECTRI( AVENUE EV READY SET GOI 954-445-8108 electrician@you rservicetast.com 2. 277/480v 3.600v step down Three Phase 120/208v Nema3r disconnect 45Kva 200amp rated nema3r Transformer Non Fused.. 3# 3 copper 1# 6 Ground _. -DA F 1 9 DUUKW 800kwOK 0Kw SpA£E 300Kw'-.r 300Kw -SPACE EV- 1 a 300Kw ;1 SPAZE ,600kw - `'` =� EV- 1b 300Kw -� -_�: -� Panel Schedule HA Q=800K ?600kv 600ki Florida Power and Light'\ LLLk. i RIC AVENUE EV READY SET GO! 954-445-8108 electrician@yourservicetast.com Landon Campus E-4 _.wdw_. q SERVICE U URREE[ ��''OIECON��NfLI � I11175 Landon Campus ab • �Ecr�ic �kEV,;-v APPROVE v � ATE EV Tx E-5 Li=r-�.'--',LfttV ILIlV" APPROVECy�` �X�z ATE —chargepoin+ CT4000 Level 2 Commercial Charging Station Specifications and Ordering Information Ordering Information Specify model number followed by the applicable code(s). The order code sequence is: Model -Options. Software, Services and Misc are ordered as separate line items. Ndrd nre • .- ..• Model 1830 mm (6') Single Port Bollard Mount CT4011 1830 mm (6') Dual Port Bollard Mount CT4021 1830 mm (6') Single Port Wall Mount CT4013 1830 mm (6') Dual Port Wall Mount CT4023 2440 mm (8) Dual Port Bollard Mount CT4025 2440 mm (81 Dual Port Wall Mount CT4027 Options Integral Gateway Modem - USA -GWI Integral Gateway Modem - Canada -GW2 Misc Power Management Kit CT4000-PMGMT Bollard Concrete Mounting Kit CT4001-CCM Software & Services .:J"Pt ��. 111111.111TIM• ChargePoint Commercial Service Plan CTSW-SAS-COMM-n' ChargePoint Service Provider Plan CTSW-SAS-SP-n' ChargePoint Assure CT4000-ASSURErtt Station Activation and Configuration CPSUPPORT-ACTIVE ChargePoint Station Installation and Validation CT4000-INSTALLVALID Note: All CT4000 stations require a network service plan. ' Substitute n for desired years of service (1, 2, 3, 4, or 5 years). ' Substitute n for the duration of the coverage (1. 2, 3, 4, or 5 years). 1830 mm (6) Dual Port Bollard USA Gateway Station CT4021-GWI with Concrete Mounting Kit CT4001-CCM ChargePoint Commercial Service Plan, CTSW-SAS-COMM-3 3 Year Subscription ChargePoint Station Installation and Validation CT4000-INSTALLVAUD 2 Years of Assure Coverage CT4000-ASSURE2 1830 mm (6) Single Port Wall Mount Station CT4013 ChargePoint Commercial Service Plan, CTSW-SAS-COMM-5 5 Year Subscription 4 Years of Assure Coverage CT4000-ASSURE4 Station Activation and Configuration CPSUPPORT-ACTIVE CT4021 The First ,lE ENERGY STAR` Certified EV Charger ChargePoint CT4000 Family CT4021 1830 mm (6 ) CT4025 2440 mr (8 ) Bollard 347 mm (13.7") CT4025 2426 mm (95.5") CT4021 1811 mm (71.3") 289 mm (11.4") 233 mm (9.2") 1186 mm (46.7") 470 mm CT4023 1830 nin, (F-) CT4027 2440 mno (8') Wall Mount CT4027 2426 mm (95.5") ELE(:Tf<ICAL kL-VIEW I APPROVE 6i�"DATE CT4023 1811 mm (71.3") 347 mm (13.7") 302 mm (11.9") 33 mm (9.2") 483 mm (19.0") 2 chargepoint.com —chargepoih+- FLEUI^kICAL kcvl�W fG� " CT4000 Family SpecificationsAPPFovE') "_� Single PC., Dual Port , Electrical Input - — - - - Standard 30A One 40A branch circuit 40A dual pole 30A x 2 T. independent 40P, 40A dual pole (non-GFCI type) branch circuits (non-GFCI type) x 2 Standard Power Share n/a n/a n/a 32A One 40A branch circuit 40A dual pole (non-GFCI type) Power Select 24A 24A One 30A branch circuit 30A dual pole. 24A x 2 Two independent 30A 30A dual pole (non-GFCI type) branch circuits (non-GFCI type) x 2 Power Select 24A Power Share n/a n/a n/a 24A One 30A branch circuit 30A dual pole (non-GFCI type) Power Select 16A 16A One 20A branch circuit 20A dual pole 16A x 2 Two independent 20A 20A dual pole (non-GFCI type) branch circuits (non-GFCI type) x 2 Power Select 16A Power Share n/a n/a n/a 16A One 20A branch circuit 20A dual pole (non-GFCI type) Service Panel GFCI Wiring - Standard Wiring - Power Share Station Power Electrical Output Do not provide external GFCI as it may conflict with internal GFCI (CCID) 3-wire (Li, 1-2, Earth) 5-wire (LI, LI, L2, L2, Earth) n/a 3-wire (Ll, 1-2, Earth) 8W typical (standby), 15W maximum (operation) Standard 7.2kW (240V AC @ 30A) 72kW (240V AC@30A) x 2 Standard Power Share n/a 7.2kW (240V AC@30A) x 1 or 3.8kW (240V AC@16A) x 2 Power Select 24A 5.8kW (240V AC@24A) I 5.8kW (240V AC@24A) x 2 Power Select 24A Power Share n/a 5.8kW (240V AC:a24A) x 1 or 2.9kW (240V AC@72A) x 2 Power Select 76A 3.8kW (240V AC@16A) 3.8kW (240V AC@16A) x 2 Power Select 24A Power Share n/a 3.8kW (240V AC@16A) x 1 or 1.9kW (240V AC@8A) x 2 Functional Interfaces Connector(s) Type Cable Length -1830 mm (6') Cable Management Cable Length - 2440 mm (81) Cable Management Overhead Cable Management System LCD Display Card Reader Locking Holster SAE J1772"' 5.5 m (18') n/a Yes SAE J1772'" x 2 5.5m(18')x2 7 m (23') 145 mm (5.7") full color, 640x48O, 30fps full motion video, active matrix, UV protected ISO 15693, ISO 14443, NFC Yes Yes x2 chargepoint.com 3 ChargePoint CT4000 Family Safety and Connectivity Features Ground Fault Detection 201 CCID with auto retry Open Safety Ground Detection Continuously monitors presence of safety (green wire) ground connection Plug -Out Detection Power terminated per SAE J1772-specifications Power Measurement Accuracy +/- 2% from 2% to full scale (30A) Power Report/Store Interval 15 minute, aligned to hour Local Area Network 2.4 GHz Wi-Fi (802.11 b/g/n) Wide Area Network 3G GSM, 3G CDMA Safety and Operational Ratings Enclosure Rating ! Type 3R per UL 50E Safety Compliance UL listed for USA and cUL certified for Canada; complies with UL 2594, UL 2231-1, UL 2231-2, and NEC Article 625 Surge Protection 6kV @ 3000A. In geographic areas subject to frequent thunderstorms, supplemental surge protection at the service panel is recommended. EMC Compliance FCC Part 15 Class A Operating Temperature -300C to +50°C (-22oF to 122ol Storage Temperature -30oC to+60oC (-22oF to 140oF) Non -Operating Temperature -40-C to +60°C (-40°F to 140°F) Operating Humidity Up to 85%@ +50oC (122°F) non -condensing Non -Operating Humidity Up to 95%@ +50oC (122"1 non -condensing Terminal Block Temperature Rating 105-C (221°F) Charging Stations per 802J1 Radio Group Maximum of 10. Each station must be located within 45m (150') "line of sight' of a gateway station. ChargePoint Inc. reserves the right to alter product offerings and specifications at any time without notice, and is not responsible for typographical or graphical errors that may appear in this document. Contact Us ® Visit chargeooint.com 0 Call +1.408.705.1992 Q Email salesgchargeogintcom AR -chargepoin+ ChargePoint, Inc. Copyright 32018 ChargePort. Inc. All rights reserved CHARGLPOINT Is a U.S registered trademark/serves mark, and an LU 240 East Hacienda Avenue registered logo mark of ChargePoint. Inc. All other products or services mentioned are the trademarks, service marks, registered Campbell, CA 95008-6617 USA trademarks or registered service marks of their respective owners DS-C74000 06. Add 2018. PN 13.001020-01 Ir -1.408.841.4500 or +1.87Z370.3802 US and Canada toll -free I sees: by Underwriters 6 T� W chargepointAOm laboratories Inc may - --` ELECTRIC AVENUE EV READY SET GO! 954-445-8108 electrician@yourservicefast.com EC13001809 Strong -Bolt 5/8 in. x 51/2" in. Zinc -Plated U SAMPLE Landon Building; Barry University, 11300 NE 2 Avenue,Miami Shores, FL 33161 4pATE_ M H d UUM "g ar ware ELEU-1 ,L KL-viE-VV APPROVED �— DATE ............... WN Re ftm RE U."m RaM56 305 M 2480 s Per !K -W FLAY- imT f-AmiAL d) �OG�oO© �o�ooA 00 of 0 0 �mv000�o ��oC®� :1DIG 4�GDAO ddH c2 �M-7I,n-:��l-IV^,I II.^,31R- ®�aeo�iaooee�s aa�mmmrrsssti_olo4tazx�mmraace� �[�amma�Ic�cv��ErtEolrE,rc+��avoamm�_ �uu�iouui��mnl=u���u �a>•uiv�uia�rs�mlm�uuu�u �FJIJlUd4a mImC�1.�SIWVJIY'1a3'�a!• �uwru.. �a:auoao 616 �ou3r�a��if� mlC��a���a� Y�IF=1Ga ��YWu ��uuu [:IC7•a!•aalala!•aal mciW>_4um:�oaa aalpl:.::ml _YCSalE1 a alaalsm G13�aDYMANESaal lC:� 3Phase 3. 146g 341/0 El 40 2])/460v Seep down 120/200v 45KVa 2" Transformer MMM r6 1 1/4" x 1/4" Steel 24" x 4" Service Disconnect 600v 3Phase 60amp rated NON FUSE 346 146g )♦. �M •W"M. M. M M �r31. me.MbM .tW auYPb �inma'.womm•.`.iu—,:m���w:—w.a.am. ""..,:"Ml :_" '-.'. �m.m.�.".wr . r �ws gtpl.z rW Po�F/.tl IMIMw9m M M M N. OwfW M1�TJmI VOrI>I .uM.SMaii. Y. WAY b.A4d1 M1A •e.wpws. w. aW r 4iOtry) (� } swwsn.n lu w..r atl.. n/. M M rx. 4e]W b"Ydu. solo.. oM ) .o . i w.,z.nww swr.acue.w suntuuu,4.w ew Neie nwm.. rsw.ww.."w.aw•) lWW IYW p.OVK®!a EI.W WWAst­firyON+i L ls�KCIOy.ls aJnv pbV.<pY.).t u . s>rR N. uwww K-0zw.r. zswrm.'KWrw.l v.<u. uwww).yrw aNw Wwlwl.z ca.,.ann m. sKmlr c.eu•."s.•.r. M M�"w NF"mn[A M InQA s ��x snrm s"w Ys...anru.a..we...cv.Nm.wrm...mw�wsww.m.a cw sw".. isoRxL ea wn,rsc "CHARGING STATION PADS" "TOP" l+"tawasla r I r I r _ I 296LBS"GRAY CONCRETE EDGE AND BROOM FINISH" Ea.Nee.�� NSERT •TlANT10 wMr P,,G 03 NE, W. 3V OWN" P..a. FL 33234 Ph...: (ass) ae4at4a Namees Peaer RE 1300s . 51 .t N 1 R. 33175 Uc64665 ms T132460 4,ap sa' I `Sa6mT.:r4`azL co O) c m Q N W Z 0 o co T T y 'c a iC 00 C �o = cD CO Cl) C CM OO J LL J N ""e O Y W w a 1 AVENUE EV READY SET GO! 954-445-8108 electrician@yourservicefast.com EC13001809 TYPE: PANEL80ARD PANEL "1 H • MAIN BUS: FULL SERVICE: 277/480V,3/,4W NEUTRAL: FULL MOUNTING: SURFACE MAINS: MLO POLES: __ 42 _ __ _ _ ___ _ _ _ _AA.C. 10K_ DEM. NO DEM. TRIP CON WIRE REMARKS OKf CKf REMARKS WIRE CON— TRIP NO DEM. DEM. K.VA K.VA POLE DUIT NO. NO DUrr POLE K.VA K.V.A. 1.3 20-1 1/2 12 LTG. 1 ST FL 1 12 LTG. 1ST FL 12 1 1/2 20-11 2.6 2.6 20-1 1/2 12 LTG. 1ST FL 3 1 4 LTG. 1ST FL. 12 1/2 20-1 2.1 2.5 20-1 1/2 12 LTG. 1ST FL 5 16 LTG. 1ST FL 12 1/2 20-1 2.6 1.4 20-1 1/2 12 VAV-1-1 7 18 2.8 20-1 1/2 12 VAV-1-2 9 10 j ELEVATOR 6 1 60-3 33 t 2.1 20-1 1/2 12 VAV-1-3 11 12 2.5 20-1 1/2 12 1 VAV-1-4 13 14 LTG STAIR OFFICE (NORTH) 12 1/2 20-1 1.0 3.1 20-1 1/2 12 VAV-1-5 15 16 LTG. STAIR OFFICE (SOUTH) 12 1/2 20-1 1.0 3.0 20-1 1/2 12 VAV-1-6 17 18 SITE LTS. 10 1/2 20-1 1.0 1.0 20-1 1/2 12 N.L. CORRIDOR 191 20 28.8 0-3 1" 6 EV Charger Tx r 211 22 RTU-1 t 1 1 125-3 100 6 23 24 6 25 26 SPACE 27 28 RTU-2 4 1 1/ 70-3 53.0 SPACE 29 30 r 31 32 SPACE 70.0 125-3 1 1/4 1 PANEL 2H" 33 - ':< 6 1/4" 60-3 28.6 35 13A 68.0 125-3 1 1/4 1 PANEL "311" 1 39 401 IPANEL "IL" 4 1 70-3 38.6 41 1 42 161.0 _ 235 TOTAL CONNECTED LOAD = 396 KVA = 477 ANew Load = 522AMPS Primary 7,2 x 4 = 28.8Kva / 830 = 35AMPS x 1.25 = 45amps = 60amp OCP i Secondary 7.2 x 4 = 28.8Kva / 360 = 80AMPS x 1.25 = 100amps = 150a Panel OCP 1 H Panel Schedule 150amp Main Breaker 3Phase 3w 1#6g 3#1/0 w f ELECTRIC: AVENUE EV READY SET GO! 954-445-8108 electrician@yourservicefast.com EC13001809 1" 40 40 Service 277/480v Step down 120/208v bisconnect 600v 3Phase 60amp rated 40 40 2„ 45Kva 2" NON FUSE 3#6 ,CIA, Transformer 1#6g 01AC ne 1 6g 4#6 1#6g Direct Bore #6 #6 "PP ROVEDed ATE 1" Panel 1H Ramses Perez RE 13006 sw 51 st Miami F1, 33175 Lic 64685 305 773 2480 Ramse-6'41�11ysl :17rRaiiie�$t JJate: 2022.11 s Perelt:3PP9T$19f T c') OJ _7 Li- 0 ui N L U) .E C(U L N C 4) Q N W Z 0 a tY) T � 'rn co > C c 0 C J CZ m Grass 1 3/4" Steel Bollards Concreted into ground 1'( one foot) Directional bore 1 1/9" 2'-0" Pad N o Bollards to be installed 3" NO —+ ,*- from the concrete pad 0 Curb Curb me M Kirk Landon Building; Barry University, 11300 NE 2 Avenue, Miami Shores, FL 33161 Scale 1/4" = 1' Typical Mi 1123 con t Sheet D• r 1 ' CONTACT INFORMATION FOR PERMIT APPLICATION FIRST NAME (print clearly) LAST NAME (print clearly) Carlos De Jesus MOBILE PHONE OFFICE/HOME PHONE 954-445-8108 954-445-8108 EMAIL (required so you can he notified on the status of your plans) electdcian@yourservicefasf.com COMMENTS 0f you are submitting a municipal plan, please provide the municipal process number(s) and ensure the municipal application is in the of- fice set of plans) _ Barry University - Landon Building - Critical Power - Two EV Chargers. D [ C U 8 2022 Miami Shores Permit # ( ELC-06-22-1507 ) BY: _ PLANS (check all that apply) Please indicate if plans qualify for the following expedited plan reviews: ElGOVT PROJECT/DEPT IaGREEN BLDG' (new construction only) El PACE PROJECT' ElAFFORDABLE/WORKFORCE HOUSING' El ECONOMIC SIGNIFICANCE' ❑ CONCIERGE ('Pursuant to Ordinance 99-140; Ordinance 05-115; and Ordinance oo-sl. Project maybave additional requirements.) REQUESTED PLAN REVIEWS (check all that apply for rework only) ❑ ALL ❑BLDG/HCAP ❑ELEC ❑ENRG YFIRE El ROOF El LANDSCAPING ❑MECH El PLUM ❑PWKS ❑PWCC ❑SIGN ❑STRU ❑ZNPR ❑WASD ❑PWIF ❑LPGX ❑SHOP DRAWING El DERM CORE El DERM AIR ❑ DERM AIRPORT ❑ DERM ASBESTOS ❑ DERM COASTAL ❑ DERM FLOOD ❑ DERM GREASE El DERM INDUSTRIAL ❑DERM PAVING & DRAINAGE El DERM POLLUTION El DERM PRE-TREATMENT ❑DERM SOLID WASTE ❑DERM TANKS El DERM TREES ❑DERM WATER TREATMENT ❑DERM WETLANDS ❑ PERMIT BYAFFIDAVIT ❑SHORT TERM EVENT ❑DOH/HRS CHECK AFFIDAVIT CHECK OPTIONAL PLAN REVIEWS (check all that apply) ❑ BLDG ❑ELEC ElM€CH ❑ PLUM ❑ STRt) OPR DERM INITIAL REVIEWS (check all that apply) El DERM CORE El DERM SPECIALTY (You will be notified after core review is complete foradditional fees) OPR DERM REWORK (OPR for specialty only available at PIC) ❑TREE ❑GREASE ❑ ASBESTOS ❑ COASTAL ❑ AIR ❑ PAVING & DRAINAGE ❑TANKS ❑INDUSTRIAL El WETLAND ElPRE-TREATMENT❑CORE El FLOOD FOR • ONLY To rcompleted r • r r r Processing Specialist APPLICATION DATE CLERK NAME ARRIVALTIME PROCESS NUMBER PROCESS NUMBER PROCESS NUMBER ❑RE -ISSUE El PLAIN REVISION ❑REWORK ❑SHOP DRAWING MtA F$ S.t fbyniltaga•tiingl•Rynfile t}ligii9t�d¢SI MtI�pHmiii$71RI'e3SigSd6bB15-21B1btr ltegov/permitsa - 04 M a1-zss . filled.pdf EL�f„1I,i�; APPROV",�— DATE -chargepoin+ EXTERED CT4000 Level 2 Commercial Charging Station Specifications and Ordering Information Orrl,.,,. q, 1,,Fnvnlatlon Specify model number followed by the applicable code(s). The order code sequence is: Model -Options. Software, Services and Misc are ordered as separate line items. Hardware _ Am"i tion Order Code Model 1830 mm(6) Single Port Bollard Mount CT4011 1830 mm (61) Dual Port Bollard Mount CT4021 1830 mm (6') Single Port Wail Mount CT4013 1830 mm (6') Dual Port Wall Mount CT4023 2440 mm (8) Dual Port Bollard Mount CT4025 2440 mm (81) Dual Port Well Mount CT4027 Options Integral Gateway Modem - USA -GW7 Integral Gateway Modem - Canada -GW2 Misc Power Management Kit CT4000-PMGMT Bollard Concrete Mounting Kit CT4001-CCM DUI(WaIE G .se! VIcus ChargePoint Commercial Service Plan CTSW-SAS-COMM-d ChargePoint Service Provider Plan CTSW-SAS-SP-d ChargePoint Assure CT4000-ASSURW Station Activation and Configuration CPSUPPORT-ACTIVE ChargePoint Station Installation and Validation CT4000-INSTALLVAUD Note: All CT4000 stations require a network service plan Substtute n for desired years of service (1'. 2.3.4. or 5 years). ' Substitute n for the duration of the coverage (1, Z 3, 4, or 5 years). UiOei UUCie axaalple5 7830 mm (6) Dual Port Bollard USA Gateway Station CT4021-GW7 with Concrete Mounting Kit CT4001-CCM ChargePoint Commercial Service Plan, CTSW-SAS-COMM-3 3 Year Subscription ChargePoint Station Installation and Validation CT4000•INSTALLVAUD 2 Years of Assure Coverage CT4000-ASSURE2 CT4021 1830 mm (6) Single Port Wall Mount Station CT4013 BY.- DEC 0 8 20Z2 ChargePoint Commercial Service Plan, CTSW-SAS-COMM-5 r, The First 5 Year Subscription i ENERGY STAR" 4 Years of Assure Coverage I CT4000-ASSURE4 Certified EV Charger Station Activation and Configuration CPSUPPORT-ACTIVE Miami Dade County Department of Regulatory and Economic Resources — Job Copy 1123002475 - 12/5/2022 3:01:18 PM ChargePoint Specifications.pdf ChargePoint CT4000 Family �OU,AL I-;cVlIV'J a APPFROV_ DATEEC 4023 CT4025 2440 mrn (8') 4027 Bollard 347 mm (13.7") CT4025 j 2426 mm 11 CT4021 1811 mm (71.3") 289 mm (11.4") 3a mm (9.2") 1186 mm (46.7") 470 mm 1830 mm (6') 2440 mm (8') Wall Mount cT4o2i 2426 mm (95.5") CT4023 1811 mm (71.3") i 347 mm 03.7") 302 mm (11.9") 33 mm (9.2") G--U 8 20a BY: 483 mm (19.0") Miami Dade County Department of Regulatory and Economic Resources - Job Copy 112300249£rgerojI205/2022 3:01:18 PM ChargePoint Specifications.pdf APP�pV } ED� ""DATE Standard 30A Standard Power Share n/a Power Select 24A 24A Power Select 24A Power Share n/a Single Port (AC Voltage 2081240V AC) One 40A branch circuit 40A dual pole (non-GFCI type) n/a n/a One 30A branch circuit 30A dual pole I (non-GFCI type) n/a I n/a Power Select 16A 16A One 20A branch circuit Power Select 16A Power Share n/a n/a Service Panel GFCI Wiring -Standard Wiring - Power Share Station Power Standard Standard Power Share Power Select 24A Power Select 24A Power Share Power Select 16A Power Select 24A Power Share Connectar(5) Type Cable Length -1830 mm (6') Cable Management Cable Length - 2440 mm (81) Cable Management Overhead Cable Management System LCD Display Card Reader Locking Holster 20A dual pole (non-GFCI type) n/a BY: Dual Port (AC voltage 2081240V AC) 32A One 40A branch circuit 40A dual pole (non-GFCI type) 24A x 2 Two independent 30A 30A dual pole branch circuits (non-GFCI type) x 2 24A One 30A branch circuit 30A dual pole j (non-GFCI type) 16A x 2 Two independent 20A 20A dual pole branch circuits (non-GFCI type) x 2 16A One 20A branch circuit 20A dual pole . (non-GFCI type) Do not provide external GFCI as it may conflict with internal GFCI (CCID) 3-wire (Ll, L2, Earth) S-wire (Ll, Lt, L2, L2, Earth) n/a 3-wire (LI, L2, Earth) 8W typical (standby), 15W maximum (operation) 7.2kW (240V AC @ 30A) 7.2kW (240V AC@30A) x 2 n/a 7.2kW (240V AC@30A) x i or 3.8kW (240V AC@16A) x 2 SAW (24OV AC@24A) SAW (24OV AC@24A) x 2 n/a 5.8kW (240V AC@24A) x 1 or 2.9kW (240V AC@12A) x 2 3.8kW (240V AC@16A) 3.8kW (24OV AC@16A) x 2 n/a 3.8kW (240V AC@16A) x 1 or 1.9kW (240V AC@8A) x 2 SAE J1772 I SAEJ1772m x.2 5.5m(18') 5.5in(181 x2 n/a 7 m (23) Yes 145 mm (5.7') full color, 640x480, 30fps full motion video, active matrix, UV protected ISO 15693, ISO 14443, NFC Yes Yes x2 Miami Dade County Department of Regulatory and Economic Resources - Job Copy 1123002475 - 12/5/2022 3:01:18 PM chargepoint.com 3 ChargePoint Specifications.pdf ChargePoint CT4000 Family rnnectivity Features Ground Fault Detection Open Safety Ground Detection Plug -Out Detection Power Measurement Accuracy Power Report/Store Interval Local Area Network Wide Area Network Enclosure Rating Safety Compliance Surge Protection EMC Compliance Operating Temperature Storage Temperature Non -Operating Temperature Operating Humidity Non -Operating Humidity Terminal Block Temperature Rating Charging Stations per 802.11 Radio Group 20mA CCID with auto retry Continuously monitors presence of safety (green wire) ground connection Power terminated per SAE J1772' specifications +/- 2% from 2% to full scale (30A) 15 minute, aligned to hour 2.4 GHz Wi-Fi (802.11 b/g/n) 3G GSM, 3G CDMA Type 3R per UL SOE UL listed for USA and cUL certified for Canada; complies with UL 2594, UL 2231-1, UL 2231-2, and NEC Article 625 6kV @ 3000A. In geographic areas subject to frequent thunder storms, supplemental surge protection at the service panel is recommended. FCC Part 15 Class A -30"C to +50°C (-22aF to 122°F) -30°C to +60aC (-22°F to 140°F) -409C to +600C (-40eF to 1404F) Up to 85%@+50°C 022°F) non -condensing Up to 95%@+500C (122eF) non -condensing 105'C (221°F) Maximum of 10. Each station must be located wi in 45m 0500 -line of sight" of a gateway station. ChargePoint, Inc. reserves the right to alter product offerings and specifications at any time without notice, and is not responsible for typographical or graphical errors that may appear in this document. Visit charoeooint.com Q Call +1.408.705.1992 0 Email sales0charaeooint corn LDATE p01(1-F ChargePoint, Inc. Copyright 02010 ChargePoint. Inc NI rights reser .CHAstGEP0NT Is a U.S. registered tadema,1thervire markand an EU 240 East Hacienda Avenue registeretl logo mark of ChargePoint. Inc NI other protlucts orservims mentioned are the trademarks, service mad¢ registered Campbell, CA 95008-6617 USA trademarks or registered service marks of d r respective axners. M5 4000-05, Apra 2018. W 73-001020-01-tl. +IA08.841.4500 or +1.877.370r3802 US and Canada toll -free Lis etl try ur�derwrlters e Miami J�}�{ O1�Q{�tty Department of Regulatory and Economic Resources - Job Coj�writphiri usm gl® 112300 475 - K/5/2022 3:01:18 PM ChargePoint Specifications.pdf 2�1 "CHARGING STATION PADS" "TOP" "BOTTOM" xI"INSERTS Q I x" INSERTS `#t4 REBAR GRADE 60 0 u A 0 h I q d U N "GRAY CONCRETE EDGE AND BROOM FINI* •.I 0 0 W V [3 b u 0 r., w a o00 44 0 #4 REBAR GRADE 60 m e ATLANTIC COAST PRECAP�b —2ai8" x" INSERTS 533 N.E. 33rd Street o" Oakland Park, FL 33334" v Phone: (954) wA4245 A o 0 lou m N m rl I .-I W f HT :� lY '-•dam-��r (—�-.r _.. 6..®.. 1 1/4" x 1/4" Steel ca 3' 3' asphalt Concrete 121, Depth 24" x 4" Miami Dade County Department of Regulatory and Economic Resources - Job Copy H 1123002475 - 12/5/2022 3:01:18 PM LJ E- 2 Bollards.pdf P RI Ron DeSantis, Governor Melanie S. Griffin, Secretary do F apr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTOR' LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES EXPIRATION DA 31, 2024 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. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 202Z THROUGH SEPTEMBER 30,,2023 DBA: ELECTRIC AVENUE INC Business Name. Owner Name: CARLOS DEJESUS Business Location: 11621 SW 22 CT SUNRISE -Business Phone: 9 5 4- 6 2 5- 6 4 4 0 Receipt #:1-2417 E 8EC RICAL/ALARMS/CONTRACTOR Business Type: (ELECTRICAL CONTRACTOR) Business Opened:10 / 19 / 2 0 0 0 State/CountylCertlReg:EC 13 0 018 0 9 Exemption Code: Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 1 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is tea -regulatory in nature. You must meet all County and/or Municipality Manning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: CARLOS DEJESUS 11621 SW 22 CT DAVIE, FL 33325 2022 .2023 Receipt #WWW-21-00248608 Paid 08/22/2022 27.00 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2022 THROUGH SEPTEMBER 30, 2023 DBA: ELECTRIC AVENUE INC Business Name: Owner Name: CARLOS DEJESUS Business Location: 11621 SW 22 CT SUNRISE Business Phone: 954-625-6440 Rooms Seats Employees 2 Receipt #: 181-2417 Business Type: ELECTRICAL/ALARMS/CONTRACTOR (ELECTRICAL CONTRACTOR) Business Opened:10 / 19 / 2 0 0 0 State/County/CerUReg: EC 13 0 018 0 9 Exemption Code: Machines Professionals Signature For Vending Business Only -Number of Machines: Mending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27 1 .001 0.001 0.00 0.001 0.00 0.00 27.00 Receipt #WWW-21-00248608 Paid 08/22/2022 27.00 ACCORo® CERTIFICATE OF LIABILITY INSURANCE DATE(19/2022 Y) 12/19/2022 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 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 endorsements . PRODUCER CONTACT NAME: Barbara Garcia PHONE (954) 587-7850 ac No ; (954) 587-7778 Madinsi Insurance Inc. ADDR� S: Marlinsii@aol.com 850 SW 40 Ave. INSURERS AFFORDING COVERAGE NAIC # INSURER A: Western World Insurance Company Plantation FL 33317 INSURED INSURER B : INFINITY INSURER C : Scottsdale Insurance Company Electric Avenue, Inc INSURER D : AmTrust 11621 SW 22nd Court INSURER E : INSURER F : Davie FL 33325 COVERAGES CERTIFICATE NUMBER: 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. [NSR LTR TYPE OF INSURANCE I NSn SUER WVD POLICY NUMBER POLICY EFF MID POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR NPP8881195 08/23/2022 08/23/2023 EACH OCCURRENCE $ 1,000,000 GE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any oneperson) $ 5,000 I PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 509-82005-2236-001 11 /04/2022 11 /04/2023 & accident) COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ C UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE XBS0168160 08/22/2022 08/22/2023 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 DED 1 7 RETENTION $ PR/COMP OPS AGG $ 2,000,000 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? DN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A TWC4099831 03/29/2022 03/29/2023 OTH. TATUTE ER E.L. EACH ACCIDENT $ 1,0000,000 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 it more space is required) Electrical Apparatus -Installation, Servicing or Repair-NOC Electric Avenue, Inc License # EC13001809 [ei=131121 Miami Shores Village 10050 NE 2nd Ave 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 Miami Shore ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD