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EL-04-22-916Miami Shores Village 10050 NE 2 Ave Miami Shares FL 33138 305-795-2204 Location Address 78 NW 110TH ST, Miami Shores, FL 33168 Contacts Wilmer Nordelus Owner ROBERT VICKERS Applicant 78 110 1401 NE 101 ST, MIAMI SHORES, FL 331382612 Other: 3057905899 bobvickers@bellsouth.net ALL QUALITY ELECTRICAL SERVICES, INC Contractor SAMUEL LIGHTBOURNE 14750 S RIVER DR, MIAMI, FL 33167 Business: 3057905899 Inspection Requests: Description: INSTALL NEW 22KW WHOLE HOUSE GENERATOR Valuation: $ 8,450.00 305-762-4949 WITH WHOLE HOUSE 200 AM TRANSFER SWITCH Total Sq Feet: 0.00 Permit NO.: EL-04-22-916 Permit Type: Electrical - Residential Work Classification: Generator Permit Status: Approved Issue Date: 06/10/2022 Expiration: 12/12/2022 Fees Amount Application Fee - Other $150.00 CCF $5.40 DBPR Fee $4.44 OCA Fee $2.96 Education Surcharge $1.80 Permit Fee $145.75 Planning and Zoning Review Fee $35.00 Scanning Fee $12.00 Technology Fee $7.39 Total: $364.74 Parcel Number 1121360030070 Payments Date Paid Amt Paid Total Fees $364.74 Credit Card 06/10/2022 $214.74 Credit Card 04/11/2022 $150.00 Amount Due: $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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws r tmg constru on an ring. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner I Applicant I Contractor I Agent June 10, 2022 -trt75 0r S Date Page 2 of 2 Miami Shores Village C�r�T�RED Building Department APR z 1 1AZ2 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY. - INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. (%L —CT1 ' 22--9((o PERMIT APPLICATION Sub Permit No. ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP p CONTRACTOR DRAWINGS JOB ADDRESS: 70 )L tj 6 S Folio/Parcel#: #—J-/ 3 6 66 3 " 00 7 U Is the Building Historically Designated: Yes NO V Occupancy Type: S Load: Construction Type: C 8s Flood Zone: IJ BFE: FFE: OWNER: Name (Fee Simple Titleholder): /-fe Y/Lt lc.n CP YJ Phone#:.?6S 7/S 77 u`f' Address: 5" City: 2..5 State: Tenant/Lessee Name: %� J n Zip:,, ll 33R/J Phone#: 1j./A Email: CONTRACTOR:: Company Name: „/�JvG Q •cJ�/ T✓IG Phone#: 3LZ— Address: /1/7 City: // /Sta/te: Qualifier Name (Li7�U-L/ /6/n?'�OLpY19l/. State Certification or Registration #: Cc 3 U / DESIGNER: Architect/Engineer: f /♦- JJ 2z Zip: 3�� 6 7 Phone#: 12N M, M21 % 7' 4 Certificate of Competency #: Phone#: Address: _ by Value of Work for this Permit: $ 5 City: State: Zip: _/ Squar Line Footage of Work: 7.( Type of Work: ❑ Addition ❑ Alteration Description of Work: L n 1 // Ii{,� Z Z./G2J INe)w ❑ Repair/Replace . ❑ Demolition t(-C..o �'� 7'!u r/S�C. q=? L&q'& 1A 6j, % A00f-r- za,) bk Specify color of color thru tile: Submittal Fee $ Permit Fee $ 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 S1 Mortgage Lenders Name (if applicable) Mortgage Lenders Address City State Zip 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 $1500, 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 wi t be a roved an a ection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 5 day ofeS 20 by day of 20;ac�a by NFSL�•-ram. �d2D� �wT10 is personally known to rw AOA who is ersonally know o me or who has produced Pl_ L -J rN-/1— as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY Print: Seal:Z Y Pubko tme of Floridg Ludny Abichet My Expires 02/122024 958024 sssssrr++++ssssssrrrrrrtssssasssss++++rsssssarsssrs++raw+++r� APPROVED BY/��'� -- Plans Examiner rJl(3_Ci��i22_ Structural Review srrs.+xse�rr�t•++ Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY' APPRAISER Summary Report Property Information . Folio: 11-2136-003-0070 Property Address: 78 NW 110 ST Miami Shores, FL 33168-4319 Owner WILNER NORDELUS 8 HERMANCE E ANTOINE Mailing Address 78NW110ST MIAMI SHORES, FL 33168-4319 PA Primary Zone 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds I Baths / Half 3 / 1 / 0 Floors 1 Living Units 1 Actual Area 1,487 Sq.Ft Living Area 1,487 Sq.Ft Adjusted Area 1,343 Sq.Ft Lot Size 9,150 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2021 2020 2019 Land Value $227,119 $206,472 $206,472 Building Value $93.473 $93,473 $93,751 XF Value $1,322 $1,340 $1,359 Market Value $321,914 $301,285 $301,582 Assessed Value $98,085 $96,731 $94,557 Benefits Information Benefit Type 2021 2020 2019 Save Our Homes Assessment $223,829 $204,554 $207,025 Cap Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES EXT PB 43-40 LOT 7 BLK 219 LOT SIZE 75.000 X 122 OR 16564-4725 1094 1 Generated On : 4/11/2022 Taxable Value Information 20211 2020 2019 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $48,085 $46,7311 $44,557 School Board Exemption Value $25,000 $25,0001 $25,000 Taxable Value $73,0851 $71,7311 $69,557 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $48,085 $46,731 $44,557 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $48,085 $46,731 $44,557 Sales Information Previous Sale Price OR Book -Page Qualification Description 10/01/1994 $77,000 16564-4725 Sales which are qualified 12/01/1971 $26,500 00000-00000 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http:/tw .miamidade.gov/info/disclaimer.asp Version: https://www.miamidade.gov/Apps/PA/propertysearch/ 4/11 /2022 Gam' ' 6.ck-1 4age16(bAb 10' rP"- St -A. jonopa)� Qu �,� )o' frar.. c4��L1�, Al su✓We J �x16rw, qr-ou7lJ-9Jf✓et f'E vn p' 7s7. U/,%�, 6�, 9 a�4, 28zz SKETCH of BOUNDARY SURVEY L � L > > C M m N m a I I I P I 9 a� CLF. GG q i "s .1 0 �' r �6 LEOENO �� A/C -AB ED100pY0 PAD Ic)-cuauTm -C[MRAME E15 -CBIER SGIOW . N. pp C f -CHAIN C, Calif. -OMR,E NM;. SWN: COMAETE WNW CLLY.-[UVAON TTR-fNQ I/7' AN NINENOIDNIFam IN -uRO MOCK -FERN-RODE Cl -COMMIT K NY-NFINIED 0.AI N ONR-ONTKED NAGS UK PA -%AT BDK 7 —NO - K -PALE OHE m. -lTPUM SYMBOL ..._.._ r— ® HRA al( m Ni -WDBPOE 216' A5P H A LT PAVEMENT B' (GONE. 424.5' 6RYA55 MXCRETC DAIWO // PARKWA 0� GRASS A I Iopy m CONIC. DLLK �` I iLLI E f w� I P= 12.2' _ A C.LF. £, o NI UWE 17.0' 1 U_ 0.7' 27.7 _ Is ONE �Z + CB.S. flD FLOOR CE g� x9 FINISHED FLOOR ELEV. No.78 ¢� Cl Tol 10A, B.0' 7.l bid STAN9. �yl GRAPHIC SCARE 20' ID' 30' b )o 41 Nlh l (�RM « y� Lr. ITi I lircn=tD n. 29 0.0' 117' GRACES AACA�\ E An A• u„NR1 M� !. it 0' ASPHALT PAVEMENT 0 ALLEY TAT 26, BLACK 219 MIMI SNORES EMNSION (PA. 43 - PG. 10. MO.C.R.) Ey=NV 2"2 MAFYRS .....•.•.••. •...••••• EID•AM4 SHOWN HEREON ARE 9LUTNE TO WMO GEODETIC VERTICAL OANY I929 1 (N.O.WR9) AND ARE BASED ON A MAMMARY ( 41NLIED By THE ENGINEERING CEPJUMIEHI Of WJB-OAOE COUNTY. RONM. BINCBYARHB H-565 (PA MAIL AND BRASS WAGNER IN MIN CORNER OF CONC SUPPORT OF TRAFFIC MAeMPN0n2: COMMON. BON). i HE 111 51 --- 91.5' SMTH M C/L M MMMI AA --- 56' CAST Of C/L B' EAST Of A MA4LUM TREE EIFVATDWNMG291- 10.75 IN FAN) LOLAIOR.' DIM M. LOT 7, OWN 210. OF YAW MORES r1i[xslex ACCORDING TO ME Pui BOON AD, AT PACE W, OF THE PUBLIC RECORDS Or MNMI-PAGE COUNTY. AMWY MY I//IM MRMN N. FARM, E1 sn WK II USr. MAMA SV� YWM. ILIA [O.MIY.IIL.b. I I I I [btk BL I I I I I I I I IPBA9HM4K I I NW BIOEA, STREET �I I tl D B B 7 B tl { 8 Y 1 JI Q ILL P I• f NW 109Eh STREET ...... '..' _ -T -T -T •7.. AA NP 1 SURVEYOR REI.ORT and NOTES....f........_e......... o. BY THE 1. THE KMl OESCRTPMN USED M 1N[ PKPAN.IDx K lltl5 SUMPCCl�EWpEffOT SHOWN r6p1N[LN(IKSMIPN..E.D THEREI� THAT WAY BITO4EE THAI ARE NOF U EXAENTINNS IOC BW,�U1.I ERAC 01 TCOUNRESTRICTTY. EXAMINATIONTO. ABNTYAS/EF RRDS C7TN GLL THAVE14 DETERMINE ECOROHIS 1 ME'SAETCH M BWN EY SWTR WAS PREPARED N ACCRTVW%MIS' CIIRREM SPANDDAAyRTp1S5 W MACDCE SET MGM BY THE FLORIN STATE BOARD OF ERKESSIOHAI.SUM[1QK MNO NAPP[M. PURSJAM TO RULE 52-17 OF THE FLORIDA ADMINISTRATIVE CODE AND ITS IYPIZIEHIING LAW.CHAPIN W27 NOME rSTATUTESACCURACY MIAMM TO ALL MMONTAL COXTPOL MEASUREMENTS AND ORME CAECNAT" OF CLOSED GEDMEMIO iICURES, MEETS OR OMEN ME CURRENT S7WAMS GF NAME SET FORM M ME FLORIDA BOARD Of PROFESSIONAL SUMMOK AND IUPPEAS AS CNMANDWR' CHARTER 54-17.06IMIKb). (BA.H M I FOOT IN 7.6CC TIED TO MBWBM WOOD A,. A,A ME KCORDEMMPMN OF THE BURNED PAMERTY FORMS A MATM[MATIMLLY CLOSER ME E. At • A. UNLESS OTHERWME NOTED. MIS SURD HAS NOT AMEI TO LOCATE ANY MOTIHO MD/OR UNKRGANAHD UTILITIES ON MO/OR ADJACENT TO ME PROPERTY. 7. THE SAMET YAP N NTEXOED TO BE DSPLAYED AT ME STATED GRAPHIC SCAIfS IN M SUM NOT Of MEASUREMENT AS DWICTED ON ME SUM MAP ATTENTION IS OWEVEO i0 ME FACT THAT SAD SUM MAP MAY BE ALTERED N SMLE BY KPMDUCTWN AND MUST BE CONSIDERED WHEN OBTAINING SCALED DATA. 6 !IMAGING DWENGNS AND BUILDING YTBACNS SHOWN MEN 4 ON ROUNDEO TO THE NEU6T NE -TOWN FBI') K A FONT. 1. THE REGAL GARBAGE' Of THE FENCES AND/OR WALLS (IF AM) WAS NOT DETERMINED, AND ME LOCATIONS SHOWN HEREON ME BASED, ON THE RECOVERED BWNDAM MONUMENTATMN. IRO ME SU NEY HAS BEEN PREPARED FM ME EXCLUSIVE UK OFME ENMIR IMMED HEREON. 11. THE THIN FLOOR ELEVATIONS[Il MORE TOM AT ME M DOWNS MIMI IRO ONSIDE OF ME BIINLMG. AS SHOWN ON SUM.11 THE SUBJECT PROPERTY CONTAINS 9,153.E SOUND FEET OR 0.210 ACRES MORE M LESS. FL000 INFORAoI............................................................ . ME SUBECT PRO DUTY LIES AMAIN A FIND MUM MWND A ROOD MMWMH OF y MM ABASE FLOOD V.DAMIN, IL& POKW17T TO ME FLOWN INSMANCE RARE MAPS PUBLSHED BY ME UNITO STATES FEDERAL EMEKNCY WNAKYENt MENCY UNDER COMMUNTY Ne: 12M52 EVIILAGE M YARN BROOKS) MD PAKL NUL .. 0139. SUFi01: I. AS LAST REVISED N OPINED 11. GOAL fi 9LARVEYOR'S CERTIFICAT7ON..... •....... ..................................... g I NEKBY DEFEND THAT THIS iNETM OF MMN SIIRVEI' WAS PREPARED UNION MY DIRECT MPEI k AND THAT R R MIA MR MIMI TO ME BED DE MY NNOWIENNE AND BELIEF. _ lMd MW0yHA1Rp0M14g00II SCD l .YIiN r A,, w. bOAM n °I O°' d4`wWyE M4Va fr FTMi.avtlY L YR y>•+ INN ly 16 9MLI B 0}MQM YNO DLF. IfMHLW WF1'. MN DROW1 YiI LW LN05fAL � Maw I 2) M BECIfp6 FIE. MIIALLi SDN MU AMN Fw y BE G /¢' IpA �mf \4fAlECf :AN ,w..lANresiv> 4,M/?off VN ftaIWR .}' _ � � w HEf E OFRMONAL Ne L Mwroz Jr. SMi PApIEESg1Yl 5NMY0PII MNDAWRER Ib.fY3 • a S' TYU7 spa k Prod,ucL,^, d_m(i w-c.l d--, qae"tFi . 551-9511 BFl-71R6 ED SKETCH of BOUNDARY SURVEY Po O DIP. LNW CORNER OF LOT 8, BLOCK 219 f I CONCRETE ?TAMPED 5' CONC. SWK. rdt90 n 'r" GRASS AREA •.• CONC. STAIRS 12.2' 0.7' 27.7' r OU in o W m C OUTSIDE o.z' oulslDE " ,]' -* ONE STORY CB.S. RESIDENCE N0.78 N 25.5, 17 0'— z 10.0' A 7.4 w • CONC. Al J0 Mia i Shores VIII Building Depa e t Zon g Dept. Dates D Z- Buil ing Dept. Date Sub ect to compliance with all Federal, State and County rules and regulations. 0.1. Ou151ut FAN ID LLt LF.LVIL'1V ............... APP GRASS G AREA\( yb1 �rD,lEti '. n Y 90. N V 0 / 1" 4HeI hf U , r r4vo 1 i OPY 479.32' RHu17� 1:1D �. T , 3 • :• •.ems • �, • c.LF.•, $ ONLINE vb o z� .. -.•• c1c ego .r U m ��P in O, .v Co.$i 04 04 O Q� �m 2�%p LPG. faA� LHQENC KS K A/C -AIR COI (F)-CALCUL C.U. L -CENTER. ON LINE C.B.S. -CONCRE fFd 1/2' LP• C.LF -CHAIN I 1D CONC. -CONCRE — r CONC. SINK.-CONCRE n. ,_ -- . t4' GRASS LINEFd 75.00 R M ............ C.LF: ' ; ::.'.'.'.'.':.'.' E.L :.:.'.:.'.'.'.': ;:.... F.... ......P.i.. ;..0.2'.1NSNR. r:.:.:..:..:.:.'.'I ... :. ..... ............ Y ... 1 2� IP-FOUND NO 0 NO IDE (9) -MEA0 D.C.R.-MMMI-1 COUNEI NW -N0MIN ................. _ _ LOT 26, BLOCK 219 MIAMI SHORES EXTENSID14 (P.B. AS - PG. 40, MD.C.R.) OHW P.O. PG. (R) UP. -OVERNE -PLAT B -PAGE -RECORI -TYPICAI LEGAL011 .............................................................. LOT 7, BLOCK 219, OF MIAMI SHORES EXTENSION. ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43, AT PAGE 4D, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. A PORTION OF SE I/4 OF ]RAW SNORES RANGE 41 EAST, I I I I (PB43'PC8 40) I I I NW 110th STREET �\ I Z I , 5 1 I 1 , 8, 2 1 1 B 7 6 4 I L 1 1 1 I 1 'Fdt/2'I.P. --�a4Pl a401TI -- --T--T--r-- 1 I1 i NO ID , I .� 1 25 28 1 27 11 28 1 28 1 30 1 31 i 32 1 1 , I 2 122 , I NW 109th STREET T T - - _ I TI I I -T---� T r 1 I I SURVEYOR REPORT and NOTES ........................... •• •••.••••. I i. THE LEGAL DESCRIPTION USED IN THE PREPARATION OF THIS SURVEY WERE FURNISHED BY THE CUL41f.' • O Z 1THERE MAY BE ADDITIONAL RESTRICTIONS THAT ARE NOT SHOWN ON THIS SURVEY THAT MAY VIM IN I THE PUBLIC RECORDS OF THIS COUNTY, EXAMINATION OF ABSTRACT OF TITLE WILL HAVE TO BE MABE TO p17 DETERMINE RECORDED INSTRUMENTS, IF ANY AFFECTING THIS PROPERTY. OF [C Q 3. THIS 'SKETCH OF BOUNDARY SURVEY" WAS PREPARED IN ACCORDANCE WITH CURRENT STANDARDS U I PRACTICE SET FORTH BY THE FLORIDA STATE BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS, RURSUkHT TO RULE SJ -17 OF THE FLORIDA ADMINISTRATIVE CODE AND ITS IMPLEMENTING LAW, CHAPTER 472T027 OF -THE D_ Q I I FLORIDA STATUTES. CALCULATIONS OF 4. THE ACCURACY OBTAINI ALLAL ND ES m CLOSED GEOMETRIC FIGURESS,, MEETSFOR OREXCE DST THE CURRENT STANDARDSCONTROLT OFA PRACTICE FORTH BY THE I I 0 FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS AS CONTAINED IN CHAPTER SJ-17.051(3)(b), 15.b.11 � OF 1 FOOT IN 7,500 FEET FOR SUBURBAN AREAS. I 00 S. THE RECORD DESCRIPTION OF THE SUBJECT PROPERTY FORMS A MATHEMATICALLY CLOSED FIGURE. 6. UNLESS OTHERWISE NOTED, THIS SURVEY HAS NOT ATTEMPTED TO LOCATE ANY FOOTING AND/OR UNDERGROUND UTILITIES ON AND/OR ADJACENT TO THE PROPERTY. 7. THE SURVEY MAP IS INTENDED TO BE DISPLAYED AT THE STATED GRAPHIC SCALES IN US SURVEY FOOT OF I MEASUREMENT AS DEPICTED ON THE SURVEY MAP ATTENTION IS DIRECTED TO THE FACT THAT SAID SURVEY MAP �� MAY BE ALTERED IN SCALE BY REPRODUCTION AND MUST BE CONSIDERED WHEN OBTAINING SCALD DATA. HIC SCALE 8, BUILDING DIMENSIONS AND BUILDING SETBACKS SHOWN HEREON AS BEING ROUNDED TO THE NEAREST NTH OF A FOOT. 9. THE LEGAL OWNERSHIP OF THE FENCES AND/OR WALLS (IF ANY) WAS NOT DETERMINED, AND THE LOCATIONS SHOWN HEREONONA ARE BASED, ON THE RECOVERED BOUNDARY MONUNEMATION. SHOWN V FEET) 10. THIS SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTRIES NAMED HEREON. ich=2 ff. 11. THE DETERMINATION OF ELEVATIONS FOR THE SUBJECT PROPERTY IS NOT A PART OF THIS SURVEY. ••• SYMBOLS ••• 12. THE SUBJECT PROPERTY CONTAINS 9,153.8 SQUARE FEET OR 0.210 ACRES MORE OR LESS. 305 551-8511 P` 1116 877-7176 IG PAD EM-[LECTRIMETER PL000 1NFORMAT10N............................................................. (on wall -WOOD POLE THE SUBJECT PROPERTY UES WITHIN A FLOOD HAZARD HAVING A FLOOD DESIGNATION OF L WITH A BASE FLOOD a K MCCO ELEVATION: NA„ PURSUANT TO THE FLOOD INSURANCE RATE MAPS PUBLISHED BY THE ,LNITD STATES FEDERAL ICE EMERGENCY MANAGEMENT AGENCY UNDER COMMUNITY No: 120652 (VILLAGE =0F _MIAM.-SLIGRESr AND PANEL NUMBER: 0139, SUFFIX: L, AS LAST REVISED IN SEPTEMBER 11, 2009. - - _ _ = BALK Sca ON PIPE SURVEYOR'SCERTIFICATION-••.••••.. .••.••••••-'%...•••......•.•••• Dral ION I HEREBY CERTIFY THAT THIS 'SKETCH OF BOUNDARY SURVEY' WAS PREPARED UNDER_MY bIREGT SUPERVISION Ddi AND THAT IT IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. _ / Dra Q Z 0 m for. S LINE WITHOUT THE ORIGINAL RAISED 110.63112 No.: PAD DIMENSI-ONS'. uN LIMA ` GENERATOR UNIT BY SEPARATE SUBMITTAL (SEE SCHEDULE FOR MINIMUM WEIGHT " REQUIRED) • . M'LENGTM >Ax YRW W90 wY0)� k� PPU �•� • ISOMETRIC VIEW GENERATOR TABLE* ROAD "ES" I, VMIN G,Dm1V - .... 2RECAV RAD ..tON-G�2ADj APPLICATIONS ONLY) .MIAMI DA4F•C9UNTA . .. . .� • • •.' WIND DESIGN REQUIREMENTS — NSEU1IX1 A., 1-10 a Roi1D.5.1101NG CODE SENOR EDrt1oN At ORACE SIGH MEINC. JLi1NA]E DE51(N WINO S.EEO Vxll • I15 mplr NOMINAL DESIGN WIN. SAM N. -'A.,R RISK CATEGORY .11 IMERNAL ANISSURE .1. IS GR4)IOLMOOEL CMACItt WIOM ]EEGTI NEIGNT WEIGH COMMFHi$ GenuL WSE)S&w504 DIEM ZOO- 3B.0]" iB.LO" 4391hs Gercrx W59.6461. 6463 16RW 33W" 4G IA" 3&w" Sl3 ih Genera WO]E] 16 RW ISM' AM" U.YJ" 44BIbS GewrMW.N]3&035885 VRW 3501" EM" i&BO" 4551bs Genrx W50]4&WNEE 1]RW 3501" 4803" 3880" I311Lz SEE Gareru DJ58E5&COSBH] 30 kW ESIMI" 48 W' 38.w" 4511h CALCLUTONS Ge"Mc Wb]398W8]30_ N RNA 35 W" 480]" 39.w" Slblh IHfMSMEf] GeKKOt6551&0.K553 I3kW ES.W_' 4800' 38.W 5]&M ROKKr MIS &FIRES 14-MEW-3601)" 48 W" 38w" SOLIDS Genre i035, MU,)O3] 16kW I350J" 48OD 3R.w" SIDE ON Genxu W]038&W]O)9 30AW 35 GJ" 48.W" 3B.w" WBIM .. 00]CN3&]M3 li rw ES W" 4B.W" 38w" 4661M [ EYUSURE CATEGORY. C .... IRECTIONWEYEACCNA.- R NS ENCLOSURE CATEGORY . N/A HEIWw r H . AT GUND U T UNGE!ACTOR. D IIS PAT NEIGNI NAI, -11$1 IN. FORCE COEFFICIENT V . 1.43 WIND PRESSURE U ' DNsa- 41 ER Io/Iu7Asdl uTEM4 ANCHOR TO PAD SCHEDULE: P. MARIVN.Nx G CI *l R)). 33,94IW03 (PSDI UPLIR GENERAL NOTES wNmun'. •EswPnux r. ANDA na NNn WwuDwr.Lml COXCRnE'. 'WEN P51 IUINENNo WAON 3' FELL* ). AGME. S.LNOpsxwwSANDSAL IiNIM.F. wINI A .IN.I EOYIVAUNT. ENBED IO CONCREII, -1 r I IN EDGE s.DE wouWweluixnlAAS STANCE. 6'MIN. ANROLNAL11. RER—le�[I. a 4AAA- K ppR ) Nn\ Uftll—c.D.GIATI oy j M G%RD LNu�ffLMnUN x NW ELLow �O _AD) FMr PX_ U) .. xv�L N• = IRArtµ: A O —N Mu. NNIrNNN.E4a O IN N I- Bx�W., PE LONO SIDE s �. 5ryq 1E.ANNN PO\�'Iuus 4r .RNAR _ Q .p EM Aw EDO[ VISiAMtt �I�NDS NADd\4 -R, rs O fACLVOES 11NLSxFS 1! a. s dX00l Nt NNSI ax um Yq\DeaCtt514WDE La r VC( S ENSUAppRE NIMVx EDGE 0151AMCf • ' wAs�l'ts'u Wrui45t0Pv an ei NrwrNNsncV14\g6104Aswn. N—AN Erc.L 1— CND � O $ O AS NOTED IN ANCHOR ECXEWLE. 4. SAW., MINIMUM IMME.G TO fwFIRMq NNUMN-AN•N �,DNnnSAID•M nN IO N ADIACNIT ANCMNT. P _ANNA,N m UMNNA 6 8 w ED g... w 5. FOLLOW MANVIA[TJNEM1'S Iry6\ALLL\ION IXSI PURIONS IO I SARLDERAGRSlrwitt att AK\e wxA4Es n n STALL AxCxG,i RARM , a e NAI..—NMI,NI—NNN.,N.M...s.M,INN.II— GENERATOR •k Slq:Du\FP ruu4 GDn AIm Ir5M4NUNW s�,MtU4DS .Rrzs wrtx MODEL E. . I GENERATOR MOUNTING CONFIGURATION: 5E.El SENAME'E • r Iuuw w LL ER x. wl .L.M..s. D GENERATOR SEE ANCHOR SCNENLE xs[D'+FxsiLNrl Mw 8 +RPM .1.1.ALL O0. ALE.-,M BASF DP 1'a d: Awx.xcl F A, wrtn noss ns sElryDRILLING n scREws GENEMIDR vyMEa vEMAI.. FAO- mnloxAl3 *SEE cf NEWmf SPECS, A nyg Rubefa vmRAnox - • - e - p€ .AD AI..PAD tonlox.0 ♦ 58}U!9 ISEF CC. L COMN"AND _ ILSINAAANALA,A. y > 4 .1..l FOR _ 6WJ P51 NORMAL 11T.IIG�JpE[ Z DIMEN0.510NSB WFIGHI - _ IT WEIGXICNCRNIX uN. AND_ I AMO TALI M MDM I�FH EDIIINE01 CNcµ'AD 3 • X POAO Mf IS. N HrtNV In\eoy , ., .xurr.ra :. s '-ME ' CONCRFr F'. DI NI NARN. 1629NOTED --- - - R"IIIr m s op[ Mf.r IDC 1 • OE5n1j0N cn19 a WIDTH SS'LENGTH FGELLS:GA mDISTANCE SIDE IRONT NNIN DEPEND ON GENERATOR MAE LENGTH, 3. ADISTAXCF ]' FROM VNI T IDGE iO Lt6. 1, DFRXD ON GENFurDR.1... NO LESS THAN ]' NO LESS rnN v�NL iw•w4iJ:w.A. �^M rw •mrs =i I`:NA— VEEN µ01„t�NV pv •susry Ll+w k. &a3, a E�4 75 ss�w.3oWuaax�xxa anroa lsanw loesE ,a �, � M gxen kE ry 8 ssn..nx waximeanuw _ .�,uowl. ww,zcowr., sore lsvl3ne g >FLL F �yy g5 Lb6l!'N�tl38 Ol31dM33U 90T 313t15 o iAuoeHavms o9T sEv 'susnaEi EE 8 -. savd lsv�3ad w max„•'; ---„- . 4 99'eS"@ ` R.... ......Ra F a a E asssa`o a§b§§§ 1, me§µ§ ie n .... �- obbaa§bb §§§ - � Imgsaaassaxax '-�+ ss�ssssssas ga�lil, �44 oqq GG �O� 'n nn`nnn 6 i sbs An aG ogloO �o a n O aE i�RRRRRRRRR$R, P - _ w KOZO ` R4y BBsgxagss „wsa8 Im_ mtiiz3�ry O • . ��_ - - .wnuO Uq aEo3 .u.xq 6uuW5 86 . r m L•_L < f N C • � b r' � s b P a Es• 1 _ - a a 5 m• E _ Q Q s fi Y E fi B e 8 °p Y b e :Sa. E F8 LL = _ � = • w E rc? L e 6 E m a D .Erc„sa Qg-� .yg$�$• � 9 R C �� o D 31 SS1ESSS iC K DB ,{[EEBE F• ry v v b n w w on we,®,.,.r�.ne�...arw.�.:.a«mnavwvw.. o.•, .eoreeuw, 0 Total BTU - Longest Run of Pipe - 5o FQv4 Omegaflex Tracpipe - Natural Gas Table- 902,965) Job Address 3 ,�- N w 11 17 47 FOREVER GAS.CORP. 181MAW fib AVR ttNtT I-1.p5„HIALEAH, FL 33015 Tel: 305-331-2572* Cel1:•305-298-0193 . . . . ... ... .. . ... ...... . Ayxe Fernandez NOTARY PUBLIC STATE OF FLORIDA Comm# GG340030 Expires 5/ 440 3012 I a vcj-� F9 1Z 441 Qualifier: Robert onzalez State # : 28379 CC # : LPG28379 Notes: All work shall be done according to NEC 2017 FFPC 71h Edition NEC 702.7 Place sign at service indicating -Location & Type of Generator Scope of work: All above ground conduit strapped to wall, Schd 40 Generator 1 X" load and 1" low voltage conduit buried from house wall to generator 18" deep, Schd 80 Generator riser rear of pad, stub up area behind genset Install 1 V PVC with a2 THWN w/grd. wires for load Install 1" with 7 conductor low voltage wires for signaling 22kW Generator VOOO GEN- EER Rod w/N6 Green 6" High Pre -Fab Concrete Pad i APPP.OVE DATE Existing 2" Cond. w/ 3- 2/0 THWN 1-------- ------ Existing I 120/240v 200A Meter ; 1 ; 1 I 1 I I I I 1 1 1 1 I I 1 I 1 1 1 1 1 1 ; I Existing %"Cond. w/84 Green 1-1/4"Cond. w/ 3-k2THWN & 14 6 Green 2" Cond. w/ 3- 2/0 THWN & 144 Green I NEW 200 AMP Automatic Transfer Switch with Integrated Service Disconnect . i"C®na. w/.3-f4161-N. cdntlorwires ... ... ... . .:. . . . .:. . . I ------------- I Existing ; 120/240v 200A PANEL A Exterior 1 I 1 I 1 I I 1 1 00 M m v m C J �p LL W C � v Ez ccCO =r' EXISTING:PANEL A 120/240v 1-phase M.L.O 200 AMPS NEMA -1 Crt Load Amps Kva Kva Amps Load Crt 1 Stove 60 1.8kva 20 Small App 2 3 Stove 60 1.8kva 20 Small App 4 5 Microwave 20 1.8kva .9kva 15 Gen light 6 7 Front Porch 20 .8kva .9kva 20 Bath rm. 8 9 Gen light 20 .9kva .8kva 20 Gen light 10 11 AC 40 8.5kva .6kva 20 Gen light 12 13 AC 40 .5kva 15 Gen light 14 15 Dryer 30 .8kva 20 Gen light 16 17 Dryer 30 .5kva 15 Gen light 18 19 AHU 30 6kva .7kva 20 Gen light, 20 21 AHU 30 60 Water Heater 22" 23 Gen light 20 .8kva 60 Water Heat^_-r 24 25 27 ..." :28: 29 30 GEN. LIGHTING LOAD 1487x3VA=4461VA TOTAL LOAD=18,061VA 1ST 10,000 @ 100% = 10,000VA REMAINING 8,061VA @ 40%= 3,224.40VA A/C LOAD = 8,500 VA TOTAL = 21,724.40 VA/240V= 90.52AMPS NEC (310.1567) 90.52 X .83=75.13 USE #3 THWN (Circuit not included in load calcs. Circuit on SMM Load Shed Device) Stove, Dryer, and Water Heater L-LtUfkIC;ALr:w�, //�,bjzzz APPROVcC�� 20/22/24 kW GENERAC` GUARDIAN® SERIES LEcrRICAL :wlEvv ///hw -Residential Standby Generators I APPROVEC_2 DATE --------------------- INCLUDES: Standby Power Rating G007038-1. 3007039-1, G007038-3, G007039-3 , • True Power'" Electrical Technology 0007042-2, G007043-2, G007042-3, 0007043-31r n II V> 0007209-0, 0007210-0 (Aluminum - a:squ )24 hw v • Two-line multilingual digital LCD Evolution'" controller (English/Spanish/French/Poduguese) • 200 amp service rated transfer switch available • Electronic governor • Standard WI-Fk® connectivity • System status & maintenance interval LED indicators • Sound attenuated enclosure • Flexible fuel line connector • Natural gas or LP gas operation • 5 Year limited warranty • Listed and labeled by the Southwest Research Institute allowing installation as close as 18 in (457 mm) to a structure.` 'Must be located away horn doors, windows, and fresh air intakes and in accordance with local codes. hit as: passets, swri. org/librarylDitectory01ListedProducls/ Constructionlndistry/973_DoC 204_13204-01-01_Rev901 FEATURES O INNOVATIVE ENGINE DESIGN & RIGOROUS TESTING are at the heart of Gen- erac's success in providing the most reliable generators possible. Generac's G- Force engine lineup offers added peace of mind and reliability for when it's needed the most. The G-Farce series engines are purpose built and designed to handle the rigors of extended run times in high temperatures and extreme operating conditions. O TRUE POWER'" ELECTRICAL TECHNOLOGY: Superior harmonics and sine wave form produce less than 5% Total Harmonic Distortion for utility quality power. This allows confident operation of sensitive electronic equipment and micro -chip based appliances, such as variable speed HVAC systems. O TEST CRITERIA: ✓ PROTOTYPE TESTED NEMA MG1-22 EVALUATION ✓ SYSTEM TORSIONAL TESTED ✓ MOTOR STARTING ABILITY O MOBILE LINV CONNECTIVITY: FREE with select Guardian Series Home standby generators, Mobile link Wi-FI allows users to monitor generator status from any- where in the world using a smartphone, tablet, or PC. Easily access information such as the current operating status and maintenance alerts. Users can connect an account to an authorized service dealer for fast, friendly, and proactive service. With Mobile Link, users are taken pre of before the next power outage. - • ;I IGENEKW. or C U� ADM Os DSTEO Note: CETLar CUL certification only app%s to untundled un Inp urRIK�paciaged• with limited circuit swllchn. Units paclaged with the Smart witcc V ER or UL ceoilied in the USA only. O SOLID-STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION: This state-of-the-art power maximizing regulation system is standard on all Generac mod- els. It provides optimized FAST RESPONSE to changing load conditions and MAXI- MUM MOTOR STARTING CAPABILITY by electronically torque -matching the surge loads to the engine. Digital voltage regulation at +-1 %. O SINGLE SOURCE SERVICE RESPONSE from Generac's extensive dealer network provides pads and service know -haw for the entire unit, from the engine to the small- est electronic component, O GENERAC TRANSFER SWITCHES: Long life and reliability are synonymous with GENERAC POWER SYSTEMS. One reason for this confidence is that the GENERAC product line is offered with its own transfer systems and controls for total system compatibility. O PWRVIEW" TRANSFER SWITCH: The General; PWRview Automatic Transfer Switch integrates the PWRview energy monitor to provide real-time energy con- sumption data that can help lower a homes electricity bill. Using a convenient mobile app, homeowners can access energy usage and alert information while under utility power or generator power. The PWRview energy monitor Is a simple to use and low cost tool which helps save money over the life of the generator. Included with model G007210-0. " ®�� GENERAC �� F GENERAC' PROMISE �` PWR -fir GENERAC WEENEW 20/22/24 kW Features and Benefits Engine • Generac G-Farce design Maximizes engine "breathing" for increased fuel efficiency. Plateau honed cylinder walls and plasma moly rings help the engine run cooler, reducing oil consumption and resulting in longer engine life. • "Spiny-lok" cast iron cylinder walls Rigid construction and added durability provide long engine life. • Electronic ignition/spark advance These features combine to assure smooth, quick starting every time. • Full pressure lubrication system Pressurized lubrication to all vital hearings means better performance, less maintenance, and longer engine life. Now featuring up to a 2 year/200 hour oil change interval. • Low oil pressure shutdown system Shutdown protection prevents catastrophic engine damage due to low oil. • High temperature shutdown Prevents damage due to overheating. Generator • Revolving field Allows for a smaller, light weight unit that operates 25% more eflicientlythan arevolving armature generator. • Skewed stator Produces a smooth output waveform for compatibility with electronic equipment. • Displaced phase excitation Maximizes motor starting capability. • Automatic voltage regulation Regulating output voltage to ±1%prevents damaging voltage spikes. ... • • • • UL2200listed For your safety. •, , Transfer Switch (if applicable) • Fully automatic Transfers vital electrical loads to the energized source of power. . .... . ...... . . • NEMA 3R Can be installed inside or outside for maximum flexibility. • • • • Integrated load management technology Capability to manage additional loads for efficient power managemerft.' • Remote mounting Mounts near an existing distribution panel for simple, low-cost installation* • "' PWRview Transfer Switch (if applicable) .. • PWRview energy monitor Energy usage al -a -glance. .. , • Ability to view real-time energy consumption data Better understand the home's energy profile. • PWRview mobile app Access daily energy intelligence and insights. Evolution'" Controls • AUTO/MANUAL/OFF illuminated buttons Selects the operating mode and provides easy, ata-glance status indication in any condition. • Two-line multilingual LCD Provides homeowners easily visible logs of history, maintenance, and events up to 50 occurrences. • Sealed, raised buttons Smooth, weather -resistant user interface for programming and operations. • Utility voltage sensing Constantly monitors utility voltage, setpoints 65%dropout, 80%pick-up, of standard voltage. • Generator voltage sensing Constantly monitors generator voltage to verily the cleanest power delivered to the home. • Utility interrupt delay Prevents nuisance start-ups of the engine, adjustable 2-1500 seconds from the factory default setting of 5 seconds by a qualified dealer. • Engine warm-up Verifies engine is ready to assume the load, setpoint approximately 5 seconds. • Engine cool -down Allows engine to cool prior to shutdown, setpoint approximately 1 minute. • Programmable exercise Operates engine to prevent oil seal drying and damage between power outages by running the generator for 5 minutes every other week. Also offers a selectable setting for weekly or monthly operation providing flexibility and potentially lower fuel costs to the owner. • Smart battery charger Delivers charge to the battery only when needed at varying rates depending on outdoor air temperature. Compatible with lead acid and AGM -style batteries. • Main line circuit breaker Protects generator from overload. • Electronic governor Maintains constant 60 Hz frequency. 20/22/24 kW Unit • SAE weather protective enclosure • Enclosed critical grade muffler • Small, compact, attractive Installation System • 14 in (35.6 cm) flexible fuel line connector • Integral sediment trap Connectivity (WI-Fi equipped models only) • Ability to view generator status • Ability to view generator Exercise/Run and Total Hours • Ability to view generator maintenance information • Monthly report with previous month's activity • Ability to view generator battery information • Weather information GENERAC• Features and Benefits Sound attenuated enclosures ensure quiet operation and protection against mother nature, withstanding winds up to 150 mph (241 km/h). Hinged key locking roof panel for security. Lift -out front for easy access to all routine maintenance items. Electrostatically applied textured epoxy paint for added durability. Quiet, critical grade muffler is mounted inside the unit to prevent injuries. Makes for an easy, eye appealing installation, as close as 18 in (457 mm) away from a structure. Listed ANSI Z21.75/CSA 6.27 outdoor appliance connector for the required connection to the gas supply piping. Meek IFGC and NFPA 54 installation requirements. Monitor generator with a smartphone, tablet, or computer at any time via the Mobile Link application for complete peace of mind. , , , , Review the generator's complete protection profile for exercise hours and totaI houis....' ...... Provides maintenance information for the specific model generate? Shen scheduled nvinleeence is due. • • informatiog.* : •' " •. , • • • " Detailed monthly reports provide historical generator .... Built in battery diagnostics displaying current stale of the battery. . , :..... Provides detailed local weather conditions for ;r ambient generatoN4a 20/22/24 kW GENERAC -__M . Specifications Generator Model G007038-1 G007042-2 G007030-3 G007042-3 G007209-0 G007039-1 G007043-2 G007039-3 6007043-3 G007210-0 (20 kW) (22 K (20 kW) (22 kW) (24 kW) Rated maximum continuous power capacity (UP) 20,000 Wafts" 22,000 Wafts' 20,OOOWwl 22,000 Wafts' 24.000 Watts' Rated maximum continuous power capacity(NG) 18,000 Watts' 19,500 Wafts' 18,000 wafts' 19,500 Watts' 21,000 Wafts' Rated voltage 240 Rated maximum continuous load current- 240 volts(U`/NG) 83.3/75.0 91.7/81.3 83.3/75.0 91.7/81.3 100/87.5 Total Harmonic Distortion Less than 5% Main line circuit breaker 90 amp 100amp 90amp 100 amp tOOMP Phase 1 Number of rotor poles 2 Rated AC Iregtlency 60 Hz Power factor 1.9 Battery requirement (not included) 12 Volts, Group 26R 540 CCA minimum or Group 35AGM 650 CCA minimum Unit weight (Ib/kg) 448/203 4661211 436/198 445/202 455/206 Dimensions (L x W x H) in / cm 48 x 25 x 29/ 121.9x 63.5 x 73.7 Sound output in dB(A) at 23It(7m)with generator operating at normal load" 67 67 67 67 67 Sound output in dB(A) at 23 it (7 m) with generator in Quiet -Test- low -speed emcise mode" 55 57 55 57 • .. •57 Exercise duration _ 5 min -••.' Engine .... Engine type GENERAL G-Force 1000 Wei . . � � � • • � � • � Number of cylinders 2 Displacement 999 cc .. • •.: Cylinder block Aluminum w/=1 iron slge7e• Valve arrangement Overhead valve Ignition system Solid-state w/ magneto. • • • • • • ..:. Governor system Electronic ..0.. ` Compression Maio 9.5:1 . • • •. • •� Starter 12 VOC Oil capacity including litter � • • • Approx. 1.9 Q1/ 1.8•..• Operating rpm 3,600 Fuel consumption • • • ; • • • , ' ' Natural gas R'� 1 /2 Load 204 (5.78) 228 (6.46) 164 (4.64) 203j5.75)- Full Load 301 (8.52) 327(9.26) 287 (B.13) 306 (8.66) Liquid propane ttsmr (gaUhr/2 fir) 87 (2.37) [8.991 92 (2.53) [9.57] 86 (2.36) [8.951 92 (2.53) [9.571 Full Load 130 (3.56) f13A81 142 (3.90)114.77] 136 (3.74) [14.151 142 (3.90) [14.771 Note: Fuel pipe must be sized tar lull load. Required fuel pressure to generator fuel inlet at all load ranges - 3.5�7 In water column (0.87-1.74 kPa) for NO, 10-12 In water column (2.4g-2.99 kPa) for LP gas. For BTU content, multiply ftumr x 2500(LP) or 8a/hr x IDOO (NG). For Megajoule content, mulffply mx/hr x 93.15 (LP) or m0r x 37.26 (NG). Controls Two-line plain text multilingual LCD Simple user interface lot ease of operation. Mode buttons: AUTO Automatic staff on utility Whars. Weakly, Biweekly, or Monthly selectable exerciser. MANUAL Stan with starter control, unit stays on. It utility [ails, transfer to load takes place. OFF Stops unit. Pont is removed. Control and charger still operate. Ready to Run/Maintenance messages Standard Engine run boom indication Standard Programmable start delay between 2-1500 seconds Standard (programmable by dealer only) Utility Voltage Loss/Relurn to Utility adjustable (brownout setting) From 14D-171 V/ 190-216 V Future Set Capable Exerciser/Exercise Set Error warning Standard RuNAlamVMaimemance logs 50 events each Engine start sequence Cyclic cranking: 16 sec on, 7 rest (90 sec maximum duration). Starter lock -out Starter tamril reengage will 5 sec after engine has slopped. Stand Battery Charger Standard Charger Fault(Missing AC warning Standard Low Ba0ery/Batlery Problem Protection and Battery Condition indication Standard Automatic Voltage Regulation with Oar and Under Voltage Protection Standard Under-Frequency/Ovedoad/Stepper Overcurrent Protection Standard Safety Fused/Fuse Problem Protection Standard Automatic Low Oil Pressure/High Oil Temperature Shutdown Standard OvercraWOveMpaed (Q 72 Hz)/rpm Sense Lass Shutdown Standard High Engine Temperature Shutdown Standard Internal FaulVinconecl Wiring protection Standard Common external tau It capability Standard Field upgradahle Browne Standard "Sound levels are peat him the tom of Bea generator. Sound levels taken from other sides of the generatr may be higher depending on installation paramount, Rating defrnilions - Standby. Applicable for supplying emergency paver for the duration at the utility power outage. No overload capability is available lot this rating. (All ratings in accordance with BS5514, IS03046 and DIN6271).' Maximum kilovolt amps and anent am subject to and limited by such factors a fluel BTU/mepajoule conlem, ambient lemperalum, altionli engine power and condition, etc. Maximum power decreases approimalely 3.5%for each 1,000 It(304.8 m) above sea level: and also will decrease apprommadety 1%for each 10'F (6'C) above 60'F (16'Q. GENERAC 20/22/24 kW Switch Options Service Rated Automatic Transfer Switch Features Model Goo7o39-1, 0007039.3 (20 kW) • Intelligently manages up to four air conditioner loads with no additional hardware. G007043-2, GOD7043-3 (22 kW) N& of poles 2 • Up to eight additional large (240 VAC) loads can he managed when used in conjunction Current rating (amps) 200 with Smart Management Modules (SMMs). Voltage falling (VAC) 120/240,10 • Electrically operated, mechanically -held contacts for last, clean connections. utility voltage monitor (find) • Rated for all classes of load, log%equipment rated, both inductive and resistive. -Pickup -omprruf 80% 65% • 2-pole, 250 VAC conlaclors. Return to Utility- Approx 13 sec • Service equipment rated, dual coil design. Exercises bi-weekly for 5 minutes' standard ETL of UL listed Standard • Rated for both aluminum and copper conductors. Enclosure type NENIANL 311 • Main contacts are silver plated or silver alloy to resist welding and socking. Circuit breaker protected 22.000 • NEMA/UL 3R aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. Lug range 250 MCM - #6 'Function of Evolution controller Exercise can be set to weekly, lit -weekly. or monthly Dimensions wi 200 Amps 120/240. to ' • • • • • Open Transition Service Rated , • • Helght Wldtlt ;'•• •, �pih ..... .... 111 1 H2 W1 W2 ...... in 26.8 30.1 10.5 13.5 6.9 }••.•' ' cm 67.95 76.43 26.67 34.18 17.5 xr r.•••• ••:• •••••• Wire Ranges .. '��• ....�. Conductor Lug Neut21 Lug Ground Lug j .... + 250 MCM-#6 350MCM-#6 1 Z/0-#14 .• • •...:. ••• . on.xJ I—w:� . ••..•� ••• PWRview Automatic Transfer Switch Features Model G0o7210-0 (24 kW) • Integrated PWRview monitor provides real-time energy usage data through PWRview app. No. of poles 2 Current rating (amps) 200 • Intelligently manages up to four air conditioner loads with no additional hardware. Voltage rating (VAC) 120240.10 • Up to eight additional large (240 VAC) loads can be managed when used in conjunction utility voltage monitor (fixed)' with Smart Management Modules (SMMs). -Pick-up 80% -Ompoul 65% • Electrically operated, mechanically -held contacts for Fast, clean connections. Return to Utility- Appra 13 sec • Rated for all classes of load, 100%equipment rated, both inductive and resistive. Exercises bi-weekly for 5 minutes' standard • 2-pole, 250 VAC contactors. ETL on ULlisted Standard Enclosure type NEMA 3R • Service equipment rated, dual coil design. Circuit breaker protected 22,000 • Rated for both aluminum and capper conductors. Lug range 250 MGM - #6 • Main contacts are silver plated or silver alloy to resist welding and sticking. 'Function of Evolution controller Exact can be set to weekly, bi-weekly, or monthly • NEMA 311 aluminum outdoor enclosure allows for indoor or outdoor mounting flexibility. • Heavy duty Generac Contactor is an ETL recognized device. Dimensions 20D Amps 120240, 1¢ Open Transition Service Rated Height Width Decant H1 112 W1 W2 in 26.8 30.1 10.5 13.5 6.9 cm 67.95 76.43 26.67 34.18 17.5 Wire Ranges Conductor Lug Neutral Lug I Ground Lug 250MCM-#6 350MCM-#6 2/0-#14 20/22/24 kW GENERAC Available Accessories Model # Product Description G005819-0 26R Wet Cell Battery Every standby generator requires a battery to start the system. Generac offers the recommended 26R wet cell battery for use with all air-cooled standby product (excluding PowerPact"). G007101-0 Battery Pad Warmer Pad warmer rests under the battery. Recommended for use if temperature regularly falls below 0 "F (-18 °C). (Not nec- essary for use with AGM -style batteries). B007102-0 Oil Warmer Oil warmer slips directly over the oil filter. Recommended for use it temperature regularly falls below 0 °F (A8 °C). G007103.1 Breather Warmer Breatherwarmer is for use in extreme cold weather applications. For use with Evolution controllers only in climates where heavy icing occurs. G005621-0 Auxiliary Transfer Switch The auxiliary transfer switch contact kit allows the transfer switch to lock out a single large electrical lead that may not be Contact Kit needed. Not compatible with 50 amp pre -wired switches. G007027-0 - Bisque Fascia Base Wrap Kit The fascia base wrap snaps together around the bottom of the new air -coaled generators. This offers a sleek. contoured (Standard on 22 kW) appearance as well as offering protection from rodents and insects by covering the lifting hales located in the base. G005703-0 - Bisque Touch -Up Paint Kit N the generator enclosure is scratched or damaged, it is important to touch up the paint to protect from future corrosion. The touch-up paint kit includes the necessary paint to correctly maintain or touch up a generator enclosure. G006485-0 Scheduled Maintenance Kit Generac's scheduled maintenance kit provides all the hems necessary to perform complete routine maigtprripgce on a Generac automate standby generator (oil not included). • • G007005-0 Wi-Fl LP Tank Fuel Level The Wi-A enabled LP tank fuel level monitor provides constant monitoring of the conge4V4 Lf;fuel tank. Mgry'tgrjng the Monitor LP tanks fuel level is an important step in verifying the generator is ready to run during,Ujili heated poy+gMjilure. Sta- tus alerts are available through a free application to notify users when the LP tank is ig ge.eQ ofj refill. G007000-0 (50 amp) Smart Management Module Smart Management Modules (SMM) are used to optimize the performance of a standby awwoor. It maqpges le4ge elec- G007006-0 trical loads upon startup and sheds them to aid in recovery when overloaded. In madypgsintsing Si can reduce (100 amp) the overall sae and cast of the system. G007169-0- 4G LTE Mobile Link" Cellular The Mobile Link family of Cellular Accessories allow users to monitor generator statusftpf V9jWhere in}IRtvbrld, using • • • • G00717H - IM-FU Accessories a smart phone, tablet, or PC. Easily access information such as the current operating Ms and maintenance alerts. Us - Ethernet ers can connect an account with an authorized service dealer for fast, friendly, and pn iwe iervice. With lJoblle Link, users are taken care of before the next power outage. G007220-0- Bisque Base Plug Kit Base plugs snap into the lifting hales on the base of air-cooled home standby generators. Thieroffers a sleek7contoured :....: appearance, as well as offers protection from rodents and insects by covering the lifting holes locate& in Abe lase. Kit contains four plugs, sufficient for use on a single air-cooled home standby generator. Model UPC G007038-1 696471074185 G007038-3 696471074185 G007039-1 696471074192 G007039-3 696471074192 G007042-2 696471074208 G007042-3 696471074208 G007043-2 696471074215 G007043-3 696471074215 G007209-0 696471071511 G007210-0 691471171210 GENERAC LEFT MMVlEW Dimensions shvnm amapprmumale. See imtMon manual for elmcl dinmmims Dimensions & PCs FRO EW Generac Power Systems, Inc. • S45 W29290 HWY. 59, Waukesha, WI 53189 • generac.com 02020 Gemw Power Gyatems, Inc. AA dgh%ms eE. AD specifications 8M subled M change whom nolke. Pad No. A0000937814 RM.A 07/I512020 Smart Management Module (SMM) ELEI; I RICAL REVIEW (� z> APPROVEj2�DA E__ FEATURES GENERAC' GENERAC°LOAD MANAGEMENT 50 Amp Smart Management Module (SMM) • .... ... .... :...... .... . :... :::•: Eta �;: r,e Intertek• „• .. Generac's Smart Power Management System is designed to optimize the performance of a standby generator or PWRcell'" energy storage system (ESS). The system can consist of up to eight individual Smart Management Modules (SMM). Unlike other load management systems that depend on another control device, the SMM's are self -aware and operate autonomously. Frequency is the true measure of system performance, and does not need to factor in increased ambient temperatures, elevation changes, or generator fuel type. The SMM monitors the frequency (Hz) of the power being produced by Generac's standby generators or PWRcell ESS. If frequency falls below a certain threshold of a correctly sized system, the SMM will automatically shed the managed loads to allow the system to recover. The modules can be set to a load priority between 1-8, or be set in a lock -out only mode for loads [hat do not need to run in an outage. This reduces the minimum size of system required for a more cost-effective solution. " It is recommended to size the generator or PWRcell ESS with appropriate excess capacity to allow starting of the lamest managed loads (i.e. loads with highest starting currents). Each managed load of the SACM and SMM must be assigned a unique priority setting, so no two managed loads attempt to start simuhaneeusly. See owner's manual for more infonnadon. SMM SPECIFICATIONS Powersupply source................................................................................................................................................................................... 240 VAC (Rom line input) Contactvoltages .............................................................................................................................................................................................................220/240 VAC Contactorcoil voltage............................................................................................................................................................................................................ 240 VAC CoilVA inrush................................................................................................................................................................................................................................. 30 CoilVA sealed................................................................................................................................................................................................................................6.5 Poles................................................................................................................................................................................................................................................ 2 Resistiveamps................................................................................................................................................................................................................................50 F/L Inductive amps.........................................................................................................................................................................................................................40 Lockedrotor amps.........................................................................................................................................................................................................................160 NEMA.............................................................................................................................................................................................................................................3R Enclosurerating.........................................................................................................................................................................................................................UL 50 Frequencyseleclability .........................................................................................................................................................................................I.........50 Hz / 60 Hz Smart Management Module (SMM) Dimensions Model G007000-0 Height (in/mm) H7 6.17/156.8 H2 2.36/60 Width (in / mm) W1 7.06/179.4 W2 4.72 / 120 Depth (in/mm) 3.7/94 Weight (Ib/kg) 2.06/0.94 Shipping weight (lb/kg) 2.44/1.11 GENERAC" Dimensions and Controls W1 O o o b SMM Controls " •• a c .. LED ON = LOAD CONNECTED ({ LED FLASH 1S = LOAD SHED 0. PRIORITY LOAD LED LOAD ON FLASH 3S=30 MIN LOCKOUT • •• \ S GENERATOR LED FLASH GS = GEN LOAD LOCKOUF LED OFF =NO MODULE POWER ® ® o U LOCKOUT TEST DISABLED Priority Dial (A) Sets module priority. Lockout Switch (B) Prevents load from operating when system is operating under backup power. Test Button (C) Disables contactor output for a specified time. LED (D) Provides module status with easy viewing through the external viewing window located in the upper right corner of the module. G ENE RAC• Generac Power Systems, Inc. • S45 W29290 HWY. 59, Waukesha, WI 53189 • generac.com ..`� 02o2D Geerx Pwm Syslan,LK. AFiIpE"m AlfpecBUDu ..tpdWNagexNOODUpOre. Parl Nn lomoozwm RWE 07 2020 Ron DeSantis, Governor Halsey Beshears, Secretary STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES LIGHTBOURNE, SAMUEL CHRISTOPHER ALL QUALITY ELECTRICAL SERVICES INC. 14750 S RIVER DRIVE MIAMI FL 33167 LICENSE NUMBER: EC13009246 EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses online at MyFloridaLicense.com .t. u. ,: f-•. ' 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. Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 5567996 RECEIPT NO. RLNEWAL BUSINESS NAMEMOCAMON 5807970 ALL QUALITY ELECTRICAL SERVICES INC 14750 S RIVER DR MIAMI, FL 33167-1039 Mr-IM OWNER SEC. TYPE OF BUSINESS ALL QUALITY ELECTRICAL SVCS INC 196 ELECTRICAL SAMUEL LIGHTBOURNE PRIES CONTRACTOR Worker(s) EC13009246 EXPIRES SEPTEMBER 30, 2022 Must be displayed at place of business Pursuant to County Code Chapter SA - An. 9 & 10 PAYMENT RECEIVED BY TA% COLLECTOR 75.00 09/212021 0226-21-003704 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a codification of the holder qualifications, to do business. Holdermust comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles -Miami-Dade Code Sec Sa-276. Em. for more information, visit wwvv.mia idad"ovAaacollegtor Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: PL-04-22-918 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: Approved Issue Date: 06/10/2022 Expiration: 12/12/2022 Location Address Parcel Number 78 NW 110TH ST, Miami Shores, FL 33168 1121360030070 Contacts Wilner Nordelus Owner FOREVER GAS CORP Contractor 78 110 ROBERTO GONZALEZ 18111 NW 68 AVE 1105, HIALEAH, FL 330153989 Business: 3052980193 Description: NEW GAS LINE FOR 22KW GENERATOR Valuation: $ 3,000.00 Total Sq Feet: 0.00 Fees Amount Application Fee -Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $55.00 Scanning Fee $3.00 Technology Fee $2.63 Total: $117.03 Inspection Requests: 305-762-4949 Payments Date Paid Amt Paid Total Fees $117.03 Credit Card 06/10/2022 $117.03 Amount Due: $0.00 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating ognsNuctippartd zoning. Futhermore, I authorize the above named contractor to do the work stated. (' ) t) 2 Signature: Owner I Applicant / Contractor I Agent June 10, 2022 }-- V I G Date Page 2 of 2 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC Miami Shores Village pldy„�DJrS Building Department ENERED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 APR 1 1 2022 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Master Permit No. E L _01i " ZZ - "I 16, Sub Permit No. PL_" 04 - Zi - j( c ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �J f' ) CONTRACTOR DRAWINGS JOB ADDRESS: / Y A t✓ /`0 S Folio/Parcel#: //—'ZI 6 _ 60 S OD 70 Is the Building Historically Designated: Yes NO V ((" / Occupancy Type: � Load: Construction Type: ,31 FFE: OWNER: Name (Fee Simple Titleholder): A ek 114&, A-Y/ Flood Zone: BFE: -d / n'f— Phone#: 3O.: 9/s Address: AJ 1kJ Ile, / qr City: Ye% State: �L Zip: Tenant/Lessee,/Name: JC/ /A Phone#: Email: 0 /1 CONTRACTOR: Company Name: y'gV44' (4's Phone#: 3o .2 SO 0/ / 3 City: RC&14a / Zip: J 3o / �$ Qualifier Name: � S'-e" O ZG�/� Phone#:Join Z9�' D/7_3 State Certification or Registration #: ; 6 V qU Certificate of Competency #: DESIGNER: Architect/Engineer: /V'4 Phone#: Address: / p CityiState:: Zip: Value of Work for this Permit: Type of Work: ❑ Addition Description of Work: ❑ Alteration u New Specify color of color thru tile: .Z2 Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ i Footage of Work: ❑ Repair/Replace ❑ Demolition CCF $_ DBPR $ CO/Cc $ Notary Double Fee $ Bond $ TOTAL FEE NOW DUE $ _ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address city State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State r.�' 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 ns ction fee will be charged. Signature Signature ONTRACTOR The foregoing instrument was acknowledged before me this V5 day of ` , n � 20 22. by -RUTYOW41I ,L.. who is personally known to me or who has produced 4�otaA<>= as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this 15-1h day of M Q I—Ch 20 a �; by RO b2.r-40 "6-7 DnZci (e' who is personally known to me or who has produced KnOcu7 as identification and who did take an oath. NOTARY PUBLIC: Sign: Sign• zwN ' Print: Print: -Aut tr✓ o Q ARLENISSILVERA AYx a FemandeZ Seal: Seal: a: MY COMMISSION NOTARY PUBLIC EXPIRES: March S, 2024 0 c STATE OF FLORIDA '':PorilP`'o ` Bonded Thru Notary Public Underwriters = Comm# GG340030 APPROVED BY x Plans Examiner ..._Otto, Structural Review (Revised02/24/2014) State of Florida Department of Agriculture and Consumer Services Registration No.: Division of Consumer Services -�2837g (850) 921-1600 Issue Date: AuOus[ =I, 202 1 2005 Apalachee Pkwy Expiration Date: Au��ust 3 ^� Yatiahassee,11ioriuj s%s9y-tiSuv 1, _021 POST CERTIFICATE Liquified Petroleum Gas License CONSPICUOUSLY LP Gas Installer Chapter 527, Florida Statutes Good for one location only Any change in ownership of this Business renders this license Invalid FOREVER GAS CORP- 18111 NW 68TH AVE APT I105 HIALEAH, FL 33015-3989 NICOLE "NIKKI" FRIED COMMISSIONER OF AGRICULTURE 005027 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOTA BILL -DO NOT PAY 6978051 WRNESSNAMFI 0Mn0N FOREVER GAS CORP 18111 NW 68TH AVE APT 1 105 MIAMI FL 33015 OWNER FOREVER GAS CORP C/O ROBERTO GONZALEZ PRES RECEIPT NO. RENEWAL 7253636 O SEC.TYPEOFRIISINESS 205 LPG INSTALLER LPG28379 EXPIRES SEPTEMBER 30, M22 Must be displayed at place of business Pursuant to County Code Chapter SA - Art 9 & 10 PAYMENT RECEIVER RYTAA QDNECIOR 8I00.00 08/01/2021 INT-21-355629 This Local Business Tax Raceipt only confirms paymerd of the local Rusimn Tax. The Reeeipt soots license, permit, or a certification otthe holder's qualiication, to do business. Holder must complywhh any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles- Miami -Dade Code Sec Ba-2n. Forman, information, visit wwwm am'dade aovRaxcollemor ACCOREF CERTIFICATE OF LIABILITY INSURANCE DATE(M 02� 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(les) 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 endorsement(s). PRODUCER Claudids Insurance CONTACT NAME:CLAUDIA M DE LA ROSA PHONE 786) 293-9141 FAX No): (786) 293-9142 �AAIL clsudia@ciaudiasinsurence.com 18901 SW 106th Ave 132 INSURERS AFFORDING COVERAGE NAIL !! Miami, FL 33157 INSURER A: SCOTTSDALE INSURANCE COMPANY 41297 Phone (786) 293-9141 Fax (786) 293-9142 INSURED INSURER B : NAUTILUS INSURANCE COMPANY 17370 INSURER C : FOREVER GAS CORP INSURER 0 : 18111 NW 68 AVE 1105 INSURER E : HIALEAH, FL 33015 (305) 298-0193 INSURER F 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. (LTR TYPE OF INSURANCE ADO INMJM UB POLICY NUMBER M�DY EFF MPOMUMD EXP LIMITS A GENERAL LIABILITY aGE COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAWSMADE 0 OCCUR ❑ GEN'L AGGREGATE LIMIT APPLIES PER: 0 POLICY ❑ PRO- ❑ LOC N N SCNNL-S 10/17/2021 10/17/2022 EACH OCCURRENCE $ 2,000,000.00 TO PRAEM SES Ea occurrence) $ 100,000.00 MED EXP (Any one person $ 5,000.00 PERSONAL & ADV INJURY $ 2,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALLOWNED ❑ SSCCHrD ULED AOS❑ HIRED AUTOS ❑ AUUTOOSSW NED ❑ ❑ (E Ma accident) SINGLE LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Per accident $ PROPERTY DAMAGE Per accident $ $ B ❑ UMBRELLA LIAR a OCCUR 0 EXCESS LIAB ❑ CLAIMS -MADE N N AN1248643 10/17/2021 10/17/2022 EACH OCCURRENCE $ AGGREGATE $ 3,000,000.00 ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEa OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If Yes, describe under DESCRIPTION OF OPERATIONS below N 1 A ❑ WC STATU- ❑ OTH- E.L.EACH ACCIDENT $ E.L.DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) GAS APPLIANCE SERVICE, INSTALL AND REPAIR LP GAS LICENSE # LI 28379 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 25 (2010/05) QF 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 U 19138 2010 AGORD GORPORATION. All rlgntS reservea. The ACORD name and logo are registered marks of ACORD e'er a JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION " CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW *' CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 8/30/2021 PERSON: ROBERT GONZALEZ FEIN: 271764059 BUSINESS NAME AND ADDRESS: FOREVER GAS CORP. 18111 NW 68 AVE APT 1105 HIALEAH, FL 33015 SCOPE OF BUSINESS OR TRADE: Oil or Gas Pipeline Construction & Drivers EXPIRATION DATE: 8/30/2023 EMAIL: ROBE RT03331 @ LIVE.COM IMPORTANT: Pursuant to subsection 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440.05(12), F.S., Certificates of election to be exempt issued under subsection (3) shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to subsection 440.05(13), F.S., notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01391565 QUESTIONS? (850) 413-1609 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 78 NW 110TH ST, Miami Shores, FL 33168 Contacts Wilner Nordelus Owner 78 110 Description: PRE FAB CONCRETE SLAB FOR INSTALLATION OF 22 KW GENERATOR - 54" WIDE X 32" DEEP X 6" HIGH Fees Amount Application Fee - Other $50.00 CCF $0.60 Concrete/asphalt/pavers, slabs, dways, $50.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Permit No.: DS-04-22-917 Permit Type: Driveways/Walkways/Slabs Work Classification: New Permit Status: Approved Issue Date:06110/2022 I Expiration: 12/12/2022 Parcel Number 1121360030070� SAMUEL LIGHTSOURNE 14750 5 RIVER DR, MIAMI, FL 33167 Business: 3057905899 Valuation: $ 1,000.00 Inspection Requests: Total Sq Feet: 0.00 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 06/10/2022 $110.30 Amount Due: $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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws reguI ng construc d ning. Futhermore, I authorize the above named contractor to do the work stated. �..�"°CiX.. G �� 0 LZZ Authorized Signature: Owner / Applicant / Contractor / Agent Date June 10, 2022 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.Znd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING Master Permit Sub Permit c()AS}Yd r%" RED APR 1 1 Z022 FBA � EL -mot-2-2--91(o Ds_64-Z:2_-qj-I ❑ REVISION ❑ EXTENSION []RENEWAL F_JPLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Folio/Parcel#:L- 2-13 b - Ub 3 — oo 76 Is the Building Historically Designated: Yes Occupancy Type: TL Load: Construction Type: (6 5 Flood Zone: ^ BFE: _ OWNER: Name (Fee Simple City: A116' 4 / Tenant/Lessee Name: Email: CONTRACTOR: Company Address: /S/7 S"U City: R/ d41 I - Qualifier Name: hfA State Certification or Registration #: DESIGNER: Value of Work for this Permit: $ r/i 006, Type of Work: ❑ Addition ❑j Alteration Description of Work: *N_ l State: �l 30 s I_ 3Q5* 991 2� 3.2_. L Zip?JUO :-._s�3+/fir; 7 f J) a Phone#: 7I of Competency #: City: State:Zip://�� t q; /Linear Footage of Work: New ❑ Repair/Replace . ❑ Demolition rN Specify color of color thru tile: AJ ,/)�, Submittal Fee $ Permit Fee $ 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 Mortgage Lenders 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 n approved an spection fee will be charged. Signat Signature CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �S day of C`t.—lam 207Z ,by Q'7 day of l� 20as by is personally known to l 14 MQ I \Qhl aomrt who i ersonally known o me or who has produced as me or who has produced as identification and who did take an oath. M.W..19mlI Ll lr APPROVED BY identification and who did take an oath. NOTARY Print: Seal: ______ +aY�. Notary P"11C State of Florida ,i�i�/" Ludny Abichet a My Commission GG 058024 a pds Expires 02112/2024 ��rl %�► Plans Examiner vy J0' I Zz� Zoning (Revised02/24/2014) Structural Review Clerk