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DS-10-1517
2010 -09 -08 23:59 RECEPTION 7862288449 » 1 800 685 7530 P 1/1 mot, ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER 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: 05/27/2010 EXPIRATION DATE: 05/26(2012 PERSON: KLAINMAN EHUD FEIN: 151664650 BUSINESS NAME AND ADDRESS: JERUSALEM BUILDERS 2003 INC 2533 JOHNSON STREET HOLLYWOOD FL 33020 SCOPES OF BUSINESS OR TRADE: 1•• CERTIFIED GENERAL CONTRACTOR IMPORTANT• Pursuant to Chapter 440. 05114), F.5„ an officer of a corporation who elects exemption from this chapter by filing a certificate of electron udder this section 'nay not recover benefits of compensation ender this chapter. Pursuant to chapter 440.05412), F_S. Certificates of election to be exempt... apply Duly within the scope of the business or uade listed DO the notice of of action to be exempt., pursuant to chapter 440.05413), F.S., Notices of election to be exempt sod certificates of efection to 1110 exempt shall be subject to reeocatfeo If at any tine after the filing of the notice or the issuance al the certificate, the person imbed on the notice m caitilica[r no Longer meets the requirements of eels section for issuance of a certificate. The department shall revoke a certificate at -ay time far failure of the person mated on the certificate to meet Ibe requirements of thls section. OWC - 252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 - 06 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 05/27/2010 EXPIRATION DATE: 05/25/2012 PERSON: EHUD KLAINMAN FEIN: 161864650 BUSINESS NAME AND ADDRESS: JERUSALEM BUILDERS 2003 INC 2533 sOHNSON STREET HOLLYWOOD. Ft •3020 SCOPE OF BUSINESS OR TRADE: 1- CERTIFIED GENERAL CONTRACTOR DWC• 262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 H E R E CUT HE RE 05 -27 -2010 QUESTIONS? (8501 413 -1E IMPORTANT F Pursuant to Chapter 440.05(14), F.S. _ an officer of a corporation who O elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 441105(12), ES., Certificates of election to bff exempt_ apply only within the scope of the bustnass or wade listed on the notice of election to be exempt Pursuant to Chapter 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 meet: 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- * Carry bottom portion on the job, keep upper portion for your records. QUESTIONS? (8501 413-1609 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 3 C * 15{ TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: 2. Description of improvement: 3'5t' thin pm of 2 Kvu fig, ,E,vt -ra,2 3. Owner(s) name and address: TRAn Interest in property: (SP"') P ,m4,<./ aes PCAXe. Name and address of fee simple titleholder: / 4. Contractor's name, address and phone number: Signature(s) of Own Prepared B Print Name Title /Office OAA4 STATE OF FLORIDA COUNTY OF MIAMI -DADE The foregoing instrument was acknowledged before me this I V day ofv ) 1 B 123.01 -52 PAGE 3I0 ' Authorized Officer /Director /Partner /Manager Prepared By _TT Print Name Title/Office VJi AjDSf7,l? I4/1'v03'FrZ. 66 n/E 17 " srnce-r WesT KEA,nnL.c c By Y �mrna•r •�•• F._ ividuall , or ❑ as for GIDEON Personall known, or ❑ produced the following type of identif,ation: Signature of Notary Public: Print Name: (SEAL) 111111111111111111111111111111111111111111111 CFN 2010R0611285 OR Bk 27415 Ps 0533; (1Ps) RECORDED 09/1)9/2010 12:26:37 HARVEY RUVIN CLERK OF COURT IIIAMI -DADE COUNTY? FLORIDA LAST PAGE Space above reserved for use of recording office tit IAM I S IIc( tr 3 3) 3 S` 665 iv 6 c? d r na tAMI S t'.e /s VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, f declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of er(s) or Owner(s)'s Authorized Officer /Director /Partner /Manager who signed above: 36q! J' (f cr • 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: ;TATE OF FLORIDA, COUNT`! ®� DE Amount of bond $ HERE 8 Y CERTIFY that the , i 6. Lender's name and address: r ,nal filed ,r s,office o + (- I du.'r of 7. Persons within the State of Florida designated by Owner upon who notices o • her • •: •• tsfay • s priovi Section 713.13(1)(a)7., Florida Statutes, bITNESS rr, d and O Seal. Name, address and phone number: ,l, „ . uif a 1J''.F. . 8. In addition to himself, Owners designates the following person(s) to • ' �': & Tenor's No ice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 3 b V CT bev -ffA 66fc-rt 4/29/2011 By 6- 121. f►• 9- 1' too -fro qi(v)itio BUILDING Permit No. j 1 0-- 15 PERMIT APPLICATION Master Permit No. eui 0 -131 D FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Address: 6 6 5 Ate 7' T City: ,A1iAnn1 S 1 ?CS Miami Shores Village au« 2 4 0w Building Department BY. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 1 ON) SI9 - LtN Y ( State: F'LcrGlb4 Zip: 3`3► Tenant /Lessee Name: Phone #: Email: JOB ADDRESS: 66 NE 9 7 S City: Miami Shores County: Miami Dade Zip: 3 3 ► 38 Folio /Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: "Ta le iA1-E&1 l c,. D f ZS Address: V; 5.5 7E City: l -e .> State: Ft- 4"ZaN* Qualifier Name: E 1.1 I-LA NO Flood Zone: State Certification or Registration #: C U C 150 ( 6 Y Certificate of Competency #: Contact Phone #: (11;4) 61 " C R° 6 Email Address: DESIGNER: Architect /Engineer: Phone #: U140,04 W*uk ? W emit: $ 960 • C› Square/Linear Footage of Work: / v Type of Work: ❑Address L 'Alteration ❑New ❑Repair /Replace Description of Work: l,v; • r411q -r,... l ctr -rot SLj-13 - A-1 Gi -s coI --594 5 '1 ki61 co 3 3 O Z c� Zip: Phone #: ❑Demolition COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** c.,--) Submittal Fee $ Permit Fee $ i � CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1241'(00 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 ivhose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the . first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 , r 371 who is personally known to me or who has produced Sign: Print: Tres 4/29/2011 NOTARY PUBLIC: � PoSNO My Commission 0)(134 4 APPROVED BY As identification a Florida NotaryAssn., Inc (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) ho did take an oath. Plans Examiner Structural Review Signature Contractor The foregoing instrument was acknowledged before me this ' L i day of t/C , 20 10 , EKva KIR,/ who is personally known to me or who has produced take an oath. NOTARY PUBLIC: as identification and who Sign: ! ""u Print: My Co ° ` f' 4 ' nsa 4/2912011 bride Nolalmer ., inc Zoning Clerk 05 -27 -2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER 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: PERSON: FEIN: 161664650 BUSINESS NAME AND ADDRESS: JERUSALEM BUILDERS 2003 INC 2533 JOHNSON STREET HOLLYWOOD FL 33020 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED GENERAL CONTRACTOR DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 05/27/2010 EXPIRATION DATE: 05/26/2012 KLAINMAN EHUD IMPORTANT: Pursuant to Chapter 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 Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113), 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. QUESTIONS? (850) 413 -1E DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 PLEASE CUT OUT THE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 05/27/2010 EXPIRATION DATE: PERSON: EHUD KLAINMAN FEIN: 161664650 BUSINESS NAME AND ADDRESS: JERUSALEM BUILDERS 2003 INC 2533 JOHNSON STREET HOLLYWOOD, FL 33020 SCOPE OF BUSINESS OR TRADE: 1- CERTIFIED GENERAL CONTRACTOR 05/26/2012 CARD BELOW AND RETAIN FOR FUTURE REFERENCE CUT HERE IMPORTANT O Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on R the notice of election to be exempt. E Pursuant to Chapter 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 meet: 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. * Carry bottom portion on the job, keep upper portion for your records. QUESTIONS? (850) 413 -1609 08/23/2010 16:33 FAX 9545870038 ACORD, CERTIFICATE OF PRODUCER Insurance Grp. Services, Inc (formerly INS) 3000 West Cypress Creek Road Fort Laudedale, FL 33309- Phone: (954) 587-6611 Fax: (954) 587-0038 INSURED rRu sALL:m HUILDr,Rs 2003, INC. 2533 1C1-NSON STREE1 1 R)LLYWOOD. Ft. 33020 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 140TM 1 ANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY E.E ISSUED OH MAY PERTAIN, THE INSURANCE AFFORDED eV THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHAWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR AD[YL pOiJ EFFECflVE POLICY EXPIRATIO LT R INSREk. rTPF OF INS(IRAKE POLICY NUMBER DATE( . . ..rb 1 .. 1 L 7 • kik GENERAL uABILITY A •••••I, OTHER commEPoIAL GENEPAI LIABILITY CLAWS MAT °CCUN ) S5on DJ PO Oli.DC ' GENL AGGRCGATE LIMIT AP P PRO. X Pr)Licy jC AUTOMOBILE LLABILITY - ANY AUTO ALL Ovo.pn AUTOS Sr.:HEOULEI) AUTOS TIRED AuToS NcN AUTOS GARAGE uASSLITY ANY AUTO CIS mum BRELLA uABILITY OCcuR I CLAIMS MADE DEDUC 1BL • I - RETENTION z3. WORKERS COMP ENSwoON AND EMPLOYERS uABILITY ANN/ pp, CfC icERrm Em HER EXCLUDE: If yrwc tbrxril)dl.1"49r F F PROVISIONS 646w Es PER LOC Cps10133978 DEScHIPTtOR OF OPERATIONS / LOCATIONS 1 VEHICLES e EXCLUSIONS A MED CARPENTRY MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NW 2ND AVENUE 3 I AM I SHORES, FL 33138 Fay (736) 228-8449 ACORD 25 (2001108) Attn: INSURANCE GROUP SERVICES LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, NAIC # INSLIEA SCOTTSDALE. INSURANCE CQMPANY 41297 INSURER El INSURER Or INSURER L% 16.SU INSURERS AFFORDING COVERAGE 9/15/2009 9/15/2010 lMIT EACH CCCUSRENCE ; 1000 000 DAMAGETO ppEm'stugg.pceJnr ' $ 10 1 MED ExP opy one 0,1-30.1 3 5,000 pEpsoNAL & AV INJURY , S I C00,000 GENERAL AGG'it GATE S 2 000,.000 PRODUCTS -cOrAPAr AGG 1 2 000 000, COmaINED siNOLE IMrr (Es eccpc ROOILY INJURY (Pix pernr) BODILY INJURY (Per pecldwirk rROPC RV( DAMAGE wet ac.;iclEn1) ENDO MENT 1 5PEIAL PROVISIONS CANCELLATION AUTO ONLY • EA ACCIDENT OTHER TflAN EA AC AUTO ONLY: A EACH OCCURRENCE AUCIRE GATE E001/001 OA TE (MWDorYTYY1 8/23/2010 WC STATU•1 0711- I TORY I PATS 6 L ACH ACCIDENT S E.L DISEASE • EA EMPLOYEE LA, DISEASE - POLICY mil 3 CERTIFICATE HOL SHouLO ANY OF THE ABOVE DESCRIBED POUctES BE CANcELLED BEFORE THE EXPIRATION DATE THEREOF, THE IMMO INSURER WILL ENDEAVOR TO MAIL () BAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAME s TO THE LEFT. BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANT *MO UPON THE INSURER, ITS ANTS OR REPRESENTATIVES. AuThORIZED REPRESENTATIVE ACORD CORPORATION 1988 Inspection Number: INSP - 148903 Scheduled Inspection Date: October 08, 2010 Inspector: Hernandez, Rafael Owner: KERSCH, PAUL Job Address: 665 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: POWERHOUSE EQUIPMENT SALES & SERVICE INC Building Department Comments October 07, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, F s Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration For Inspections please call: (305)762 -4949 Permit Number: PL -7 -10 -1319 Phone Number 305/758 -9375 cel Number 1132060171910 Phone: (954)658 -4454 INSTALLATION OF 500 GALLONS OF LP TANK Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 8 of 19 THE ANY MAY POLICIES. IRSR LTR POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wTH RESPECT TO WHICH THIS CERTIFICATE MAY BE iBSUED OR PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DATE ( MMIDD/YYYY) 07 22 10 NSR • NSR • TYPE OF INSURANCE P OLICY NUMBER POLICUMW DATE POLICY EXPIRATIO DATE (MM/DD1YY) LIMITS INSURER A: NAUTILVe INSURANCE CO. - RUI.T. A INSURER B: ESSEX INSURANCE CO. GENERAL 9 LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE I� OCCUR NNO38942 No .ADDITIONAL OisLISEDS TJNLESS ENDORSED 07/25/10 07/25/11 1 EACH OCCURRENCE $1,000,000 PREMlSES(Easccueecce) $50 MED EXP (Any one person) S EXCL PERSONAL B ADV INJURY $ 1 , 000 , 000 GtNERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY C 1 78: I I LOC AUTOMOEILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS M I.E LIMIT (Ea =dent) $ • -- I— - - -• -- BODILY INJURY (Per person) 6 BODILY INJURY (Per incident $ PROPERTY DAMAGE (Per accident) I---I GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT 5 OTHER THAN EA ACC 3 AUTO ONLY: AGG 5 EXCESS /UMBRELLA LIABILITY OCCUR I I CLAIMS MADE XOVA316310 07/25/10 07/25/11 EACH OCCURRENCE 53,000/000 X I AOCRECATE $3,000,000 DEDUCTIBLE 1 RETENTION 3 $ $ y WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFF IC ER/MEMBER EXCLUDED? H yea, C RO ISiO SPECIAL PROVISIONS below WC SIATU- OTFF � I1ORY LIMITS ER E.L EACH ACCIDENT EL. DISEASE - EA EMPLOYE : 3 E.L. DISEASE - POLICY LIMIT S C OTHER EQUIPMENT FLOATER EC68919986 07/25/10 07/25/11 10 DAYS NOTICE IF CANC FOR NON -PMT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS FAX# 30 5 - 756 - 8 972/954- 796 - 5988/786- 228 -8449 r•Cr,eI CIA �r r....�- ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID SL O POWER-4 DATE ( MMIDD/YYYY) 07 22 10 PRODUCER INNOVATIVE INSURANCE CONSULTANTS, INC. 5461 UNIVERSITY DRIVE , #103 CORAL SPRINGS FL 33067 Phone : 954- 340 -9551 Fax: 954 -340 -9456 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 INSURED SALE SE SERVICE INC. NT & SALES S & SERVICE Aft 4900 NW 104TH A CORAL SPRINGS FL 33076 INSURER A: NAUTILVe INSURANCE CO. - RUI.T. 17370 INSURER B: ESSEX INSURANCE CO. 39020 INSURER C: ASSURANCE ccea•urx Oa AHERIC. _ 19305 INSURER D: INSURER E: 2010-09 -09 00:09 RECEPTION COVERAGES E HOL ACORD 25 (2001/08) VILLAGE OF MIAMI SHORES 10050 NE 2 AVENUE MIAMI SHORES FL 33138 7862288449 » 1 800 685 7530 MIAMI -6 P 1/1 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BB CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR 10 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AU IZED REP N ]TAE ® ACORD CORPORATION 1988 2010 -09 -08 23 :57 POST LICENSE CONSPICUOUSLY ; 4,/', '--- o // RECEPTION 7862288449 » 1 800 685 7530 vvvou tVU.) LyUINI 1I IIL y U`+-I UJ J,7UO a.ala■ • 1 1 lye! •A Department of Agriculture and Consumer Services _ _�_ _ Division of Standards Bureau of Liquefied Petroleum Gas inspection (850) 921-8001 Tallahassee, Florida POWERHOUSE EQUIPMENT SALES & SERVICE, IN 4900 NW 104TH AVE CORAL SPRINGS, FL 33076 -1750 License Muatber. Expiration Date: Date of Issue: License Fec: Type and Class: Liquefied Petroleum Gas License CATEGORY 1 LP GAS DEALER GOOD FOR ONE LOCATION ONLY ANY CHANGI~ 01' OWNERSHIP OR SALE OF THIS SUS1NESS RENDERS T141S LICENSE INVALID This license is issued under authority of Scotian 527.62, Florida Statutes, to: State of Florida Department of Agriculture and Consumer Services Division of Standards Bureau of Liquetied Petroleum Gas Inspection (850) 921 -8001 Tallahassee, Florida MASTER QUALIFIER CERTIFICATE This Certificate is issued under authority of Section 527.02, Florida Statutes, to. STEPHEN STAFFORD Valid For L1eease Number: 22306 POWERHOUSE EQUIPMENT SALES & SERVICE, INC 4900 NW 10411-1 AVE CORAL SPRINGS, FL 33076 -7750 22305 AuOust 31, 2011_.. . . September 1, 2010 5425,00 0601 P 7/7 p.I LES H. BRON COMMISSIONER OF AGRICULTURE Certil+Cate No: 21377 Exam bate; July 10, 2006 Issue Date; July 10, 2009 Expiration Date: July 9, 2012 Exam; 0601 RLES H, DRONS COMMISStoweR OF AGRICULTURE BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): 665 iV 9fit" Address: City: Tenant/Lessee Name: City: Folio/Parcel #: PI Arm 1 s ao p t Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: 1) 00 /`)" I ey t ti Av i Type of Work: ❑Address Description of Work: Scanning Fee $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 NJAlteration Miami Shores Village Building Department 3A.& 5 -TAW State: W(Nnso' r-Lcrii),A Permit No Ip©MTC9 JUG 1 9 2010 BY: ... ................ Master Permit No'- t Phone #: Phone #: Zip: 33/3V' Email: JOB ADDRESS: � 6 A/ q -9 :th . T �'C Miami Shores County: Miami Dade Zip: 33 1 3 NO Flood Zone: Phone #: (150 531 - G V 3 3- City: c 44 i 5 f e ■ N.Z.I S State: 'z-c ( Di\ Zip: 3ci 76 Qualifier Name: ,5 `t epil vA . f1 ie_D Phone #: (i v) '` " 6 3 J State Certification or Registration #: 22- 3 6 '6 - Certificate of Competency #: -2 I IT Contact Phone #: C`) 5-(4 -s 1 E V 3 3 Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $L1 ( x Square/Linear Footage of Work: ❑Demolition UNew URepair/Replace L - f' ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ '- (- {- Permit Fee $ CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1'7 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 as .roved and a .inspection fee will be charged. Signature APPROVED BY Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 , by , day of , 20 , by who is personally known to me or who has produced / who is personally known to me or who has produced As identification and who . e an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: /7 ,00 , 00 , ,1 i Agent GIDEON DJE Sign: Print: My Commission Soyiroatm .. * * * * * * * * * * * * * * * * * * * * ** ` yAssn., Inc (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Signature My Commisssoi4ES - •;,f i or ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *- * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Zoning Structural Review Clerk ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE IMW o, 0 HAVE BEEN ISSUED TO THE INSURED OF ANY CONTRACT OR OTHER DOCUMENT BY THE POLICIES DESCRIBED HEREIN HAVE BEEN REDUCLU BY PAID CLAIMS. POLICY NUMBER PRODUCER Cypress Insurance Group BO -CL P.O. Drawer 9328 Fort Lauderdale, FL 333104328 954 771 -0300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED West Kendall Electric Inc. 9305 SW 94th Street Miami, FL 33176 -2013 INSURER A: Landmark American Insurance Co. 33138 INSURE CastlePoInt Florida Ins Co 13599 Nsurltltc;. X INsuRER D' INSURER E. el MED EXP (My one person) 1 ANY MAY POLICIES LTR A HE POLICIES REQUIREMENT, PERTAIN, NSRC OF INSURANCE LISTED BELOW TERM OR CONDITION THE INSURANCE AFFORDED AGGREGATE LIMITS SHOWN MAY TYPE OF INSURANCE HAVE BEEN ISSUED TO THE INSURED OF ANY CONTRACT OR OTHER DOCUMENT BY THE POLICIES DESCRIBED HEREIN HAVE BEEN REDUCLU BY PAID CLAIMS. POLICY NUMBER NAMED ABOVE W1TH RESPECT IS SUBJECT TO DAVE (eg�FDDrYY1 FOR THE POLICY TO WHICH THIS ALt, THE TERMS, EXCLUSIONS P V?EEIMM PERIOD INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE ISSUED OR AND CONDITIONS OF SUCH LIMITS' MINERAL OA BURY COMMERCIAL GENERALUABILRY LBA068651 -00 02/28/10 02/28/11 EACH OCCURRENCE 8 1,000,000 $100,000 X Rf N FT.�FaocniRer1 I CLAIMS MAUI X UCCUII el MED EXP (My one person) $5,000 X BI /PD Dad: 500 PERSONAL BADVINJURY $1,000,000 t210000O00 81, 000.000 ..--- OE NEI IAL AU(3HtUA 1 r_ t,Mi. AGGREGATE LIMIT APP1 IIPS PFR• PROi)1!CTR COMP/OP Ann 7 POLICY IT Furl I I LOC AUTOMOBILE LIABILiT' ANY Al I O ALL OWNED AUTOS SCHEDULED AU i LY HII IEU AL.1 OS NOM -O W N tU R IJ I V:; COMBINED SINGLE LIMIT (Fe ncirlrn7) EL/OILY INJUItY (Per person) nom Y INIIIRV (Per sccideni PIiOI'EI I IY UAMAUE (Pei ecddenl) GARAGE LIABICTTV ANY AID 10 AUTO ONLY CA ACCIDENT $ ClTI If R Tt IAN 1-A AC( $ AUTO ONLY: AI-3-i $ EXCESS/UMBRELLA LIAB FAC:H Cx1CIIRRFNOP $ I Occur I CLAIMS MADE DEDUCTIBLE IIEIENIKIN $ AfCDECATE S. $ $ $ 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRO PRiFTOWPARTNPRIF)(r()iTIVE UhhIUEIUMEMBEH EX(:LUUED? 11 Ye, r1,XUIl u, i,1 v SPECIAL rnc,vISfONS k,wuw WCP760129000 01/01/10 01/01/11 x I I(1HY TpnTU- I lOTiI- l E.L. tACHN�CIUENT 8500,000 $500,000 $500,000 C.L. DISEASE CA CMPLOYCC E I. DISEASE - POLICY UMR OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS/ vEN1CLES Workers Compensation applies to Florida / EXCLUSIONS ADDED BY ENDORSEMENT (SPECIAL PROVISIONS operations and employees only. INDRTIPle.A•C un, n 2010-09 -08 23:57 RECEPTION —772 - 9424 Page: 004 ACORD 2e (2001/08) 1 of 2 Village of NGami Shores Buiding and Zoning 10050 NE 2nd Avenue Miami Shores, FL 33138 #S97a9s/M86260 7862288449 » 1 800 685 7530 CANCELLATION AUTHORIZED REPRESENTATIVE ~et A l , P 5/7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING' INSURER WILL ENDEAVOR TO MAIL _la_ OAY$ WRITTBV NOTICE TO THE CERTIFICATE (OLDER NAMED TO THE LEFT, BUT FAILURE TO DO BO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CL '%) ACORD CORPORATION 19S6 112■3ji0 fix•. —51 31 ►t1-110 BIB Its) z-- BUILDING PERMIT APPLICATION FBC 20 Address: JOB ADDRESS: 66 5 N€ e q" S T cE @T DESIGNER: Architect/Engineer: osums Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): TAMES Ws nt t,S('12- Phone #: 46 5 A! E lth s ,'r City: N+IA^" 1 'S 4zia.r State: FLor At Tenant/Lessee Name: Phone #: Email: City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRALTO ; Company Name: T La bI L eLE tZ C Phone #: ICE1 ' mil . (.o Address: q ''t City: State: Qualifier Name: R c Au1 l2. State Certification or Registration #: l t Certificate of Competency #: Contact Phone #: Email Address: Value of Work for this Permit: $ ; e)Joe Square/Linear Footage of Work: Type of Work: U Ad s A1t gNew ❑R; ,air • eplace qq Description of Work: ration �: 4 Permit No j 10 -INK Master Permit No. r *"visipU1y, 19 2010 zip: 33 I 3� Zip: 33138' Phone #: 9 CCF Submittal Fee $ mod' Permit Fee $ � CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ CO /CC $ Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the . first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature The foregoing instrument was acknowledged before me this /6 The foregoing instrument was acknowledged before me this > day of ,20 kb by , day of , ..JU\y ,2010 , by PIS7/1'It'_; 11L lL =/ who is personally known to me or who has produced who is personally known to me or who has produced C f t $ t K'+ l as identification and who did take an oath. As identification and wh NOTARY PUBLIC: Sign: Print: My Commission APPROVED BY d T% .... ,,or ne • Agent GiOEON (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) id take an oath. • NOTARY PUBLIC: X g Print: My Commis ion xpires: q n 3c : i 1 Plans Examiner Structural Review ammrri Aliit OPEZ •Not Public - S tate of Florid. � . ' c < < , 'res Jul 11, 201 'v!'�" c Commission # DD 694457 ' "4 os � S Bonded Through National Notary Assn. ,nu +, * * * * * * * * * ** Zoning Clerk FE .94,44 p him E NZ PArtiRS ti 364 SW 4 CT., Dania Beach, FL 33004 Phone 954-922-3800 Fax 786-228-8449 TO Dr. Jimmy Windsor 665 NE 97th Street Miami Shores, FL 33138 305 323 3869 • POWER QTY DESCRIPTION Gas tank and generator • Engineering for Elect, Gas, Structural • Electrical permit • Gas Permit • Inspection by municipal inspectors • Generator startup • Shipping & crane • Att tabor • All material • Two (2) years warranty on ail labor provided by EmPower Generator • Two (2) years manufacturer's warranty on all parts Current property survey with certificate of elevation, shall be provided by the customer ES IMAM PROPOSAL JOB Same LOCATION ne (1) whole house standby generator to be installed at the above specified job location. The installation to include: • One (1) Generac QuietSource, twenty seven (271 kW Liquid Cool, Propane Gas powered, standby generator, Aluminum Body, model QT02724 (Newest 1800RPM Generator) • Concrete Pad for Generator • One (1) 400 amp. automatic transfer switch • Transfer switch wired between generator, main electrical service, and main electrical panel • 500 Gal underground LP Gas tank and installation • LP Gas fill-up not included • LP Gas regulator, shutoff valves, pipes, and piping between LP Wall paint, lawn repairs, pavers repair, shrubbery, trees or fences around the generator are not included in this proposal UNIT PRICE $27,860.00 TOTAL QUOTATION # 561 DATE: JUNE 21, 2010 EXPIRATION DATE SALESPERSON • JOB PAYMENT TERMS • ESTIMATED DEWRY 27kW Aluminum body See Terms and Conditions • 4 - 6 weeks from Permit Thank you for considering EmPower for your emergency power needs. We are pleased to present to you the following specification estimate / quotation. This tion / estimate / quotation covers only the products and services explicitly outlined below. OEITWZD AUG 1 8 1010 g UNE TOTAL $27,86000 7,860.00 SUBJECT 1 CCMPIJANCE WITH ALL FEDERAL STATE AND CC UN iY riULES AND REGULATIONS BLDG DEPT =ZONING I APPROVED_ 1 �ERW UT #: EL-10- 131 III4 BY liami Shores Villa! ever/6 T171(6 LIJ 1 2. - + 1 \j vz/t- 1 . W/F ON UNE CC SCALE LL it o LOT 18 LOT 19 BLOCK 101 Pcm BLOM 101 50 0 G TANI 0.30' 1/2" NO ID ASPHALT PAVEMENT ..... . . • • 0 8 W/F 0 FIR 1/2" NO ID S. : OF BEARIN GS: .............. ............. ........... LOT 21 BLOCS 101 W/F ON LINE FEATURES QT027 Standby Power Rating 27 kW 60 Hz STANDARD EQUIPMENT • All input connections in one single area • High coolant temperature shutdown • Low oil pressure shutdown • Low coolant level automatic shutdown • Overspeed automatic shutdown • Crank timer • Exercise timer • Oil drain extension • Cool flow radiator • Closed coolant recovery system • UV /Ozone resistant hoses • Watertight state of the art electrical connectors • Innovative design and fully prototype tested • UL2200 Listed • Solid state frequency compensated voltage regulator • Dynamic and static battery charger • Sound attenuated acoustically designed enclosure • Quiet else level erertise • Acriustic* didgrtecl ertgjrte poling system • Higetkpli is exhaust system • Stag ;th i',,th� k:l;a.� �I system with R100 digital • Mainline circuit breaker • Radiator drain extension • Battery charge alternator • 2 Amp static battery charger • Battery cables • Battery rack • Fan and belt guards • Isochronous governor • Flex fuel line • Hour meter JUL 1 9 2010 Liquid Cooled Gas Engine Generator Sets GENERAC 2.4L ENGINE Naturally Aspirated Gaseous Fueled Meets 2009 EPA Emission Regulations • Watertight electrical connectors • Rodent proof construction • High efficiency, low distortion Generac designed alternator • Vibration isolated from mounting base • Matching Generac transfer switches engineered and tested to work as a system • All components easily accessible for maintenance • Electrostatically applied powder paint I APPLICATION & ENGINEERING DATA GENERATOR SPECIFICATIONS TYPE Synchronous ROTOR INSULATION Class H STATOR INSULATION Class H TOTAL HARMONIC DISTORTION <5% TELEPHONE INTERFERENCE FACTOR (TIF) <50 ALTERNATOR OUTPUT LEADS 3 PHASE 4 wire BEARINGS Sealed Bap COUPLING Flexible Disc LOAD CAPACITY (STANDBY RATING) 27 kW EXCITATION SYSTEM Direct NOTE: Generator rating and performance in accordance with 1508528 -5, BS5514, SAE J1349, 1S03046, and D1N6271 standards. GOVERNOR SPECIFICATIONS VOLTAGE REGULATOR TYPE Electronic SENSING Single Phase REGULATION t 1% FEATURES V/F Adjustable Adjustable Voltage and Gain LED Indicators GENERATOR FEATURES I Revolving field heavy duty generator I Directly connected to the engine O Operating temperature rise 120 °C above a 40 "C ambient O Insulation is Class H rated at 150 °C rise O All models are fully prototyped tested CONTROL PANEL FEATURES O SEVEN LED INDICATOR LIGHTS O ADDITIONAL FUNCTIONS • System ready • Utility sensing • Low fuel pressure • Delay on utility failure for engine start • Low battery • Engine warm-up before transfer • Low oil pressure • Delay to retransfer to utility • High coolant temp /ow coolant temp • Engine cooldown timer • Overspeed • Exerciser not set • Overcrank • Hour meter I INTERNAnU IONS: • • • • • • 3 plan switcfL do.o11 gnd a» • - • 2 will Ott fc an transfer *toll • • • • • • Communicates with the denerrdc RTS trs isf&Switch • Built-in 7 day exerciser • Selgctabbe engine speed at exercise • Governor controller is Out inTeXte master qtranal tgard • T*emp range 4n to :0 ° C • • • • • • • •• • • •• • • • • • • • ••• • Rating definitions - Standby: Applicable for supplying emergency power for the duration of the utility power outage. No overload capability is available for this rating. (All ratings in accordance with liS�514, ISO40 ang D1N6271). • • • • • • • • • • • • • • ..• • • • • • • • • • • . • •• •• • • • •• • ••• • • • ••• • ENGINE SPECIFICATIONS ENGINE LUBRICATION SYSTEM ENGINE COOLING SYSTEM FUEL SYSTEM ELECTRICAL SYSTEM QT027 MAKE Generac MODEL Inline 4 CYLINDERS 4 DISPLACEMENT 2.4 Liter BORE 3.41 STROKE 3.94 COMPRESSION RATIO 8.5:1 INTAKE AIR SYSTEM Naturally Aspirated VALVE SEATS Hardened LIFTER TYPE Hydraulic TYPE Electronic FREQUENCY REGULATION Isochronous STEADY STATE REGULATION .t 0.25 ADJUSTMENTS FOR: Speed Yes Droop Yes OIL PUMP Gear OIL FILTER Full flow spin -on cartridge CRANKCASE CAPACITY 4 Quarts TYPE Closed WATER PUMP Belt driven FAN SPEED 1980 FAN DIAMETER 17.75 inches FAN MODE Pusher FUEL TYPE Natural gas, propane vapor CARBURETOR. Down Dot SECONDARY FUEL REGULATOR Standard FUEL SHUT OFF SOLENOID Standard OPERATING FUEL PRESSURE 5" - 14" H2O BATTERY CHARGE ALTERNATOR 12V 30 Amp STATIC BATTERY CHARGER 2 Amp RECOMMENDED BATTERY Group 26, 525CCA SYSTEM VOLTAGE 12 Volts QT027 • • ••• • GENERAC® RATING: All three phases units are rated at 0.8 power factor. All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable to varying loads for the duration of a power outage. There is no °tribal capai flit% for this rating. Ratings are in accordance with ISO - 3048 -1. Design and specifications are subject to change without notice. • • • ••• • • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • QT027 KW RATING 27 ENGINE SIZE 2.4 Liter Inline 4 GENERATOR OUTPUT VOLTAGE/KW - 60Hz 120/240V, 1- phase, 1.0 pf 120 /208V, 3- phase, 0.8 pf 120/240V, 3- phase, 0.8 pf KW Nat. Gas AMP KW LPG AMP CB Size (Both) 25 104 27 112 125 25 87 27 94 100 25 75 27 81 90 GENERATOR LOCKED ROTOR KVA AVAILABLE @ VOLTAGE DIP OF 35% Single phase or 208 3 - phase 43 ENGINE FUEL CONSUMPTION (Natural Gas) (Propane) Exercise cycle 25% of rated Toad 50% of rated Toad 75% of rated load 100% of rated load Natural Gas (25 kW) Propane (27 kW) (ft (gal/hr.) cu ft/hr 42 0.44 16 108 1.2 44 197 2.2 81 287 3.2 118 359 4.1 147 ENGINE COOLING Air flow (inlet air including alternator and combustion air) ft /min. System coolant capacity US gal. Heat rejection to coolant BTU/hr. Max. operating air temp. on radiator °C ( °F) Max. ambient temperature °C ( °F) 2,400 2.5 120,000 60 (150) 50 (140) COMBUSTION AIR REQUIREMENTS Flow at rated power 60 Hz cfm 68 SOUND EMISSIONS IN DBA Exercising at 7 meters Normal operation at 7 meters 62 75 EXHAUST Exhaust flow at rated output 60 Hz cfm Exhaust temp. at muffler outlet °F 130 900 ENGINE PARAMETERS Rated synchronous RPM 60 Hz HP at rated KW 60 Hz 1800 40 POWER ADJUSTMENT FOR AMBIENT CONDITIONS Temperature Deration 3% for every 10 °C above - °C 1.65% for every 10 °F above - °F Atitude Darabori ' ' 1 • • • •• • ' • 1�ojprbyery 100m above -m • • • ... .. • 3' fOr % p ?y 1000 ft. above - ft. 25 77 183 600 ENCLOSURE • 11atdr l • • •• • • • • • Chi • • • • • • • : • • . • • •• • • Aluminum PMS 422 (Bisque) QT027 • • ••• • GENERAC® RATING: All three phases units are rated at 0.8 power factor. All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable to varying loads for the duration of a power outage. There is no °tribal capai flit% for this rating. Ratings are in accordance with ISO - 3048 -1. Design and specifications are subject to change without notice. • • • ••• • • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • INTERCONNECTIONS GENERATOR CONNECTION BOX Ground Level STUB -UP AREA Concrete Slab See Install Dwg for Dimensions Installation Drawing Ref. No. OG0325 INSTALLATION LAYOUT d 000000 CONTROL PANEL • ••• 9 • 62.2 46.02 DOOR TYP • • v' • •Q (• •o q i • • •• • • • • • • ••• • •• •••° ••A • ••SEA INSTALMWG 0t$370 FOR DETAILS • • • . •• • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • GENERAC® • • • • • • • • ••• • • • • • • • • • •• •• • • • ••• • • • ••• 33.5 0 CIRCUIT BREAKER SIZE KW VOLTS / AMPS LUG SIZE 27 2401 0 125 #2 to 1/0 27 208 3 0 100 #4 to 1/0 27 240 3 0 90 #4 to 1/0 Transfer Switch To Generator Control Panel FRONT VIEW QT027 WEIGHT: 891 lbs. Generac Power Systems, Inc. • S45 W29290 HWY. 59, Waukesha, WI • generac.com • 02109 Generac Power Syste ns, Inc. AO rights reserved. AO specifications are subject to change wIthout notice. Bulletin 0177710S8Y/Printad In U.S.A. 05.08, rev: 03.09 • • • • • • • •• •• Jlliami Shores Village 1 I 31Vb .4Nc &LV {i1D 1itV ,tit. 1.4 ONV 3LVIS . / HIIM '� , e+ 133P9ns 1 APPROV f , : � ` i 1• ,0, BLDG DEPT] , -- f 0 a_ c Q • G LOT 18 BLOCK 101 • •• VII • L/ "L'IL. 0 0 • •• • • ..• • . . . . • • • • • • • • • • • • ••• • • • • • • •• • • •• • •• • • • ••• • • • • • o ; /2° **NO NO I@:: :: :::: W/F ON UNE LOT 19 BLOCS 101 .30' 0 0 w 0 • • • •• • • • • • • • .s...w... • • • .•. +• . •': : �: • • ••• •• • • :.R : :.•.Y• : ::; • • •. • • • • • : ::x:.�:::•::::: :: • • • • • • • •. •:::: •: : : : .4• : : - : -: • • • • • • • • • • • • • ASPHALT P �' ENT:: 97TH STRE 75' R /W 0 NG ID W/F ON UNE 0 01 0 0 0 0 FIR 2 " NO ID 0 r; M OF, WEST LOT21 BLOCS 101 W/F ON UNE Chamfer (TYP) 8 9 14" —y 12 "•-1 7" 9 13" 1 e TOP VIEW 8 • Y. • • • I • 6' -0" 7 "X14 "Opening 6' -0" FRONT VIEW ff 6" 1 11 3' -0" I'AL) EA. 5.5" GALV. HOOK LIFTERS • • • • SLAB .33 CYDS TOTAL: CASTING: STEEL WT.: 0 • • • • •op COS t � 1 0� Precast Orlando, Inc. • • UCTION AGE WEIGHTS 1,293 CONC WT. #4 DRAWN: EDDIE CHECKED: PRODUCED: STR. NO.; PAD I S.O. NO.: NOTES: 3/4" CHAMFER ON ALL EXPOSED TOP EDGES 4,000 J'$I • • • • • • • • • • • • • • •• • • • • • •• •• • • • • • • STRUCTURE TYPE "72X36X6 PAD" 890 WET TAFT— VINELAND RD a ORLANDO, FLORIDA 32824 1 • (4Q71 $6§�; 580 ..FAX: (407) 866 -2424 • • �R� P(�)WrR :C,FNFRATnRS • •• ••• • • • •• • •• ••• • • • ••• • • PROD YAR DRAWING NO.: REINFORCEMENT C4 10" OCEW CTR DATE: 5/19/10 DATE: SHIPPED: LN. NO.: LOC.: • • • ••• • • • • 2R • • Flex hose • •• • • • • • • • w • • •• • • • .. •. • • • • • •Detail 3/4" galvanized second stage reg. shut off sediment Trap 06,000 f,Tu's 100 POWERHOUSE EQUIPMENT' Propane & Natural Gate Sir$ve Sttsfftart Hoed Ditch Digger (S 4) 794'11 -za 4O • Fox (e 4) T -668$ 49013 1..W. 104h Avenue 4 Coral Springs, FL 33076 Run distance 5o 0 First stage regulator Gallon Underground tank :gin • I Table 6. (t) Polyethylene Plastic Pipe 54-42 Length (ft) 10 20 30 40 50 60 70 80 90 100 125 150 175 200 250 300 350 400 450 500 550 600 650 700 750 800 850 900 950 1,000 1,100 1,200 •• ••• • 1u300• • • • • ••; • • • • >R50p • • • • ••• •f600• 1,700 • •• • • • 1,800 • • • • ,910• •• • • • • • • :.P74°: • • •• • • • Note: All tag OD: ID: • • • • • • ••• • • 128 • • 124 •• ••• • • • • • • • • i • • • ••• • • • • • • • • • •• • • • • • ••• •• •• • •• • •• •• • SDR 9.33 0.660 1,860 1,280 1,030 878 778 146 139 •• 134 705 649 603 566 535 474 429 395 368 326 295 272 253 237 224 213 203 194 187 180 174 168 163 158 154 SDR ILO SDR 11.00 0.860 1.077 1.328 1.554 3,720 2,560 2,050 1,760 1,560 1,410 1,300 1,210 T,130 1,070 949 860 791 736 652 591 544 506 475 448 426 406 389 374 360 348 336 326 317 308 293 279 267 257 247 119 239 115 231 112 224 • • 218 • • .106 212 • 4• entries gre rounded to 3 significant digits. NATIONAL FUEL GAS CODE ANSI Z223.I Pipe Size (m.) Inlet Peeczuue: Pressure Drop: Specific Gravity: Capacity in Cubic Feet of Gas per How 6,710 4,610 3,710 3,170 2,810 2.550 2,340 2,180 2,050 1,930 1,710 1,550 1,430 .1,330 1,180 1,070 981 913 856 809 768 733 702 674 649 627 607 588 572 556 528 504 482 463 446 431 417 404 393 . 382 11,600 7,990 6,420 5,490 4,870 4,410 4,060 3,780 3,540 3,350 2,970 2,690 2,470 2,300 2,040 1,850 1,700 1,580 1,480 1,400 1,330 1,270 1.220 1.170 1,130 1,090 1,050 1,020 990 963 915 873 836 803 773 747 723 701 680 662 Gas: Natural 2.0 psi 1.0 psi 0.60 1i '. SDR 11.00 2 SDR 11.00 1.943 17,600 31,600 12,100 21,700 9,690 17,400 8,300 14,900 7,350 13,200 6,660 12,000 6,130 11,000 5,700 10,200 5,350 9,610 5.050 9,080 4,480 8,050 4,060 7,290 3,730 6,710 3,470 6,240 3.080 5,530 2,790 5,010 2,570 4,610 2,390 4,290 2,240 4,020 2,120 3,800 2,010 3,610 1,920 3,440 1,840 3,300 1,760 3,170 1,700 3,050 1,640 2,950 1,590 2,850 1.540 2,770 1,500 2,690 1,450 2.610 1,380 2,480 1,320 2,370 1,260 2,270 1,210 2,180 1,170 2,100 1,130 2,030 1,090 1,960 1,060 1,900 1,030 1.850 1,000 1,800