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EL-10-1489Protect Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Parcel Number 520 NE 102 Street Miami Shores, FL 1132060171060 Block: Lot: JOHN FRANZOSA 1 JOHN FRANZOSA 520 NE 102 ST MIAMI SHORES FL 33138 -2455 0 Contractor(s) LONGMAN ELECTRIC INC Phone (305)758 - 1211 Cell Phone Type of Work: overhead service Additional Info: service Classification: Residential Scanning: 1 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $150.00 $3.00 $0.80 $154.60 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Phone Pay Date Pay Type Invoice # EL -8 -10 -38716 08/26/2010 Credit Card 08/18/2010 Credit Card Amt Paid Amt Due $ 104.60 $ 50.00 $ 50.00 $ 0.00 Date Expiration: 02/22/2011 Applicant Cell Available Inspections: Inspection Type: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. August 26, 2010 August 26, 2010 1 Inspection Number: INSP - 151071 Scheduled Inspection Date: September 13, 2010 Inspector: Bruhn, Norman Owner: FRANZOSA, JOHN Job Address: 520 NE 102 Street Miami Shores, FL Project: <NONE> Contractor: LONGMAN ELECTRIC INC Building Department Comments September 10, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: EL -8 -10 -1489 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060171060 Phone: (305)758 -1211 leaving Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can bescheduied until re- inspection fee is paid. Inspector Comments / e / Page 18 of 26 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR IAD' NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM/DDIYY) POLICY EXPIRATION DATE IMMI00IY !) UNITS A INSURER A Nationwide Mutual Flre Insurance Company GENERAL LABILITY X COMMERCIAL GENERAL LIA ®UTY 77AC856157 -3001 09/07/2010 09/07/2011 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea ocaurence) $ 100,000 CLAIMS MADE IX 1 OCCUR MED EXP (Any one parson) $ 5,000 $ Inc luded PERSONAL &ADVINJURY GEM_ X GENERAL AGGREGATE $ 2,000,000 AGGREGATE UMITAPPLIESPER: POLICY 1F LOC PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILEuABILTY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OM ED BA- 0472R150- 10-SEL 05/12/2010 05/1212011 COMBINED SINGLE UMIT (Ea accident) - $ 1,000.000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGELAABIUTY ANY AUTO AUTO ONLY- EAACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: ACS, $ EXCESSIUMBRELLA UABIUTY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ i $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC STATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY LIMIT $ A OTHER Inland Marine 77AC856157 -3001 09107/2010 09/07/2011 Unscheduled E 5,00011,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ACORD CERTIFICATE OF LIABILITY INSURANCE I. DATE(MMIDDIYYYY) 09/07/2010 PRODUCER Phone: 7-696 -1333 Pontell Insurance and Financial Group, Inc. 1484 Tuskawilla Road Oviedo, FL 32765 License #: D051255 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 Longman Electric Inc 844 N. E. 98th Street Miami Shores, FL 33138 I INSURER A Nationwide Mutual Flre Insurance Company INSURER B: Travelers Insurance INSURER C: INSURER D: INSURER E OVERAGES CERTIFICATE HOLDER ACORD 25 (2001108) CANCELLATION 1 0-x`18 Miami Shores Village P-305- 795 -2207 10050 NE 2 Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO 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. AUTHOR(�ED REPRESENTATIVE (DMS) © ACORD CORPORATION 1988 Printed by DMS on September 07, 2010 at 10:07AM i IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Printed by DMS on September 07, 2010 at 10:07AM BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder)') ® \(1 c 5a.. Owner's Address 2 % a t O"2 -r16 CityNAN' o_r \ S State f L Tenant/Lessee Name g� E -MAIL: \rc' r\2.0SC ® .�\s®� , . Job Address (where the work is being done) S City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES N� Architect/Engineer's Name (if applicable) **x* Submittal Fee $) ; Permit Fee $ /--# d Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Zip County Miami -Dade Permit No.� 1...1O Master Permit No. Phone # Phone # Phone # CCF $ CO /CC mosnwslA 06j fo _4 7c3S 141(4:7 t. �` Zip Contractor's Company Name jj yo,..")g„i k)„,..,mt.... Phone # ,305. - 751 -1 ;// gift? y0 g Contractor's Address [ �,5p 1 , 1 , -- Cit i> 51.. -J c4 }} State pi - Zip 3 7/ ?8 Qualifier Name /6 GIkQc G . ! ,.,, Phone # )f— 7 54- - l // State Certificate or Registration No. f^ C.- 13c'037) 3 Certificate of Competency No. E -MAIL: Value of Work For this Permit $ frp`9Or DO Square / Linear Footage Of Work: Type of Work: ❑Addition 'Alteration ['New El -Repair /Replace • ❑ Demolition Describe Work: L.f '&Y ,r:✓ ;Ie "8.41# 4# C. air." d7;✓ 6 o.../ t is 4- Y_L J / d b -�,t� 1 tl c, •11 Lip rla lL 1'oli �iyj xxrxxx xxxF xxxxx xicx xxxxxxacrwwwwww *wxxaYxxxxxxxx*x'xxx Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Bond $ Code Enforcement $ Double Fee $ DPBR $ Zoning $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ 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. ZL`' —V) — C.3 °®t31 — Signature C % 3h / .ewi _- Contractor The foregoing instrument was acknowledged before me this 1C, The foregoing instrument was acknowledged before me this 1 day of 01 , 20 10 , by },A i .,L4 e �PX�7 , day of 4/lad , 20 /0 , by to t L .J 1._ Perez , who is personally known to me or who has produced F( D who is persona y known or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY P , 1 LIC: Signature NOTARY PUBLIC: Sign: Print: (Revised 02/08/06) Owner or Agent Notary Public State of Florida Michelle Perez ig My Commission EE002609 4 oi ego Expires 04/08/2013 • My Commission Expires: LIE g` 2.01-5 APPLICATION APPROVED BY: ** ** * * ** a:** •ar * vex as* * *ye *** ix** xxx* ****** xxx xx * *****xxxrx x*****xxxxxx was **xxxx xx x xxxxxx x x *'x***************r* Sign: 44 -" Print: / #A •ti Notary Public State of Florida Michele Perez My Commission EE002609 , o pp Expires 04 /08/2013 • P ?�.�.�- - - - - My Commission Expires: Plans Examiner Engineer Zoning • • ••0•.. • *•.•• • • • ••.•.• ••..• •• 000.• • • 00 ••00• • • 0 • 000••• • • 00 •••00• 520 NE 102nd Street Miami Shores, FL 33138 John Franzosa METER 200 AMP Existing T 3# 2/0 THHN 2" IMC New 3#2/OTHHN 2 " PVC Existing + #4 Ground Update 200 AMP Nema 3R PANEL 1 Phase 120 / 240 Existing •.•• • • ROD 8' X 5/8 Longman Electric EC 13003713 ROD 8' X 5/8 T.v avT Cold Water tz-L._ 10 t 491 S ,c ��i�c j BY DATE �!BJ' CT CO CC NIPI.IANCE WITH ALL FEDERAL ' f�!_` (2/.1; ��t llil F5 A ;n `L " FGULATIONS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH31 ANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSU 3ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS DF SUCH POLICIES. AGGREGATE LIVIITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURAI ICE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) —' LIMITS GENERAL LIAB!UTY EACH OCCURRENCE $ COMMERCIAL GENER,1L LIABILITY FIRE DAMAGE (Any one fire) $ CLAIMS MADE L I OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY I I JEC I 1 LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO I AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ I OCCUR I I CL 41MS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ A WORKERS COMPENSATION AND EMPLOYERS LIA131111Y 76 WEG 1X1296 05/01/10 0 5 / 01 / 11 X I TORY LIMITS 1 I OER E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $10 0 , 0 0 0 E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS /La;ATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Those usual to the Insured's Operations. ACORD CERTIFICATE OF LIABILITY INSURANCE DATE - 03-08-2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PAYCHEX INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 210705 P : () - F:(888)443-6112 A TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 SAN ANTONIO TK 78265 INSURED LONGMAN ELECTRIC INC 844 NE 98TH Sr MIAMI FL 33133 COVERAGES Miami Shores Village 10050 NE 2ND P.VE MIAMI SHORES, FL 33138 ACORD 25 -S (7/97) ADDITIONAL INSURED; INSURER LETTER: INSURERA:TWln City Fire Ins Co INSURER B: INSURER C: INSURER D: INSURER E: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON - PAYMENT) 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. AUTHOR INSURERS AFFORDING COVERAGE r NTA1WE 7 l ACORD CORPORATION 1988