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EL-07-2071Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -63753 Scheduled Inspection Date: June 20, 2011 Inspector: Devaney, Michael Owner: JENSEN, LESTER Job Address: 1299 NE 104 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LS CURTIS INC Permit Number: EL -10 -07 -2071 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)892 -6507 Parcel Number 1122320300030 Phone: 305 - 892 -0115 Building Department Comments ELECTRICAL SERVICE UNDERGROUND AND SERVICE INCREASED. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 17, 2011 For Inspections please call: (305)762 -4949 Page 30 of 30 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 BUILDING PERMIT APPLICATION FBC 20 DEC 1. 7 2010 BY:..... Permit No. G 1-1 0-03-9_091 Master Permit No. Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): 6N5 S Phone #: .$ Jt'4�. -C=Zg Address: I R iV & 1 r 4 City: ri State: F Zip: 1 g Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 1Z- 99 NI (jam /0446' City: Miami Shores County: Miami Dade Zip: 7 1 Folio/Parcel #: Is the Building Historically Designated: Yes NO �/ Flood Zone: CONTRACTOR: Company Name: 1- 5 Co ILI 1 AddresiL.Q r 4 Arles , 1,0 City: ®4.. kr State: "� Zip: 1 Vo Qualifier Name: ZekurfS 5ietteLL CUAA'l Phone #: --- 4g b? State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: Phone #: 604g92,-60 7 DESIGNER: Architect/Engineer: Nyts- Phone #: Value of Work for this Permit: $ Type of Work: DAddress Description of Work: UAlteration Square/Linear Footage of Work: New ORepair/Replace ODemolition *************************************** Fe ee- �s�x�� :�x�::��xx:x�x:+x�:�x�x�:*** :�x** ***** * * * * ** * * * **** **** Submittal Fee $ Permit Fee $ 150 . OD CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 su .'sted notice, the inspection will not be roved and a reinspection fee will be charged. Signature The f day of Owner or A oing instrument was ac 20 L b who is personally known to me or who has produced As identification and who did take an oath. PtT1 1C -STATZ OF FI,OJIPA Catherine A. Duman Commission #DD85784I APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this / 1� ,2d i3 ,blur S S Clu day of DC who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: My Commission Expires: sr 1/Mk' !: f1, ..111 [rte ... Catherine A. Duffin Comr &sion rIDD857841 Fw:y Tres: MAR. 07, 2013 =GIRD /MAIM n'ICTiWADIN©CB..JNc. Zoning Clerk A� c°1 CERTIFICATE OF LIABILITY INSURANCE PROOUCPR ;NrIAN;..�,:'t DURANCE INDUSTRIES INC 953 NE 125th St N Miami, FL 33161 30 9 - 9 RP.) LS CURTIS INCORPORATED 20341 'NORTHEAST 30 AVENGE #108 AVER TJRA, FLORIDA 133180 C • J_. q. THE POUCIES OF I URWCE unto - FLOW HAVE BEEN MEMO TO '1 q ANY REOUIREM TERM OR CONDITION OF q'Y CONTRACT OR OTHER 0�' W� R SPU.TT y CH THIS CERTIFICATE MAY `& MAY PERTAIN ,____THE INSURANCE AFFORIF[I BY 'I'F14 POLICIES DE HEREIN IS SUEUSCT TO ALL THE TERMS, EXCWSIONS AND a IV mums. AGE- FeGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLA110. .,•t a ���i 11�•l::q ��l6i °xt'I�' ►� • . K , .. �Ia sI����. La�!l��tlesti /� �� �!!�!t r�• POLICY NUMBER 0 9ALL65773 10/26/10 10/26/11 GARAGE LAWN ANYAUTO Ate. IIXcESS11 UMeRELIA LIABILITY * OCCUR aAaiS A$W EMPUPREIrtGEELM IN ill rim OEOUCTIBLE RETENTION $ DESCRIPTION / LOCATIONS / IC / EXC+LU, IONS 0.71. EMIGRE *ELECTRICAL WORK - WITHIN BUILDINGS CER11RRCATE HOMIER MIAMI SHORES VILLAGE 10050 NE 2ND AVE MAW SHORES, FL 33138 FAX:305 -756 -8972 SHOULD ANY OP TM mow DE$CRI$EP POWER 9a apocaLuto WORE TES 81tPIRA M01ICB 10 THE C$*Tfl ICAth ROIABR NAM5D TO TMB LEPT. ouT F*U.0*E 10 PO SO $fW.L INAOMI NO 0BU12ATION oft Loatu Y 01P ANY MU IW*N ME MOM OS *05Nf9 OR • ACORD2S(2009 /01) t0 /t6 mid VO1ir: RD C The ACORD name and logo are registered marks of ACORD saI L snaNI 3ONVenSNI MON.. dg rest. L9E9T6890E ZZ:ZZ OT8Z /9t /tt ACORD. CERTIFICATE OF LIABILITY INSURANCE AUTOMATIC DATA PROCESSING INS AGCY 250717 P:(877)287 -1316 F :(888)443 -6112 PO BOX 33015 SAN ANTONIO TX 78265 INSURED L. S. CURTIS INC. 20341 NE 30TH AVE APT 108 VENTURA A FL 33180 COVERAGES DATE 103 -08 -201( f THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS �1TIF%CATE DOES NOT AMEND, EXTEND AR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INSURERS AFFORDING COVERAGE l t $,RERA: Twin City Fire Ins Co INSURER e: ,INSURER C: INSURER 0: INSURER E: THE POLICIES OF- INSURANCE US'TEO BELOW HAVE B N ISSUED TO THEINSURED NAMED ABOVE FOR nit POLICY PERIOD I4DICATED. NbTWITHSTANDINi 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 AU. THE TERMS. EXCLUSIONS AND CO6IDITI0NS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLLOAII(MGYS. % LTRR TYPE OP INSURANCE POLICY NURSER I DATE I 1 E PAATE�IItIM® IN 9 MOTS TS GEC uass rs• LCOMMERCIAL GENERAL UABiUTY CLAIMS MADE U OCCUR I ! GENT. AGGREGATE LIMIT APPUES PER: POLICY Ir' .. T I toe g EACH CE m 8 FIRE IMAGE IA►V one t tC) { $ MEDEXP Ow* one maw) 1 • PERSONAL r3 AOV INJURY { S GENERAL AGCATE __ _.. i $. PRODUCTS • COMPMOP AGG l $ 1 AmGlamm UAEWW i ANY AUTO 1 Ati OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON•OWNED AUTOS COMDR EO SINGLE LIMIT (Ea madam, BODILY INAPT( .Pat persona 1' s BODILY INJURY ,8 I(Pes seasleral 8 ammo LASIUYY 1 1 ANT AUTO i MESS LIABILITY OCCUR CLAMS MADE IT DEDUCTIBLE n. RETENTION WOE ODMPENSATION AND A . MOM { AUTO ONLY • EA ACCIDENT 1 8 OTHER THAN AUTO ONLY: EA ACC 8 AGG ; 5 176 WEG TR4954 JAW.' OCCURRENCE AGGREGATE 18 8 tt W ST U• o X I TORY UANTS I ER 05/01/11 EL EACHACCwENr El, 000, 00 EL DISEASE • EA EaIPLovEE .1 . 0 0 0, 0 0 El. DISEASE . POLICY LIMIT Si , 000 , 00 DESCRIPTION OP OPERATIDMICICATWNd ADDED BY ENDDRBEPAINTISIEcIAI. PROVISIONS Those usual to the Insured's Operations. ADDiEIONAt DISURED: tt LETTER: C Miami Shores Village Building Department 10050 N.E. 2nd Ave. Miami Shores, FL 33138 %CORD 25-S (7197) MOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAX DAYS WRITTEN NOTICE 410 DAYS FOR NON - PAYMENT) TO THE CERTIfICA1 OLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO ',LIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS 011 PRESENTATIVES. ° ACORD CORPORATION MIN Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type. lectrieal Owner's Name (Fee Simple Titleholder) Zes9-62v" J 23e y Phone # e72 6 sT0 Permit No. L *Thbil 1 aster Permit No. Ow Owner's Address ____1,29Q AJ /0 City / t. � � O-r— State �'2_ Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) City Miami Shores Village Zip FOLIO / PARCEL # Phone # 12 e 04S} County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name , 61 et- Phone # jgC Contractor's Address 7! �© 41,4/ /49 City �� l/!:t r' State Zip 3' 1 •?%.D Qualifier Name 1..44r..4' ..44r r� S 64 t/7 State Certificate or Registration No. Certificate of Competency No. E -MAIL: Phone # Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ A�19 c2 Square / Linear Footage Of Work: Type of Work: ['Addition Describe Work: ❑Alteration ['New Repair/Replace El Demolition ** * * * * ** * ** * ** deg: * * * * * * * ** * * * * * *x * * **** Fees************* * * * * * * *xxxxxx *xxxxx *x ** ** * ** *** Submittal Fee $ k)J) Notary $ Scanning $ Bond $ Permit Fee $ /...4-769/190" Training /Education Fee $ Radon $ Code Enforcement $ CCF$ CO /CC Technology Fee $ t1.►1- Zoning $ Structural Review. $ Double Fee jg 1 all Fe MIAMI HORES 01 ow 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. Signature Owner The foregoing instrument was a kni wledged before me this f day of d ,20 61,by (05)(JeitkOk who is personally known to me or who has produced As identification and who did take an oath. r Agent NOT Contractor The foregoing instrument was acknowledged before me this /f, day of ij i , 200(, by 664,4 J 6:A,72; who is pers , all known to me or who has produced d take an oath. Print: °- rA r iCONBESSIOb DD40u�om My Commission Expires: a` '. Exnrlt s r Ann 22 rxxxxxx xxxxxxxxxx xxxx xxxacxxxxrxxxxxxaexxxxXxxx,Yxd: x*** wxxr xxxxxx**ic ,txi.+,Yx,:xr.,4,cxxx9: xxx*x,k,Yxxd::kdtxic,: xxxx,Yxxxxx,Y,Y,: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) }�se9D®i Plans Examiner Engineer Zoning APPROVED • • ••• • • • ••• •• •• • • • •• •• • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • ••••••• • .•• • • • • • ••• •• • • • • • • • • •• • • • • • • •• • • • • • • • • • ••• • • •• • • •• • • • •• ••• •• • • • • • • • • •• • • • • • ••• •• RECEIVED OCT ICI O7 BY: . PROPOSED POWER UPGRADE & RELOCATION UNDERGROUND fP 1229 NE 1O4TH STREET MIAMI SHORES, FL 33181 Miami Shores Village ZONING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS • • •• •• • • • • • • • • • • •• • • • • • • • • • ••• • ••• • • 0 • • • • • ••• • • • ••• • • •a • • • • • ••• •• •• • • • • • • • • • • • • • ••• • • • • • • • • • • • •• • • • • •• • •• ••• • •• • • • • • ••• •• ••• • • • • • • • • • • • • •• • • • Spacing 6Ft Min. 2' Empty Conduit Underground Heading Toward Power Co. Facilities Coordinate With Florida Power 4 Light Co. 250 Volts 2 -1=ole, 200 Amp Main Circuit Breaker (22,000 A.I.C.) in Nema 3R Enclosure 0 Meter 200 Rain Tight Main Meter Combo W/ Factors Buss 2 '+'2/0 Copper Wires 101/0 Copper Wire 1 *4./0 Copper Wire In 2" Conduit 200 A 120/240 V 10/3W Panel *4 Copper Ground To 3/4 "Min Cold Water Pipe *4 Copper Ground To Grounding Rod. FlctrJc FRiser Diagram PROPOSED POWER UPGRADE & RELOCATION UNDERGROUND 1229 NE 104TH STREET MIAMI SHORES, FL 33181 • • ••• . w • • ..� •• •• • • • •• •• • ELECTitf CyAi i:4NE : SC1 .4EDULE • • ••• • • • ••• PANEL AMPS VOLTAGE PHASE • WIRES • MAIN • • CIRCUITS • ••• MOUNTING MANUFACTURER TYPE A 200 120/240 1 •• • •. • • :L;U' • : X40 FLUSH CM. NO. WIRE COND. INCH OCT. E1KR • •• ••• • SERVING •• • • •• • • •• LOAD • •• • •--•,• CXT. NO. ••• • • WIRE •• COND. INCH CKt. 13KS SERVING LOAD POLE AMPS POLE AMPS 1 6 2 40 • • • • • • •• • • s•• • • AIR HANDLER (A) • • •. • • • :01° • • ••• • 6000 • •i s • • • ••• 10 2 30 SPA HEATER 6000 3 • ••• 4 5 12 — 2 25 AIR CONDENSER UNIT (A) 1500 6 12 1 20 SPA MOTOR I500 6 8 — — — — SPARE — 9 12 — I 18 OVEN 1200 10 14 — I 15 BATHROOMS AND SMOKE DETECTORS 1500 11 — — — — SPARE — 12 14 — 1 15 GEN/LTS. 4 OUTLETS 3W sq ft 13 12 — I 15 STOVE TOP 1200 14 12 — 1 20 GARBAGE DISPOSAL 1600 15 SPACE 16 14 — I 15 GEN/LTS. 4 OUTLETS 3W sq ft 11 15 10 1 15 DRYER 4000 10 14 — 1 15 GEN/LTS. 4 OUTLETS 3W sq ft 20 — — — — CIELING FAN — 21 12 — 1 20 SMALL APPL 1500 22 14 — 1 15 GEN/LIS. t OUTLETS 3W sq ft 23 12 — 1 20 REFRIGERATOR 2000 24 12 — 1 20 SMALL APPL. 1500 25 14 — 1 15 GEN. LIGHTING t NEC. 3W sq ft 26 14 — 1 15 GEN/LTS. 4 OUTLETS 3W sq ft 21 12 — 1 15 28 14 — 1 15 I 29 12 1 15 30 12 — 1 20 SMALL APPLJBATHROOM FAN 1500 31 12 — 1 15 32 12 — I t 20 SMALL APPL. 1500 33 12 — 1 18 GPI 34 12 - 1 20 SMALL APPL. 1500 35 12 1 15 GFI 3W sq ft 36 6 — 2 40 AIR HANDLER (B) 6000 31 14 — 1 15 GEN. LIGHTING 3W sq ft 38 39 14 1 15 GEN. LIGHTING 3W act ft 40 12 — 2 25 AIR CONDENSER UNIT CB) 1500 41 14 — 1 15 GEN/LTS. 3W sq rt 42 ** Arc Fault Circ Interrupter SUE3 TOTAL 2 412 5 GEN/LTS. i OUTLETS • 3W •q ft 1815 sq ft = 5625 1st 10K a 100% 10000 ,4 /C LOAD 1500 REMAINDER 6 40% 2650 TOTAL 44215 = 1E34,5 IS LESS TI-IAN 200 4MFS = OK PROPOSED POWER UPGRADE & RELOCATION UNDERGROUND 1229 NE 104TH STREET MIAMI SHORES, FL 33181