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EL-11-1013Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 161107 Permit Number: EL -6 -11 -1013 Scheduled Inspection Date: June 20, 2011 Inspector: Devaney, Michael Owner: BENEDETTI, RAFAEL Job Address: 864 NE 91 Terrace Miami Shores, FL 33138- Project: <NONE> Contractor: LONGMAN ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060050330 Phone: (305)758 -1211 Building Department Comments CHANGE OUT METER AND RISER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments ra/ June 17, 2011 For Inspections please call: (305)762 -4949 Page 25 of 30 A�,,'�°/!R CERTIFICATE OF LIABILITY INSURANCE U022 DATE (MMJDD/YYYY) 06 -02 -2011 THIS CERTIFICATEIS 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 POUCIES 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 ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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 PAYCHEX INSURANCE AGENCY INC P: ()- F: (888)443 -6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONN: IF,N0): (888)443-6112 Alo.ExU PRODUCER CUSTOMERIDa: INSURER(S) AFFORDING COVERAGE NAIC 1/ /AWNED LONGMAN ELECTRIC INC 844 NE 98TH ST MIAMI FL 33138 INSURER A : Twin City Fire Ins Co HAMMY COMMERCIAL GENERAL INS B RER I"SU c' INSURER D : INSURER E : EACH OCCURRENCE 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. AWN TYPE OF 9AACE 91511 1511 sr VD W POLICY NUMBER GENER4L HAMMY COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ _05'L AGGREGATE UMIT POLICY 1 PER: PRODUCTS - COMP/OP AGG $ I ' LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE OMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Par accent) $ PROPERTY DAMAGE (Per accident) $ $ $ _ UMBRELLA LIM EXCESS LUM OCCUR CLAIMS -MADE EACH OCCURRENCE $ _ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORMS COMPENSATION Y/N IETOR/PARTNER/EXEC ANY PROPRIETOR/PARTNER/EXEC OFRCER/ EMBEREXCLUDED? � (MandaLeryhAM If yes, describe under DESCRIPTION OF OPERATIONS below N/A 76 WEG IX1296 05/01/201105/01 /2012 XITOUMITSI I ER E.L EACH ACCIDENT $1,000,000 E.L DISEASE - EA EMPLOYEE $1,000,000 E.L DISEASE - POLICY UMIT $ 1,000,000 DESQ?PT/ONOFOPEAATIOAS / LOCATIONS / VEHICLES Attach ACCRA 107, AddBlmral Remarks Sdreduin I mem space b mqu/redl Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2ND AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REA ITATIVE .v� 4 702- ACORD 26 (2009/09) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): JUN 02REC , Permit No. 'E U l — �O \ Master Permit No. f qe4 Oevye4 of / Phone#: Address: / q rr City: fl j (c7,47/ � J 5 State: r� Zip: 33) )S Tenant/Lessee Name: Phone#: Finail 1 • JOB ADDRESS: j 01_ 4-4 G City: Miami Shores County: Miami Dade Zip: FoliolParcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 20. /61i ....., /l Q' J7 "L Phone #: ,3 7541 - 2 ?)/ Address: / i)► f City: ,M,/ / o State: FL- Zip: 33/ 3S Qualifier Name: Ali-17e( e( e L-424, 6-404,i Phone#: 3 -75;5- )43-// State Certification or Registration #: JL, ) 3 to e7 37 ) ? Certificate of Competency #: Contact Phone#: 7$(® 4/7;2— 23 6 / Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ erepo.e0 Square/Linear Footage of Work: Type of Work: C1Address l DAlteration ONew )(Repair/Replace Demolition ) Description of Work: e ,4t?Mj / erd Me- k ********a ****** * **** *** * **a,x******* **s* Fees * * ** * *axe ****, ass * *** * * * ** **** ******** x ****** Submittal Fee $ Permit Fee $ %,0'l3 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ti Z - ls> 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 FT FCTRICAL 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 T() 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. Owner or Agent The foregoing instrument was acknowledged before me this 9 The foregoing instrument was acknowledged before me this 9- Signature Contractor day of , 20 1(, by who is 6rsonally kno to me or who has produced As identification and who did take an oath. NOTARY P .' , IC: Si Print: My Commission APPROVED BY P, he Notary Public State of Florida (f. Michelle Perez • My Commission EE002609 N01ikd p Expires 04/08/2013 day of l%/d/ -C.-- , 20 11, by me or who has produced as identification and who did take an oath. NOTARY PUBL Sign: Print: My Commissio iimimmorei ** **** ******* * ** * * * ***N*** * * **** ****** �� Y7ans Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Notary Public State of Florida Michelle Perez 44. ' `._ r My Commission EE002609 '401,10v Expires 04 /08/2013 * * +,**.*;: ****** * * *** * *** *** Zoning Clerk 864 NE 91 Terrace Miami Shores, EL 33138 Rafael Benedetti +_.3# 1/0 THHN 2" IMC METER 200 AMP 3# 1/0 THHN 2 "PVC 175 Amp Nema 3R PANEL 1 Phase 120 / 240 4— #4 Ground ROD 8'X5/8 la JUN 0 2 2011 jg B Y: ..... i ROD 8' X 5/8 ZONING DEPT BLDG DEPT Sl113.11:CT TO COMPLIANCE WITH ALL FEDERAL In FE AND COUNTY RULES AND REGULATIONS Cold Water 864 NE 91 Terrace Miami Shores FL 33138 Rafael Benedetti Residence LOAD CALCULATION 2200 sqft x 3VA Small Appliance Laundry Dishwasher Water Heater Disposal Dryer Pump Total 6600 3000 1500 1200 4500 1000 5000 1200 24000 - 10000.00 14000 x 40% 10000 5600 15600 10,000 NC 25,600/240 SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS 106 Amp