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EL-11-1736Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164725 Permit Number: EL -9 -11 -1736 Scheduled Inspection Date: March 14, 2012 Inspector: Devaney, Michael Owner: HIRN, WOLFGANG & NATALIA Job Address: 102 NW 106 Street Miami Shores, FL 33150 -1248 Project: <NONE> Contractor: LONGMAN ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (786)566 -9669 Parcel Number 1121360080010 Phone: (305)758 -1211 Building Department Comments SERVICE CHANGE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Com ; nts - -- /Y,/z 2c; /z-- March 13, 2012 For Inspections please call: (305)762 -4949 Page 2 of 2i 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 No. j 11 H ( Master Permit No. Permit Type: Electrical jj� ®® � �� " OWNER: Name (Fee Simple Titleholder): N o 1- ��- (#t Phone#: i pu ��_ �«c1 Address: 10 2- N W (c5 Lo 5+ City: An; ck (nn I 3 hot/C S State: PL— Zip: 331 S 0 Tenant/Lessee Nam, e: , N 1 A Phone #: Email: nCAv- e�Arv4 hiCVl E 31"\O l \• Cc JOB ADDRESS: t a 2- Li w 10 4, S4. City: Miami Shores County: Miami Dade Zip: '53! S® Folio/Parcel #: I I-2.15(9- 008 -Q C (t0 Is the Building Historically Designated: Yes NO X Flood Zone: 14 6 CONTRACTOR: Company Name: /. 6/6.0,2 -,✓ f f Plii c� Phone #: 3 -75,5- / del / Address: i N L( ,vg- q.g 519,e.."-- City: 411.'W2 4 e 1°e s State: t":2-- Zip: 2 3 1. 3, P� 3 Qualifier Name: .4'2-/i...-4 ' e ) I3j 47 4..4/ Phone#: 3 °-- 7.5"�r P1/ State Certification or Registration #: £"C.- 13 003 7/ 3 Certificate of Competency #: Contact Phone #: 766 e? 9- -13 6/ Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 3 Ct9, 2 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New pair/Replace ❑Demolition Description of Work: le, Lls�r e, ///06k fde..- ** **•x**** ****** x *******u * ** **+x***+x+xx *** Fees ******** ****** **+x*****m*** may *** * **+x*** ****** Submittal Fee $ Permit Fee $ /''45't ' 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrum nt was acknowledged before me this'd 1 by >\(ctc et l r ✓ ✓� day of 1 20 , by 1y:dray l-t,,� ho has produced FL ) L who i rsonally known me or who has produced entification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Mon.) invit £D�1 4 to oftt2 • atttlect PrOS ,TS tut, iraliqx3 offoo'..1 4.0tA • .:••! oh• vp.emtroe) ARA vtatoP ttn9atite. twomE E1C IlNAS% 33130 613700-4 B Lw6MANeince 'C INC 844 NE 98 ST 33138 MIAMI SHORES wits KCAL TAX.ReCE.PT . • _ ADE COLKIV r ST*TE.OP mil► EXPIRES SEPT WW2 MUST 00 DISPLAYED AT PLACE Of PtJ SUANTToCOOStrY CODE CHAPTER M'/CM!'ie•E4 THIS IS NOT A BILL - DO NOT PAY RENEWAL STATE E4'1303713 °wLONGMAN ELECTRIC INC 1 tCC�T CAL CONTRACTOR THXe 11 A '1 DOES T PFeIIT4 l atme wa 4A of T O0Es It AWAIT MI 4i0 SERI A Atigi tOT A CE ATTOM DF m WADERS MAMA. ACM MoDrANITY TAX 08/11/2011 090100I0001 000045.00 SEE OTHER SIDE WORKER /S 1 1* NOT FORWARD LONOMAN ELECTRIC INC MICHAEL LONGMAN PRES 844 NE 98 ST MIAMI SNORES FL 33138 FIRST-CLASS U.B. POSTAGE PAID MIAMI, FL. PERMIT NO. 231 640014-7 62 102 NW 106th Street Biscayne Park FL Wolfgang Hirn LOAD CALCULATION ZO WG DEPT w r E P T 1 1 COMPLIANCE WITH ALL FEDERAL Cl !N IY RULES AND RrGUI.AI InNS 1444 sqft x 3VA 4332 Small Appliance 3000 Laundry 1500 Dishwasher 1200 Water Heater 4500 Disposal 1000 Dryer 5000 Range 10000 Pump 1200 Total Longman Electric Inc. EC 13003713 844 NE 98th Street 31732 - 10000.00 10000 21732 x 40% 8700 18700 10,000 A/C 28700/240 120 Amp 102 NW 106th Street Miami Shores, FL Wolfgang Him T<i 3# 2/0 THHN 2" IMC METER 200 AMP 3#2/OTHHN 2 " PVC 1 200 AMP Nema 3R PANEL 1 Phase 120 / 240 4— #4 Ground ROD 8' X 518 ROD 8' X 518 Cold Water Longman Electric Inc. EC 13003713 844 NE 98th Street Miami Shores, FL 33138 ACQRDTM CERTIFICATE OF LIABILITY INSURANCE DATE(M$VDDNYYY) 09/06/2011 TYPE OF INSURANCE PRODUCER Phone: 407486 -1333 Pontell Insurance and Financial Group, Inc. 1484 Tuskawilla Road Oviedo, FL 32785 License #: P085436 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 NAIL # INSURED Longman Electric Inc 844 NE 98th St Miami Shores, FL 33138 -2533 I INSURER A: Nationwide Insurance Comoanv of America 25453 INSURERS: Travel@rs Property Casuafv Company ofAmerica ACP5905107300 INSURER C: 09/07/2012 INSURER D: $ 2,000,000 INSURER E: $ 100,000 COVERAG THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 ADD1 NOD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDD/YY1 POLICY EXPIRATION DATE IMM/DDIYYI LIbIT= A N GEIERALUABIITY X COMMERCIAL GENERAL LIABILITY ACP5905107300 09/07/2011 09/07/2012 EACH OCCURRENCE $ 2,000,000 PPREMEMISES OEa aence) $ 100,000 CLAIMS MADE I X I OCCUR MED EXP (Any one Person) ' $ 5,000 PERSONAL 8 ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GENT. AGGREGATE LIMIT APPLIES PER: X7 POLICY f ECT n LOC PRODUCTS - COMPIOP AGG $ 2,000,000 B N AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA0472R150 05/12/2011 05/12/2012 comBINED SINGLE LJMR (Ea accident) $ 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG 8 DICESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE IF $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARI NERAEXECUTIVE OFFICER/MEMBER EXCLUDED? Eyes. deecdbe under SPECIAL PROVISIONS below I WC LIMA I I Ea EJ_ EACH ACCIDENT $ EL. DISEASE- EA EMPLOYEE $ EL DISEASE- POUCY LIMIT $ A OTHER inland Marine ACP5905107300 09/07/2011 09/07/2012 Unscheduled E 10,000/1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 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 MAT. 30 DAYS merrier NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUOATIO N OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORRZEDREPRESENTATrIVE k i_.lA / (DMS) ACORD 26 (2001108) O ACORD CORPORATION 1988 Printed by DMS On September O6, 2011 at 1212PM