EL-12-2440Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 188538
Scheduled Inspection Date: April 04, 2013
Inspector: Devaney, Michael
Owner: STEIN, DOUG
Permit Number: EL -12 -12 -2440
Job Address: 1165 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Rh
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050170030
Phone: (305)758 -2000
Building Department Comments
SERVICE REPAIR RELOCATION DROP UNDER GROUND
Infractio
INSPECTOR COMMENTS
Passed Comments
False
ficits/
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
4//ifia / 3
April 03, 2013
For Inspections please call: (305)762-4949
Page 26 of 26
Miami Shores Village
Building Department
DEC .2 7 2012
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 No. El 12 —2.44C
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: Electrical_
OWNER: Name ( Fee Simple Titleholder): 6t4 Phone#:
13 ° 6 5
�j36
%s ( Address:_ / l rc /YE 7 7
City: /' 'd J ..51C f State: c2 A Zip: . 3 i 3
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: //65 5 /t f 7 s
City:
Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
NO Flood Zone:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: % ` 'oy ` ' Phone#: 75E C
Address: 6 6 z,c) 9405 ?
City: o /td AA ..-i[e-J' xY'
State:
Qualifier Name: '`f e AA) t 7 /4-17® Phone#:
State Certification or Registration p #:.t -G 6O6/d9 9 Ceertificate of Competency #:
✓
Contact Phone #: 0c� 7'.C7 0 ®® Email Address: —70-114.) CP ®c9 / I �®
Phone#:
zip: 33 /gg .
DESIGNER: Architect/Engineer: /0//4
of Work for this Permit: $ 0110e,O e9 0 Square/Linear Footage of Work:
Type of Work: Address OAlteration ONew lkepair/Replace
Description of Work:
e. /3 , k.c43,' .=.145c) a- "-�^�'
********** ** * * * * * * * * * ** **:** ** **** * *****F '************* ***** ***** *** * ***** *** *********
DDemolition
Submittal Fee $ Permit Fee $ /f2 '4174 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW D
i o .Z�
Bonding Company's Name (if applicable)
Bonding Company's Address /V
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 d a reinspection fe w e charged.
Owner or Agent
E
The fore ooiinnginstrumentt was acknowledged before me tr►is IT
day of ��✓ , 2012 ; by 61)1145 �+f I() ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Contractor
The fore ng instrument was acknowledged before me this
Yee) of Y� , 20 % 2-;by -6 n
who is personally known to me or who has produced
as identification and who did take an oath.
********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
LOG a- fZ.—
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NOT
Sign:
Print:
My Commissio
RY PUBLIC:
` *A. MY COMMISSION # DD 979267
EXPIRES: May 11, 2014
, , _. ,E, Bonded taro Notary Public Underwriters
Zoning
Clerk
Dec. 26. 2012 10:26AM
-�1
No. 5479 P. 1/1
mvvu11-1 uP ID: GC
'`' , -'`"'• CERTIFICATE OF LIABILITY INSURANCE
DATE 26/2012
12/zs/zolz
THIS CERTIFICATE IS 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 POLICIES
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 ADDITIONAL INSURED, the policy(les) must be endorsed. 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 !feu of such endorsementtsj.
PRODUCER
Workers Compensation Group phone: 961 -392 -3300
P O Box 410 Fax: 561 -361 -1132
Boca Raton, FL 33429.0410
Workers compensation Group
CONTACT
NAME; Greg Carignan
rat , Eut).561- 392 -3300 WG Nor 561- 361-4132
E-MAIL SS; cars .Bworkeraoompgroup.com
INSURERS! AFFORDING COVERAGE
NAIC 11
INBURERAi arid gefleld Employers Ins
10101
INSURED Moody Electric, Inc
669 Northwest 90th Street
Miami, FL 33150
INSURER D;
INSURER C:
INeuRSR DI
INSURER t; ;
INSURER P ;
REVISION NUMBER:
THIS 1S 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.
INSR AD , L ' UBR
_LTS. TYPE OF INSURANCE INSR WVD POLICY NUMBER (POUc yy EEF�pp W1 IMMLICY EXP
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE n OCCUR
Galt AGGREGATE UMITAPPUES PER:
POLICY - FRO- - LOC
AUTOMOBILE LIABILITY
A
ANYAUTO
ALL OWNED
AUTOS
HIRED AUTOS
UMBRELLA LIAR
EXCESS LIAR
LIMITS
EACH OCCURRENCE
DAMAGE-TO RENTED
PREMISES (Ea occurrence)
ME0 EXP (My one parson)
PERSONA[, & ADV INJURY
GENERAL AGGREGATE
$
PRODUCTS- COMP/OP AGO
$
$
AUTOSULED
AUTO ED
MBINED - IN LE
(Ea accident)
BODILY INJURY (Per person)
8
BODILY INJURY (Per accident)
8
(P GE
(Per sodden()
8
DEO 1 I RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
a
AGGREGATE
ANY PROPRIEYOR/PARTNeAIEXECUTIVE N
OFFICER/MEMBER EXCLUDED? I I
(Mandatory In NH)
Byea, describe under
DESCRIPTION OF OPERATIONS below
N /A
030-29673
01/01/2013
01/01/2014
)(lanai I ER
$
E,L EACH ACCIDENT
s 500,000
EL DISEASE - EA EMPLOYEE
$ 500,000
DESCRIPTION OP OPERATIONS / LOCATIONS / VEHIOLt:B (Attach AOORD 1aS, Additional Remarks Schedule It more space Is required)
8/27/07— increase EL Limits to $500,000/$500,000 /4500,000
CERTIFICATE HOLDER
Village of Miami Shores
10050 NE 2nd Ave.
Miami Shores, FL 33138
EL. DISEASE -POLICY LIMIT
8
500,000
CANCELLATION
MIAMIS3
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2010/05)
1988 -2010 /WORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of AcORD
MOODY# ELECTRIC, INC.
vvww.moodyelectric.com
669 N.W. 90 Street • Miami, FL 33150-2166
Tel: (305) 758-2000 Fax (305) 754-1333
200-AMP
Main Breaker
250-Volt
NEMA 3R
16 STA.TE A T!!,e7".", ,---•!.. !*-!! !' -- • --. ! ,•:!-,!0•?!..i.,,
eYricr-----...e../ #0
T; ■-7) 1', 6f---
c .
:v.arri Shores Viilage
AP
r
PROVED
ZONING DEP
BLDG DEPT
SUBJECT 1.0 CC:NI ,1-1H
//5 9757-
i2
itizet40-11 „Silev-/e,of 12,A,
arz-t 9--ay"
Aka) a/n 94,-az,,,• a/Se/alit/ e
#4 THHN
EX-ilort Pc;\
1 1/2" Conduit
3 #2/0 THEIN
5/8" x 10'
e 1- Aletz n
kw/LA go erbiA,
Su pp/ ed
FeL‘
cwP
In Garage 4fe450"1.v,
200-AMP
M.L.O
Single-Phase
250-Volt
32-CCT
Load Center
NEMA 1
) Ore ‘, 3Goe F Goo
cue 1/V 69—A i Net0
Fee_ reA
MARY PAT BRIGGS
14 MY COMMISSION # DD 979267
EXPIRr: May 11 ,u2014
BndedThm
MOODY# ELECTRIC, INC.
www.moodyelectric.com
669 N.W. 90 Street • Miami, FL 33150 -2166
Tel: (305) 758 -2000 Fax (305) 754 -1333
Lth'q
/ /6 ,u 7�
RESIDENTIAL DEMAND LOAD CALCULATIONS
W / SQ. FT fVe.,®
REFRIGERATOR
APPLIANCES
DISHWASHER
GARBAGE DISPOSAL
MICROWAVE
CLOTHES WASHER
DRYER
RANGE
WATER HEATER
OVEN
FREEZER
TRASH COMPACTOR
GARAGE DOOR MOTOR
JACUZZI
JACUZZI BOOSTER HTR.
IRONING BOARD
POOL EQUIPMENT
SPRINKLER PUMP
LANDSCAPE LIGHTS
STEAM SHOWER
A/C WALL UNIT
SPARE CAPACITY
SPARE CAPACITY
K.W.
/4 K.W.
3. K.W.
�• K.W.
K.W.
K.W.
K.W.
5-40 c K.W.
•® K.W.
_$ K.W.
K.W.
1S K.W.
K.W.
K.W.
K.W.
�--' K.W.
K.W.
• K.W.
• K.W.
• K.W.
K.
r
K.W.
• K.W.
K.W.
&-'C // 94
TOTAL CONNECTED LOAD 1/`7, / K. it
FIRST 10 K.W. @ 100% I/% /0 10.0 K. .
REST @ 40 %. 37,10 /t,/,P./K.W.
A/C @ 65% / MEAT @ 100% /(>it'ek) • /D, 6 K.W.
TOTAL DEMAND LOAD�.i]V
301VO __ K.W. / 240 VOLT = / '/5 AMPS
MARY PAT BRIGGS
MY COMMISSION # DD 979287
EXPIRES: May 11, 2014
Rmdad Thru Notary Public Underwriters
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