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DS-10-132807/30/2010 10:01 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Ii 001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 0352 RECIPIENT ADDRESS 93055538447 DESTINATION ID ST. TIME 07/30 09:59 TIME USE 01'45 PAGES SENT 2 RESULT OK Permit No: 10 - /j2& Job Name 7,0 7? , 2010 Miami Shores Viiiage Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page1 oft 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132050180400 Owner's Name: CLAUDIO GONZALEZ Job Address: 1178 98 Street Miami Shores, FL 33138 -2508 Owner's Phone: Total Square Feet: Total Job Valuation: 64 $ 800.00 Contractor(s) BEST CONSTRUCTION CORP Phone (786)423 -4663 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 8/5/2010 : Yes Comments: ZONING CODE REQUIRES THAT ALL ABOVE GROUND STRUCTURES WHICH WOULD INCLUDE ABOVE GROUND TANKS AND ASSOCIATED SLAB /FOUNDATION, MUST BE LOCATED NOT LESS THAN 10 FEET FROM SIDE LOT LINE. 8/5/10 MAKE SURE ANY SLAB ASSOCIATEDWITH THE TANK OR GENERATOR IS LOCTED NOT LESS THAN 10 FEET TO SIDE LOT LINE AND NOT LESS THAN 5 FEET TO REAR LOT LINE. SLAB /FOUNDATION LOCATION IS NOT IDENTIFIED ON THE PLAN FOR TANK 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132050180400 Owner's Name: CLAUDIO GONZALEZ Job Address: 1178 98 Street Miami Shores, FL 33138 -2508 Owner's Phone: Total Square Feet: Total Job Valuation: 64 $ 800.00 Contractor(s) BEST CONSTRUCTION CORP Phone Primary Contractor (786)423 -4663 Yes Planning and Zoning Criteria and Comments Approved'IJ0 Date Approved: " -As,A Comments: ZONING CODE REQUIRES THAT ALL ABOVE GROUND STRUCTURES WHICH WOULD INCLUDE ABOVE GROUND TANKSAND ASSOCIATED SLAB /FOUNDATION, MUST BE LOCATED NOT LESS THAN 10 FEET FROM SIDE LOT LINE. SLAB /FOUNDATION LOCATION OR PLAN FOR TANK NOT PROVIDED Permit No: 10- tee)(1- Job Name 77;3 , 2010 Miami Shores Viiiage Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Ao*C•l /h %n i 4 k / A Ater f Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 149017 Permit Number: DS -7 -10 -1328 Scheduled Inspection Date: August 30, 2010 Inspector: Bruhn, Norman Owner: GONZALEZ, CLAUDIO Job Address: 1178 NE 98 Street Miami Shores, FL 33138 -2508 Project: <NONE> Contractor: BEST CONSTRUCTION CORP Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050180400 Phone: (786)423 -4663 Building Department Comments SLAB 74" X 42" X6" FOR GENERATOR Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 27, 2010 For Inspections please call: (305)762 -4949 Page 16 of 34 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1178 NE 98 Street Miami Shores, FL 33138 -2508 1132050180400 Block: Lot: CLAUDIO GONZALEZ Owner Information Address Phone Cell CLAUDIO GONZALEZ 1178 NE 98 Street MIAMI SHORES FL 33138 -2508 1 Contractor(s) Phone Cell Phone BEST CONSTRUCTION CORP (786)423 -4663 Valuation: Total Sq Feet: $ 800.00 64 1 Approved: Yes Comments: ZONING CODE REQUIRES THAT ALL ABOVE GROUND STRUCTURES WHICH WOULD INCLUDE Date Approved: 8/5/2010 : Yes Date Denied: 7/21/2010 Type of Work: SLAB FOR GENERATOR Additional Info: GENERATOR Bond Retum : Scanning: 3 Classification: Residential Fees Due CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $9.00 $0.80 $110.60 Pay Date Pay Type Invoice # DS -7 -10 -38485 07/20/2010 Credit Card 08/10/2010 Credit Card Amt Paid Amt Due $ 50.00 $ 60.60 $ 60.60 $ 0.00 Available Inspections: Inspection Type: Final Sidewalk Landscaping Foundation 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 10, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 10, 2010 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY: Permit No.1) 510 1 328 Master Permit No. BUILDING PERMIT APPLICATION FBC 2004 aRRY31) Permit Type (circle): Building Roofing Owner's Name (Fee Simple Taiittleholder) 0 h lJ.Ni2 4,�24 L e 2- Phone # k' ) 513 - 8 5 Owner's Address Jld City 4/1-' � State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) 1/9 A e- 9'J 7 EE City Miatni Shores Village County Miami -Dade Zip 0 - / -e FOLIO / PARCEL # - i/ 5P -P a P /Pe2 &) Is Building Historically Designated YES NO (al A '3(-r)---22.--7 112Z2_ Contractor's Company Name / C a,4-S e' 'L 7 i' L , Phone # (?6) 23 T7i -R Contractor's Address ? ye S a., V/ 74,,,-----, City �l a/�� i /State F/ Zip 33 / 5 c Qualifier Name r� 4p,--7- .51 /"/e® ic4,7 Phone # (' J 6) y23-766 6 State Certificate or Registration No. C6'6717,33 9 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ . co Square / Linear Footage Of Work: >K 6 Type of Work: ❑Addition ❑Alteration "New • Describe Work: . -7 1 x 40 0 _xCo cr ❑ Repair/Replace ❑ Demolition ******** * * * **** ** * ** * * ** * ** ****** **** ** Fees************* ** * * * * ** ** ** * ***** * *** * * *** * *** Submittal Fee $ 53 • CD CCF $ CO /CC Permit Fee $ Notary $ graining/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -, DPBR $ Zoning $ 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, BOIT.ERS, 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 issue= . ' absence of such posted notice, the inspection will not be approved and a reinspection fq will be charged. - Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 /_ L'_LA072i 0 ®1U1 CE?, day of who is p rson known to me or who has produced Fa_, ) who is 1 _i C U 6 As identification and who did take an oath. NOTARY PUBLIC Signature The foregoi Contractor g instrument was acknowledged before me this , 20 /e) , by OrYlePi 11J '2 known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC -STATE OF-FLORIDA NOTARY PUBLIC: Hilda Menendez : Commission #D1812333 Expires: SEP. 27, 2012 Sig Print: My Commission ExpiretoNniauTtu ATLANTIC BONDING 00," *************************** ** ** ***** * ** ***** * ** * * ** ***** ** Hilda Menendez ,. Commission #DD812333 o Expires: SEP, 2702012 APPLICATION APPROVED BY: (Revised 07/10/07) Si Print: My Commission Expires: ****************** * * * * * * * * * * * * * ** * * * * * * * * * * * * * * ** •'•• u c INGC IN O.C. Plans Examiner Engineer Zoning Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #:'1 - a DATE: (r2., I 10 1, C pr q Ac-wt kc- - Contractor ❑ Owner ❑ Architect 7R4164--- C Picked up 2 sets of plans and (other) C i C Address: I 111 1 c8 Ls1 From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: e5A--\. NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 1 2-13 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: TAX FOLIO NO. t l - 324 01 c' - THE UNDERSIGNED hereby gives notice that improvemvitlitt 1 property, and in accordance with Chapter 713, Florida Stafi is provided in this Notice of Commencement. anginal Nod In thl a on 111111111111111111111111111111111111111111111 CF14 201080521261 OR £k 27374 Ps 244001 tips} RECORDED 08/03/2010 13:51:41 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE WITNESS my HARVEY RUVIN Ct. 1. Legal description of property and street/address: // fl(g (re above reserved for use of recording office 2. Description of improvement: "'s7»1,4'- 1, % >t� s IWO O8, 416 .�.. 3. Owner(s) name and address: J /aa /b CgU 24/B - '/ Y ' e 1143 .44. t 1 .544°4425 f Interest in property: 0 GL' Name and address of fee simple titleholder: 4. Contractor's name, address and phon numbers --` 3 2, S— c5%l) . -S/1 �C�.� . Ai j f 316 5 1 ,r) 227 '22Z 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A. NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signatu s) of Owner(s) or Owner(s)' Authorized OFFcer /Director /Partn /Manager �' By , . : By WA kr . �h G Print Name p4n+ ie eZZ ��LO °u I r dl.(t �4 -l(,t ��Jl Title /Office ` Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The foregoing instrument wascknowledged before me this vZ.. /day of . r% d Individually, or ❑ as ❑ Personally known, or ® produced the following type of identification: NOTARY PUBLIC.STATE OF ture of Notary Public: Hilda Menend � print Name: Commission #DD812333 • „„.,•�' Expires: SEE 27, 2012 (SEAL) VERIFIC I Miff1'1ON 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer /Director /Partner/Manager who signed above: By By aco o, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYY) 07/14/10 PRODUCER ^ Frankfm Insurance Group 8672 SW 72 Street Miami, FL 33143 Phone (305)630 -3923 Fax (305)675-5964 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 9 INSURED Best Construction Corp 8240 SW 41 Terrace MIAMI, FL 33155- INSURER k ACCIDENT INSURANCE COMPANY INSURER B: INSURER C: INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LIS i t1.) HAVE BEEN ISSUED TO THE INSURED ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NAMED ABOVE FOR WITH RESPECT IS SUBJECT TO THE POLICY PERIOD INDICATED. NOTWITHSTANDING TO WHICH THIS CERTIFICATE MAY BE ISSUED OF ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH Lift INSRD OF INSURANCE POUCY NUMBER POLICY DATE LIMITS (MIND A ll GENERAL UABIUTY n COAMMERCIAL GENERAL uABILITY A90068 041141 2010 04/14/2011 EACH OCCURRENCE 1,000,000.00 DAMAGE TO RENTED PREMISES Ma ocxaurence) 100,000.00 MED DIP (Any one Penn) 5,000.00 ❑ n CLAIMS MADE • OCCUR n BI/PD DED 1000 PERSONAL & ADV INJURY 1,000,000.00 • GENERAL AGGREGATE 2,000,000.00 GENT. AGGREGATE UMIT APPLIES PER: • POUCY ❑ PROJECT • LOC PRODUCTS - COMPIOP AGG 1,000,000.00 AUTOMOBILE LIAOUTY COMBINED SINGLE UMff (Ea =Meld) • ANY AUTO • ALL OWNED AUTOS BODILY INJURY (Per Person) • II SCHEDULED AUTOS • HIRED AUTOS BODILY INJURY (Per accident) • NON OWNED AUTOS • PROPERTY c DAMAGE III II GARAGE LIABILITY II ANY AUTO • AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG • EXCESS / UMBRELLA LIABILITY • OCCUR ❑ CLAIMS MADE • DEDUCTIBLE EACH OCCURRENCE AGGREGATE II RETENTION $ WORKERS COMPENSATION AND EMPLOYERS UAWI I1Y YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory In NH) IhrEatesa1130 under VISIONS t WC 0 p A TORY U ER EL EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E L DISEASE - POUCY uMrr OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS GENERAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION MIAMI SHORE VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES FL 33138 . 1(305)795-2204 (305) 756-8972 FAX SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR ID MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL WPM NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE MATTEL WONG ACORD 25 (2008/01) OF ®1988-2009 ACORD CORPORATION. AU rights reserved. The ACORD name and logo are registered marks of ACORD BATCH NUMB- ? SEE OTHER SIDE DO NOT FORWARD BEST CONSTRUCTION CORP ROBERT S MEDINA PRES 8240 SW 41 TERR MIAMI FL 33155 06 -02 -2009 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATiON LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 06/0212009 EXPIRATION DATE: 06/02/2011 PERSON: MEDINA ROBERT S FEIN: 352184694 BUSINESS NAME AND ADDRESS: BEST CONSTRUCTION CORP 8240 SW 41 TERRACE MIAMI FL 33155 SCOPES OF BUSINESS OR TRADE: 1— CERTIFIED PLUMBING CONTRACTOR 3— CERTIFIED GENERAL CONTRACTOR 2— CERTIFIED ROOFING CONTRACTOR IMPORTANT: Pursuant to Chapter 440. 05(141 F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05412), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. *QUESTIONS? (850) 413-1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 1 1 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1178 NE 98 Street Miami Shores, FL 33138 -2508 1132050180400 Block: Lot: CLAUDIO GONZALEZ Owner Information Address Phone CeII CLAUDIO GONZALEZ 1178 NE 98 Street MIAMI SHORES FL 33138 -2508 Contractor(s) CAYAMAS ELECTRIC CORP Phone (305)227 -4222 CeII Phone Valuation: $ 19,000.00 Total Sq Feet: 64 1 Type of Work: GENERATOR & ATS INSTALLATION Additional Info: GENERATOR Classification: Residential Scanning: 1 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $11.40 $3.80 $665.00 $3.00 $15.20 $698.40 Pay Date Pay Type Invoice # EL -7 -10 -38486 07/20/2010 Credit Card 08/10/2010 Credit Card Amt Paid Amt Due $ 50.00 $ 648.40 $ 648.40 $ 0.00 Available Inspections: Inspection Type: Final 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 10, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 10, 2010 1 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 No. FROMMT OIL 0 ?NU E Lt O -132- Master Permit No. 10 -' 1323 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) �.4 /9i"D2i) ®,'2i9L Phone # Owner's Address //c 4 . ;:e City /41/4 "/ 5 71 /b 5 State L Tenant/Lessee Name E- MAIL C3 51 to f g5 zip 5- /3Q Phone # Job Address (where the work is being done) City Miami Shores Village County FOLIO / PARCEL # //.F .®6 ®/ te,lit V Miami -Dade Zip 3 /3 Is Building Historically Designated YES NO Contractor's Company Name 2%V4, ,15 Phone # Contractor's Address ems° g 0. City ," , / State Zip�°�3 Qualifier Name ‘777/94)//,;/( /e 1/4(E,05/02)&- Phone # 3D5-49,P 9- State Certificate or Registration No. �G! E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: Describe Work: Certificate of Competency No. I7t Oa) ) Phone # Square / Linear Footage Of Work: X c( ❑Addition DAlteration ['New ❑ Repair /Replace 6,Ekreeirin2_ .1-1c45- 7746449-77 0/Q ❑ Demolition ******* ** ************* ********* * * *** ** ** Fees************ **************************** *** * Submittal Fee �J�-' Permit Fee $ / . pJ r 0 0 CCF $ CO /CC Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ (QL j 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. 1 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. 1 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 EN 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 iss d In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged 1..:..41:i Signature Owner or Agent Contract _ The fore oing instrument was acknowledged before me this ,.,,V The forego g instrument was acknowledged before m= this L3 day of ✓ , 20 /P, by obi 0 4®I`1Z01- 2 day of � ' , 20/1', by Jmcpvlat..l ie. who y - {verso illy known to me or who has produced ja S. who is perso ` ally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: 6 - 2.}-0- - ero U CC'AuSG Sign: Print: PUB Hilda Menende Commission #DD812333 My Commission Expires ,,; to Expires: SEP. 27, 2012 km Tan ATLANTIC BONDING CA,D4 a' esY ****of****x*****a:***icxxxx* aYxwxx* Icac*Ic x9e* xxxxxxxxx* x*& *nY3:** wavxxxxx &xxx**acxxxxic**************** ********** *** NOTARY PUBLIC • NOTARY PUBLIC -STATE OF FLORIDA "" Hilda Menendez Commission #Db812333 Expires: S P. 27, 20y�1�2 Y.4 A.1 'INGco,rxCn Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02 /08/06) Plans Examiner Engineer Zoning 040363 -4 SLIMNESS N C l 8Z25 SW 41 UNIN AYAMAS ELE( THIS IS NOT A BILL -DO NOT PAY RENEWAL RECEIPT NO. 040363-4 STATE# EC0000507 FIRST -CLASS U:S POSTAGE. PAW MIAMI, FL _ PERMIT NOS DO NOT FORWARD CAYAMAS ELECTRIC CORP JOAQUIN MENENDEZ PRES 8225 SW 41 TERR MIAMI FL 33155 1111 i11f 111 1131131313311111119}I111+.11t1h 11/d1111111l16i1J. BATCH NUMBER SEE OTHER SIDE DO NOT FORWARD CAYAMAS ELECTRIC CORP JOAQUIN MENENDEZ PRES 8225 SW 41 TERR MIAMI FL 33155 tatltaatfiaathJDl hlhJtt�ta ;ttfa�tltt�tta ttt�a�t }t{ rt {a! FROM : III TECH INSURANCE FAX NO. :305 675 3173 Jul. 20 2010 09:08AM P1 ACORD CERTIFICATE OF LIABILITY INSURANCE 1 DATE 02010 Y ) THIS CERTIFICATE 15 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 SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(&), AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER, ' IMPORTANT: If Me certicate holder fa an ADMIONXCINSURED. the polky(ies) must be endoro00. 1$ SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement On this certificate dose not confer lights to the certificate holder In 06u of such ondonunner (81. PR0OVcrat HI -Tech Insurance Agency, Inc. P.O. I3ox 441748 Mlaml. FL 33144 ocaf cr AVM 4 a.Bie; 906225 -sa11 1 Fwc.„ibx 6753173 EAAIL ADDRESS, ID 0: INSuBERISIAPRIRDINO OOMERA0E NAIC8 smarm Cayamas Electric Corp 8228 S. W. 41 Ter MIaml. F133155 INSBRERA: Atlantic Casualty Insurance Co Gn OCCUR sisuRERa : F U B A d INSURER C: INSURER LW : 0912312010 INSURER a : $1,OOQA00. mums' F: ( c Sin, ,) REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS• • RIM 'TYPE OP INSURANCE AWL =LAW SUBR PCLN:YNUMBER (NNIDONVYYJ IMMIDONYYYYY LM A GENERAL E LABILITY COMMERCIAL GENERA.LJA&LJTY Gn OCCUR C] d L136006111 09123/2009 0912312010 EACH OCCURRENCE $1,OOQA00. ( c Sin, ,) 8100,000 III r II CWNLR•MADE MID EIIP (AN ace mum) $ 5,000 PERSONAL8 ADM INJURY S 1,000,000 III GENERALARGREGATE 8 2,000,000 C EN L AGDRE TE��UUJT APPLIES PERK l POUCYf ,ACT I'1 LOC PRODUCTS • COMPCPAGG t 1,000,000 S I AUTOMOBILE ti aa„ I _ ,tee mo e la LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HItEDAUTOS NON-OWNED AUTOS Eit3 COMBINED SINGLE LIMIT (Eaaadident) 8 . BODILY INJURY (Per meleos) S BODILY INJURY (Pet deckled) 8 PROPERTY DAMAGE .1Pwa�aMud) $ $ $ .rr. UMBRELA L IAB , WASS NAG OCCUR CLAUas•MADE E, a «-I EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ 8 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWENECUTIVE I-'-') OFFICERMEMBER EXCLUDED? i plNyaegBpNmlylaNIB AADESC OPERATIONS be10 N/A 0 10643891 04f0112010 01101/2011 iiIW F76.3 E.L. EACH ACCIDENT $ 100,000 EL. DISEASE - fAEMPLOYEE $ 100,000 EL OISPAMP • POLICY UNIT $ 500,00 DESCIEPn0NOF OPERATIONS 1 LOCATIONS IVNMCLEB WW1 ACORD NIL Additional Remarks Sekedukk. Neese space Is resulted) Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF The ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE IRE OPIUM DATE THEREOF, Nonce WILL BE DEUVERED Di AccoRDANC=WITH THE POLICY PROVISIOII$- AUTHOR= a' ATTVE 411N/4 / ACORD 25 (2009100) 0198134009 ACORD C01 1'QRATION. All Melds reserved The ACORD name and Togo are registered mama of ACORD tt�� Android =lug POTPIE BaoWabardiwlal .wwal,F it4lmdPmmoNau .PIi5IIsldngs$os3BAw Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 32'6 Inspection Number: INSP- 149018 Permit Number: EL -7 -10 -1329 Scheduled Inspection Date: August 18, 2010 Inspector: Devaney, Michael Owner: GONZALEZ, CLAUDIO Job Address: 1178 NE 98 Street Miami Shores, FL 33138 -2508 Project <NONE> Contractor: CAYAMAS ELECTRIC CORP Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Generator Phone Number Parcel Number 1132050180400 Phone: (305)227 -4222 Building Department Comments GENERATOR & ATS INSTALLATION Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 17, 2010 For Inspections please call: (305)762 -4949 Page 6 of 14 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1178 NE 98 Street Miami Shores, FL 33138 -2508 1132050180400 Block: Lot: CLAUDIO GONZALEZ 1 Owner Information Address Phone Cell CLAUDIO GONZALEZ 1178 NE 98 Street MIAMI SHORES FL 33138 -2508 Contractor(s) Phone Cell Phone RODLAND ENTERPRISES INC (786)462 -5447 (786)251 -8723 Valuation: Total Sq Feet: $ 4,000.00 0 1 Type of Work: PLUMBING Type of Piping: GAS LINE Additional Info: GENERATOR Bond Retum : Classification: Residential Scanning: 1 Fees Due CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $0.80 $150.00 $3.00 $3.20 $159.40 Pay Date Pay Type Invoice # PL -7 -10 -38524 07/28/2010 Credit Card 08/16/2010 Check #: 1125 Amt Paid Amt Due $ 50.00 $ 109.40 $ 109.40 $ 0.00 Available Inspections: Inspection Type: Final Press Test ROW 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 16, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 16, 2010 1 Miami Shores Village Building Department AUG 12 zoo BY: 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. Al tO ^ 1 PERMIT APPLICATION Master Permit NoiT 10~ 2- FBC 20 Permit Type: PLUMBING r OWNER: Name (Fee Simple Titleholder): g 1 1/t2 6 )f `(' Phone #: Address: 1 j 71 /v6 eieSfr" City: 111 10 1 S#1 I State: R.— Tenant/Lessee Name: Phone #: Email: Zip: 33/ y6" JOB ADDRESS: /17 45? /V (.; ! 6 St- City: Miami Shores County: Miami Dade Zip: 9 ;% e Folio/Parcel #: Is the Building Historically Designated: Yes () Flood Zone: CONTRACTOR: Company Name: R6V1 AP PM-Vitas rokic. Phone #: 44(0 — 4Z-44 Address: ri Z G l) S [a) 2' 5-1 p� City: W))!'t`I Y M 1� ` state: f L' zip: 3 (T 3 Qualifier Name: �J v LA ° A QoD 1�A E viz Phone #: 1 `, 6 Z5l 13 c72-3 State Certification or Registration #: CSC. Ic.tz 8 13 Certificate of Competency #: Contact Phone #: '-1-`� (n ' 2-5i-61-1-3 Email Address: R' OM® 2.000E. RUC , NM DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ oo Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration New ❑Repair/Replace ❑Demolition De cription of Work: f A 3 kl (, “ 0 yktio 1) fleet 6€41.e afri-trz- ******** * * * * * * *** * ** ** * * *** ****** * * **** Fees************* * * ** ** * ****** ** * * * ***** ** ** * *** Submittal Fee $ Permit Fee $ /re") 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 ngt f e approved and a einspecti n fee will be charged. ill; Signature Signature WV Owner r Agent f Contractor The foregoing instrument was acknowledged before me this The fore oing ins ment was acknowledged before me this day ofd / who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: day of 20 t 0, by , who is personally known to me or who has produced ,2d , by Sign: Print: My Co ****** ****+k*:k *****:k****** * ** *****-y' *************** ******* ********* * ************** k*********** ******** **** APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk m) "Plumbing contractor" means a contractor whose contracting business consists of the execution of contracts requiring the experience, financial means, knowledge, and skill to install, maintain, repair, alter, extend, or, when not prohibited by law, design plumbing. A plumbing contractor may install, maintain, repair, alter, extend, or, when not prohibited by law, design the following without obtaining any additional local regulatory license, certificate, or registration: sanitary drainage or storm drainage facilities; venting systems; public or private water supply systems; septic tanks; drainage and supply wells; swimming pool piping; irrigation systems; or solar heating water systems and all appurtenances, apparatus, or equipment used in connection therewith, including boilers and pressure process piping and including the installation of water, natural gas, liquefied petroleum gas and related venting, and storm and sanitary sewer lines; and water and sewer plants and substations. The scope of work of the plumbing contractor also includes the design, when not prohibited by law, and installation, maintenance, repair, alteration, or extension of air - piping, vacuum line piping, oxygen line piping, nitrous oxide piping, and all related medical gas systems; fire line standpipes and fire sprinklers to the extent authorized by law; ink and chemical lines; fuel oil and gasoline piping and tank and pump installation, except bulk storage plants; and pneumatic control piping systems, all in such a manner as to comply with all plans, specifications, codes, laws, and regulations applicable. The scope of work of the plumbing contractor shall apply to private property and public property, shall include any excavation work incidental thereto, and shall include the work of the specialty plumbing contractor. Such contractor shall subcontract, with a qualified contractor in the field concerned, all other work incidental to the work but which is specified herein as being the work of a trade other than that of a plumbing contractor. Nothing in this definition shall be construed to limit the scope of work of any specialty contractor certified pursuant to s. 489.113(6). Nothing in this definition shall be construed to require certification or registration under this part of any authorized employee of a public natural gas utility or of a private natural gas utility regulated by the Public Service Commission when disconnecting and reconnecting water lines in the servicing or replacement of an existing water heater. 08/10/2010 15:10 3052220552 RODLAND PLUMBING PAGE 01/04 asmgman*.,,■•■•■.n 71•■••••■■1 co_80. CERTIFICATE OF LIABILITY INSURANCE 00 02 DA7m__ILL__amgYro) DMA 'mammal Insurance Agency _Arai Medina 2370 E 8 Ame Hialeah FL 33013 Phone:305-693-00 3 Fax:305-691-4381 iRtsmttes, Inc, Miami FL g3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHT8 UPON THE CERTIFICATE HOLDER. THIS CERTiplcATE DOES NOT AMEND, EXTOND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES Snow, INSURERS AFFORDING COVERAGE MEURER A'. American Vehicle Xns. Co. INSURER Il; INSURER D• MAP „. iNSURER E, NAIC * ms MUM'S OF INSLIPANOE USTED %LOW NAVE BEEN !num TO THE INSURED NAmeo ABOVE FOR THE POLICY PERIOD INDICATED NDTwrTNISTANDINO AN REDUIREMENT, TERM Oi coNcrroN CF ANY CONTRACT OR OTHER DOCUMENT WITH KW:MOT TO WHICH THIS CERT RIDATE MAY SE iSSUED OR MAY PERTAIN, Tma INSURANCE, AFFORDED SY THE POLICIES, Di9CRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCIJOONS AND CONDITIONS OF SUCH POLICIES. AODEEDWE LIMITS SHOWN MAY HAVE BEEN REDLIGIi0 BY tTAI D CLAIMS. ry .ofpa p4c NUMEER ; GENERAL, LIABILITY X COMMERCIAL OSNERALLIARUTv M-0506000049-00 J CLAMS MADE 13WOOCAIR L ASomKre LIMIT APPLES PER PoLIOY PRa Lo. AUTOMMLA LIABIUTY ANY AUTO ALL OWNED ALrOS SCHEDULED AUTOS j HIRED AUTOS NON.OWNED AUTOS GARAGE MAMMY AW AUTO ExcESEAMBRELLA LIABILITY =OR r-1 CLAIMS MADE olopCTIELE RETENTION s —BRAME coheseKnots AND EMPLoYEREf LiIMALITY ANY PROPS ETOR/PARTNER/EXEGITTIVE WIWI/AMMER ExCLUDISCr? 11.5, cl*PP:The unglor sPcLPM0VIi E Wow USE tlEiscRIPTI0N/110 tbck9a / DUCE- B1 EMU= General Contractor/ Plumbing Contractor. CERTIFICATE HOLOCR AC Miami Shores Village Eadg. Dept. 308-156-8972 10050 NE 2nd Ave Miami Shores El 33138 025(2001 LIMITS EACH OCCURREN 1,000 000 3100000 MED PEP (Any ono pkirfarl q 5,000 $1,000,000 PERSONAL S APV INJURY GENERAL AOCRESATE $ 2 , 0 0/3_,L 00 0 0 2 , 000 000 PAX:IOC:TB - C,OBAP/OP AOG cool NR) SINGLE LINT $ (Ea =Went) 0ILY {05nD INJURY pripILY INUnrY --- PROPERTY MAACK oPer =MAK; -,-------;-..—..-------..---7 Auto oNix • EA AccIDENT $ THAN EA ACO $ arm AUTO ONLY: AGE -....— EACH ODOLEIRENDE $ AGGIRECIATE 0' _______ 0 II• • TO' LIM S ER E.L, EACH Accr NT ., s eL DISEASE . EA EMPLOYEE 0 E L. b!SEASE - POLICY LIMIT CANCEL. VON wino ANY OF THE ABOVE DESCRIBED POLICIE S RE CANCELLED BEFORE TM EXPIRATION OATS 7t40, ¶IE MUM MEURER YELL ENDEAVOR TO MAIL 30 DAY E WRITTEN Nolen TO TME. OEFTTipleATE HOLDER NAMED TO NE LEFT, BUT FAILURE TO M SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY IMO UPON THE INBURER,113 AGENTS OR REPRESENTAIWEs. —A-X-T5FTMEATIvE axa at■■••■■• ACORD CORPORATION 1955 08/10/2010 15:10 3002220552 RODLAND PLUMBING PAGE 03/04 STATE OF FLORID,. DEPARTMENT Ox' BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING HOARD (850) 487 -1395 940 NORTE MONROE STREET TALLAHASSEE FL 32399 -0783 RODRDE O RODLAND ENTERPRISES 6968 NW 43TH ST $AY #2 MIAMI FL 93156 Congratulations! With this license you become one of the nearly one million FI0rtdlans licensed by the !Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht Drafters, from boxers to barbegue restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.mydorideitoenee.som. There you can find more Inhumation but our divisions and the regulations thel impact you, subscribe to department newsletters and learn more about the Depertment'e initiapves. Our mission at the Department is: License Effioiently, Regulate Fairly. We constantly strive to Serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations nn your new license! AC# 387293 DETACH HERE STATE OF FLORIDA "L'ARc EWAT f6N T 8ATRVER AMLHIRP NI", .AQ#L000724130828 F3ATC;H r' u\IBER'; 08:'.'. 31 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the pxovioione of ,Chapter 489 FS, Expiration date: AUG 31, 2010 R ©D It3UEZ r +JQLIO ARMANDO ROD ENTERPRISES INC • 6965 NW 43TH ST SAY # MIAMI FL 33166 CHIt.RLIE_ _CAIST CRUtrK I►1?AdC 08/10/2010 15:10 3052220552 RIJDLAND PLUMBING 11 -20 -2008 PAGE 02/04 ALE SINK STATE OF FLORIDA CHIEF IOtNANC1AL OFFICER DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO LIE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW of CONSTRUCTION INDUSTRY EXEMPTION This Certifies that the individual fisted below has eletittd to be exempt from Florida Workefs' Compensation law. EFFECTIVE DATE 11/20/2009 EXPIRATION DATE: 11/20/2010 PERSON: RODRIGUEZ FEIN: 850994890 BUSINESS NAME AND ADDRESS: ROfLAND ENTERPRISES INC 8505 NW 43RD ST MIAMI FL 83188 JULIO A SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUNBINC CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR iP O$TANT: PvtOt*al 10 Wpm: 440 • 05f141, F.1., ea 41114111 01 10erptttollo* w10 ele;+s; eaetapttoo Item t111* eb.Oter bp tiling a eerttliceta 01 11100,100 andet 1411 accii00 pay not /two! beoal11r 01 compinlatlaa 00101 11111 elosptnr. Putluant 10 Chaplet 440,05412i, r.5., Certilleelet DI flee1144 le be exempt,.. *0010 only MtI0*0 the **opt DI out boolietf or NOM Valet 0n the splice 04 electron 10 be eaempl. Frt30001 Io Chfplrl 410,C51121, 1.0., MOltees 04 elealten to be efelepr awl oert01040a 0l erection le ea mewl stall be sublets to revocation II, at *ay lima alttl or* ,fling 01 to HIRE 01 1.111 ,71.0/011 al rat Wiliam*, tea 04rf4e *me on 111* notice or Oarrificate OO bogus dealt Anti ro4alteate'lf of leis tertian 101 'sumo 01 f G*rtl■cott TR* ireertine41 0011 ISVe00 a cor1111a *le 01 say 1111* 104 1111011 01 lea P01100 eeniee tie t1F cortitiCN* 10 teeel Ills r,4alrfineplt of th14 fee }iOn. OWC-252 CERTIFICATE OF ELECTION TO 85 EXEMPT REVISED DE-DE QUESTIONS? 1650) 413 -1609 PLEASE CUT OUT THE CAIUI BELOW A•ND RETAIN FOR FUTURE REFERENCE STATE OF FLOWN DEPART ENT OF FINANCIAL SERVICES DNfS101t OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY OTO DE F CERTIFICATE CGMht3N9ATO N LAW ESEJYIP _ PROM FLORIDA WORKERS' EFFECrivE 11/20/2005 EXPIRATION DATti 11 /20 /2010 PERSON JULIO A RODRIGUEZ FEIN; 138t3f 90210 BUSINESS NAME AND ADDRESS, RONAN" 0NTE a+4ISES aiG es0b ew 4;110 01 MMMI, 1.t 77114 SCOPE OF 9USINESS OR TRADE; CEWtTIF100 PtUUeete COarru,CTOI* 0• C4RTriIEO aEttERn; tQNTRAC'TOR IMPORTANT F Pursuant to Chapter 44q.08114i, F,S„ On officer o1 a corporation who Q elects exemption from this chapter by filing a certificate of erection L undo* this section they not recover ganef PIS oT compenaetion under this D dopier, Pursuant to Chapter 440.05(12), P,S., 4 ertifleates of election to be H exempt... opply only within the scope of the business or trade Estee on the notice of election to be exempt E Pursuant to Cheater 440.051131, P,3., Notice! of election to be exempt end certificates cif election to he exempt shall be subject to revocation If, at any time after the thing of the hottoe or the iOSuance of the certificate, the person named an the notice or certificate no longer meets the reauiremehtS 01 MIS section for iosuence of a certifieate.e The department shell revoke a Certificate 41 any time for ietWre of the person named on the certificate to meet the requirements of this Section, QUESTIONS, 181101 411-1601 CUT HERE • Carry bottom portion • on the job, keep upper portion for your reoorde, DwC -752 CERTIFICATE Of ELECTION TO OE EXEMPT REVISED 09-06 OB/10/2010 15:10 3052220552 1 RODLAND PLUMBING PAGE 04/04 Iu •••••.. '•••' ,':••;,!'..°''••• • ''..•••••••••••••7:.:::•°,f.....i,i,„;,4`.1!.,$)!. • 4.4t4 ouram4 AL:CP.081%0E 000 MIKA. PERME010,201 -po Mgr PAY RottAL . • ' • s• : •f! Atittitittiti • .,0:9•6•64*".? • %TATO Ce4pIgg0,13 " • :UV.. • SEE OTHER WORKER/B 1 DO NOT FORWARD ROOLAND ENTERPRISES INC JULIO A RODRIBUEZ PRES 6965 NW 43 ST BAY •2 MIAMI FL 33166 ildkA.001m111,JkOnlit,(1,12te Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) t 2 , pu2.4e4L Phone # Owner's Address 1 f 8 /J q$ 6-07E67- gw au 74.10 Permit No.P 1 10 — 0,11 Master Permit NoL 10-1 City/ 04,4 S tfp'ZE State f TenantlLessee Name Email Job Address (where . work is b City Miami FOLIO / PARCEL # Is Buildi i � Historically ( &s-) 673 f &J -c Contractor's mpany N Contractor's Ad City Jt i aM Qualifier Name State Certificate or Registrat Contact Phone 7,6 ? S Architect/Engineer's Name (if applicable) Value of Wot'lc For this-Permit $ Type of Wox AeditiO � Phone # 505— 94 2 c.,44/ 10, ertiSS at o f Competency No. E -mail ff ctif:: d f j'eS e e'ii''-L 1lf,ik. Describe W Square / Linear Foc?Nage Of Work : ENew [); „Rcpair/Replace nye 6-4 Z,le-re-pgi 2 Demo option * * * * * *** * * ** ** * * * * ** * * * * ** * * * * ** Fees************* * * * * * ** * * * * * * * * * * * ** * * * * ** * * *x* Submittal Fee $ Permit Fee $ Notary $ Scanning $ Double Fee $ Training/Education Fee $ Radon $ Structural Review. $ CCF $ DPBR $ Violation date: CO /CC $ Technology Fee $ Bond $ 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 COMIVIENCEME1V 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 certifiei 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 rein ection fee will be charted. 9 Osyner or Agent / r v' Co actor The G7D� The foregoing instrument wali acknowledged before me this day of who i NOT b day of ft--11 , 201A, by who is Sign: did take an' oath. Print: Print: My Commission Expires: My ommission Expires: APPROVED BY Plans Examiner Zoning (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Clerk checked SEE OTHER SIDE DO NOT FORWARD RELIABLE INDUSTRIES INC RYAN TEJEDA PRES 5850 SW 63 CT MIAMI FL 33143 lf111 {1111111111111111 11111111111111 111111111 }111111111415171 .State of I6ric a ,:`' .. Bureau of LP Gas:InSpectiof. C .PT!F *ID *TF OF F (AMIMATION Rafael Tejeda 08 -03 LP Gas Installer A This qualifier identification card Is evidence that this person has pasacd a competency .examination administered by the State of Florida, c and may act to= QUALIFIER for an LP gas company licensed In the, category Chapter 427, •F.lorida Statutes. This card is NOT A LICENSE TO 00 BUSINESS IN THE STATE OF FLORIDA • CERT NO 25300 CHARLES H. BRONSON Expires: Oct 26, 2011 i COMMISSIONER OF AGRICULTURE 08 -03 } LP Gas Installer A, Scope of Work Installation, servicing, altering or modifying of apparatus, piping, tubing, tanks, and equipment for the use of liquefied petroleum or natural gas and selling or offering to sell, or leasing or offering to lease, aparatusY, appliances and equipment for the use of liquefied petroleum or natural gas. Florii :a Department of Agriculture and Consumer Services Bureau of Liquefied Petroleum Gas Inspection P.O. Box 6720 Tallahassee, Florida 32399 -6720 License Number: 2759 Business Mailing Addr RELIABLE INDUSTRIES INC 5850 SW 63RD CT SOUTH MIAMI, FL 33143 -2152 The liquefied petroleum ga address on the license. Ea roe jetted annually. Any au fee for restoration of a Tice resume operations. IN THE EVENT OF AN 0 transferred to any person, to the department by the o licensing requirements mu transfer, contact the Burea Pursuant to Chapter 527, F owner, or end user upon re installing LP Gas systems For future correspondence, and/or your licensed Iocatio s Licensed Location Address RELIABLE INDUSTRIES INC 5850 SW 63RD CT SOUTH MIAMI, FL 33143 -2152 license at the bottom of this form is valid ONLY for the company located at the h business location of a company must be licensed. All LP Gas licenses must be e allowed to expire shall become inoperative because of railure to renew. The e is equal to the original license fee and must be paid before the licensee may NERSHIP CHANGE AT THIS BUSINESS LOCATION: This license may be rm or corporation for the remainder of the current license year upon written request ginal license holder. License transfers must be approved by the department. All be met by the transferee and a transfer fee of $50 will apply. To apply for a of LP Gas Inspections at 850/921 -8001. orida Statutes, LP Gas licensees must present proof of licensure to any consumer, uest when engaged in the business of servicing, testing, repairing, maintaining or nd/or equipment. please make any needed corrections or changes to your business mailing address address and retum the UPPER PORTION with corrections to: Flori • a Department of Agriculture and Consumer Services Bureau of Liquefied Petroleum Gas Inspection P.O. Box 6720 Tallahassee, Florida 32399 -6720 POST LICENSE CONSPICUOUSLY Depart Liqu ANY CHANGE 0 This Ii Cut Here State of Florida ent of Agriculture and Consumer Services Division of Standards Bureau of Liquefied Petroleum Gas Inspection (850) 921 -8001 Tallahassee, Florida License Number: Expiration Date: Date of Issue: License Fee: Type and Class: fied Petroleum Gas License LP GAS INSTALLER GOOD FOR ONE LOCATION ONLY OWNERSHIP OR SALE OF THIS BUSINESS RENDERS THIS LICENSE INVALID nse is issued under authority of Section 527.02, Florida Statutes, to: RELI BLE INDUSTRIES INC 5850 - W 63RD CT SOU H MIAMI, FL 33143-2152 27590 August 31, 2010 September 10. 2009 $300.00 0803 HARLES H. BRONS COMMISSIONER OF AGRICULTURE STATE CONT WITH THIS IS TO CERTIF CONTRACTOR CERTIFI TRADE: L.P. GAS REGISTRATION EXPI HAVING MET THE RE REGISTERED AS A S 0004 LIQUID PETR WITH ALL WORK TO OF QUALIFYING AGE ALTERATION, REPRO RELIABLE INDUSTRI 5850 SW 63 CT MIAMI MIAMI -DADE COUNTY BUILDING CODE COMPLIANCE OFFICE 140 W. FLAGLER ST., SUITE 1602 MIAMI FL, 33130 (305) 375 -2527 CTOR'S CERTIFICATE OF VOLUNTARY REGISTRATION IAMI -DADE COUNTY ISSUED SEPTEMBER 14, 2009 THAT RELIABLE INDUSTRIES INC ATE NO.: LPG27590 TION DATE: 08/31/2010 ISTRATION REQUIREMENTS OF MIAMI -DADE COUNTY, IS TE CONTRACTOR IN THE FOLLOWING CATEGORY(S): GAS ST803 E DONE UNDER THE SUPERVISION, DIRECTION AND CONTROL T TEYEDA RAFAEL S.S.N. - - 191 UCTION OR TRANSFER OF THIS CERTIFICATE IS PROHIBITED. HERMINIO GONZALEZ, P.E. SECRETARY, CONSTRUCTION TRADES QUALIFYING BOARD S INC FL 33143 .4%<7'C"R1I7 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYY) 09/28/09 PRODUCER Acceptance Insurance Services 6887 S.W. 40th St. Mianii, FL 33155 Phone (305)740-0515 Fax (305)740 -0518 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 Reliable Industries, Inc. 5850 SW 63rd Ct South Miami, FL 33143- 1 (305) 068 -5343 INSURER A: NAUTILUS INSURANCE COMPANY INSURER B: BRIDGEFIELD CASUALTY INSURANCE CO INSURER C: INSURER 0: INSURER E: COVERAGES THE POUCIES OF INSURANCE USTED 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 OF MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LIR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMIDDY) POLICY EXPIRATION DATE (MM/DD/YYYY)_ LIMITS A GENERAL IJABILFTY i COMMERCIAL GENERAL LIABILITY 011 CLAIMS MADE U OCCUR ❑ BN999395 08/05/2009 08/05/2010 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100,000 MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: kJ POLICY [,._,J PROJECT Li LOC PRODUCTS - COMP/OP AGG 1,000,000 ❑ AUTOMOBILE LIABILITY ([f ANY AUTO ❑ ALL OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) II SCHEDULED AUTOS L HIRED AUTOS BODILY INJURY (Per accident) ■ NON OWNED AUTOS MI PROPERTY DAMAGE (Per accident) ❑ • GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG ❑ EXCESS 1 UMBRELLA LIABILITY • OCCUR ❑ CLAIMS MADE L 1 DEDUCTIBLE [l RETENTION $ EACH OCCURRENCE AGGREGATE B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YM ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below 0196 097720 08/05/2009 08!0512010 11:1 WC STATU {0 OTH- TORY LIMITS ER E.L. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT 100,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS GAS LINE INSTALLATION, SERVICE, REPAIR MACHINE EQUIPMENT. Request policy for complete detail of endorsements and exclusions. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE 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 10 DAYS WRITTEN NOTICE 10 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. AUTHORIZED REPRESENTATIVE 25 (2009!0 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 149403 Permit Number: PL -7 -10 -1359 Scheduled Inspection Date: August 25, 2010 Inspector: Hernandez, Rafael Owner: GONZALEZ, CLAUDIO Job Address: 1178 NE 98 Street Miami Shores, FL 33138 -2508 Project: <NONE> Contractor: RODLAND ENTERPRISES INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132050180400 Phone: (786)462 -5447 Building Department Comments GAS PERMIT FOR GENERATOR Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 24, 2010 For Inspections please call: (305)762 -4949 Page 12 of 26 S NCE 1934 NAME: C ,. 8Ut MAILING ADDRESS: 1 178 MIAMI PHYSICAL ADDRESS: CL AUDIO 1178 I'none 305-691411 Mallifl eriGge Jopane PO BOX 4702(7 ICI 1GONZ LEZ NE 98TH ST SHORES FL 33138 GONZALEZ NE 98TH ST or BUO -273 -13511 Address SERVICE ORDER INVr l 1V0. Miami, FL. 33247 b ... °:71,12.1 BILLING: INVOICE ACCT. NO.: HiN933 DATE: 11114/23/J1 ° SERVICE REQUESTED: PHONE: (786) 79.,7 -@ 99 ■ CASH SALE • CHARGE SALE • N/A DATE START g`l�I`i1 FI ',-ji CLI1L. 1 D I VIttK AND /PR SERVICES PERFORMED /S RATE AMOUNT ORM' D M�. j Y eS 0 ,�*, : 3 77) il) ,0 k I DA.M. ❑RM. DA.M. ❑RM. j' a ? e Ott-VC' TOTAL OUAN. PART NUMBER MATERIAL UNIT PRICE AMOUNT H iul Fi Vili rg a , 1 1- az I i_ns t al 1 e d for a TOTAL MATERIALS / Ch -Ac! REMARKS & 1 i n e 7 if Ok to -Fill cal 1 o 'F c gtin Do p h e c k TRIP CHARGE $25.00 TRANSPORTATION FUEL CHARGE CONTAINER ❑ASMCTANK • DOT CYL. METER HAZ MAT CHARGE MFR. DATE MFR. SERIAL NUMBER SIZE METER SERIAL NUU R MBER METER EADING DATE SEAL DATE LABOR :44 7 quo S � � °' -1 t 0 w.c. SALES TAX p w ❑ a. TOTAL PIPING PRESSURE TEST SYSTEM LEAK TES SAFETY CHECK Performed a Safety Gas �f Showed Customer how to _do, Appliance System Check al Yes • No turn off gas in an Emergency W Yes • No Clearly explained the operation of the Gas Appliance System Performed Odor Test and to the Customer ® Yes • No explained to Customer [Yes ❑ No Clearly explained service work Left the Consumer performed to the Customer EYes ❑ No Information Packet IZrYes ❑ No STAGE FIRST SECOND/INTEGRAL PRESSURE PSIG PSIG 0 IN. WC. El PSIG END 'PRESSURE PSIG PSIG 13 IN. ❑ ptinl v., C. START TIME O AM. p P.M. D A.M. 0 R.M. DAM' 0 •M. END TIME CI A.M. D P.M. DAM. D P.M. DA.M. D .M. REGULATOR OPERATION I CERT!FV HAVE BEE. x THAT ALL THE ABOVE TESTS N COMPLETED AS PRESCRIBED. I HEREBY ACKNOWLEDGE THAT THE ABOVE SERVICE WORK WAS PERFORMED MY SATISF AC11ON AND THE TERMS OF THIS AGRE r `ARE UNDERSTOOD AND ACCEPTED. e fk I f� f l ' , X e':: INTEGRAL TWIN STAGE DATE CODE MFR. MODEL FLOW Sat LOCK -UP PRFRRIIRF IN.WC. IN.W.C. TWO STAGE 1ST ,5",/, G , gg P 3 f:q 422444 • I 4I • PSIG p ,p °1 4 SIG 2ND 3 f V "" • S / .4 d'FC �. , IN. W.C. / . IN. W.C. SA SMAN /SERVICEMAN ` CUSTOMER'S SIGNATURE PAYMENT TERMS: NET 10 DAYS • DUE AND PAYABLE IN FULL 10 DAYS FROM DATE All new merchandise sold herein Is guaranteed to This order is subject to correction of errors in price and extens on.- OF DELIVERY AND /OR SERVICE. Failure to pay the full account balance within 30 days ' the extent of the manufacturer's warranty only. No from date of delivery and /or service shall result In a default and the assessment of a warranty of any kind LATE CHARGE and /or a RE -BIWNG CHARGE. specified In wfitii on used merchandise unless SEE BACK g herein. FOR IMPORTANT SAFETY AND BILLING INFORMATION IM!ORTANT SAF INFORMATION FOR PROPANE USERS PROPANE IS A COLORLESS, FLAMMABLE GAS THAT PROVIDES MANY SUPERIOR BENEFITS OVEI OTHER ENERGY FUELS. TO HELP INSURE THE SAFETY OF ALL PROPANE USERS, YOU SHOULD BE AWARE OF THE FOLLOWING: A distinct odorant has been added to help detect a gas leak, which can cause accidents such as fire and explosion. Mike sure you and your family, employees, etc. are familiar with this order. If anyone on your premises can ot smell the odor of propane, call us immediately. Propane is heavier than air and will collect at floor level. Carefully smell at floor level and in low spots to check for propane. Should anyone ever smell this odor, quickly open doors and windows, vacate the building and turn off the service valve at the tank. Call your gas supplier immediately from an off - premises telephone. Remain outside until the leak has been repaired. Some people limitations, oc gas detector i Property han propane appl trained. may not be able to smell the odorant in propane for various reasons, including medical' r fade, or masking by the presence of other strong odors. We suggest you install a propane your home or building if you suspect any of these conditions exist. led, propane is a safe, economical energy source. Do not permit anyone to service your nces or controls or make a delivery to your home or business that has not been properly Insure that yo don't run out of gas. If a gas valve has been left open, a line disconnected or any appliance moved, a leak can occur when the system is pressurized. Inform our trained personnel to relight all pilots in the event of a out -of -gas' situation. Every gas sys em should have a periodic check -up at least every other year for both safety and efficiency of operation. Co tact us and schedule a Safety GAS Check, which includes a carbon monoxide check, of your propane syste by a certified, trained technician. Carbon mono ide is colorless and odorless and if exposed to certain quantities, it can be harmful to your health or even fatal. Carbon monoxide and propane gas detectors are available from several suppliers and may provide a additional means of warning in identifying the presence of either of these gases. Payment Terms, Net 10 Days Due and payable in full 10 days from date of delivery and /or service Failure to pay the iull.account balance within 30 days from day of delivery and /or service shall result in a default and the assessor nt of a late charge and /or re- billing charge. The customer agrees to pay all invoices plus applicable taxes a the time of delivery or service work. In addition to tank rental and propane charges, we may charge our Gusto era various charges as applicable, including, without limitation, a Regulatory Compliance Charge, a Transportation Fuel Charge, "out of gas" service charge, tank disconnected or pickup charges, trip charge, meter chalge, labor charges, minimum use charges, re- billing and late charges. These charges may be changed by us frofrii time to time at our sole discretion, and may vary in different retail. locations. These charges may also vary in amount depending upon the volume of propane purchased, Customer classification, Customer location and owne hip of equipment. You may obtain a current schedule of our charges by contacting your local district .office. You gree to pay the rates and other charges in effect on the date that propane is delivered; or services are rende ed. Taxes: The customer agrees to pay all personal property taxes and other taxes, assess- ments or similar c rges that may be levied on any tanks or equipment while in the possession of the customer. Use of Tank: To p mote safety and to comply with regulatory codes; the customer will not allow anyone other . than the company to supply propane into any tank owned by the company which is leased or loaned to the customer. These t ms will be subject to the individual laws of the state from which they were entered into and those laws will su rsede any provisions of these terms that may run counter to those statutes. The company shall have no obli ation to supply, or continue to supply, any propane, tanks, equipment or services to any customer failing to ake timely payments in accordance with the payment terms or is otherwise in default of any . obligation to the ccrhpany. 11/15/09 PERMIT # 1 3 29 CONTRACTOR: , C I0,C IC' SUBMITTAL DATE: 36t,., 9-0( D ' ADDRESS: \ \ 1 B 018 NAME: RESUBMITAL DATES: PROJECT TYPE: ZONIN STRUCTURAL ELECTRICAL CT FEES PLUMBING 1 ME ICAL NOC BLDG QUIET$WJRCE® SERIES STANDBY GEREFIATO.p§ ie • • J. 22kW INCLUDES: • Generac Naturally Aspirated Gaseous Fueled 2.4L Engine • Two Line LCD Tri-lingual Digital Nexusrm Controller • Isochronous Electronic Governor • Closed Coolant Recovery System • Smart Battery Charger • UV/Ozone Resistant Hoses • ±1% Voltage Regulation • Natural Gas or LP Operation • UL 2200 Listed blia-,:opieKI-Errgine Generator Sets • • • • • Standby Power Rating Model 01022 (Gray) - 22 kW 60Hz c®u$ USTED QUIE Meets 2010 EPA Emission Regulations FEATURES cRuNE . 7' are key components of GENERAC'S success in "IMPROVING POWER BY DESIGN." But it doesn't stop there. Total commitment to component testing, reliability testing, environmental testing, destruction and life testing, plus testing to applicable CSA, NEMA, EGSA, and other standards, allows you to choose GENERAC POWER SYSTEMS with the confidence that these systems will provide superior performance. PROTOTYPE TESTED NEMA MG1-22 EVALUATION SYSTEM TORSIONAL TESTED MOTOR STARTING ABILITY SOLDERSTARE FREQUENCY COMPENSATED VOLTAGE 'REGULATION, This state-of-the-art power maximizing regulation system is standard on all Generac models. It provides optimized FAST RESPONSE to changing load conditions and MAXIMUM MOTOR STARTING CAPABILITY by electronically torque-matching the surge loads to the engine. An unequalled -±1% voltage regulation. SCEREE SOURCE SERMCE RESPONSE from Generac's extensive dealer network provides parts and service know-how for the entire unit, from the engine to the smallest electronic component. EF ENE:NERVED RUFEE,ENEEDE DEENEERENE Long life and reliability are synonymous with GENERAC POWER SYSTEMS. One reason for this confidence is that the GENERAC product line includes its own transfer systems and controls for total system compatibility. GENERAC® • • ••• • • • ••• •. •• • • • • • •• •• • • • • • • • • • • • • • • • • • • • ••• • • • Application & Engineering Data • • ••• • • • : • :• QT022 GENERATOR SPECIFICATIONS • ••• • . • . • • ENCIjVE PErCIFICM1014S TYPE Synchronous ROTOR INSULATION Class H STATOR INSULATION Class H TELEPHONE INTERFERENCE FACTOR (TIF) <50' ALTERNATOR OUTPUT LEADS 3 PHASE 4 wir® I BEARINGS Sealed Ball COUPLING Flexible Disc LOAD CAPACITY (STANDBY RATING) 22 kW EXCITATION SYSTEM Direct VOLTAGE REGULATION TYPE Electronic SENSING Single Phase REGULATION ± 1% GENERATOR FEATURES Revolving field heavy duty generator Directly connected to the engine Operating temperature rise 120 °C above a 40 °C ambient Insulation is Class H rated at 150 °C rise All models are fully prototyped tested ENCLOSURE FEATURES Aluminum weather protective enclosure Ensures protection against mother nature. Electrostatically applied textured epoxy paint for added durability. Enclosed critical grade muffler Quiet, critical grade muffler is mounted inside the unit to prevent injuries. Small, compact, attractive Makes for an easy, eye appealing installation. • • •• • • • • • Mt:(G. ••• •;• ..• Generac MODEL In line CYLINDERS • • • • • • 4 DI :PL�CEMEfMT • • • • 2.4 Liter B1 : : ;•• ••• 3.41 STROKE 3.94 COMPRESSION RATIO 8.5:1 INTAKE AIR SYSTEM Naturally Aspirated VALVE SEATS Hardened LIFTER TYPE Hydraulic GOVERNOR SPECIFICATIONS TYPE Gear Electronic FREQUENCY REGULATION CRANKCASE CAPACITY Isochronous STEADY STATE REGULATION 17.75 inches ± 0.25% ADJUSTMENTS FOR Speed Droop Yes Yes ENGINE LUBRICATION SYSTEM OIL PUMP Gear OIL FILTER Full flow spin -on cartridge CRANKCASE CAPACITY 4 Quarts ENGINE COOLING SYSTEM TYPE Closed WATER PUMP Belt driven FAN SPEED 1980 FAN DIAMETER 17.75 inches FAN MODE Pusher FUEL SYSTEM FUEL TYPE Natural gas, propane vapor CARBURETOR Down Draft SECONDARY FUEL REGULATOR Standard FUEL SHUT OFF SOLENOID Standard OPERATING FUEL PRESSURE 5" -14" H2O ELECTRICAL SYSTEM BATTERY CHARGE ALTERNATOR 12V 30 Amp STATIC BATTERY CHARGER 2 Amp RECOMMENDED BATTERY Group 26, 525CCA SYSTEM VOLTAGE 12 Volts Rating definitions - Standby: Applicable for supplying emergency power for the duration of the utility power outage. No overload capability is available for this rating. (All ratings in accordance with BS5514, IS03046 and DIN6271). (All ratings in accordance with BS5514, IS03046, IS08528, SAE J1349 and DIN6271). • • ... • • • .. • • • • • • • • • • • • • • en rac QuietSource® Series Standby' eheratorL 22 kW GENERAC® • ••• • OPEfl�1�TINl pA'rp : • • : : : • • • KW RATING (LP /NG) . �' 22/22 ENGINE SIZE • • • • • • .. 2.4 Liter Inline 4 • GENERATOR OUTPUT VOLTAGE/KW - 60Hz '. • • ;'; .. • - . . • My P CB Size 120/240V, 1- phase, 1.0 pf •• 120/208V, 3- phase, 0.8 pf 120/240V, 3- phase, 0.8 pf • • • . • . • • n • • 22 22 . "' • 92 76 66 100 80 80 ENGINE FUEL CONSUMPTION (Natural Gas) (Propane) Exercise cycle 25% of rated load 50% of rated load 75% of rated load 100% of rated load Natural Gas (ft3 /hr.) 42 100 190 255 316 (gal /hr.) 0.44 1.1 2.1 2.8 3.4 Propane cu fVhr 16 40 75 101 125 ENGINE COOLING Air flow (inlet air including alternator and combustion air) ft3 /min. System coolant capacity US gal. Heat rejection to coolant BTU /hr. Max. operating air temp. on radiator °C ( °F) Max. ambient temperature °C ( °F) 2,400 2.5 99,000 60 (150) 50 (140) COMBUSTION AIR REQUIREMENTS Flow at rated power 60 Hz cfm 68 SOUND EMISSIONS IN DBA Exercising at 7 meters Normal operation at 7 meters 61 70 EXHAUST Exhaust flow at rated output 60 Hz cfm Exhaust temp. at muffler outlet °F 165 900 ENGINE PARAMETERS Rated synchronous RPM 60 Hz 1800 POWER ADJUSTMENT FOR AMBIENT CONDITIONS Temperature Deration 3% for every 10 °C above - °C 1.65% for every 10 °F above - °F Altitude Deration 1% for every 100 m above - m 3% for every 1000 ft. above - ft. 25 77 183 600 RATING: All three phases units are rated at 0.8 power factor. All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable to varying loads for the duration of a power outage. There is no overload capability for this rating. Ratings are in accordance with ISO- 3046 -1. Design and specifications are subject to change without notice. KW rating is based on LPG Fuel and may derate with natural gas. • INTERCONNECTIONS • • .•. • • •.. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • •• • • ••••••• ••.• QT022 QT SERIES ENGINE GENERATOR CONNECTION PANEL 0 m E1 E2 1 aZO 194/15B :Z; f� �,� 23 :_: Y CZ CZ: COD m ■11 NOTE. MATCH WIRE NUMBERS TO TERMINAL NUMBERS ••• UTILITY SlrfiLY,f1101VP SERVICE DIS EONNECT GROUND NEUTRAL BLOCK NOTE: POWER LEADS AND TRANSFER SWITCH LEADS IQ BE RUN IN TWO DIFFERENT CONDUITS. EXCEPTIONS: IF THE INSULATION RATING ON ALL WIRING IS RATED FOR 600V ANQTHE LENGTH OF THE CONDUIT IS 305 OR LESS IT IS ACCEPTABLE TO INCLUDE GENERATOR CONTROL & POWER WIRING IN ONE CONDUIT NEXUS' CONTROL FEATURES • • • • • • • • • • • • • • • ••• •• • • • • • • • s • • • TIAIQSFER SWITCH • _0 • • . • . • •. • • • • • • • • • • • • • • ••. .• LLD N1 N2 GROUND LIQUID COOLED INSTALLATION I I I I I I I I CUSTOMER LOAD (DISTRIBUTION PANEL) 2 -Line Plain Text LCD Display Simple user interface for ease of operation Mode Switch -Auto Automatic Start on Utility failure. 7 day exerciser -Off Stops unit. Power is removed. Control and charger still operate. - Manual/Test (start) Start with starter control, unit stays on. If utility fails, transfer to load takes place. Programmable start delay between 10 -30 seconds Standard Engine Start Sequence Cyclic cranking: 16 sec. on, 7 rest (90 sec. maximum duration) Engine Warm -up 5 seconds Engine Cool -Down 1 minute Starter Lock -out Starter cannot re- engage until 5 sec. after engine has stopped. Smart Battery Charger Standard Automatic Voltage Regulation with Over and Under Voltage Protection Standard Automatic Low Oil Pressure Shutdown Standard Overspeed Shutdown Standard, 72Hz High Temperature Shutdown Standard Overcrank Protection Standard Safety Fused Standard Failure to Transfer Protection Standard Low Battery Protection Standard 50 Event Run Log Standard Future Set Capable Exerciser Standard Incorrect Wiring Protection Standard Internal Fault Protection Standard Common External Fault Capability Standard Governor Failure Protection Standard *Single and three phase connections may vary , refer to the owner's manual for specific connection information. m Z m 11 n m o 6 o CD 53 CI co 3 CD `< y 65 g 2 C n • A 5 N co N O S a (J] t co zE w g. m fv O 02 V CO CD • m 7 v co n 5' 6 c 0 BATTERY 12 VOLT GROUP 26 525 COLD CRANKING AMPS NOTES. 1) MINIMUM RECOMMENDED CONCRETE PAD SIZE! 1041 (41.0') WIDE X 1892 (74 1/2') LONG. REFERENCE INSTALLATION GUIDE SUPPLIED WITH UNIT FOR CONCRETE PAD GUIDELINES. 2) ALLOW SUFFICIENT ROOM ON ALL SIDES OF THE GENERATOR FOR MAINTENANCE AND SERVICING, THIS UNIT MUST BE INSTALLED IN ACCORDANCE WITH CURRENT APPLICABLE NFPA 37 AND NFPA 70 STANDARDS AS WELL AS ANY OTHER FEDERAL, STATE AND LOCAL CODES FOR MINIMUM DISTANCES FROM OTHER STRUCTURES. 3) CIRCUIT BREAKER INFORMATION. SEE SPECIFICATION SHEET WITHIN OWNERS MANUAL. 4) INSIDE STUB -UP AREA FOR AC LOAD LEAD CONDUIT CONNECTION, NEUTRAL CONNECTION, BATTERY CHARGER 120 VOLT AC (0.5 AMP MAX. ) CONNECTION, ACCESS TO TRANSFER SWITCH CONTROL WIRES, AND TRANSFER SWITCH CONNECTION (IF SO EQUIPPED). REMOVE FRONT COVER FOR ACCESS. 4A) ONE 1 -1/2' NEMA ELECTRICAL KNOCKOUT AND TWO 1/2' NEMA ELECTRICAL KNOCKOUTS PROVIDED FOR OUTSIDE AC LOAD CONDUIT CONNECTION, NEUTRAL CONNECTION, BATTERY CHARGER 120 VOLT AC (0.5 AMP MAX. ) CONNECTION, ACCESS TO TRANSFER SWITCH CONTROL WIRES, AND TRANSFER SWITCH CONNECTION (IF SO EQUIPPED). REMOVE FRONT COVER FOR ACCESS. 5) REFERENCE OWNERS MANUAL FOR LIFTING WARNINGS. 6) REMOVE LIFT -OFF ENCLOSURE TO ACCESS EXHAUST MUFFLER. AIR INLET LOUVERS 152.5 [6'] -+ MIN. 13.5 (17/32') DIA. MOUNTING HOLE (4> PLACES, 12.7 (1/2') DIA. MASONRY ANCHOR BOLTS RECOMMENDED REAR VIEW CONCRETE MOUNTING PAD SEE NOTE 1 WEIGHT DATA ENGINE/(V ENCLOSURE RATER,AL VEITM IGENSET ILLY) KG (LDS] WEIGHT (SHIPPING CARTON /SKID) KG MOST SHIPPING WEIGHT ( GEN3ET, SKID, ICARTDN) KG (LDS] 641/22KW ALUNINUI 383 (0431 30 [�] 113 (909] 641/2760 ALUMINA 105 (0911 431 (957] 152.5 r [6'] MIN. 100 [3 15/16'] TYP (MOUNTING HOLES) 228.6 [9'] C 1380 [54 5/16'] TYP (MOUNTING HOLES> FUEL LINE CONNECTION 3/4' NPT FEMALE COUPLING CENTER OF GRAVITY 889 [35'] 22KW UNIT 908 [35 3/4'] 27KW UNIT REMOVE COVER FOR ACCESS TO RADIATOR FILL 708 CAP [27 7/8'] TYP (MOUNTING HOLES) 165.1 [6 1/2'] CONTROL PANEL FRONT COVER SEE NOTE 4 CIRCUIT BREAKER SEE NOTE 3 497,5 [19 9/16'] TOP VIEW STUB -UP AREA SEE NOTE 4 325 [12 3/4'] 1580 [62 3/16'1 1169 [46'] DOOR TYP SERVICE ITEM ACCESSIBILITY CHART 13.5 (17/32') DIA. MOUNTING HOLE (4) PLACES LOCATED ON BOTTOM OF GENERATOR MOUNTING FRAME VISE ACTION LATCH, ONE PER DOOR, ONE LIFT -OFF DOOR P R SIDE OF GENERATOR SEE NOTE 4A 152.5 [6'] MIN. 38 1 235 [1 1/2'] [9 1/4'] 325 [12 13/16'] 400 -' [15 3/4 ] f 1040 [40 15/16'] 48 [1 7/8'] SERVICE ITEM ACCESS OIL FILL CAP THRU RIGHT DOOR OIL DIP STICK THRU RIGHT DOOR OIL FILTER THRU RIGHT DOOR OIL DRAIN HOSE THRU LEFT DOOR RADIATOR DRAIN HOSE THRU LEFT DER AIR CLEANER ELEMENT THRU LEFT DOOR SPARK PLUGS THRU LEFT DOOR MUFFLERS SEE NOTE 6 FAN BELT THRU RIGHT IXOR BATTERY THRU LEFT DOOR REFERENCE OWNERS MANUAL FOR PERIODIC REPLACEMENT PART LISTINGS EXHAUST AND AIR DISCHARGE LOUVERS - FRONT AND SIDES 697 [27 7/16'] DOOR TYP 851 I [33 1 /2'] 152.5 [6'] MIN. RIGHT SIDE VIEW • • • • • •• • • •••• • • •••• ••• • • • •• • 736 • • [29'] • • I • • 4 • •• •• •• • • • • LIFTING PROVISION (4) PLACES, SEE NOTE 5 AND CENTER OF GRAVITY DIMENSIONS FUEL LINE CONNECTION 3/4' NPT FEMALE COUPLING LOCATED ON OPPOSITE SIDE (RH) • FRONT VIEW • • •• •• EXHAUST MUFFLER ENCLOSED WITHIN, SEE NOTE 6 • •• • • • • • • • •• • • • GENERAC NEXUHPA. 4411.filiNSFER SWITCHES • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • - • • • • • - , • - ill, •- • • • • • • • ' • • • • • • • • • • • • • • • • • •• • •• • • • • • • • • ••• • : : • - -100•- 2I;(;)0 Amps, Single Phase •• • • • • • ••• DESCRIPTION Generac Nexus Smyt Switches are desAned to operate with the Nexus corMer used o air-copied generators and trie control used ::duc-cooied ser,es gaseous gerleatos from 22 K11 thmugg 60 KA The Smart Switcn .e! operate og,y witn Inc Nexus or Generac R200 scitTlier. T'ise 100 200 and 400 amg open trans,ten switcnes are avaiaPie !g s'ngie phase In ootn service rates and tog-service rated cortf;durat:ons STANDARD FEATURES An Smart Switches are housed In an awm!num NEMkILL Tyne 3R enciosLre eiectTostatcaily adored and oaked powder paint The rteavy Duty Generac Cor.tactor :s a t— ,ecogglec dev,ce. oesg-ed to years of service 7.t e control at tree generator hard,es an tne t07-wtg senswig and exe!-cfs.r:g ttYtct,o:-Is DLM TECHNOLOGY Througn the use ot Dqta! Load Management techgoiogy (D/1r eac, these swatches has tne capabwty to truly manage two air conditionttg loads with no add:tiona ttardware When used :n tandem with the individual DLM moduies. up to tour more additional loads can oe inteihgently managed IndivIdualiy. GENERAC • • •0• • •ll •* 0 • • • • • 0 • • • • • ••• • • • • • • • •0• • • • 0 ••• 0* •• • • • • 0 • • 0 Nexus %mart Switches 100-400 amps, Single Phase FUNCTIONS ••• • • • • Oil% •.0 *0 . • • • • 1 0 • • • • • • • AS 'Trning and sensing functions o ginate in the generator controller • • • • • • ::• :•: • •i• :.: • • Utility voltage drop-out.. <60% Timer to generator start .15 seconds . ..... „ ......... ..... . ,, . ,,,,,, .. Engine warm up delay • • • • • •• • • • •.• ',. seconds • • • • • • • • • Standby voitage sensor • •• • • • • • • • • 90% • • • • • 4, • • Utility voltage pickup.. • • • • • • • • • -,- 80% • • • • • • • • ••• •• Re-transfer time delay 15 seconds Engine cool-down timer 60 seconds Exerciser 15 minutes every 7 days The transfer switch can be operated manually without power applied. SPECIFICATIONS Mode i RTSX100A3 ! RTSD100A3 RTSX200A3 1 RTSD200A3 RTSX400A3 RTSD400A3 Amps 100 100 200 200 400 400 Voltage 120/240, 10 120/240, 10 120/240, 10 1 120/240, 10 120/240, to 120/240, 10 Load Transition Type rAutomat1c) Open Transition Open Transition Service Rated Open Transition Open Transition Service Rated Open Transition Open Transon Service Rated Enclosure Type NEMA 3R NEMA 3R NEMA 3R NEMA 38 NEMA 3R NEMA 3R Withstand Rating (Amps) 10,000 10.000 10,000 22,000 18,000 22,000 Lug Range 2/0 - #14 40 MC , - #4 600 MOM #4 or 2-250 MOM Unit Weight - ibs as 20 9.07 22.5 9.97 20 9.07 39 17.69 133 60.32 140 63.50 EXTERNAL DIMENSIONS 100 Amps 120/240. to , 100 Amps 120/240. lo Open Transition Open Transition Service Rated •--, Height : Width , • Height : Width ' • , Depth Depth • H1 ' H2 1 v/ W2 . H1 H2 , Vti 1 ' yV2 , . •_, , . Inches . 17 24 20 ' 12.5 • 14 6 ' 7 09 . 17 24 20 , 12.5 • 14.6 , 7 09 • 438 0 508 4 ' 318 0 372.0 1 130 0 438.0 • 508 4 1 318.0 ' 372.0 i 180.0 200 Amps 120/240. 10 200 Amps 120/240. 10 Open Transition , Open Transition Service Rated Height Width : h Height i Width D th Dept., HI 1 H2 W1 W9 , H1 ' H2 W1 , W2 .: eP11 inches, 17.24 , 20 12.5 14.6 . 7.09 274 30.0 11.4 13.5 i 7.09 inro:', 438.0 • 508,4 : 318.0 372.0 ' 180.0 , 692.0 ' 762.4 289.0 :: 343.0 180.0 400 Amps 120/240, 10 400 Amps 120/240. 1 o Open Transition Open Transition Service Rated 11-T- HelgPt . Width , Heloht: , WidtO ptn „. .0/2 Depth H1 H9 V4'1 A2 '1 12 t12 Nie , 4- --- Lipches_ 42.91 48 0 16.69 21 82 ' 10.06 42.91 j 48.0 16.69 21.82,H 006_i dun 1090.0 1219.3 1 424.0 554.3 255 5 1090.0 1219.3 1 424 0 1 554.3 1 255.5 GENERAC bt2 DEPTm WI W2 H2 , ! ! i ■ 1 , 1 • ■ DEPTH W2 Ht Generac Power Systems, Inc. • S45 W29290 HWY. 59, Waukesha. WI 53189 • generac.com „c2010 Generac Power Systems. Inc. All nghts reserved. All specifications are subjeCt 10 change without nonce. Bulletin 0186670S8Y-A !Printed In 1J BA Oa 16.10 SINGLE FAMILY SERVICE LOAD CALCULATIONS BASED ON THE 2005 NEC SECTION 220.82 GENERAL LOADS - NEC 220.82(b) TOTAL SQ FOOTAGE APPLIANCE CIRCUITS LAUNDRY CIRCUITS COOKING EQUIPMENT CLOTHES DRYER LOAD WATER HEATER LOAD • • ••• • • • ••• •• •• • • • •. •• • Claudio ion 4 ; • ; • • 117$ �t s i • • • • Miami Shores, FL 33150 1,800 X..., "• 3VA.MR $Q. FT. .' • 2 X; • , ` `1,540 IA tACH ; • • 1 X`•` • 1,544 /4EACH.i• ••• 0 X 0 VA EACH 0 X 0 VA EACH 0 X • • •'4 IA g/V-1• • • . • ••• • • • • •• • • • • MISC. LOADS 120 VOLT QTY • • ` `k1V S' • • i i i • • .V51-TS 1 Dishwasher 1 X 6 X 120 2 Microwave 1 X 7 X 120 3 Refrigerator 1 X 6 X 120 MISC. LOADS 240 VOLT QTY AMPS VOLTS TOTAL GENERAL LOAD FIRST 10 KVA AT 100% REMAINDER OF LOAD AT 40% SUBTOTAL GENERAL LOAD HEATING & COOLING LOADS - NEC 220.82(C) ITEM #1 - AIR - CONDITIONING LOADS 5,448 VA X 100% = 5,448 VA ITEM #2 - HEAT PUMPS NO SUPPLEMENTAL 0 VA X 100% = 0 VA ITEM #3 - ELECTRIC CONTINUOUS 0 VA X 100% = 0 VA ITEM #4 - HEAT PUMPS WITH SUPPLEMENTAL 0 VA X 100% = 0 VA ITEM #5 - SPACE HEATING (1 -3 UNITS) 5,000 VA X 65% = 3,250 VA ITEM #6 - SPACE HEATING (4+ UNITS) 0 VA X 40% = 0 VA TOTAL HEAT & AC LOAD (LARGEST OF ITEMS #1 - #6) TOTAL LOAD KVA TOTAL LOAD AMPS 16,320 VA / 240 VOLTS = 68.0 AMPS PAGE 1 OF 2 5,400 VA 3,000 VA 1,500 VA 0 VA 0 VA 0 VA 720 VA 840 VA 720 VA 12,180 VA 10,000 VA 872 VA 10,872 VA 5,448 VA 16,320 VA SINGLE FAMILY SERVICE LOAD CALCULATIONS BASED ON THE 2005 NEC SECTION 220.82 NEUTRAL LOAD PER 2005 N.E.C. SECTION 220.61 TOTAL SQ FOOTAGE APPLIANCE CIRCUITS LAUNDRY CIRCUITS TOTAL CONNECTED NEUTRAL LOAD FIRST 3,000VA (100 %) FROM 3,000- 120,000VA (35 %) OVER 120,000VA (25 %) SUBTOTAL RANGE DEMAND FROM 2005 NEC TABLE 220.55 COLUMN C 70% LOAD NEC 220.61 1,800 2 1 3,000 6,900 0 • • ••• • • • ••• •• •• • • • •• •• • •CI ucl o Genzarg . • . • :1178=J .i.St• i • • ••• Miami Shores, FL 33150 • • • • • • • X • • • X X ••• • • • • • e • • •• • • • • • • • • • 3VA FKII SQ�FT. •:• 1,500 VA EACH • 1,500 VA EACH •• • • • •• ••• • • • X • X X 0 VA 0 X =.0: 0.35 0.25 0.70 • • • • • • • • • • PAGE 2 OF 2 = 5,400 VA = 3,000 VA = 1,500 VA • • 9,900 VA • • • • • • • • • ••• •• DRYER DEMAND FROM 2005 NEC TABLE 220.54 70% LOAD NEC 220.61 0 X 0 UNBALANCED 120 VOLT MISC. LOADS AT 100% NEUTRAL LOAD VA NEUTRAL LOAD AMPS FURTHER DEMAND FACTOR - 2005 NEC 220.61(B)(2) FIRST 200 AMPS AT 100% AMPS ABOVE 200 AT 70% MINIMUM NEUTRAL CONDUCTOR AMPACITY SUMMARY TOTAL LOAD FROM PAGE 1 OTHER NEUTRAL LOAD FROM PAGE 2 TOTALS NOTES Service 200 Amps Service 2 # 2/0, 1 # 1/0, 1 #6 ground in 2" C. 200 amps Meter PREPARED BY: CAYAMAS ELECTRIC COR ,.. f0, 6,855 VA / 240V = L1 AMPS 68.0 68.0 X NOTARY PUBLIC-STATE OF FLORIDA' Hilda Menendez y,. Commission #DD812333 '• ' Expires: SEP. 27, 2012 BONDED THRII ATLANTIC BONDING CO., INC. 0.70 28.6 AMPS 28.6 AMPS 0.0 AMPS 28.6 AMPS L2 AMPS 68.0 68.0 3,000 VA = 2,415 VA = 0 VA 5,415 VA 0 VA 0 VA 1,440 VA 6,855 VA NEUTRAL AMPS 28.6 28.6 • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • ••• • Generator Lo,315,t 0D Btu • � Vd • • • • • • • • • • • • • • • ••• • • • •• • • • • • • • ••• • • • • • • • • • • •• • • • •'• •• • • • • • • • • ••• •• • • • • • • • • ••,SPdimer. CTrap • • V 500 Gallon L/P Tank Aboveground Set Shut -Off Valve 4-2nd Stage Low Pressure Regulator High Pressure 1st Stage Regulator 10' - 1/2" Polyethylene Pipe Underground Notes: L/P Tank fill port will be 10' minimun from source of ignition. GAS NOTES: Propane Gas Longest Run 13' Total Load - 315,000 Btu (1) Outlet (1) Connect (1) 500 Gallon L/P Tank Aboveground set FBC - Fuel Gas 402.4(25) Galvanized Pipe Aboveground H/P 402.4(26) Galvanized Pipe Aboveground L/P 402.4(34) Polyethvlene Underground H/P L/P Tank has a 25' Minimun from Structure and adjoining property that can be built upon. L/P Tank has a minimun of 5' to sides and rears, which are . 15' service alleys. Reliable Industries, Inc. 5850 SW 63 Ct. South Miami, Fl. 33143 JOB: Claudio A. Gonzalez 1178 NE 98 St. Miami Shores, FI. DATE: 7/17/2010 Revised: N/A Scale: N. T. S. Drawn By: R.T. Approved By: Rafael Tejeda Affidavit: This Installation Shall Comply With NFPA 54, NFPA 58, as well as all sta '&?local codes and regulations. GENER SI E PLA■ .,, "j ,,3-- 1 of 1 Signature Of Qu. Print Name: Rafael Tejeda Qualifier # LPG 27590 / LPG025300 Sworn to and subscribed before me this % f day of `i , 2010 (Seal) � ,, Personally Known — J ? / J �'' Or Produced iae nation NOTARY PUBLIC-S1ATL OF MUM " " ", Hilda Menendez ,=--- Type Of Identification 3:a ,= COmmiSSiott #nnR12131 <. .s Expires: SEP. 27, 2012 BONDED THRU ATLANTIC BONDING CO,, INC. 5' 0 0 O O O O O 3' 0 0 0 L/P Tank Slab 6" # 3 Rebar 12" on Center Each direction Reliable Industries 5850 SW 63 Ct. South Miami, FI. 33143 JOB : Claudio Gonzalez 1178 NE 98 St Miami Shores, FI. DATE: 8/4/2010 Revised: N/A Scale: N. T. S. Drawn By: R.T. Approved By: Rafael Tejeda Affidavit: • Installation Shall Comply With NFPA 54, NFPA 58, as well as all:- ate : local codes and regulations. NERAL SITE P � Page 1 of 1 SignaturiQf alifier • Print Name: Rafael Tejeda Qualifier # LPG 25300 Sworn to and subscribed before me this day of , 2010 (Seal) Personally Known Or Produced Identification Type Of Identification U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION $.EFt7Ii9C'�ATE • • • • • Federal Emergency Management Agency ; ' • ; • • ' • • • • • • • • • National Flood Insurance Program Important: Read the inttructoq$ortipages 1 9. ••• • OMB No. 1660 -0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION A1, Building Owner's Name CLAUDIO GONZALEZ • • • • • • • • • • A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P:O;RQute and liox N;. • 1178 NE 98 STREET • • "' • City MIAMI SHORES State FL ZIP Code 33138 •• •• A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc!) • • • O LOT 23 BLOCK 180 PB 31 PG 41 • ••• . . • • . • • •• • • - • • • •• •• A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) RESIDE ITIAL A5. Latitude /Longitude: Lat. 25.5194 Long. 80.1047 Horizontal Datum: A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? ❑ Yes ® No N/A sq ft N/A N/A sq in ❑ NAD 1927 ® NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage 400 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State CITY OF MIAMI SHORES 120652 MIAMI -DADE FLORIDA B4. Map /Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12086C0306 L Date Effective /Revised Date Zone(s) AO, use base flood depth) 9 -11 -09 9 -11 -09 "X" NONE B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date N/A ❑ CBRS ❑ OPA ❑ Yes Z Nc SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1.• Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR /AO. Complete Items C2.a -h . below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized B- 62Vertical Datum NGVD -1929 Conversion /Comments N/A a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 10.11 b) Top of the next higher floor 12.06 c) Bottom of the lowest horizontal structural member (V Zones only) N /A. d) Attached garage (top of slab) 10.11 e) Lowest elevation of machinery or equipment servicing the building 10.50 (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 9.84 g) Highest adjacent (finished) grade next to building (HAG) 10.11 h) Lowest adjacent grade at lowest elevation of deck or stairs, including N /A. structural support Check the measurement used. ® feet feet Z feet Z feet feet ® feet ® feet ® feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Z Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No Certifier's Name ROBERTO R. BRIZUELA License Number 3064 Title PROF. LAND SURVEYOR Company Name ROBERTO BRIZUELA & ASSOCIATES Address 7319 WEST FLAGLER STREET City MIAMI State FL ZIP Code 33144 Signature Date 7 -12 -10 Telephone 305 - 551 -4393 PLACE SEAL HERE FEMrA Farm 84 31,'Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding jpfoJmation from Section A. Building Street Address (including Apt., Unit, :uitee artd /er [fig. N4) orr0'F$oute and Box No. • • . 1178 NE 98 STREET . • • • • • • • • • ••• City MIAMI SHORES State FL ZIP Code 33138 • • o SECTION D ! SUF VEYOj?,•ENSINEER, OR ARCHITECT CERTIFICATION (CONTINUED) . . - - • . . • Copy both sides of this Elevation Certifioete,for ;1) community offjcial, (2S insi:ra$ce agent/company, and (3) building owner. • ••• • ••• • • . Comments NOTE: CROWN OF ROAD : 9.62' • • C2(e) : TYPE OF EQUIPMENT: AIR CONDITIONER NOTE: LAT /LONG WAS TAKEN USING GAS G4141IN p;VI CE • • • • • • • • • Signature •• • • • • ••• • • •• • • • • . •• • • • • • • • • • • • Date 7 -12 -10 ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment servicing the building is Cl feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance /Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Communiiy Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions • ••• • • • •• •• • • • • • • • • • • • • • ••• • • • • • ••• • Building Phbto'glrapris See Instructions for Item A6. • • • ••• • • • • • • •• • • • • • • • • • • • Building Street Address (including Apt, Unit, Suite, and /or Bldg. Na) or PLO. Roe apd3ox N. : : 1178 NE 98 STREET • • • • • • • • • • • • • For Insurance Company Use: Policy Number City MIAMI SHORES State FL ZIP Code 33138 •• • • • •• ••• ••• • Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix °°t°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°°° below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. FRONT VIEW: ••• • • :•.•1-0 • uilc iin�•Photographs ••• • • • • • • Cdntintration Page For Insurance Company Use: Building Street Address (includinglipt., U•nit, Suite, anti /or Bld9� No.) or P.O. Route and Box No. 1178 NE 98 STREET • • • . • • • • • • • . • • • • • • • •• . . . • • City MIAMI SHORES State FL 2IP.C6de 3'3138• • . • • • • Policy Number Company NAIC Number ••• ••• •• • • • •. If submitting more photographs titan wr•'�I it on tl:e :RCec%ding page, affix the additional photographs below. Identify all photographs with: date taken; "Frapt Vjw "arid 1R4aiVje4 "; and, if required, "Right Side View" and "Left Side View." • • • •• REAR VIEW: i • • •.• • • • ••• •• •• • • • •• • •• • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • SKETCH OF BOW. MANY • VEY SCALE: 1,"=201. • 8.33' • • • • • • • • • • • • • • • • • • • • • • • • • • • • N.E. 9818•'ST'REET '•' 75.00' Total R/W •• • 21' Asph'ajt • • • •• • • • • • • • • • • • • ••• • 8.62' • • •• ••• •• FND.I.P.1 /2" (NO ID) LOT 22 'q. BLOCK 180 tvli- LL 0 0 0.8 CL • • •• • • • • • ••• •• 27.5' Parkway 104.10' FND.I.P.1 /2" (NO ID) n 6.70' 9.00' N C 0 U m 10.11' 15.00' 8.25' 5.00' Planter 9.84' 10.0 0' 24.10' Garage: 10.11' 20.60' 0 to ONE STORY CBS RESIDENCE # 1178 F.F. 12.06' 60.35' 15.65' LO 0 of co 1 0.00' \_777v 6.00' �o NC co i 18.30' 11.26' ��. Wood Floor Septic 6.00' Tank 9.52' 0 M rn 9.82' / 9.84' d On FND.I.P.1 /2" (NO ID) E O.H.P. 77.85' 15' ALLEY W.P.P. E FND.I.P.1 /2" (NO ID) W.P.P - NOTE: THIS SURVEY HAS BEEN PREPARED FOR EXCLUSIVE USE OF THE ENTITIES NAMED HEREON. THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY. LEGAL DESCRIPTION: REVISED PLAT OF TRACTS 178B, 178 C, 179 B, 179 C, 180 A, LOT 23 BLOCK 180 OF & N 1/2180 C, OF REVISED PLAT OF MIAMI SHORES SECTION 8 SUBDIVISION, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 31 AT PAGE 41 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. PROPERTY ADDRESS; 1178 N.E. 98th STREET, MIAMI SHORES, FL 33138 CERTIFICATION TO: CLAUDIO GONZALEZ LOCATION MAP N.T.S. SURVEYOR'S NOTES: 1.) EXAMINATION OF ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 2.) LOCATION AND IDENTIFICATION OF UTILITIES IF ANY ARE SHOWN IN ACCORDANCE WITH RECORDED PLAT. 3.) OWNERSHIP IS SUJECT TO OPINION OF TITLE. 4.) TYPE OF SURVEY." BOUNDARY SURVEY". 5.) THIS SURVEY IS NOT VALID UNLESS SIGNED AND SEALED BY THE SURVEYOR OF RECORD. 6.) ALL RIGHT OF WAYS SHOWN ARE PUBLIC UNLESS OTHERWAISE NOTED. 7.) LANDS SURVEYED AS DESCRIBED. 8.) NO UNDERGROUND INSTALLATIONS ON IMPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED. LOOD ZONE INFORMATION Community Number Panel Number Suffix Date of Firm Index Firm Zone Base Flood Elev. 120652 0306 L 9 -11 -09 "X" NONE SOURCE ELEVATION PROVIDED BY DADF COUNTY SURVEY DE RELATIVE TO MEAN SEA LEVEL NATIONAL GEODETIC VERTICAL DATUM OF 1929 LOCATOR INDEX BENCHMARK NO. ELEVATION COPYRIGHT ROBERTO BRIZUELA & ASSOCIATES, INC. "LEGEND" P.R.M.- PERMANENT REFERENCE MONUMENT P.C.P. - PERMANENT CONTROL POINT F.I.P.- FOUND IRON PIPE S.I.P.- SET IRON PIPE 12" STAMPED F.D.H.- FOUND DRILL HOLE S.D.H.- SET DRILL HOLE CIL CENTER LINE RES .- RESIDENCE LF.E- LOWEST FLOOR ELEVATION F.F.E.- FINISH FLOOR ELEVATION C.LF. CHAIN UNK FENCE U.E- UTILITY EASEMENT W.F.. WOOD FENCE M: MEASURE R.- RECORD S.N.D.-SET NAIL & DISC STAMPED P.LS. F.N.D.- FOUND NAIL & DISC C.B.S. - CONCRETE BLOCK STRUCTURE ENC. - ENCROACHMENT RAN. RIGHT OF WAY CL- CLEAR NOTE: THIS SURVEY IS INTENDED FOR MOPTGAGE OR REFINANCE PURPOSE ONLY, EXCLUSIVELY FOR THIS USE BY THOSE TO WHOM IT IS CERTIFIED. THIS SURVEY IS NOT TO BE USED F■' CONSTRUCTIO, , PERWTING, DESIGN OR ANY OTHER USE WITHOUT WRITTEN CONSENT OF ROBERTO PRIZUELA. ROBERTO R. BRIZUELk & ASSOCIATES Land Surveyors OFFICE: 7319 WEST FLAGLER STREET MIAMI , FLORIDA 33144 PHONE: (305) 551 -4393 FAX: (305) 266 -6112 1 HEREBY CERTIFY: TEAT THE ATTACHED "SKETCH OF SURVEY" OF THE ABOVE DESCRIBED PROPERTY IS CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AS RECENTLY SURVEYED UNDER MY DIRECTION, AND THAT THERE ARE NO ENCROACHMENTS OTHER THAN THOSE SHOWN, AND MEETS THE INTENT OF THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS IN CHAPTER 01 O 17 OF FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027 FLORIDA STATUTES. JOB NUMBER. 10 -06 -160 FIELD BOOK:FII FS FIELD WORK DATE. REVISIONS 1: REVISIONS 2: REVISIONS 3: 07-09-20 0 ROBE '0 R. BRIZUELA PROFESSIONAL LAND SURVEYOR No. 3064 STATE OF FLORIDA