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EL-16-1567 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-261793 Permit Number: EL-6-16-1567 Scheduled Inspection Date: June 27,2016 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GOLDENBERG, EVELYN Work Classification: Alteration Job Address: 1557 NE 105 Street 7-2 Miami Shores, FL Phone Number Parcel Number 1122300530660 Project: <NONE> Contractor: POWER BY PURKIS INC Phone: (305)281-0546 Building Department Comments PROVIDE ELECTRICAL POWER FOR NEW WATER Infractio Passed Comments HEATER THAT WILL REPLACE EXISTING ONE INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction a Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 24,2016 For Inspections please call: (305)762-4949 Page 33 of 37 ' Miami Shores Village 10050 N.E.2nd Avenue NEY Miami Shores,FL 33138-0000 " Phone: (305)795 2204 x � � 17X i Expiration: 12120/2016 Project Address Parcel Number Applicant 1557 NE 105 Street Number: 7-2 1122300530660 EVELYN GOLDENBERG Miami Shores, FL Block: Lot: Owner Information Address Phone Cell EVELYN GOLDENBERG 1557 NE 105 ST TOWNHOUSE 7-2 MIAMI SHORES FL 33138-2115 Contractor(s) Phone Cell Phone Valuation: $ 800.00 POWER BY PURKIS INC (305)281-0546 __......... __.._...___ Total Sq Feet: 00 Type of Work:PROVIDE ELECTRICAL POWER FOR NEW WA Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# EL-6-16-60081 $2.00 06/23/2016 Credit Card $69.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 06/06/2016 Check#:1066 $50.00 $0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $119.60 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 inform ion is accurate and t all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the abov ed co ractor t e work stated. June 23,2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 23,2016 1 Miami Shores Village70 -0- 6 Building Department BY 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECrION UNE PHONE NUMBER:(305)762-4949 FBC 20/'-/ ` BUILDING Master Permit NoZ- &— /6�6 PERMIT APPLICATION Sub Permit No. []BUILDING [�j ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL (PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:/557 NE 105 Street City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titl#holder): C�yp9 Phone#: Address: City: State:�I'� Zip: Z Tenant/Lessee Name: We Phone#:3A Email: CONTRACTOR:Company Name: Power by Purkis, Inc. Phone#: 305 2810546 Address: 12222 SW 131 Avenue City Miami State: FL. Zip• 33186 Qualifier Name: Michael Purkis Phone#: State Certification or Registration#: EC13005447 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑Repair/Replace ❑ Demolition Description of Work: Provide electrical power for new water heater that will replace existing one. Specify jr 19�Submittal 3t �rn�tF CCFCO/CC$ Scanning FRaoee DBPR$ Notary$�_�-� Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$Aq (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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-the7ecorded notice of commencement must bre-posted-at the-job-sire for the first inspection which occurs seven (7) days after the building permit is issued. in the absence such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT COAACTOR The foregoing instrument was acknowledged before me this The foregoing I 4rument was acknowledged before me this day of C> .20 O by Q a 1 day of �V .20 .by N r�N ho is personally known to � �� a ii who is personally known to L rr��P Y P Y me or who has produced ��1y21 vim as me or who has produced 'J� ds�I CSA identification and who did take an oath. Identification and who did take an oath. NOTARY PUBLIC: 1031b /!�°° NOTARY PUBLIC: Sign: Sig UJ C&' I_ Print: sap ® '�= Print:-Lok'(t r✓1 C�- Seal: ;•L��3 y .�;' Seal: UNIIIIIAMOAM �s SIWW•. �� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) DURABLE POWER OF ATTORNEY FOR FINANCE OF EVELYN GOLDENBERG ARTICLE I Creation I, Evelyn Goldenberg, as Principal and a resident of the State of Florida designate my daughter, Minna Miller to serve as Attorney-In-Fact(my "Agent") for me and to act as the guardian or limited guardian of my estate should guardianship proceedings become necessary or desirable. ARTICLE II Effectiveness; Effective Immediately This Power of Attorney shall become effective immediately and shall survive and continue during any disability, incompetence, incapacity,or partial incapacity I may experience. This durable Power of Attorney is not terminated by subsequent incapacity of the principal except as provided in chapter 709, Florida Statutes. Disability, incompetence, incapacity or partial incapacity shall include,without limitation,my inability to manage my property and affairs or caring for myself effectively, for reasons such as mental illness,mental deficiency or other mental incapacity, physical illness or disability,advanced age, senility, chronic use of drugs, chronic intoxication,which may be evidenced by a written statement of my regularly attending physician or two other qualified physicians or by court order. ARTICLE III Powers My Agent shall have all powers of an absolute owner over my assets and liabilities, whether located within or without the State of Florida, including, without limitation, the following power and authority: A. Power relating to real property transactions. I empower my attorney-in-fact to: 1. accept as a gift or as security for a loan,reject, demand, buy, lease, receive, or otherwise acquire an interest in real property or a right incident to real property; 2. sell,exchange, or convey,with or without covenants; quitclaim; release; surrender;mortgage; encumber; partition; consent to partitioning; subdivide; apply for zoning,rezoning, or other governmental permits; plat or consent to platting; develop; grant options concerning; lease; sublet; or f DPOAF of Evelyn Goldenberg Page 1 of 16 Initials: ` ' Date: DATED this 'day of ,20 . Avel Gol nberg, cipal Social Security Number: Residing at: PO Box 560451 Miami,FL 33256-0451 The principal is personally known to me and I believe the principal to be of sound mind. I am eighteen(1 S)years of age or older. I am not related to the principal by blood or marriage, or related to the attorney-in-fact by blood or marriage. The principal has declared to me that this instrument is her power of attorney granting to the named attorney-in-fact the power and authority specified herein,and that she has willingly made and executed it as her free and Volun act for the purposes here'in expressed. [Witness Signature] [ iM ignatute] I- ° P � Civ U SGI C1C)) [Print Name] [Print Name] DPOAF of Evelyn Goldenberg Page 15 of 16 Initials `; Date: % STATE OF ss. COUNTY OF .!kday ,20�L ,before me,that on this�. °f duly commissioned This is to certify , undersigned Notary Public in and for the state of 00�a eared Evelyn Goldenberg,to me known to be the Person described and qualified,personally app and who executed the within and foregoing Power of Attorney,andacknowledged m t u' act and deed,forth rposes therein she signed the same as her free and voluntary mentioned. WITNESS WHEREOF,I have hereunto set my hand and affixed my official seal the day and year first above written. �;"i AL' , -V ,%ar A IRFJIY P.YAW Notary Signa e MY COMMISSION 4 EE 632150 Print Name:3 t�IPi` �'Y& 'I�� * * EXPIRES:SepWbet 14,2016 NOTARY PUBLIC in and for the �°TFOF FLOP', 50M TIuU BuE9et SV-" state of ,residing at My commission expires: DPOAF of Evelyn Goldenberg Page 16 of 16 Initials` Date: yNoREs .... .....� Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. L,-,l COPY OF QUALIFIER'S STATE LICENCES B. jZ COPY OF LOCAL BUSINESS TAX RECEIPT C._/COPY OF LIABILITY INSURANCE* D. k-' COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: BUSINESS ADDRESS: a a a SO Z 31st 'x-ITY STATE ZIP �p BUSINESS PHONE: (-j — c.� S- �D FAX NUMBER(__) CELL PHONE ( ) QUALIFIER'S NAME: / / �� �.z V/ 041,x? QUALIFIER'S LIC NUMBER: C-- C /g oo �� ' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PURKIS, MICHAEL JOHN POWER BY PURKIS, INC. 12222 SW 131 STAVE MIAMI FL 33186-6402 Congratulations! With this license you become one of the nearly _- one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to EC13005447 ISSUED: 06/01/2014 serve you better. For information about our services,please log onto - www.myfloridalicense.com. There you can find more information CERTIFIED ELECTRICAL CONTRACTOR about our divisions and the regulations that impact you,subscribe PURKIS,MICHAEL L JOSiN to department newsletters and learn more about the Departments POWER BY PU 2i JO' 1INC: Initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constant) strive to serve you better so that you can serve your Customers. lank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! Exphdlon date:AUG 31,2016 L1406MOOD3143 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC130QW7 The ELECTRICAL CONTRACTOR a Named below IS CERTIFIED s Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 �. .il PURKIS, MICHAEL JOHN POWER BY PURKIS, INC. 12222 SW 131STAVE MIAMI FL 33186-6402 ISSUED: 06/01/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1406010003143 Report Viewer Pagel of, T i, 100'96 i; d JEM Almmm MMY MANCM STATE OF FLORIDA DEPARTMENT OF FTNANC1AI..SERVICES DIVISIONOFWORI(EIMCOMPENSATION h CERTIFICATE OF ELECTION TO BE E>IEMPT FRS FLORIDA Vim'COMPENSATION LAW•' CONSTRUCTION INDUSTRY EXEMPTION This omSes that the InclMdual listed below has elected to be exempt Umn Florida WbrCmnpwmbm law EFFECTIVE DATE: 01222015 t7(PIRA7I0N DATE: OMM17 r PERSON: P)RIDS MICHAEL FEIN. 650412525 BUSINESS NAIL AND ADDRESS: POWER BY PURIUS INC a l' 3 17122 SW 131 AVENUE MIAMI FL 33186 i SCOPES OF BUSINEW OR TRADE: t CONTRACTOORCTRI 4 Fteaml4to ClmpW440AR114XF.S.,an etmerdaampaxatimralaeWdsa mi buftrw aaei�afthmuWmdwOda sem mares ere®aa.ar mor..as.a roc ma4o.os(rAFcm dewtWmoee�q oeg u affidn tliasaepa d0e mbads 9n4tlm81e d m 6a P=.4 brum'(131 FS.t�Maii Ee axil0011 d mOee atre7 he btevo�Wif,ffie. Emaami mora mca mm d0ma . gd Ore penxnl�e0W0readbe orcm�amYlogetxierffi0ea teq�xieabolIDb 6ec0ex0a'rsswmeafaae�aTOeQupaimeQs6xlmaemea 9 DFG424Nm—82 GERTmATE OF ELECTM TO BE EXEMFr FWVMW 08-13 OUEN1tIXNS?(856)4184609 q9 T b 001744 I Local Business Tax Raceipt. i Miami-•Dade Corny, State Qf Florida -THIS IS NOTA BILL - Do NOTPAY 1 . 3129723 � suSttuEse auvaterLoc�a, POWER BY PURKI.S INC RECEtrr mo. EXPIRES 5901 SW 93 PL' 118MaL SEPTEMBERS 2076 MIAMI FL 33173 32268M Must be dN*Wed at plamof iw>ta Pursuant to County Comte, Chapter 8A-ASL s&10 OWNER POWER BY�1RKIS INC SEC_TYPE OF BUSINESS Workers) I EC130o6447 196 ELECTRICAL CONTRACTOR sr Tr YEu cCuEcran 875.00 07/09/2015 Tms Localody FPPU02-15-016145 Walk arra Camt�iaa ofd��(et yq�aa( Lead Besi s Tax.The Receipt��a Iia�e, or RECEIPT meam��lam alldr arIA�6 soq�nt With any gvvwnmuw a6oreeam be d �aD � �-��d-Dade Cade�8a-Zlrb Por ttWa la>ioa,visit . https://apps8.fldfs.co crrepo 8/11/2015 DATE(MNIDWYYM A400 CERTIFICATE OF LIABILITY INSURANCE 5/10016 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: M the cerilfieate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,sulk to the terms and conditions of the policy,certain policies may require an endorsement. A sl aimnent on tht certHicate does not confer rights to the certlHcats holier In lieu of such end s PRODUCER Liberty Mutual Insurance HAIM PO BOX 188065 PHONE NO-962-7132 FA" 800-845-3M6 Fairfield, OH 45018 a BusinessSeroi uhlal coal AFFORDING COVERAGE NAIL s INSURERA: Ohio Seaulty Insurance Company 24082 INSURED INSURERS: Power By Purkis Inc 12222 SW 131 St Ave INSURER C: Miami FL 33186 INSUROM INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 259a9886 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RPOLICY EFF POLICY M(P LTTYPE OF DISURANCE SlBR POLICY NUMBER LBDTS A COMMERCIAL GENERAL LIABILITY SKS56663177 412=16 412WM17 EACH OCCURRENCE $ 1,000,000 CLAMS-MADE ©OCCUR POSES $ 3W,OW MID DIP Any am pew,) $ 15,0W PERSONAL&ADV 94JLIRY $ 1,0W.Wo GEWLAGGREGATE LWT APPLIES PER- GENERALAGGREGATE $ 2,QW,0W ✓ POLICY F�,PIERCaT F-1 LOC PRODUCTS-COMPIOP AGO $ 2,000,000 OTHER: $ AWOMONLELWSIJTY COMBINEDS $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(PW aoddoft) $ AUTOS ONLY AUTOS HIRED AUTOS ONLY AUTOS EDONLY PROP(PrERTY DAMAGE $ UArBREL1 A LIAR OCCUR EACH OCCURRENCE $ DtCESS UAD CLANS-MADE AGGREGATE $ DED I I RETENTION S $ WWRIUM COIIPENSAT1ON I PER AND EMPLOYERS'LIABILITY YIN STATUTE ER AFFHR RIETORIPARTNERED?CUiNE EL EACHACCIDENT $ OFF�RlMEMBERDCCLIIDEtYt � N/A t(f yes 71 in NH) EL DISEASE-EA EI@PLOYE under $ DESLIRIPTIOF OPERATIONS belay EL DISEASE-POLICY LIMIT $ DESCfBPTION OF OPERATUM I LOCATIONS/VEHICLES(ACOFW109,AddMoeel RemmU SdmduN,may ba anmcMd ff nwm apace b requb" Lic.#13005447 CERTIFICATE HOLDER CANCELLATION MiamiShores Village Building D8 rtafinent THE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami h 2nd Ave� 9 E EXPIRATION DATE THEREOF, NOTICE WALL BE DELR/ERED IN Miami Shores A 33138 ACCORDANCE WIfiTHTHE P°uCYPR°vlsroNS. AUTHORUIEDREPRESENTATM Nathan Ryals - e ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD 29969886 1 56663177 1 16-17 Master Certificate I Nathan Ryals 1 5/18/2016 1:09:56 PM (PDT) I Page 1 of 1 a Power" by ftrki s., Inc. 12222 SW 131 Avenue,Miami,FL. 33186:Telephone(305)281-0546:Email/michael.purkis@aol.com Date: State of Florida County of Miami Dade Before me this day personally appeared Michael Purkis who be sworn,deposes and says: That he will be the only person working on the project located at 557 NE 105 Street, Miami, FL.33138. Sworn to(or affirmed)and subscribed before me this day of `,�� .20 by h i c kc,\e,l J-. Pu r k,'5 0 Produced Identification ` C1 3 1-/V -� Type of Identification produced rA® d c,, /A\ 14�9A9161 V. aa�.�teaA0c14 Print,Type or Stamp Name of Notary �SORES s� Miami shores Village Building Department OVTVS '' 10050 N.E.2nd Avenue �ORiDA Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. i Signature: of SA241, fA 6& Owner State of Florida County of Miami-Dade 2 The foregoing was acknowledge before me this J day ofC�T �� ,20_L4__-) who is personally known to me or has produced r--k—�Q'r� identific IIIc!fj,, Notary: �a�4o•' "a ;�� SEAL: _ �� �� •60= *0 s '• 2°�' o�e� $ ill . . . . . . . . : : V � a �t. sr �r k rri1 -�'•' • • • • • ••• • • j \ •• • • • • • ••• •• FFFp S�I � 16 s'6 z =f APPROVED BY DATE � ZONING STRUCTURAL it ELECTR'sC IL - (b PLUMBING G .. •.• . . . . •. Ito . .. . . . . ... . MECHAPC:CAL •• ••• •• • •• ''ice C . z BDG. . •. LL rLIER!,L. I ... . • . • .•. • • STATE AN", COUNT ( R:"E. i.ivG tEU_LAr")"S • • . . •. .. . . . .. .• . ... 0 • ..• .. .. . . . .. .. . • . . . . . . . . . . . . . ... . . .. . ... so* .. ... •• . . .. . . . . . . .. • . • • . ... • ••s • • • • •• • -Panel w/I 60 amp breaker for tankless water heater Tankless Water heater Within 25'of Panel and Vsible dF #6 in%"EMT or FMC if FMC is used a#10 green must accompany wire. .. ••• . . • . .. .. . .. . . . . . .. ... .. . . . .. i 557 NE 106 Itreel,Miami,FL.33138 Drawn By:Michael Purkis w/Power by Purkis,Inc . . . . . . . . . . . .. .. . . . .. .. ... . . . ... . . ,q Free shipping on all orders over$159 Tankless Water Heaters Tankless Water Heaters I All Products I Why Tankless? 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Electrical Requirements Breakers a Wire Max kW @ 22OV1240V Available Voltage Max AMP @ 220V/240V 60 Double Pole/ 208V/220V 6 AWG Wine 11.8kW 54 (2-1 type,2 hots+ground) 240V/277V Notes:Ratings above using standard 240 Volts.Higher voltage will increase power,just as lower voltage will have the reverse effect.When installing,check specifications on unit used.Voltage,amperage,breaker and wire size may vary depending on local electrical standards.Consult your local professional for guidance.