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MC-14-2147 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220743 Permit Number: MC-10-14-2147 Scheduled Inspection Date: December 19,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: ANDREA COLON, LISA GUINOVART Work Classification: Addition/Alteration Job Address:766 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060142070 Project: <NONE> Contractor: AA MASTERS MECHANICAL AIR MOVING AND ENGINEERD Phone: (305)244-0667 Building Department Comments Infractio Passed Comments MECHANICAL FOR ADDITION INSPECTOR COMMENTS False V Inspector Comments Passed lb Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 16,2016 For Inspections please call: (305)762-4949 Page 1 of 60 Y=' Q.i �� y Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220743 Permit Number: MC-10-14-2147 Scheduled Inspection Date: December 19,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: ANDREA COLON, LISA GUINOVART Work Classification: Addition/Alteration Job Address:766 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060142070 Project: <NONE> Contractor: AA MASTERS MECHANICAL AIR MOVING AND ENGINEERIP Phone: (305)244-0667 Building Department Comments Infractio Passed Comments MECHANICAL FOR ADDITION INSPECTOR COMMENTS False Inspector Comments Passed I&D Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 16,2016 For Inspections please call: (305)762-4949 Page 1 of 60 Permit NO. MC-10-14-2147 ones Miami Shores Village ■ Permit Type: Mechanical-Residential 10050 N.E.2nd Avenue NE Work Classification:Addition/Alteration £_1_ Miami Shores,FL 33138-0000 ' Permit Status:APPROVED ,— � Phone: (305)795-2204 f�oRioA Expiration: 08/01/2016 Issue Date:211312,016 Project Address Parcel Number Applicant 766 NE 96 Street 1132060142070 LISA GUINOVART ANDREA COL Miami Shores, FL Block: Lot: ----1 Owner Information Address Phone Cell LISA GUINOVART ANDREA COLON 766 NE 96 Street MIAMI SHORES FL 33138- 766 NE 96 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,500.00 AA MASTERS MECHANICAL AIR MOV (305)559-7004 Total Sq Feet: 1100 Tons: Available Inspections: Additional Info:MECHANICAL FOR ADDITION Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved: :In Review Underground Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.60 Invoice# MC-10-14-53127 DBPR Fee $2.62 02/03/2016 Cash $ 194.04 $0.00 DCA Fee $2.62 Education Surcharge $0.60 Permit Fee $175.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $194.04 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 infUe-nam s ur a and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the abont r to do the work stated. February 03, 2016 Authorized Signature:Owner / Applicant nt Date Building Department Copy February 03, 2016 1 Miami Shores Village IRE7F_ Building Department i O 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 I, Tel:(305)795-2204 Fax:(305)756-8972 i:3 .l. INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 ID BUILDING Master Permit IN PERMIT APPLICATION Sub Permit No. 11.41 BUILDING ❑ ELECTRIC ROOFING REVISION ❑ EXTENSION Ej RENEWAL ❑PLUMBING dMECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 766 ne 96 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Lisa GuinoVart Phone#: Address:766 NE 96 st city: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: 6 CONTRACTOR:Company Name: M 11 S Te✓vLS NlL A r VL, AA h/1 jjPhone#: 74'6 7 �33� Address: 6f Q / 5cc, l d fo Q)A4 C� _ City: f0-A ( 4Tki (( State: O�C_ Zip: -3 f Qualifier Name:, / • . kt.,,oY/y,4 Phone#� �a '6 5S tate•Certification•or.Registration.M. Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: d d Type of Work: ❑ Addition ❑ Alteration ,'New ❑ Repair/Replace ❑ Demolition Description of Work: Addition ftwglaV /1 C HA ro IM 1, Specify color of color thru tile: c] Submittal Fee$ (� n Permit Fee$ CCF$ �!�' i j CO/CC$ Scanning Fee$ vt C�� (� Radon Fee$ ��DBPR$ o_-Ga Notary$ Technology Fee$ Training/Education Fee$ Cdr Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised 02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) tA 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 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 ed. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this Th foregoing instrument was acknowledged before me this( 41T- I day of 20 by day of ;L`Jr ,20 ,by 111 DV who is personally known to ��^i�. fie//PA— ,who is personally known to me or who has produced Q L as me or who has produced as identification and who did take an oath. identification takJE.ROSSEAU NOTARY PU L " '"°"m JORGE SSEA � MY COMMISSION#FF119045 NOTARY PUBL q �P M COMMI I N#F 19 45 ,,6�',` EXPIRES May 4, 2018 o )3 n t for a to �S rvice.com :4 P PIR 'y 4, 2 18 Sign: �q FloridaN tar'S ces Sign: Print: Oti ha S s Print: Seal: Seal: *��rr**r*r�****r*** *** r** *****r�r* •r**�* w• • ** +r**r* *. * **r***:**********rw*sr******rr****:*: APPROVED BY Plans aminer Zoning Structural Review Clerk (Revised02/24/2014) _. -, y,.,...,.1...'- -.e<'y,•-� a+\... "ti .`t `-:.re• •_ -♦ ..•,yati. .^..'��.-y1. 'S+,: ji]�, 'Z�¢}� -"SA"�:ry: �7`- zy�; 'x�." '»'ti; '.,+a.. 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's-. .d�-�H. �1 ?�[��,,.�a`.: .� �'��7 , 'L .y l � SCOTT.RICK GOVERNOR ` f 1 CONSTRUCTIONSTATE OF FLORIDA ULATION DEPARTMENT OF BUSINESS AND PROFESSIONAL REG BOARD ltCEH��t,y1,��lQER iThe CLASS rA%AtR CONDITIONING a CONTRACTOR malmed b•a ,. t)rgjef the prDwrA3os S GLJERRk FELIX ; 3-: T-525 r fr 96 DISsAS REC, gSSLIM ,i- ,', � _ - � -' .'. ��.':r •` ,! dfp5 .a �� yi y'y--,1 �a.`:, ' ' tea'' MVA Dodo 14 a� -i F�� csv E �� '-� '� LF E•�' y i \\ 20 c •y.'. ow -h.. S^'F;`,^t ,�.av �.. �,: \��,°•' � y,, � � q SQ /3 2s,5's h \� a w , . a \ s ... ...... W ItTk J, . `e lee lilql�o SNoRFs m,,, nmMiami shores Village d Building Department o� OR 10050 10050 N.E.2nd Avenue 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. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore,you may be personally liable for the worker compensation injuries of any person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner ontr t Print Name: S GO I N Print Na Signature: A41,14 4 Signature: 10 oieiw . State of Florida) State of FPhrida) County of Miami-Dade) County of Miami-Dade) Sworn to and subscri ed b fore iris Sworn to and subscr' e fo me this�, r day of Cr y of —'� EAU By <: �°�8;,, J06�OE ROSSEAU o.F JOSE FtC?S�. ION#FF11904 MY COMMISSION#FFA 1�oAG MY Commioe ACP st o` Ii�ES May 4, 20l S �,i of hd (SEAL) ;;,� �* EXP Fwtic�e�sezarY�ery+c,�com Type of Identification produced ;3;,,,>; ri°"j"' .cir�Serv'ce rom Type of Identification'Produced