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MC-17-392 Permit No. MC-2-17-392 `yBoaEs°�i Miami Shores Village Permit Type: Mechanical-Residential 10050 N.E.2nd Avenue NW �,•��� Work Classification:A/C Replacement "" 1 '"' Miami Shores,FL 33138 0000 Perlill't Perrnit Status:APPROVER Phone: (305)795-2204 �'GORtDp' Issue Date:2/21/2017 FExpiration: 08/20/2017 Project Address Parcel Number Applicant 460 NW 112 Terrace 1121360010180 Miami Shores, FL 33168- Block: Lot: LEO DE LA ROSA Owner Information Address Phone Cell LEO DE LA ROSA 460 NW 112 TERR (305)751-7067 MIAMI SHORES FL 33168-3328 Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 TYCOON FLOW CONTROL (305)828-6655 Total Sq Feet: p Tons:3 Available Inspections: Additional Info:replacing of the unit Inspection Type: Classification:Residential Ventilation Approved: In Review Final Comments: Date Approved: :In Review Rough Date Denied: Type of Work: Hood Scanning: 1 Rough Duct Smoke Test Duct Detector Test Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# MC-2-17-62951 DBPR Fee $2.00 02/21/2017 Check#: 13264 $66.80 $50.00 DCA Fee $2.00 Education Surcharge $0.60 02/15/2017 Check#: 13265 $50.00 $0.00 Permit Fee $105.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $116.80 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 AFFIDAVI I if II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru ion and zo i rmore, I foregoing e bov - med contractor to do the work stated. February 21, 2017 orize Signatu • er / Applicant ! Contractor / Agent Date Building Department Copy February 21, 2017 1 Miami Shores Village FEB-'- E '15 2011 Building Department 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 � BUILDING Master Permit No. SIC PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECT41C ❑ ROOFING ❑ REVISION ❑ EXTENSION QRENEWAL ❑PLUMBING FE-] MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 460 NW 112 Terr City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-2136-0014180 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Leopoldo De La Rosa Jrphone#:786-457-0151 Address:460 NW 112 Terf City: Miami State: Fla Zip: 33168 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Nam#; Tycoon Flow Control Corp Phone#: 305-828-6655 Address: 2500 West 78 Street Bay 9 City: Hialeah state: Fla Zip: 33016 Qualifier Name: Felipe D Sgler Phone#: 305-218-0788 State Certification or Registration#: CAC1813706 Certificate of Competency#: DESIGNER:Architect/Engineer; Phone#: Address: City: State: Zip: Value of Work for this Permit; Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Renew the permit - MC-5-07-873 Q1'e p1a c e +�/C U n i�- Specify color of color tftru tile: Submittal Fee$ OV 1 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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 pbtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issu4oce 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 FINANCIN fi, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a conc_#Iion to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a cgpy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to atfpchment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which'pccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approveq pnd a reinspection fee will be charged. c.- Signature� Signa OWNFF or AGENT CONTRACTOR The foregoing instrument w1F acknowledged before me this The foregoing instrument ryas acknowledged before me this Ai k—' of ' ,20 l ,2 by day of �� ,20 �, by 9 '/4 3`wh�s personally known to who is personally known to me or who has produced LQQpOIidO D2 La Rosa as me or who has produced Felipe D Soler as identification and who did*e an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ey• NEREIpA SOLER ODALYS ACOSTA = n#FF;082157 ,�.���� .,Sign: c Janua 9 Sign: • ' otary Public -State of Fforlda hN m mur0J88-7019 S. Commission Dow Print: Print: �� a x ires Apr 13,2020 Seal: Seal: Bonded through National Notary Assn. 01 c APPROVED BY � � lans Exa finer Zoning Structural Review Clerk (Revised02/24/2014) RICK SCOTT. GOVERNOR KEN LAWSON. SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC 1813706 i The CLASS AAIR CONDITIONING CONTRACTOR ' Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date AUG 31 2018 % .� SOLER. FELIPE DELJESUS TYCOON FLOW CONTROL CORPORATION ti 1271 WEST 62ND STREET HIALEAH FL 33012 ISSUED 08/07/2016 DISPLAY AS REQUIRED BY LAW SEo# 11608070001922 Local Business Tax Receipt ? Miami—Dade County, State of FloridLBT a ' -THIS IS NOT A BILL-DO NOT PAY e :g 8 D 164975 M I BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES Zy rn pM TYCOON FLOW CONTROL CORP RENEWAL SEPTEMBER 30, 2017 2500 W 78 ST BAY#9 5398706 Must he d'sl ley d ,l hia;.f:rt ,1r.ess to c m N A m HIALEAH FL 33016 P�rsu.��.;� A�.uunry 16� u' ch:,l,tr.r aA- �1& ro 6) t - TYPE OF BUSINESS OWNER SEC. PAYMENT RECEIVED ! M �COON FLOW CONTROL CORP 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR CAC1813706 545.00 07/21%2016 Worker(s) 1 CHECK21-16-098482 This Local Business Tax Receipt only confirms payment of the Local Business Tax The Receipt is not a license, permit,or a certification of the holder s qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO above must be displayed on all commercial vehicles-Miami-Dade Code Sec lfa--276. DATE(MMIDDlYY) A "ter CERTIFICATE OF LIABILITY INSURANCE � 02/06/17 _......_...._...._......._..__..............................-......_....__._._ _ - - ----- ----- -- ._-_"I ---- ... - PRODUCER South Pacific Professional Ins. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 500 K W.49th Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Hialeah,FL 33012 ALTER THE COVE AFFORDED BY THE POLICIES,BELOVi!_,__.__.. Phone(305)825-3535 Fax (305)825-5694 INSURERS AFFORDING COVERAGE 1 MAIC# 1`_._INSURER A: GRANADA COMMERCIAL INS CO 113683 INSURED TYCOON FLOW CONTROL CORP ...._..__.. INSURER B:._.__--a.___._____ 2500 W 78 St Bay#9 _ _._.._...._ _.....................: INSURER-C;_._......-_—_.........................__....-- --.__......_-._ _._.� Hialeah, FL 33016 INsuRFR o_ __ �PH(305}218-0788 - -- ----..............----._.. ........ _ INSURER E NORMANDY INSURANCE COMPANY t..... ._ . ._- — _..__ ._. ._— ....._._.. . _ _ .......... COVERAGES _ ............................... -- -- ........ . { THE POLICIES OF INSURANCE LISTED 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 AFFORQED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - ---- -- ......... ----.. . I ­­ -.1 __ INSR ADD'LI { '.POLICY EFFECTIVE POLICY EXPIRATION LTR„-INS __TYPE OF INSURANCE _POLICY NUMBER 'DATE(MMIDDIYYYY iDATE(MMIDDIYYYY) LIMITS � _ . .. .. .. GENERAL LIABILITY ,EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED [�]COMMERCIAL GENERAL LIABILITY 10185FL00052827-04 ! 09!23/2016 09/23/2017 PREMISES(Ea occurrence) 100,000 U01 CLAIMS MADE © OCCUR MED EXP(Any one person) 5,000, 1 - - 'A ' �� � � ;PERSONAL&ADV INJURY � 1 '666,600” ❑ -- { GENERAL AGGREGATE 2,000,0001 ❑ -- ._ -"--........................... PRODUCTS COMP/OP AGG 2,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: 1 1 ❑� POLICY ❑PROJECT LOC ---........ --- - 1 i ! AUTOMOBILE LIABILITY j COMBINED SINGLE LIMIT 1 ' ANY AUTO (Ea accident) I ; I❑ ALL OWNED AUTOS 1 j BODILY INJURY ❑ ❑ SCHEDULED AUTOS {Per person). ._......_........... ' ❑ HIRED AUTOS BODILY INJURY 1 ❑ NON OWNED AUTOS (Peraccident) - i — .......... ........... ❑ ... i (PROPER DAMAGE Per accident _. _ —_.-. ....... �......----- - GARAGE LIABILITY I { AUTO ONLY-EA ACCIDENT i ❑ i❑ ANY AUTO I OTHER THAN EA ACC ;..........._._._..._............................. j i❑ __— _.._. AUTO ONLY. --AGG 1I EXCESS I UMBRELLA LIABILITY ; EACH OCCURRENCE I _...... 1 ❑ I❑ OCCUR ❑ CLAIMS MADE r AGGREGATE I - I❑ DEDUCTIBLE I --- --------............. ❑ RETENTION $ I .._— - ... 1....--_ . .............. .. __. _ _ ._. _ ..... 71 WORKERS COMPENSATION AND NHFL0042112015 09!23/2016 09/23/2017 _j_TORv a airs. -_ _. RH ,........_.. EMPLOYERS'LIABILITY Y/N E ANY PROPRIETOR/PARTNER!EXECUTIVE E.L.EACH ACCIDENT 500,000 OFFICER i MEMBER EXCLUDED? N 1 ----.------ — J { (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE. 5_00,0001 _...... if yes,describe under E.L.DISEASE-POLICY LIMIT 500,000i SPECIAL PROVISIONS below—- OTHER _ .................. ........ _ ___ _ ..................................... DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT(SPECIAL PROVISIONS f 1 'CERTIFICATE HOLDER LISTED AS ADDITIONAL INSURED L--........._...._._.___........ ..... ...........____.-....._...._........ _.__..._____._......... __.____.._._._.._...-- CERTIFICATE HOLDERCANCELLATION _...._._......... — _........ ,—-.._.... __._.. __.. ............ ...._....... —–- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 1 EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2 AVENUE THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 1 MIAMI SHORES, FL 33138 OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ____ _._..._.___—___ __..__....._------.-___._...._...--_----..._..........._....� FAX 305-756-8972 AUTHORIZED REPRESENTATIVE _ . . ..... ...._.. _____ -.._ ____. — ACORD 25(2009101)QF �1_ - 009 ACORD CORPORATION.Ail rights reserved. The ACORD name and logo are registered marks of ACORD Permit NO. MC-5-07-873 Miami Shores Village Permit Type: Mechanical-Residential 10050 N.E.2nd Avenue NW work Classification:A/C Replacement Miami Shores,FL 33138-0000 Per I'tPermit Status:CANCELLED Phone: (305)795-2204 FtORIDp Issue Date:513/2007 Expiration: 01/01/2999 Project Address Parcel Number Applicant 460 NW 112 Terrace 1121360010180 Miami Shores, FL 33168- Block: Lot: LEO DE LA ROSA Owner Information Address Phone Cell LEO DE LA ROSA 460 NW 112 TERR (305)751-7067 MIAMI SHORES FL 33168-3328 Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 AIR KING MECHANICAL CONTRACTC 305-823-5888 Total Sq Feet: 0 Tons:3 Available Inspections: Additional Info:replacing of the unit Inspection Type: Classification:Residential Ventilation Approved: In Review Final Comments: Date Approved::In Review Rough Date Denied: Type of Work: Hood Scanning: 1 Rough Duct Smoke Test Duct Detector Test Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# MC-5-07-28341 Education Surcharge $0.60 Permit Fee $120.00 06/05/2007 Check#:2156 $ 128.40 $0.00 Permit Technology Fee $3.00 Scanning Fee $3.00 Total: $128.40 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. February 15, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy February 15, 2017 1