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MC-17-91
,r ^�4\ Miami Shores Village z - Building Department JAN 122017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305)795-2204 Fax:(305)756-8972 �� INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 BUILDING Master Permit No.16-860 PERMIT APPLICATION Sub Permit No. M C - �-- ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING Q MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9503 NE 2nd Avenue City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-013-3920 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):DVS LLC Phone#: Address:201 NE 95 Street City: Miami Shores State: FL Zip: 33138-2711 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: All Temperature Service Inc. Phone#: 954-434-7074 Address: 6040 SW 188 Avenue City: SW Ranches ate: FL Zip: 33332 Qualifier Name: Todd E Williams Phone#: 954-214-4138 State Certification o;Registr ion#: CAC056912 C ti to of Competency#: DESIGNER:Architecineer: nn Phone#: Address: V City: State: Zip. Value of Work fo(: cv mit:$ Square/Linear F otage of Work: Type of Work: ition Alteration ❑ New Repair/Replace ❑ Demolition Description of WM tiyl �CJ� vv� Specify color of color thru tile:- Submittal ile:Submittal Fee$ Permit Fee$ _ CCF$ 2 CO/CC$ Scanning Fee$ Radon Fee$ l& • DBPR$ ��2 a Notary$ Technology Fee$ Training/Education Fee$ _4- Double Fee$ 7�Ju 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 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 issued. In the absence of such posted notice, the inspection will not be approv -and-einspect' n fee will be charged. Signatur Signature L A �J Gq 1 Z ER or A T ` CONTRACTOR The fore ing instrum t was acknowledged before me this The foregoing instrument was acknowledged before me this I a day of20 by 1_day of �il,lUAM 120 17 by 09r19� Qe'�' t,sp,w o is personally known to ( 0 t713 [- i�.R�fir�1S who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: AMM oldallan oa1111ft on r 0002M Sign. d.— Sign: as ' Lqft Aqua 21,2020 Print: Print: ^' Seal: ;f "L. ELIZABETH ELCIqF Seal: MY COMMISSION p•• EXPIRES January iAPPROVED BY ` �Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) `SNORES L� Miami Shores Village X.y�' Building Department • [!� ...,� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 fiCOR1D Tel:(305) 795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address(where the work is being done):9503 NE 2nd Avenue City: Miami Shores Village County: Miami Dade Zip Code: 33138 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL# COND. UNIT MODEL# KW HEAT NOM TONS AHU Cu PKG 1)M.C.A AHU Cu PKG AHU Cu PKG 2)M.O.P AHU Cu PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 4. Size Disconnecting Means: Contractors Company Name: Ali Temperature Service Inc. Phone: 954-434-7074 State Certificate or Registrpti o. C056912 Certificate of Competency No. Signature Date: January 11, 2017 (Qualifier's signature) IRevised02/24/20141 F � STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ` 1 CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 ,w4t� 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 WILLIAMS, TODD EVERETT ALL TEMPERATURE SERVICE INC 6040 S W 188TH AVE SOUTHWEST RANCHES FL 33332 Congratulations! With this license you become one of the nearly one mil;ion Floridians licensed by the Department of Business and , STATE OF FLORIDA Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. Y PROFESSIONAL REGULATION Every day we work to improve the way we do business in order CAC056912 ISSUED: 06/20/2016 to serve you better For information about our services, please to onto www.myfloridalicense.com. There you can find more CERTIFIED AIR COND CONTR information about our divisions and the regulations that impact WILLIAMS,TODD EVERETT you, subscribe to department newsletters and learn more about ALL TEMPERATURE SERVICE INC the Department's initiatives. Our mission at the Department is: License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can �S CERTIFIED unae� the provisions of Ch 489 FS serve your customers. Thank you for doing business in Florida, and congratulations on your new license! Expirrondate AU331 20.8 1_16II5200000451 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON.SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD } ; CAC056912 The CLASS AAIR CONDITIONING CONTRACTOR Named below IS-CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31„2018 WILLIAMS, TODD EVERETT a o ALL.,TEMPERATURE SERVICE INC 6040 SW188TH AVE FT LAUDERDALE FL 33332 ISSUED: 06/20/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1606200000451 jj12f�'7 ALLTEMI OP ID: CW CERTIFICATE OF LIABILITY INSURANCE DATE 051126//20162016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER t CONTACT Riemer Insurance Group -PHONE Robert B Mittleman FAX-`�" ---" Hallandale Branch (A1c,No,Exti 800-742-1691 !_tAlC.Nop 954-454-9552 PO Box 250 E-MAIL "_._._._._.___-.. ._. _� —_ Hallandale,FL 33008-0250 ADDRESS' - Robert B Mittleman INSURERS)AFFORDING COVERAGE +—t- NAIL t _ INSURER A:Old Dominion Insurance Co. 40231 INSURED All Temperature Service,Inc. INSURER 8. Kelli 6040 SW 188th Ave. INSURER c_' SW Ranches, FL 33332 INSURER 0: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ,NSR 1 `66L SUHR-' --- - 06LICY EFF-,ao6lcrExP_.,� ____. _ __-___ LTR I TYPE OF INSURANCE POLICY NUMrtER MM!DDNYYY MMIDOIYYYY UWTS GENERAL LIABILITY { EACH occuHPENCE S 1,000,00 _ 7IAi 1 +MPG5236A 05!11!20161 05/1112017+0CGETB RENT EO A X 500,00 1 COMMERCIAL GENERAL LIABILITY 1.PREMISES(Ea occwrence� �_S t j CLAIMS-MADE X_I OCCUR MEO EXP Tnr,y one prior) S 10,00 j T l i l PERSONAL&ADV INJURY S 1,000,00( GENERAL AGGREGATE T !!S 2,000,00 GE,N1 AGGREGATE LIMIT APPLIES PER. PRODUCTS-CMIP10P AGC S 2,000,00 .. 4— . ^POLIC1 Xl 1.—..pp PRO I�"j LCC 7 AUTOMOBILE LIABILITY ! CaMSINED SINGLE LIMIT ) ANY AUTO l i 1 BODILY INJURY tPcr pmsor) i 5 OWNED SCHEDULED�� I k..._ AUT03 ALL O �. AUTOS I I 1 BODfLY INJURY leer anode d) S ._.�. ._. HIRED AUTOS NON OWNED PCVJffRTY pAAAAGE ` SAUTOS PER ACCIDT) t 4 I i I IS �UMBRELLA LIAR i OCCUREACH_OCCUNRENCE �S _ ~�EXCESS LIAR _ �,_�_CWLIS-NADE� l 'AGGREGATE_m`T�,_.,__ i._S DED i 1 RETENTION 5 I i WORKERS COMPENSATION I I WC STATU- Tai AND EMPLOYERS'LIABILITY YIN AVY PROPRIETOR,PARTNERIEXECUTIVE(� E L EACH ACCIDENT 5 ^FFICFR:A'EVBER EXCLUDCO7 i_1 NIA _ (Mandatory In NN) i I i I'yes, (Mandatory In-te leder i y E DISEASE•EA EtdPIOYEf,$ _ DE LCR PTION OF OPERATIONS bsla.v E.L.DISEASE POLICY LIAUT i 5 ' t 1 I i I i i 3 DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORD 101.Addt ional Remarks Schedule,if more space Is required) RE: CAC License CAC056912 CERTIFICATE HOLDER CANCELLATION Miami Shores Village MIAMSHI g SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 N.E.2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010!05) The ACORD name and logo are registered marks of ACORD BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA: Receipt#:183-914 ' ALL TEMPERATURE SERVICE INC xEATING/AIRCONDITION CONTRA R Business Name: Business Type:(A/C CONTR CLASS A) Owner Name:TODD E WILLIAMS Business Opened:06/25/1997 Business Location:5040 SW 188 AVE State/County/Cert/Reg:CAC056912 FT LAUDERDALE Exemption Code: Business Phone:954-434-7074 Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Pena::y Prior Years Collection Cost Total Paid 27.00 0.00 0.00 J.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: TODD E WILLIAMS Receipt #ICP-15-00015761 6040 SW 188 AVE Paid 07/25/2016 27.00 FT LAUDERDALE, FL 33332 1 2016 - 2017 r AC Off, DATE(MM/DD/YYYY) 164� CERTIFICATE OF LIABILITY INSURANCE 1/11/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Michael D Holleman Work Comp Associates, Inc. aICNN Ext: (561)500-3592 AIC,No): (561)500-2329 E-MAIL P.O.Box 33297 ADDRESS: MailWorkCom A �_ p ssociates.com Palm Beach Gardens, FL 33420-3297 INSURER(s)AFFORDING COVERAGE NAIC# INSURER A. Florida Citrus,Business&Ind. n/a INSURED INSURER B: All Temperature Service, Inc. INSURER C: 6040 S.W. 188th Avenue INSURER D: Southwest Ranches, FL 33332-1347 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADDLSUBFI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MIDD M/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurre.1 15AMAGO N $ CLAIMS-MADE F]OCCUR MED EXP(Any one $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JE a LOC $ AUTOMOBILE LIABILITY OMBIN INGLE LIMIT Ea accident $ ANY AUTO SCHEDULED ODILY INJURY Perperson) $ ALL OWNED AUTOS AUTOS ODILY INJURY Per accident $ NON-OWNED OPERTY DAMAGE HIRED AUTOS AUTOS Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-- HUAnF AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION XTORY LIMITS AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVEE.L.EACH ACCIDENT $ 1000000 - A OFFICE/MEMBEREXCLUDEDI [Y6/, N 10645787 10/1/2016 10/1/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) According to DBPR,Todd E Williams is the license holder for All Temperature Services,Inc.,license#CAC056912. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE Miami Shores Village WITH THE POLICY PROVISIONS. 10050 N E 2nd Avenue Miami Shores Village, FL 33138-2382 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD All Temperature Service, Inc. PROPOSAL 6040 SW 188th A-ve. SW Ranches,FL 33332-1347 Date Invoice# Phone# 'J$44,14-7074 Fax# 954434-7$7*7 6,29!2016 199214 CLIENT., JOB: Slate(omstruction'StIviim"lnc. Pacific DcnW Scrvims Lee Babitt 9503 NF--Ind Avcntw 1802 NE 2()71h St Miami Shofcc A wentura.FL 33 180 Phone Fax# Customer E-mail- 964-803-3069 lec Ci�,xlatc,nidvixonl Terms CONTRACT"PFRIICE —r— () Dw on rtvcipt $40.000 Qty Description Unit Price Total I BUILD OUT-CO:UMERCIAL-SUPPLYAND INSTALL CX)MPI.FTE HVAC AS PYR PLANS WITH(5 1-00),W) 40.0 5 TOX YORK 15 SX+R UNITS Approved! Not included is the following(finless expressed in before job descriplion).- permitfee.y,electrical work,plumbing work, concrete nw/I cutting,structurallroofing, work in addition to that described on the plans, a"work- unrelated to air conditioning or requiring special engineering to install. Credit acrd payments may he subject to a 2%processing fee "SER PTCE YOU WILL RECOAMEND Total$40.000.00