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MC-08-1838 Miami Shores Village DEC 0 3 2014 Building Department � o 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F-BC 20 C� BUILDING Master Permit No. =,:, "' 6 PERMIT APPLICATION Sub Permit No v ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION MR6NEWAL ❑PLUMBING 0 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 123 NE 97 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ROBERT S BUTLER Phone#:305-751-2112 Address: 123 NE 97 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: CAPITAL AIR Phone#: 954-792-4942 Address: 2951 SIMMS STREET City: HOLLYWOOD State: FLA Zip: 33020 Qualifier Name: PETE CALLAHAN Phone#: 954-792-4942 State Certification or Registration#: CAC058746 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 8000.00 Square/Linear Footage of Work: 6 rt Type of Work: � Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: NEW AIR CONDITIONING7g=.netA.) r�1 r- Specify color of color thru tile: Submittal Fee$ 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) 5-..7�' •9 1 1 , A 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 i the ab nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signat re OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this /n� day of 20 ,by day of /vine«• a- 20 y by W Awwb! eD .whoispersonally known to "Z C4414A-44-J who' personally known me or who has produced 'b& Ic \Q I- ( N d�" as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTA USUC: NOTARY PUB Sign: Ltk Sign- Print: lJA L° Print: e-C® /LZ/- c. Seal: ,�• aSeal: CONSUELO RIZZI-HARPER DAVID p HESTER P�Ift•State of FI Ie . MY COMMISSION#FF070613 my Co".Expires Jul 16,2016 °.' � EXPIRES December 8.2017 APPROVED BY s� Plans Examiner Zoning Structural Review a Clerk (Revised02/24/2014) 2014-11 -24 07:54 Capital Air Cond. 9547970029 >> 1 800 685 7530 P 3/3 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC058745 The CLASS B AIR CONDITIONING CONTRACTOR--•": Named below IS CERTIFIED a, Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 CALLAHAN, PETER MICHAL: CAPITALAIRINC 17111 SW64TH•COURT...y:,.. ..:..,•yam'`"" � . ..:��•"•'�. ' - :"•: . FT LAUDERDALE-'. =-••)=L63331 '�'•. ISSUED; 07M/2014 DISPLAYAS REQUIRED BY LAW SEn# L140721000066a BROWARD COUNTY LOCAL BUSINESS TAX Rr=CEIPT 115 S.Andrews Ave., Rm, A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 DBA: Receipt CAPITAL AIR INC #:�83-1722 Business Name: Business Type-(A/C CONTRACTR (A/C LTD 15 'TONS CONTR) Owner Name:PETER M CALT.,AHAN Business Opened:o5/13/1985 Business Location:2951 SIMMS STREET State/County/Cert/Reg:CAC058746 FT LAUDERDALE Exemption Code: Business Phone:954-792-4942 Rooms Seats Employees Machines Professionals 1 Fat Vending soalness Only Number of Machines: Vending Type: Tax An OUN Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paitl 27.00 0.00 0,00 a.on 0,00 O.UO 29.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN'YOUR PLACE OF BUSINESS CITY OF HOLLYWOOD LOCAL BUSINESS TAXECEIPT `� �',.,•_ RPRINT DATE: / / •�.�.�. 9 15 I4 THIS IS'YOUR LOCAL BUSINESS TAX RECEIPT, PLEASE DETACH AND POST IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. PLEASE DO NOT REMIT ANY PAYMENT.MS IS NOTA BILL F ne CAPITAL AIR, INC. 10ija 2951 SIMMS ST Aess Class: CONTRACTOR/AIR CONDITIONER asis:: 2S WORKEt�s ipt Number: is 00050579 ipt Year: 3,0/01/14 ation Date: 09/30/15 NEW CHARGESL(Itemized Below) 316.00 Comments.; Base Fee 316.00 Additional Charges: 2014-11-24 07:53 Capital Air Cond. 9547970029 >> 1 800 685 7530 P 2/3 M CAPIT10 OP ID;XR CERTIFICATE OF LIABILITY INSURANCE DATE 1 10/006/261201144 THIS CERTIFICATE IS ISSUED A$ 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pDlicy(ies) must be endorsed, If SUBROGATION IS WANED, 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)feu of such endorsement(s). PRODUCER Phone:305-364-7800 CONTACT BROWN L8,BROWN OF FLORIDA INC 14900 NW 79th Court Suite#200 Fax:305.714-4401 PHONE FAX Nu Miami Lakes, FL 33016-5869 EMAIL Marc D.Jacobson INSURER(S)AFFORDING COVERAGE MAIC P INsuReRA:Commerce and Industry Ins Co 19410 wsuRGO Capital Air,Inc. INSURER u:Amerisure Insurance Company 19488 dba Capital Air Conditioning PrIMSURERC:Amerisure Mutual Insurance Co 23396 Callahan Property __.__......... Acquisitions,inc_ INSURtR D: 2951-2953 Simms Street INSURER E Hollywood,FL 33020 ihmuRaRP: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. Lrti TYPE OF INSURANCE ADDLSUS POLICY EFF POUCYEXP POUCYNUMBER M DDY D LIMITS GENERAL UABILITY EACH OCCUKKHNCN $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY 01-206442005 0911612014 09/16!2015 PREMISES eaoccwrence) $ 100,00 CLAIMS-MADE OCCUR MGD EXP(Any one person) S 5100 PERSONAL&ADV INJURY S 11000100 GENERAL AGGREGATE $_ _ 2,000,00 GEN'L AGGREGGAI E LIMIT APPLIES PER; PRODUCTS-COMP/OP AGG S 2,000,00 POt.ICv X PRO I,OC -- AUTOMOBILE LIABILITY COMBINED SINGLE LIMB 1_,000,00 (Eeacdtlent) S B RAUJ.08 ANY AUTO CA206442105 09/16/2014 09116/2015 BODILY INJURY(Per Deleon) SALLOW - ALLOWNED -'"' AtCNOESULED BODILY INJURY(For accident) $ •IIRED AUTOS X NON-OW NEI)ALMOS PROPGRTY OAMAGC $ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000, A X EXCESSLIAB CLAIMS-MADE BE032459107 09/16/2014 09/1612015 AGGREGATE $ 5,000, DED RMMJTION S WORKERS COMPENSATION WL'STATU 01'11- S AND EMPLOYERS'UYIN ABIUTY X TORY LIMITS C ANY PROPRIETOR/PARTNEWEXECUTNE WC208028703 01/01/201/401/01/2015 E.l.EACHACCIDENT $ '1,000, OFMCC•R/MIMMER EXCLUDED? U N I A (Man atoryinMR) E.L.DISEASE-EA EMPLOYEd S 1,000,00( DESCRIPTION OF OPERATIONS DeXtw I.L.DISEASE-POLICY t!MIT I$ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONSI VEHICLES(Attach ACORD 101,Additional Remarks Schodule,i1 more space is required) X"banical COutructor u+xcense# CLC058746 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A80VE DESCRIBED POLICIES 8E CANCELLED BEFORE Miami Shares Village THE EXPIRATION DATE THEREOF, NOTICE WILL RE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue Miami Shores,FL 33138 AUTHORIZEDREPRESENTATIVE O 19OB-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD P• I LOCATION OF WORK P ITMAINTENANCE INVOICE CAPAL NO. 78240 I STRCITY AMR CONDITIONONG (-,Ondibormc 2951 Simms Sbwt - HdVtirood FL 33020 DATE WORK IV&% M%�m COMPRESSOR Air (954) 792-4942 0 Fax: (954) 797-0029 0 Suction.-------PSIG 0 Head—PSIG cap1ta1a1r2m 0 961Ca)yahoo.coV—A El Electrical Connections 5 F QTY. ITEM PRICE NAME BILL TO PHONE &Contacts Tight&Clean 9'CONDENSER COIL FILTER X X STREET 11Clean Coll 0 Ent OF Lv---.!F STATE ZIP 5?REFRIGERANT CITY 1011 0 Leaks 0 Charge MAKE MODEL SERIAL NUMBER 6?FAN&MOTOR 1:1 V—A_ MAKE MODEL SERIAL NUMBER 0 Electrical Connections "i &Contacts Tight&Clean Iii?COOLING COIL E]WARRANTY El SERVICE CONTRACT DINCOMPLETE 0 Clean Coil DATE ❑DESCRIPTION OF WORK PERFORMED 0 Leaving Air Temp. oF 0 FAN&MOTOR 0 V—A 0 Fan Pulleys(Adjust Belt) 0 Lubricate Bearings&Motor El Electrical Connections &Contacts Tight&Clean C, W CONDENSATE AREAS 0 Inspect&Clean Drain Pans C0 Inspect&Clean Drain E?AIR FILTERS 0 Cleaned 0 Replaced R HEATING ASSEMBLY 0 Bumer&Interchanger 0 Fuel Supply and Pressure EI Pilot Assembly(also Clean) 13 Flame Adjustment 0 Stack Switch&Flue 0 Fan&Limit Switch operation IV THERMOSTAT COST UPON INSPECTION OUR TRAINED PERSONNEL RECOMM ND BREAKDOWN NVOICE SERVICEMAN NO. NUMBER ITEM AMOUNT.-- TOTAL MATERIAL AI SER"I�E"1AN 0 SERVICE CHARGE C—U TRAVEL CUSTOMER'S AUTHORIZATION CUSTOMER'S ACCEPTANCE A y Ak SALES TAX 0 CUSTOMER NUMBER URE SIGNATURE —tAL TOT, $ TERMS: NET DATE OF INVOICE When making Payment,please refer to Invoice Number December 15,2010 Dantins Services,Inc. 12671 S.W. 190th Street Miami, Florida 33177 Re: Miami Shores Building Permit MC 08-1838 Dear Sirs, Please accept this as formal notice that your services are no longer required on the above permit for renovation of my home at 123 NE 97th Street, Miami Shores, Florida 33138. This notice will be on file with the Building Department of Miami Shores. Respecftully, 111111UIIV�—' Robert Butler A. S nature 0 Agent Item Complete if Rhestrict�2Delivery is deplete ired X _ E3 Add ■ Print your name and address on the reverse C e De 8o that we can return the Card to you. B. ■ Attach this card to the back of the mailPlece, ! Yes CJ or on the front if space permits. D. Is delivery address different from Item 1? E3 No 1. Article Addressed to: If YES,enter delivery address below: Ov l 6 7/ E •c/J - l GG 5� 3. Seroir�'[ype /! / t �°7' 0 Cerdfl�Mail 0 Express Mall 1q,tri J ' t, j' °� i ! f 0 Registered 13 Return Receipt for Merchandt� ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. A,ticie Number 7010 1670 0001 6804 4799 (rn3nsfer from sww a label) JOMS-oz-M-15 PS Form 3811,February 2004 Domestic Return Receipt Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-97783 Permit Number: MC-10-08-1838 Scheduled Inspection Date: February 02,2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: BUTLER, ROBERT Work Classification: Addition/Alteration Job Address: 123 NE 97 Street Miami Shores, FL 33138- Phone Number (786)556-2919 Parcel Number 1132060132440 Project: <NONE> Contractor: CAPITAL AIR INC Phone: 954/792-4942 Building Department Comments INSTALL 2 NEW HVAC SYSTEMS Letter received from All Dade A/C cancelling permit/no work started. NB 4-22-09 �i Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 30,2015 For Inspections please call: (305)762-4949 Page 31 of 31 IR Miami Shores Village REC I ; Building Department pus , 2011 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)7952204 Fax:(305)756.8972 BY: INSPECTION'S PHONE NUMBER:(305)762.4949 r BUILDING Permit No. 0 r PERMIT APPLICATION Master Permit No. M e-, 18 e 10. - 1 93 S FBC 20 Permit Type: MECHANICAL �}- •7A, 55G--M 1-17 ci.1( I OWNER:Name(Fee Simple Titleholder): ® BldLtr_ Phone#: 365 `76 Address: I A S N - E q 9 !S±C City: \0-M l ,5�)®1(F 5 State: Zip: '35138 Tenant/Lessee Name: Phone#: Email: ku ex c, t rn Q L66An ci JOB ADDRESS: 1 g ?s I V w F, 9 Ciq _S-k A p� City: Miami Shores County: Miami Dade Zip: 33139.c.33A Folio/Parcel#: 11 —3 a o(o _ 0 t 3 —a q�f D-�l"1!6 �a C Sgr,Ij D'7 a Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: CCLV i ! -A', n, Phone#: Address: ol '5 -`q_ T mr_o, City: CA State: �_ Zip: rr ii 3 31 0_ . Qualifier Name: O� Phone#:q5 I M^t'1 q? State Certification or,Reegiistratiorn�#:�1C (J ®�9� � Curti c to of Competency#: Contact Phone#: C1-. "t 9 Q d. 4 q 4 9% Email Address: Ca-Dt11 �I r'3 q St 4- CL® 1 , Cdr$ 1Y\ DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ 10, &10 ,1'0 Square/Linear Footage of Work: Type of Work: OAddress %,alteration ❑New ORepair/Replace ODemolition Description of Work: 3S 1APL t Q4-+ A,-"aV A 1 K_ (w o t*Ll- Lxki t)j2 R_/( aa *axx **!FeesT" C mx z :ax � x -:�m ux Submittal Fee$ Permit Fee$ F$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ W (/may Bonding Company's Name(if applicable) IF . 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. 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 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted ah the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not beapproved and a reinspection fee will be charged. 12 1A Ac Signature Signature Owner or Agent Contractor rd The foregoing instrument was acknowledged before me this AJ The foregoing instrument was acknowledged before me thi day of ,201,by 16� rstJ-Ow— , day of .20�,by 4 G4 I h—, who is personally known to me or who has produced ' 7 who ' personally know to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY LI • a a Sign Si IE 17697 Print:y Commisy'pub6eu My Commission Ex y, CONSUELO RIM-HARPER f*r MY COMMISSION#DO 945016 EXPIRES:December 6,2013 Bonded"Ndteypublioundef ritWO daak�a$apgaalsapeiaapalarpapalaayap�a$qa ala aJsaJa akakNa .� � ap skskp�sk�skakskak�ak�+KasNN�shaksH+kskNa�aksA�M��dask�Haakshsk+kHa�aH�+sksk�sA��NaHaeb�ks#skrts�adaskHaaksh�fs8sa&sk APPROVED BY clans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) �. s r � 5 ORJ yi Miami Shores Village "" ""'ITI Building Department 10050 N.E.2nd Avenue ,�pRYpp► Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 ARCHITECT Permit N.was "� w Owners Name (Fee Simple Title Holder): c �— Phone#: 7�(-&) /i Owners Address: City: ZdM 7/KOyS5 State Zip Code: Job Address(Of where work is being done): City: Miami Shores State:—Florida Zip Code: Contractors Company Name: �2(TRL G 1-(L I WC, Phone#: Address: Q0N k 5 W a S -C Fr-(2aAGlF- f6A`� +- �;Z City: F-1 . L1A 700(,-L. tVP1A-rte State: C — Zip Code: 331 Qualifiers Name : GAL-VA Acv;-J Lic. Number: 0,(k e.(nS 2�1 Architect/Engineer of Record Name: Phone#: Address: City: State: \ Zip Code: Describe Work: ' 1)1Z 04A"i�_ �P I—C LPA I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal invo ent. Sig 9 nature Si natur ,3h� owner or Agent Contractor or Architect The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me thday of`y •201�,by 1�U2 this cW day of} ,20 by jLt&LA4J Who is personally known to me or who has produced who is personally known to me or who has produced as indent�fication. D�.Son�-u.w Knee� as indentification. OIJ ll U��llIli��(�. Notary Public: ,8 p ss9`�p �,',; Nota lic: Sign: !�mo� = Si Seal: Seal. ,;�rP.•••, pSELORIZZIHARPER ZdOZ/ �0 s ol MY COMMISSION#DD 945018 %.����'.ail X?�•.•;� `�� = EXPIRES:December 8,2013 //�s S j ula \\���� �p;'r� ` Bonded Thru Notary Publk Underwriters lUIIII `g OR�s .•. allot" Miami Shores Village Building Department �l 0 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. / COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. ✓ COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: LOA A111c, l o G BUSINESS ADDRESS: 61 S w A STATE ZIP CODE 3 3 BUSINESS PHONE: (� ) 19.1, -q 9 YdZ FAX NUMBER q O D;k q CELL PHONE(ffA-) r �, ,5' QUALIFIER'S NAME.RJ-,e_V- 0aj/0tje410 QUALIFIER'S LIC NUMBER: U C o_" -a 7� E-MAIL ADDRESS (IF APPLICABLE): ',01, Co 0� Created on 3119109 BY MLOV 1 RV 3126109 MLDV ACORD® CERTIFICATE OF LIABILITY INSURANCE OP ID MQ DATE(MMIDD/YYYY) 01/03/11 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 )terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the .ertificate holder in lieu of such endorsement(s). PRODUCER NAME: PHONE BROWN & BROWN-HBA DIVISION Alc,No,Ext): _ (AIC,No): 2500 NW 79TH AVE, SUITE 101 ADDRESS: MIAMI FL 33122 CUSTOMER ID M CAPIT10 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERISURE INSURANCE CO ;Capital Air, Inc. INSURER B: TECHNOLOGY INSURANCE CO. 42376 Dba Capital Air 2961 SW 23 Terr. Bay #2 INSURERC: AMERISURE MUTUAL INS CO Ft. Lauderdale FL 33312 --- --- INSURER D: 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 LTR TYPE OF INSURANCE I N S R WVD POLICY NUMBER —MM%D[YYYY POLICY EXP ( ) (MMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,000 AMAGE 7U_RENTED— A —x,! COMMERCIAL GENERAL LIABILITY GL2064420000000 109/16/10 09/16/11 PREMISES(Ea occurrence) $ 50,000 r CLAIMS-MADE X OCCUR ! ! MED EXP(Any one person) ! $5 000 -_------- f- -- L PERSONAL&ADV INJURY �$ 1,000,000, GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY j X JE ! LOC - -- - ._ -- $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 1 OOO OOO X (Ea accident) r r JI ANY AUTO 'CA20644210001 109/16/10 09/16/11 r---- -- - - ---- - - BODILY INJURY(Per person) $ 4 ALI.OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS -__-_ __ 1 �---1 PROPERTY DAMAGE $ A X HIRED AUTOS (Per accident) A i X 1'iNON-OWNED AUTOS -_ p _ Com rehensive $ 500 ded A X '' Com reh/Collision Collision $ 500 ded C X UMBRELLA LIABX OCCUR CU206442200 '09/16/10 109/16/11 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE' - L�_ AGGREGATE $ DEDUCTIBLE RETENTION $ j $ B ! WORKERS COMPENSATION TFjC3263245 O1/O1/11 '01/01/12 X ' WCSTATU- OTH AND EMPLOYERS'LIABILITY Y/N 1 TORY LIMITS ER 1 ANY PRC PRIETOR/PARTNER/EXECUTIVEE.L EACH ACCIDENT $ 1,000,000 OFFICEFt/MEMBER EXCLUDED? N 1 A i (Mandatory in NH) — -_- --I--- -- E L.DISEASE EA EMPLOYEE' $ 1,000,000 If yes,describe under iDESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S 1,000,000 � ' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101.Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village 10050 Ne 2 Avenue AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 s reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD r,. ,�.F .� •�.• trr`,, wF:l �� Al-f a ,����;;;•••r t°s3,1.''}'T. 1_: j: R s.. �,�t +i�•��t > ;}1.45+w'.'J:r}J�tl,y�t�l }rF(Sf,}P(1 S.'�+.;1 � - �/�(/��}�r y 4� �r 4•., �i 1r s:4.r�A t. I/•'�}..�-�1�,t,•��',4tite 1-. 4"' _ ait.KF y,� d`•��'��ij. 7 �-{ � tt1V"' t�. _ !C CfiJlI v S"S �,i,,,,, lt,'• d+§t .%fa:s )r r. �. A` jd"�t p, ,+r 6"•SSS-": Y ♦ h e. Y e FR.r t 1, S:IONAL FtEC�t � .•_ { 11�4c : CEN3ING BOAS 4 '""}p _d �,..t�.?'tC7 "r �r y al: ;;i rl."�'�r�•�' � �. x ,'�.� Sf 1 :t 171.1 .i41 sett 'l_ fl r - �.."fit :Gti1F���h@ 4i1.]Li�i,�►7—u�tJ y..- �1,,��.' _ I i rt,j��'k4���,"LI'� FXy Q p. t Expirat by l'-' ' 31 K,il ��ar7..d't\ �ttd"�-.F` �';r ,fit{ .•�,ft �'Mtid t } ' i •� Mair } �.Y`a� '� .`'�rvl�' fep�t 1�.-r '� i�tr��)1����r 4t rr},� #....� : `-''- ,� _ `•�" si'- ;1'� ,}Idt i�t �t��"vts F,v'wfl} t.;d �. �at M "I+. ) t1yi d•�� a ,,�D� �; � _ a _: , '+.yii �i�t�'r.�a�r� /;`�'a h� F {'► r " i t}�^`.:(�iY"tfii"}i:-Ss!( tr� � 14. FT' r ,.r , t}.�� �f►i ~j; t t° �t.�� � � pi �fi,�t� )} 1 q p P ,+ ;�} ��j ;;ti��t �irr♦k rNsrex�.�a'lh Y.^� it':.�t-a�xF} °�g5;at r't.:a:'I/ fir-..? tr af'F'ii(�r��` °`}�(` •�. ?k ���,+pti t,,�-�. fish Via. l..y.yrr �1''yshr2��'y1i d,�'��1_ E "2"i.��.17J:�1•i �g°1 J� �� ,r �,.��.. J ,i .r � t r.a,t 7 0. �`' r�C' � + 'Yl�i k r "4at9IRE0 BY LAW ME 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 —954-831-4000 VALID OCTOBER 1,2010 THROUGH SEPTEMBER 30,2011 Receipt#183-1722 DBA: HEAT NG/AIRCONDITION CO C7 Business Name:CAPITAL AIR INC Business Type: (A/C LTD 15 TONS CONTR) Owner Name:PETER M CALLAHAN Business Opened:05/13/1985 Business Location:2561 SW 23 TER 2 State/County/Cert/Reg:CAC058746 FT LAUDERDALE Exemption Code:NONEXEMPT Business Phone:954-792-4942 Rooms Seats Employs" Machines Professionals 1 For Vending Business only Number of Machines: Vending Type: Collection Cost Tot Penalty Prior Years al Paid N Tax Amount Transfer Fee SF Fee _ Y 27.00. 0.00 0�D,O 0.00 1 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: PETER M CALLAHAN Receipt #05A-09-00029390 2961 SW 23 TER BAY '#2 Paid 09/07/2010 27.00 FORT LAUDERDALE, FL 33312 2010 - 2011 CITY DF- DAN IA BEACH Bu-siness Tax VALID THROUGH DATE BELOW CAPITAL AIR CONDITIONING�D/EIA` CAPITAL AIR, INC. 2961 SW 23 TER2 , FT. LAUDERDA'IftfR3 �1�7 ' an Business Na 'e: 4. CA�'ITAL AIR-CONDITIONING D/B/A 2961 SW 23 TEFF 2 Location Address : �.... Number/Class: 11-0000439819 8 --CONTRACTOR - MECHANICAL Sepf 09 2010 Issue Date: ;. � ,. r 'cr he- 'K. rZ atior �DExpir �. aeO �. Nth F SPP I- L•` p i nAt - ..... is �• i i Primary'-Li_____ Fee: � 21'0� 00 i Secondriay Licentse Fee $13:00 u , k, $0,00 ri Penalty '�u� .m $21'0' �d,,,, Total. l� J t 4 ry. Comments AIR C&DIT�IONING CONTRACTOR Restrictions: _ SUBJECT AND ISSUED ACCORDING T PbbtlNESS TAX RECEIPT ORDINANCE CHAPTER 15. This Business Tax Receipt does.not permit:the holder-to operate in violation of any City lavv, ordinance. or regulation. Any change in location or ownership.must be disapprove the holder's kil'or competence'or of throvqd*by the City, e hoider's complianect to zoning ce restrictions. non-compliance with th other laws.s Tax tregulations does not endorse, standaards rove, or MUST BE POSTED:CONSPIC000SLY AT BUSINESS LOCATION 100 Vilest Dania Bt�ach R(}Ulevard * 1)*�ii.i t tE?+(:li tis rt q a Miami Shores Village Building Department �► �� g p 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUN 2 9 RECP A I ail I _ S I i'._ Tel: (305)795.2204 Fax: (305)756.8972 (f' INSPECTION'S PHONE NUMBER: (305)762.4949 BUILDING Permit Permit No.(.0 &O., PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL Owner's Name(Fee Simple Titleholder)VjjZ-ftCL�1 ��J�1C.fL2. Phone#'A-)S 2 1 + Owner's AddressIL"j �_ q,—1 3 �\City k1Am j S�1.�RJR Ntate ^Q-_ Zip Tenant/Lessee Name Phone# Email � Job Address(where the work is being done) IJ iVIL 9-1 S-T City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO Flood Zone Contractor's Company Name Com) I%,Ct2 Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Contact Phone E-mail Architect/Engineer's Name(if applicable) Phone# *Value of Work For this Permit$ Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑Demolition Describe Work: T2��c G O Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Bond$ Double Fee$ Violation date: Structural Review.$ Total Fee Now Due$ See Reverse side-� Bonding Company's Name(if applicable) of-A- Bonding 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 not be approved a rei e . n fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 Ikn ,by l -b bl&Z-7 day of ,20 by who iiiTersonally kno—w-A-15me or who has produced 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: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07/10/07)(Revised 06/10/2009) Miami Shores Village wilding Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING Permit No. D PERMIT APPLICATIO ApR 32009 Master Permit No. OX' 1345 FBC 2004 Permit Type: Mechanical t9----------- Owner's Name(Fee Simple Titleholder) � � �✓ Phone# q r` � !J7 L. Owner's Address Al6 �- city MA (dr" 1 State Zip Tenant/Lessee Name Phone# E-MAIL: �— Job Address(where the work is being done) AAC�o 9917 •S' City Miami Shores Villase County Miami-Dade Zip FOLIO/PARCEL# f/.r 3204- Q/ 3—2,ii a Is Building 111storkally Designated YES NQ—&- � Contractor's Company Name �Aas�o �� ��tZJ l G Phone# Contractor's Address City " dm 11 State T- Zip 53/7 7 Qualifier Name Phone# State Certificate or Registration No. g�::AG 1'i31 V I'] i Certificate of Competency No. E-MAIL: 3 n ZA+ ' . Go• Architect/Engineer's Name(if applicable) 4'"<< C!Mt�a& Phone# 167-7 tom!► $D Value of Work For this Permit /r Square/Linear Footage Of Work: Type of Work: ❑Addition dA�ration []New Q Repair/Replace Demolition DescribeWork: AJJ m3W AIL w artA irk fYa#*,ticdntrias i Bei*,t�*stta Jr+tt,tt,cit�,ri ir,aftr*`*F��,t,t 4&*rt�t b,t�r*i it&k,t#sirir#rsY+t4+YR*Jt Jt1rate sir*ri a,r,►a�rtTrt+t,a Submittal Fee$ Permit Fee$ (� 7& CCF$ CO/Cc- Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Dae$ 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 seamed 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 IIKPROVEMENTS 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 approved and a reinspection fee will be charged Signature Si Owner or Agent Contractor The foregoing instrument was1 be r e this The foregoing instrument was acknow edged before me this day of 14 ,20 bya�` !� day of IAP .20 d 9 by ItG�' who is personally known to me or who has produced who is personally known to me or who has produced •L • As identification and who did a an oath. L ' as identification and �k an oath. NOTARY PUBLIC: was WdWtY '1[djB11 IC: 0P�Q fy�e 014 )©g16112 1 � �� �� 19,2O10 �' afi� Sign: er Sign: 4 Print: EXp\R �pallota�Y�Nca Print: My Co :5� My Co ttr.aa,t*a,ra,c,�r,t«,rtaar.ara,�rw,xt�,t�,�.,►,ta*,r,t,�,tea*.ro:,►,te.,t*ae,Baastra,rw*,�,��,�,t,r,�,tCsr,tat,�,att�,a*�r�r*�*,�eartr,�araarra,�r*,�,t*a�,t* APPLICATION APPROVED BY: V1 �d G Plans Examiner Engineer Zoning (Revised 02/08/06) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING LRIECO(VE-110D Permit No. KC.0�-1S)�PERMIT APPLICATION 1u ster Permit No. (' Op —1?�FBC 2004 Permit Type: Mechanical / Owner's Name(Fee Simple Titleholder) ` � I�v� / phone# — — j C 25 g Owner's Address 123 City "-('f C4,-�f State I Zip Tenant/Lessee Name Phone# E-MAIL: Job Address(where the work is being done)_z�3 /✓� 97 577 City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# ��"' ,��(��Q/;��. 21V 412) Is Building Historically Designated YES NO Contractor's Company NamePhone# J d�`' ! q— 72?5 Contractor's Address 0 3tkr e5w of y ravyl- City0 OF 1N1A4 61Z State Zip Qualifier Name /©6Q 0/ 'l A Q. Phone# 3cS1 � C)f State Certificate or Registration No._ �i Certificate of Competency No. E-MAIL: Architect/Engineer's Name(if applicable) Phone#_ -7c) 17 Value of Work For this Permit$ Square/Linear Footage Of Work: Type of Work: FkKd-dith ❑Alteration N, w e air/Replace ❑ Demolition Describe Work: I/ / mmmmmmdemmmmmmmm4cmmoammmmm4amaemmmm4em•mmmgem Fe SmmmmmmoTx ekx4e 4cmmmmmmzc dcmmmmmm,e scmmmmmmmmmsemmmkmm Submittal Fee$ Permit Fee$ G w CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ 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 State ! Zip City A a� � ' ' ' ' ' l_tions',r+as.indicated. l certify that no work or installation has Application is hereby made to obtain a permit to dtfaSb�S ,c., commenced prior to the issuance of a permit and that all work will be� formed to meet the standards of all laws regulating construction in this jurisdiction. l 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$21"e applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochu�e-wr bed vexed t. the person whose property is subject to attachment. Also, a certified copy of the recorded notice of comme,Ce m nt mine posted at.the job site for the first inspection which occurs seven (7) days after the building permit is issued. In-ihe absenod of such posted notice, the inspection will not be approved and a rei p tionfee will be charged. f Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoi g instrument was cknowle ed before me this g !� I day of �Q l� ,20Q�,by day of ,20 by ' who is personally known to me or who has produced who is personally known to me or who has producer P.L� As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY P IC: OR fViARQ Sign: Sign: I14 Al ONi6+7-21- ti ov N LC Print: . EXPIRES November 19,2010 Print: ad1l� irr05 Flart��Notesysero"�` My Commission x o�° y�res.05n, 12 - My Commission Expires: x dexdex%Xxxdexxxxxdexxxxxxxxxxdrxxxxxxxxdexxxxxxdeuxxxxxxxxxdexx xxxxxxdaxdexxxxxxde dexxxxxxxdexxxxxxxxx dcx :xxdexcx&s APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06) -is e Mcchawica' D/B/A All Dade Air Conditioning CACO 042586 ADACgBellsouth.net e-mail 305-278-8833 PHONE 10465 SW 184 Terrace 305-254-5411 FAX Miami, Fl. 33157 April 8,2009 Miami Shores Village-Hall APR 2 1 2009 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Y�__ msoo©om FAX 305-756-8972 Ref: Cancellation of Mechanical Permit: MC081838 Robert Butler(Owner) 123 NE 97 ST Miami Shores, Fl. Attn: NORMAN BRUHN FAX(305) 876-7925 Dear Mr. Bruhn; Ply accept this letter as request to cancel permit number MC081838. It is a mechanical permit obtained for the property address 123 NE 97I' ST,Miami Shores,Fl. I will be notifying both the property owner and the general contractor.No work has been performed on the job. Please feel free to contact me at 305-278-8833 if you have any further questions. Sincerely, --liana R. Bouzon Office Manager Cc: Robert Butler(Owner) 123 NE 97 ST Miami Shores,Fl. Lou Fernandez 305-758-7666 FAX 04/08/2009 10:25 3052545411 ALLDADE AC PAGE 01 -" .4 el xr D/B/A All Dade Air Conditioning CACO 042586 ADACQWellsouth. e-mail 305-278-8833 PHONE 10465 SW 184 Terrace 305-254-5411 FAX D '?` Miami,li1. 33157 _ -- April 8, 2009 APR 0 9 2009 BY---� --------- Miami Shores Village Hall 10050 Northeast 2nd Avenue Miami Shores,Florida 33138 FAX 305-756-8972 Ref: Cancellation of Mechanical Permit: MC081838 Robert Butler(Owner) 123 NE 97 ST Miami Shores,Fl. Atta: NORMAN BRUHN FAX(305) 876-7925 Dear Mr.Bruhn; Please.weept this tetter as request to cancel permit number.'MC081839.1t is-a mechanical permit obtained for the property address 123 NE 97th ST,Miami Shores,Fl. i will be notifying both the property owner and the general contractor.No work has been performed on the,job. Please feel free to contact me at 305-278-8833 if you have any£tmther questions. Sincer ►, Diana R-Bouzon Office Manager Cc: Robert Butler(Owner) 123 NE 97 ST Miami Shores,Fl. Lou Fernandez 305-758-7666 FAX 07/13/2008 10:20 30525OR411 ALLDADE AC PAGE 02 ALL DAD» AIR CU141 MINING &HEAT"ING,INC. PROPOSAL State LiCTAN# 10463 SW 184terr CAC 0475% M mh FI 33157 Mr.Peal Klin Tel(305)2784833 Pre"Ut Phoar.305—49641992 Fax(305)254-5411 meted to: Dawns= Lon Fwowadez Ad 123 97 Th Mist81„Sbores 1�1, lam:30;5 77666 All Da&Air C Witlaning 8t Heating,bots-will install, fAgbuBmg 2.5 tan IN" 3..,5 an LIM, RacEi and?.,200.t1Q odbom itr m 1j".00 AAEI staggis> .OQ 30.00. 1213112 lineaO.QQ . LAW 3AWAQ Ya�tllatlog Q CE All of a MVAC system. TOTAL CONTRAT ........................ .....$16,500.00 TERMS OF PA,XMMU TO BE MADE AS FOUDWS 501* WITH AGRE>r�NP Upm COMPI.t:T1011>: All dial ft pwmnW to be as seabe& work to be comphad in a waimm kite mmum aomdft to standW powicm Any a10mfiw/"deviation 6ovc spmifxofww km&bg c,ctrs casts work be agacoW only upon wtlttea sd will bei an over and above the esriumle. All agmemmu congagm upon smkes,souldow or delay beyond ow Uwnsr to =" fine torumb atter cadres==aeay ice. Ow workers ate My aoverod'by yl► ijuram Now Thus propoesi my withdrawal by ns. Auaborized NpWurc. o ll If stot a ttad within 10 tkw& Ampmm offtupoW-TU above p iccs,sp=Mca ions end condifiaas „ore hereby actapatc& You are awhm=d to 41)t>te work as spccified P"m w01 be made as outlined abtrva