MC-16-1595 x
Miami Shores Village r t4lt~ ? 13C11� :.
10050 N.E.2nd Avenue NE
+, �Oi1C' a1vSlc� [?tiIditiOl�AltetatiAn
Miami Shores,FL 33138-0000
Phone: (305)795-2204 t
33
Expiration: 01/14/2017
Project Address Parcel Number Applicant
10433 NE 6 Avenue 1122310120180
Miami Shores, FL Block: Lot: CAROL INVEST USA INC
Owner Information Address Phone Cell
CAROL INVEST USA INC 990 BISCAYNE Boulevard
MIAMI FL 33132-
990 BISCAYNE Boulevard
MIAMI FL 33132-
Contractor(s) Phone Cell Phone Valuation: $ 3,200.00
ALOHA AIR CONDITION INC (954)772-0079 Total Sq Feet: 500
Tons: Available Inspections:
Additional Info:INSTALL NEW A/C UNIT AND DUCTWORK I Inspection Type:
Classification:Residential
Final
Approved:In Review Rough Duct
Comments: Date Approved::In Review Review Mechanical
Date Denied: Type of Work: Underground
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40
Invoice# MC-6-16-60117
DBPR Fee $2.00 06/08/2016 Credit Card $50.00 $75.40
DCA Fee $2.00
Education Surcharge $0.80 07/18/2016 Credit Card $75.40 $0.00
Permit Fee $112.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $125.40
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. Fut re,I authorize t - amed contractor to do the work stated.
July 18, 2016
Aonze ignature:Owner / Applicant / Contractor / Agent Date
BuildKg Department Copy
July 18,2016 1
° Miami Shores Village
JU 08 2016
Building e art ent AJ4
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY°
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
BUILDING Master Permit NOV. - (mac► I
PERMIT APPLICATION Sub Permit No.HCI(-lS-9 J
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING QX MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10433 N.E. 6 Ave.
City Miami Shores County' Miami Dade zip: 33138
Folio/Parcel#: 11-2231-012-0180 is the Building Historically Designated:Yes NO X_
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Carol Invest, USA Phone#:
Address: 990 Biscayne Blvd Suite 801
City: Miami state: Florida zip: 33132
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Aloha Air Conditioning Phone#: (954)772-0079
Address: 4474 Weston Rd. # 170
city: Davie state: Florida zip: 33331
Qualifier Name: James E Bary Phone#: (9544)772-0079
State Certification or Registration#: CAC 025379 Certificate of Competency#:
DESIGNER:Architect/Engineer: Victor Bruce Phone#:( 305)310-5030
Address: 370 N.E. 101 St. City: Miami Shores state:Fl. zip:33138
Value of Work for this Permit:$ 3,200 Square/Linear Footage of Work: 500 Sq. Ft.
Type of Work: ❑ Addition Q Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Install new A/C unit and ductwork in master area
Specify color of color thaw tide:
Submittal Fee$
0�3Permit Fee$ v� CCF$ C�' 6 CO/CC$
� ``
Scanning Fee$ %�—--- _ Radon Fee$ _W DBPR$ Notary 5
Technology Fee$ ' Training/Education Fee$ 6 ` Double Fee$
Structural Reviews$ 0Bond$
TOTAL FEE NOW DUE$ r
(Revised02/24/2014)
J
Bonding Company's Name(if applicable) N/A
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) N/A
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 approved and a reinspection fee will be charged.
Carol I est SA, Inc. James Ba
Signature �— Signature
OWNER oT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of J QVC 120 RA by 4 day of ti by
�}e ►�iOl �OICX�C�,who is pgrcnnally kanwn to �" T wh 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:
Sign: Gt c �X�2�- Sign: jj&�J
Print LU GIG �� 1�CiSI Print: /q,4 Alk4yL
Seal: r` , TERRI L FLAHERTY
'
Seal: MY COMMISSION#FF078761
LUCIA C ISASI EXPIRES January 28,2018
j� MY COMMISSION#FF182628
(407)3W-W53 Flo .com,
APPROVED BY ��s Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
STATE.OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
•� CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET (850) 487.1395
TALLAHASSEE FL 32399-0783
BARRY JAMES ELLIOTT
ALOHAAIR CONDITIONING INC
4474 WESTON RD#170
DAVIE - FL 33331
Congratulatlonsl-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
from architects to yacht brokers,from boxers to barbeque.restaurants, a STATE.OF FLORIDA
and they keep Florida's economy strong. DEPARTMI;
T5-•UF BUSINESS ANC
Every day we work to i PROFESsi ." GWLATION
improve the way we do business in order to u- E ,
serve you better. For Information about our services ! o9 CACO2537.E 7i 16,2fl14
www myfloridallsense.cam, There you can 1 please 1 onto0 {� ,
about our divisions and the find more information
regulationthat impact you,subscribe � •CERT1F1Eb Al •!,�'••�:;
in departrrrent newsletters and seam more about the Department's :" : SA XMIN
initiatives.
BARRY,.JAM ".
ALOHAAIR
Our mission at the Department is:Li ja
`�":':.A
License Efficiently, Regulate Fairly. ;".;; "''. ; �;:ai•
We consta strive to serve you better so that-you can serve your
customers. Thank you for doing business in Florida,
and Congratulafions on your new licensel is C ERTiPIE•D untfer Y e.pro'visiorss o;`fin,489.F S..
:'Ezpaatix date.:AUG 31..'9
1..1407!Woo�
DETACH HERE
RICK SCOTT,GOVERNOR ,
,.
.....,..:... ....... _ ... N LA E ARv
• .. SCNECR
S ,
STATE OF-FLORIDA
_ DEPARTNlgA1T OF'BUSINESS,AND-.PROFESSIONAL REG
C"ONS•�'RUC'TfO,N.�'NDWULATIt71d
STRY'LiCEI�SING.BOdtI D
The-CLASS AAIB-CONDITIUNING,:GONTRA
Namea-bdow IS CERTIFIED- GT.QiI
a..cs,a•.;a .
Urfcter 1the'pr6Wii6of - :
.I<xplr�fion date: A G Chapfer.
:3 i,201'6 . .., :` i,:• ,
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e'101 '411
FROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S.Andrews Ave., Rm. A-1GQ, Ft. Lauderdale,* FL-33301-18 5 964-83 1_4000
9
VALID OCTOBER 1,2013f THROUGH 'SEPTE
M13ER 30,2016
DBA:
Business Name:ALOHA AIR CONDITIONING INC Receipt#-183-13isio
HEATING/AICITIO
Business Typo:(CEP
'T.,F:IEDRAIRONDCO2MN CCON
MUR
Own"NSMS.JAMES ELLIOTT BARRY. CLASS)
Business Location:4474 WESTON RD #170 Business 0pened:46/43./3 883
c
DAVIE state/ 0UntY/C8rt1R09:CA- 0025379
Exj!ppuo!j Code.,
Business Phone:77z-0$79'.
Rooms
py
Enip)'
Professionals A
ForVandIng 8"Famm"
Nwtibar of machl&W.
vow
Tax Arriourt Transfer l=ee l'!.
ytl 10. osrt Total Paid
27.00
27.00 1
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A FAX RECEIPTThis tax Is levied f&the.prMft' t of doing business Within Broward County and Is
non-regulatory in nature..You j�ust meet an County armor Municipality planning
WHEN VALIVATEt) and zoning requiraments.•This'Business Tax Recelpt must be transfermd When
the business is sold, business name has changed or you have moved the
business IOCRtlori-This receipt does not friftate that the business is legal or that
it Is in compliance With Stgf&or jowl.laws and regulations.
Mailing Address:
ALOHA AIR CONDITIONING INC
4474 WESTON RD #170 Receipt #ICP-24-000IS377
DAVIE, FL 33331 Paid 07/27/2015 27.00
- 2016
Client#:21874 ALOHAAIR
ACORD. CERTIFICATE OF LIABILITY INSURANCE DAs TE 1071oI)s
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 C E cT Jeanne B.Bender
Cypress Insurance Group A/CN a :954 771-0300 ac No; 954 772 9424
PO Box 9328 E-MAIL eanneb c ressinsurance.com
ADDRESS:j yP
Fort Lauderdale,FL 33310-9328
954 771-0300 INSURERS)AFFORDING COVERAGE NAIL A
INSURERA:National Trust Insurance Co.
INSURED INSURER B:Bridgefield Employers Ins.Co.
Aloha Air Conditioning,Inc. INSURER C:
dba Air Conditioning Excellence
4474 Weston Road#170 INSURER D
Davie,FL 33331 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.
LTSRR ADDL SUB POLI�y EFF POLICY EXP
TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD M/pp LIN R3
A GENERAL LIABILITY GLOO143204 10/01/2015 10/01/2016 EACH OCCURRENCE
$1,000,000
PREM
X COMMERCIAL GENERAL LIABILITY ISES &IE r°ence $100 1 000
CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $5,000
X PD Ded:1,000 PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
POLICY JECT LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED d
BODILY INJURY Per accident) $
AUTOS AUTOS ( )
NON-OWNED PROPERTY DAMAGE
HIRED AUTOS AUTOS Perkllnt $
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
B WORKERS COMPENSATION 83036957 10/01/201510/01/201 X WCSTATU- oTH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/F�CUTIVE YIN E.L.EACH ACCIDENT $1,000,000
OFFICERIMEMBER EXCLUDED? N I A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1.000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K more space Is required)
Workers Compensation applies to Florida operations and employees only.
James Bevy,License#CACO25379
CERTIFICATE HOLDER CANCELLATION
Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores,FL 33138
AUTHORIZED REPRESENTATIVE
wr�F Phi ifiG(,o
01988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S224072/M210308 JBB