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MC-17-714 Miami Shores Village 10050 N.E.2nd Avenue NE * $ �� � tiClt�lA�ttE��&t�011 Miami Shores,FL 33138-0000 Phone: (305)795-2204 " 0�„APp� R �s z'] Expiration: 0 /19/2017 1? 3 aC. Project Address Parcel Number Applicant 600 NE 97 Street 1132060171680 Miami Shores, FL 33138-2471 Block: Lot: EDUARDO J GONZALEZ I' Owner Information Address Phone Cell EDUARDO J GONZALEZ 600 NE 97 Street (786)459-2356 MIAMI SHORES FL 33138- 600 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 300.00 WEATHERMAKERS AC CONTRACTOI (305)233-5820 __ _ _ _ .....:... _..__....... Total Sq Feet: 0 Tons: Available Inspections: Additional Info:TWO EXHAUST FANS Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Review Mechanical Date Denied: Type of Work: Underground �JE Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# MC-3-17-63335 $2.25 03/23/2017 Credit Card $ 114.10 $50.00 DCA Fee $2.25 Education Surcharge $0.20 03/16/2017 Credit Card $50.00 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $164.10 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. March 23, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 23,2017 1 Miami Shores Village RECEIVED 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 208 BUILDING Master Permit No.F_CI -7—4 '�r'c' PERMIT APPLICATION Sub Permit No. M C F7 — -� I L-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION Ej RENEWAL PLUMBING dMECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:6©® N c�'-- s4 2C,e l City: Miami Shores County: Miami Dade Zip: I�� Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: II Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ��VC41 O Goy �G IP 2, Phone#: Address: 6C9® F cf� 6i City: All 0%!M State: FL Zips:: 33135 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 6C Phone#: 3�5�2�3 5kZn Address: 13 T§SC Sj I q A v4t-- City: AA ch M i State: -FL Zip:33( R b Qualifier Name: rvi lClou SPCO Phone#:`3�'�� 233 S Fr Z/J State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit:$ 300 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration (' El New ElRepair/Replace El Demolition Description of Work: w e��Ot v' S t I CAO. J Specify color of color thru tile: (� Submittal Fee$ � Permit Fee$ v GCo CCF$ CO/CC$ Scanning Fee$ Radon Fee$ Z Z DBPR$ Z- Notary$ S Technology Fee$ Training/Education Fee$ ° Double Fee$ Structural Reviews$ Bond$ EQ TOTAL FEE NOW DUE$ i (Revised02/24/2014) R 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-approved and a reinspection fee will be charged. Signa —'a Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The fore oin/ru�m�ent was acknowledged before me this �day of 20 1� by d 20 1-7 by '�vl +� �f�-oLis,personally known to (C� �� who is p onall know o me or who has produced ��--1. }�� � 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: ,t�tBti�l i,GMS��yy Sign: Sign: Print: J=M: ' ooly"'l". YENISENIA ALONSO Seal: ; ��9e,9ga1�oma ` Seal: ,�?�,� Pur Notary Public-State of Florid NOISSIW� « .•@ Commission#FF 906263 My Comm.//���/// ��111S• Sep 22,201 SIN,��� \` Bonded throuE9h National Notary Ass �llllllltl APPROVED BY \�\Nlanl Examiner Zoning Structural Review Clerk (Revised02/24/2014) ®y1; R 93" tons allot" Miami hores Village Building Department � R 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 C I I IF CONT TOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. PY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT, D. COPY OF LIABILITY INSURACE* E, COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: f ®S BUSINESS ADDRESS: 3q5� � �� l OA CITY i q-JU-; STATE r(— ZIP 3Y/E BUSINESS PHONE: ( 1_ 'x°.33 'SW)-O FAX NUMBER � 0� X33 - 413310 CELL PHONE(�) QUALIFIER'S NAME: C d !�;OeAo QUALIFIER'S LIC NUMBER:0 AO- 07W ' 016671 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT ABILL-DO NOT PAY 2241230 ,LBTJ 1 BUSINESS NAME&OCATION RECEIPT NO. EXPIRES WEATHERMAKERS A C CONTRACTORS INC RENEWAL SEPTEMBER 30, 2017 13955 SW 119 AVE 7484910 Must be displayed at place of business MIAMI FL 33186 Pursuant to County Code Chapter BA-Art 9&10 OWNER SEC.TYPE OF BUSINESS WEATHERMAKERS A C CONTRACTORS IW6 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED CAC1818645' BY TAX COLLECTOR Worker(s) 1 $75.00 07/08/2016 CREDITCARD-16-037232 This Local Business Tex Receipt only confines payment of the Local Business Tax.The Receipt is not a license, permIL or a certification of the holders quallDoations,to do business.Holder must comply with any goveramemal or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Be-276. For more Information,visit www miamidade.govAoxcollector RICK SCOTT,GOVERNOR _ _ c KEN LAWSON,SECRETARY STATE OF FLORH)A DEPARTMENT OF BUSIASS AND PROFESSIONAL REGULATION CONSTRUCTION-INDUSTRY LICENSING BOARD "-1 The CLASS AAIR CONDITIONING CONTRAIGO NalTjed below IS CERTIFIED i Under the:provisions of,Chapter-489.FS. Expiration date: AUG 3l 2018. SACO;MICHAEL GEOR ' WEATHERMAKEfRS.QI r x3955 SW 1�-gnA r (�IIIALfIII �� L' '* h ISSUED: 05/22/2016 DISPLAYAS REQUIRED BY LAW SECT# L1605220000551 WEATH-1 OP ID: LJ ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmYY)03/14/2017 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(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 CONTACT NAME: Wilson,Washburn and Forster PHONE 305-666-6636 MCC No;305-662-7778 16505 N.W.13th Avenue AIC No Ext Miami,FL 33169-5719 E-MAIL ificates@�lww,�,,�,Fins.com Sarah J.Washburn Carfora ADDRESS:certificeites@wwfins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Bridgefield Employers Ins.Co. 10701 INSURED Weathermakers Air Conditioning INSURER B:Hanover American Insurance Co. 36064 Contractors,Inc. 13955 SW 119th Avenue INSURER C Miami,FL 33186 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. INSR LTR TYPE OF INSURANCE D D WVD SUBR POLICY NUMBER MMILDDtYYYY MY EFF MIDD EXP LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE XOCCUR LZJ8817485 04/01/2016 04101/2017 DAMAGE To RENTED PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a JECT FLOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE UHJ8815073 04/01/2016 04/01/2017 AGGREGATE $ 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE X ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 0830-14313 04/01/2016 04/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) License#CAC 1818645 CERTIFICATE HOLDER CANCELLATION MIASH01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Avenue Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD