MC-16-453Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number
PPR'
Expiration: 08/24/2016
Applicant
1050 NE 105 Street
Miami Shores, FL 33138-2106
1122320280060
Block: Lot:
PHILIPPE ALLUARD
Owner Information
Address
Phone
CeII
PHILIPPE ALLUARD
1050 NE 105 Street
MIAMI SHORES FL 33138-
1050 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s)
MG TECH INC
Phone CeII Phone
(786)256-0241 (305)216-9721
Valuation:
Total Sq Feet:
$ 525.00
00
Tons:
Additional Info: DISCONNECT/RECONNECT EXISTING A/C S
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Scanning: 1
Date Approved: : In Review
Type of Work:
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$5.00
$150.00
$3.00
$0.80
$164.10
Pay Date Pay Type
Invoice # MC -2-16-58738
02/26/2016 Credit Card
02/19/2016 Credit Card
Amt Paid Amt Due
$ 114.10 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Rough Duct
Review Mechanical
Underground
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 ELECT fCC?
OWNERS AFFIDAVIT:
construction 40- zoning.
L, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
I certify tha = e for . r g information is accurate and that all work will be done in compliance with all applicable laws regulating
Futhe • • re, I = • = ize . e above-named contractor to do the work stated.
horized Si nature: Owner / Applicant /
Buding partment Copy
February 26, 2016
February 26, 2016
ontractor / Agent Date
1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
L
Inspection Number: INSP-253215
Permit Number: MC -2-16-453
Scheduled Inspection Date: April 11, 2016
Inspector: Perez, JanPierre
Owner: ALLUARD, PHILIPPE
Job Address: 1050 NE 105 Street
Miami Shores, FL 33138-2106
Project: <NONE>
Contractor: MG TECH INC
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1122320280060
Phone: (786)256-0241
Building Department Comments
DISCONNECT/RECONNECT EXISTING A/C SYSTEM IN
REMODEL BATHROOM
Infractio
Passed Comments
INSPECTOR COMMENTS
False
k/b
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
April 08, 2016
For Inspections please call: (305)762-4949
Page 16 of 42
Miami Shores Village [RiV t
FEB 1 9 2616
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: / L7 ® Nc_
FBC 20/L/
Master Permit Nolese / /f ,!Z)9
Sub Permit No/%%C �6 953
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 3 13?
Folio/Parcel#: // 22 g2 02g 0 9 6 is the Building Historically Designated: Yes NO —
Occupancy Type:
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): A,/71 p
Address:�1,� /0 a"O NC-. io5—s, /
City: Am/. Smaeet State:
AIM
Flood Zone:
4 -LL
BFE:
FFE:
Phone#:713/
Tenant/Lessee Name:
Email:
Phone#:
Zip: 3 3/Sr
CONTRACTOR: Company Name: 6 T� X77 � M
Address: to310 .501) 5``0 S�
City:
Qualifier Name:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer:hi4/WVz 3 C (A Why i/C,.i/ feakitt'4 Phone#: 3 yr ES' 0990
Address: 6 MA/ oeg r City: (O a 'l / ate: re_, Zip: 3313
Value of Work for this Permit: $ `I
Type of Work: ❑ Addition [r Alteration
Phone#:
(j)
2ar2kk 7z--)
( I C{/y1 ' State: _Ft—
r-dit4fGAr0 6onz4- )e
zip: g3/ b3
Phone#: Z1% 9 t -Z /
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace
❑ Demolition
Description of Work: >/S C SNC C'r% /t 1!` & /#VE T £Dc 17,w 4 AVC., CYYS rim
"614:p L/9D__ A7%I123D/7.
Specify color of color�thru tile:
Submittal Fee $ ®-C 0 Permit Fee $ l /7L 015 CCF $ G ' G Q
CO/CC $
Scanning Fee $ - (0 Radon Fee $ r� S DBPR $ D. Notary $ •'M
Technology Fee $ ®'
Structural Reviews $
(Revised02/24/2014)
Training/Education Fee $ ®'343 Double Fee $
Bond $
TOTAL FEE NOW DUE $ I ('1' ° d 0
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 whi h occur. seven (7) days the building permit is issued. In the absence of such posted notice, the
inspection will notea op % 5 ved a `; a reinspection f •, a will b; charged.
OWNER
The foregoing instrument was acknowledged before me this
day of��//151�be' , 20 /.S ', by
4 /! U1 -?Ci , who is personally known to
me or who has produced /—PL as
identification and who did take an oath.
NOTARY PUBUC:
Si
Print:
Seal:
******
Notary public State or nw
jOanna M Fettc+ano
My Commission FF 082753
Expires 0111212018
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
/ lsday of ce1=, , 201(#01 , by
1.).‘ 41/41\A o c osrtQ't e,parho is personally known to
me or who has produced P ---PL. 524, f 0.17.7.1 ash
identification and who didtake an oath.
NOTARY PUBUC:
Sign:
Print:
Seal:
JAVIER PINO
MY COMMISSION # FF 162093
EXPIRES: November 21, 2018
Bonded Toru Notary Pubfe Undem rs
*************************** **********,*************************************************************
is Examiner
APPROVED BY
(Revised02/24/2014)
Zoning
Structural Review Clerk
RICK SCOTT, GOVERNOR
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
LICENSE NUMBER
The CLASS AAIR CONDITIONING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
GONZALEZ, MARIANO
MG TECH INC
10310 SW 5011H ST
MIAMI FL 33165
ISSUED: 06/08/2014 DISPLAY AS REQUIRED BY LAW
SEQ # L14408080001034
002299
Local Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOTA BILL - DO NOT PAY
6391221
BUSINESS NAME/LOCATION RECEIPT NO.
MG TECH INC RENEWAL
10310 SW 50 ST 6659057
MIAMI FL 33165
OWNER
MG TECH INC
Worker(s)
LBT
EXPIRES
SEPTEMBER 30, 2016
Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art 9 & 10
SEC. TYPE OF BUSINESS
196 SPEC MECHANICAL CONTRACTOR
CAC1816159
PAYMENT RECEIVED
BY TAX COLLECTOR
$75.00 08/31/2015
ECHECK-15-160865
This Local Business Tax Receipt only confines payment of the Local Business Tax. The Receipt is not a license.
permit, or a certification of the holder's qualifications, to de fussiness. Holder must comply with any governmental
or nongovernmental regulatory lawn and requirements which apply to the business.
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Bade Coda Sec Ba -276:
For more information, visit www.miamidada.gov/teicefiectot
ARL®
CERTIFICATE OF LIABILITY INSURANCE
DATE(MWDD/YYYY)
2/18/2016
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 1s an ADDITIONAL INSURED, the policy(1es) must be endorsed. It 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 Iieu of such endorsement(s).
PRODUCER
ANDYS ASSURANCE AGENCIES
1441 W Flagler St
Miami, FL 33135
CONTACT
NAME. Rodolfo J. Patifo
PHONE e(): 305-262-2200
c,N005-262-2227
E-MAIL
ADDRESS . net
INSURER(a) AFFORDING COVERAGE
NAC/
INSURER A : Catlin Specialty Ins Co/N-SO
INSURED
MG Tech, Inc
10310 SW 50 Street
Miami, F1 33165
305-216-9721
INSURER B Associated Industries Ins Co
INSURER c .Commerce & Industry/N-So
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.
(AMR 1
LTR
TYPE OF INSURANCE
IADDL
uuao
SUER]
wvD I
POLICY NUMBER
POLICY EFF '; POLICY EXP
MM/DDIYYYY) I(MMIDD/YYYY;
LIMITS
Ate'
X COMMERCIAL GENERA. LR8UTY
Y
1000104386 '11/16/15111/16/16
N
EACH OCCURRENCE
$ 1,000,000 '
CLAIMS -MADE r X OCCUR
RENTED
PREMISESPTO(Ea occurrence)
$ 100,000
_
MED EXP (Any one person)
$ 5,000
GGEEML
A
PERSONAL &ADV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER.
POLICY7-7 PRO -
_LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS
PRODUCTS - COMP/OP AGG
$ 1 , 000,000
$
AUTOMOBILE
—
LIABILITY
ANYAUTO
ALL OWNED ' SCHEDULED
AUTOSAUTOS
—' NON -OWNED
HIRED AUTOS _ AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE $
(Per accident)
$
C
UMBRELLA LIAB X I OCCUR
N N EBU 019894650
11/18/15;
11/18/16
EACH OCCURRENCE
$ 1,000,000
R
EXCESS LIAB � CLAIMS -MADE
AGGREGATE
$ 1,000,000
OED RETENTION $
$
B
WORKERS
AND
ANY
j0FFICERIMEMBER
1 (MS
1)
DESCRIPTION
COMPENSATION
EMPLOYERS' LIABILITY
1 1
1
I AWC1043633
N
AWC1060483
(
!03/13/15
!03/13/16
03/13/16
03/13/17
PEROTH-
STATUTE R 1 ER
E.L. EACH ACCIDENT $ 1,000,000
PROPRIETORIPARTNERIEXECUTIVE ..,
EXCLUDED? I',N/A
E . DISEASE - EA EMPLOYEE$ 1 000,000
Matory In NH)
descnbe under
OF OPERATIONS below
E L DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached rt more space is required)
HVAC - Airconditioning Installation, Service, Repair, and Maintenance.
CERTIFICATE HOLDER
CANCELLATION
Miami Shores Village
Building Dept.
10050 NE 2nd Ave.
Miami Shores, Fl 33138
(305) 756-8972
ACORD 25 (2014/01)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN
ACCORDA s 9 ITH THE POLICY PROVISIONS.
AUTHO'14 1 PRESENT
®1988- c ORD CORPORATION. All rights re= erved.
The ACORD name and logo are gis =red marks of A'' 0