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Com- Ct. 11414CD Inspection Number: INSP-268300 Inspection Worksheet Miami Shores Village / _+ 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 E,C � _ 2 3L), 0 Permit Number: MC -10-16-2693 Scheduled Inspection Date: August 23, 2017 Inspector: Perez, JanPierre Owner: CIO SASHA BERDEGUER, ROBERT serttoomrt Job Address: 671 NE 105 Street Miami Shores, FL 33138-2053 Project <NONE> Contractor: MARNO AIR CONDITIONING SERVICE INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1122310120100 Phone: (305)885-2195 Building Department Comments REPLACE 3 CENTRAL UNITS WITH DUCT WORK RHEEMIEQUAL infractio Passed Comments INSPECTOR COMMENTS False (6V) --"b \\ Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid Inspector Comments August 22, 2017 For Inspections please call: (305)762-4949 Page 4 of 36 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ID PLUMBING Q MECHANICAL JOB ADDRESS: 671 ne 105 st Miami Shores Village 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 D ROOFING PUBLIC WORKS Master Permit No. Sub Permit No. FBC 201q 12-0A6 - 2346 N G(-2693 REVISION 0 EXTENSION ❑ RENEWAL ❑ CHANGE OF ® CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-22231-0100 Occupancy Type: Load: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): robert moreno Address:14629 sw 104 st 498 City: miami Tenant/Lessee Name: BFE: FFE: Phone#:3053483903 state: fl Zip: 33186 Phone#: Email: CONTRACTOR: Company Name: marno a/c service Address: 2012 w 73 st Phone#: 305-885-2195 City: hialeah Qualifier Name: Juan perez State: fl Zip: 33186 Phone#: State Certification or Registration #: cac042630 Certificate of Competency #: 000013581 DESIGNER: Architect/Engineer: Phone#: Address: , L City: State: Zip: $ Value of Work for this Permit: 31°41* 1. 6 ( Square/Linear Footage of Work: 6,000 Type of Work: ❑ Addition ❑ Alteration Description of Work: replace 3 central units with duct work rheem/equal ❑ New 0 Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ 5A). 3Permit Fee $ k rr D CCF $ 6 61. 2"' CO/CC $ 0 Scanning Fee $ Radon Fee $ 10 • 3 I DBPR $ 1 (Q • S Notary $ LI 0649 Training/Education Fee $ (o. Double Fee $ age' 55/ Technology Fee $ Z 5. Structural Reviews $ (Revised02/24/2014) Bond $ .� TOTAL FEE NOW DUE $ f ® 39• 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. A ailL Signature—.wi / W 9G T Signature CONTRACTOR The foregoing instru ent was ackn/ ledged before me this Th foregoing instr nt as acknowledged before me this da of % -ad ''r , 20 (,C. , by day of �i , 20 ' by -Than �. Itt.( ..#' who is personally known to me or who has produced as me or who has produced - as identification and who did take an oath. NOTARY PUBLIC: of Sigt Print: Seal: 1/L/italtez klwi/ Notary Public State of Florida Herminia Marrero My Commission FF 183338 V. yi,dr Expires 09/26/2018 identification and who did take an oath. NOTARY PUBLIC: Print: V Seal: ************************************************************** APPROVED BY (Revised02/24/2014) \ \ �1\\`"Plans Examiner Structural Review 04711i , VILMA E. FERNANDEZ °S1s4,1ts MY COMMISSION 0 FF 893080 EXPIRES: June 16, 2020 4J^tf .44' Bonded Thru Notary Public Underwriters Zoning Clerk RIC{K SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CAC042630 The CLASS AAIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 PEREZ, JUAN MARNO AIR CONDITIONING SERVICE, INC. 8555 MENTEITH TERRACE MIAMI LAKES FL 33016 ISSUED: 07/26/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1607260000928 001005 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 1827659 BUSINESS NAME/LOCATION RECEIPT NO. MARNO AIR CONDITIONING SVC INC RENEWAL 2012 W 73 ST 1827659 HIALEAH FL 33016 OWNER MARNO AIR CONDITIONING SVC INC Worker(s) 10 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC MECHANICAL CONTRACTOR CAC042630 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 08/09/2016 CHECK21-16-110950 • This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Sa-276. For more information, visit www.miamidade.aov/taxcollector AC D® Policy Number: Date Entered: 8/29/2014 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD YYYY) 9/29/2016 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 is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or 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 Ileu of such endorsement(s). PRODUCER Westland South Insurance 2608 NW 97th AVENUE DORAL FLORIDA 33172 CONTACT NAME: PHO(AtC'-ND,.Fdn: (305) 593-0600Ne); (305) 593-2533 ADDRESS; E-MAIL homero@westlandsouthins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:STARR INDEmN/TY AND LIABILITY COMPANY INSURED MARNO AIR CONDITIONING SERVICE, INC 2012 WEST 73RD STREET HIALEAH, FL 33016 tssuRER B : BRIDGEFIELD EMPLOYERS INS CO INSURER c •NATIONAL GENERAL 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 IINNSD R MD POLICY NUMBER POLICY EFF (MM(DDIWYY) POLICY EXP MU (MDD/YYYYI LIMITS A X COMMERCIAL. GENERAL LIABILITY OCCUR v X 1000054487161 01/08/2016 01/08/2017 EACH OCCURRENCE AMAG£S�EaEN occurrence) $ 2 , 000 , 000 CLAIMS -MADE X $ 50, 000 GEN'L MED EXP (Any one person) $ 5 , 000 PERSONAL 8 ADV INJURY $ 1 , 000 , 000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY I 1 JECT OTHER: LOC PRODUCTS - COMP/OP AGG $ 4 , 000 , 000 $ C AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS -OWNED ONLY 2002960633 01/07/2016 01/07/2017 COMBINED SINGLE LIMIT (Ea accident) $ 50 , 000 ___ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ _-a 1 NON I AUTOS PROPERTY DAMAGE (Per accident $ $ UMBRELLA LIAB I EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ j DED f RETENTION IS $ B WORKERS COMPENSATIONPEATH AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECl1TIVE OFFICERIMEMBEREXCLUDED? (Mandatory In NH) Ryes describe under DESCRIPTION OF OPERATIONS Y / N NIA 830-29656 12/01/2015 12/01/2016 J STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 1 E.L. DISEASE - EA EMPLOYEE $ 1 r 000,000 below E.L. DISEASE - POLICY LIMIT 1 000 000 $ + + DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) k/C INSTALLATIONS AND REPAIRS LICENSEE'S LICENSE #CAC042630 IERTIFICATE HOLDER IS ALSO NAMED AS ADDITIONAL INSURED. CERTIFICATE HOLDER 4IAMI SHORES VILLAGE 3UILDING DEPARTMENT L0050 NE 2AVE dIAMI SHORES , FL , 33138 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. AUTHORIZED REPRESENTATIVE HOMERO LAVERNIA c/ ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD •oduced using Forms Boss Plus software. www.FormsBoss.com; Impressive Publishing 800-208-1977 • CT )"-a Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 270013581 AIR CONDITIONING SERVICE INC PE EZ JUAN Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/3012017 RICK SCOTT, GOVERNOR ' KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND, PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The CLASS B AIR CONDITIONING CONTRACTOR,; Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2017 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TQCONTRACTING IN ANY AREA) PEREZ,JUAN MARNO AIR COND SERVICE INC 2012 WEST 73RD STREET HIALEAH FL 33016 000411 ISSUED. 07/21/2015 DISPLAY AS REQUIRED BY LAW Local Business Tax Receipt Miami—Dade County, State of Florida ' -THIS IS NOTA BILL - DO NOT PAY 703745 BUSINESS NAME/LOCATION MARNO AIR CONDITIONING SERVICE INC 2012W73ST HIALEAH FL 33016 OWNER MARNO AIR CONDITIONING SVC INC Worker(s) 10 RECEIPT NO. RENEWAL 703745 SEQ # L1507210000588 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC MECHANICAL CONTRACTOR 000013581 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 08/09/2016 FPPU11-16-014772 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Ba -276. For more information, visit www.miamidade.aov/taxcollector HALEAH City of Hialeah Business Tax Receipt Mayor Carlos Hernandez No: 238220-69 (OLD -1711-2) Amount: $ 150.00 The person, firm or corp. listed here has paid the business tax required to engage in or operate the business specified subject to the regulations and restrictions of the City of Hialeah, Florida Owner: Type of Business: 2016-17 Plumbing, Heating, and Air -Conditioning Contractors MARNO AIR COND SERVICE, INC. 2012 W 73 ST HIALEAH, FL 33016 Validating No.: 0000 THIS IS NOT A BILL Business Location: 2012 W 73 ST Expires September 30, 2017