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MC-15-579 (2)c 14 (223 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-230451 Permit Number: MC -3-15-579 Scheduled Inspection Date: July 08, 2016 Inspector: Perez, JanPierre Owner: KERMANI, AMIR Job Address: 1680 NE 104 Street Miami Shores, FL Project: <NONE> Contractor: QUALITY COOLING SYSTEM Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)965-0170 Parcel Number 1122320320440 Phone: 305-255-9439 Building Department Comments REPLACE AC EQUIPMENT AND ALTER DUCTWORK Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 07, 2016 For Inspections please call: (305)762-4949 Page 2 of 32 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. MC -3-15-573 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: APPROVED Issue Date: 3/25/2015 Expiration: 09/21/2015 Parcel Number Applicant 1680 NE 104 Street Miami Shores, FL 1122320320440 Block: Lot: AMIR KERMANI Owner Information AMIR KERMANI Address 3180 S OCEAN DRIVE HALLANDALE BEACH FL 33009- Contractor(s) QUALITY COOLING SYSTEM Phone Cell Phone 305-255-9439 Phone (305)965-0170 Cell Valuation: Total Sq Feet: $ 3,800.00 0 Tons: 5 Additional Info: REPLACE AC EQUIPMENT AND ALTER DUCT Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved:: In Review Type of Work: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.00 $2.00 $0.80 $133.00 $9.00 $3.20 $152.40 Pay Date Pay Type Invoice # MC -3-15-54820 03/25/2015 Check #: 1262 03/17/2015 Credit Card Amt Paid Amt Due $ 102.40 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical 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: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo uthermore, I authorize the above-named contractor to do the work stated. Authorized Signature: Owner / Applicant / Building Department Copy March 25, 2015 Contractor / Agent ate March 25, 2015 1 a\(6\(7.- -/ BUILDING PERMIT APPLICATION 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 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING 1gi MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: I eo Master Permit No. Sub Permit No. ❑ REVISION ❑ EXTENSION RECEIVED MAR 17 2015 BY* FBC 201Q ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR AI & 17 ❑ RENEWAL ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: 33 12 Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: NO FFE: OWNER: Name (Fee Simple Titleholder): /J' ,yy,4,r// Phone#:� —x/96 ? Address: /(4L)h16, /t2V 671 City: /6/1/4////: CO,S Tenant/Lessee Name: Phone#: Email: State:71:(1_, Zip: 3?/3g CONTRACTOR: Company Name: uA — T COO 04 -Sy S a .5, Z3C Phone#: -786 -713 -104c Address: 13 0 Sus 1 3A A46 v 1T' 4 1 ,/ 1 City: IA I1 Nl 11 /� /` -�� n State: ,'LO RID pi zip: 33 i Civ q2 Qualifier Name: ^e0 � 2 W P/'"i, S Phone#:30S `910 `' / J C State Certification or Registration #: CF c o `E Zi 1 3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: �y00 Value of Work for this Permit: $ 31 VL'D . Square/Linear Footage of Work: Type of Work: ❑ Addition rg Alteration ❑ New Mi Repair/Replace Demolition Description of Work: � 1-14 iX Ci Gaul Q T i JDl.-Tt(l.. D0L-1-1Wle.X '.SXR'.... it ] Specify color of color thru tile: .a. Submittal Fee $ Permit Fee $ 0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ ( TOTAL FEE NOW DUE $ 102_. LI kD sqr-i, (Revised02/24/2014) Sr 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 occur seven (7) days after the building permit is issued. In the absence Af such posted notice, the inspection will not be approv d s d a reinspection fee will be charged. Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this \C:' day of \*Aab.SCiA , 20 \S , by /7-.1‘—' day of 4,0--6'/c , 20 is , by \N.k.! V.R3 kl-taN.Lk , who is personally known to , who is personally known to me or who has produced as m� or who has produced PH -74,4 as identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARY PUBLIC: Sign: Prin Seal: if ,.: .: MY COMMISSION # EE 171626 1EXPIRES: May 7, 2016 fly` 4 ,;c Bonded Teri rotary Public (Members „ Sign: Print: '4 • , Q '� � Seal: Ga, l ANA M. RODRIGUEZ MY COMMISSION N EE190991 ci EXPIRES: April 19, 2016 os ********************************************** ********************** APPROVED BY (Revised02/24/2014) xaminer Structural Review ******* ************************ Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): ((0 'B 0 N.c. 1 04 snumi- City: 4z— City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES 0 UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS c AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Re ' ration No. Certificate of Competency No. Signature Date: 3/3'10206 (Qualifier's signature) (Revised02/24/2014) 005496 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 1931220 BUSINESS NAME/LOCATION QUALITY COOLING SYSTEMS INC 13220 SW 132 AVE UNIT 1 MIAMI FL 33186 OWNER QUALITY COOLING SYSTEMS INC Worker(s) 1 RECEIPT NO. RENEWAL 2038628 EXPIRES SEPTEMBER 30, Must be displayed at place of burin Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC MECHANICAL CONTRACTOR CAC042713 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 07/08/2013 TXHS1-13-013021 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 holders 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 Ra -276. For more information, visit wwwmiamidade.gov/taxcollector STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 PARRIS, ROGER W QUALITY COOLING SYSTEMS INC 13220 SW 132ND AVENUE UNIT 1 MIAMI FL 33186 ISSUED: 06/01/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406010002727 n r' r^ n 03/17/2015 12:51PM 3052555514 QUALITY COOLING PAGE 01 BUSINESS NAMEILOCATION QUALITY C©CiUNG SYSTEMS IN 13220SW.132A11EUNITI :< :MIAMI FI 33T86 _' OWNER ., QUAL! SEC TYPE.OF SUSINESS PAYMENT.; RECEI1tEt7 Y COOLI NG SYSTEMS INC .196 SPEC MECHAf�MECAL CONTRACTOEI ; sY TAX CGI LECTOR':,? :>' iker(s)' 1 CAC042713, : $75.00 �38/06/2014`<,: €CHECK I4--140588 This..., „. usmessTax Receipt apiy confirms payn{ent of the tonal Businees Tax. The iteeeiptis not a Iicanse pvnait or e certificahan'oi the holder sgaaliticatrons. to do business. Hoidec.rirlrst.complywith any pavemmeiitai ocnortgovernmentaf regulatory laws andrequirements which apply to the business: + �� ....,, • T�Tha lECfIFTtld'shave must be displayed em ail con rcial vehicles ;:Miami—Dade Code Sec a S. Forraoremfoimation vwttvww.mfamidade.govifaxcsiiector; 03/10/2015 04:38PM 3052555514 Client*: 1531283 QUALITY COOLING 132QUAI.ICOO PAGE 03 R(;UHVu CERTIFICATE OF LIABILITY INSURANCE DATE DI "°MITT) 3/10/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW. THIS CERTIFICATE OP INSURANCE 00ES NOT CONSTITUTE A CONTRACT BITWEBN THE ISSUING BISURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS POLICIES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polioylles) must be endorsed. if SUBROGATION IS WAIVED, subject to the teens and conditions of the policy, certain policies may require an endorsement. A statement on this oertif tate does not confer rights to the certificate holder In lieu of such endorsement(s). PRQeucan BBBT-Osvraid Tripp. and Company 9200 S. Dadeland Blvd, Ste 314 Miami, FL 33156 305 670-0083 Allsa Josephs Eat 305 870-0083 Italy**8668028668 A°0 jAFl AFFORDING COVERAGE tort e samsER A : As on Insurance Company 11240 INSURED567 Ctuality CoolingSystems lett. 13220 SW 132 Ave #"1 Miami, FL 33186 EiNVERAANN anIrREIt B : RIFirSt Insurance Company 10700 INSURER c 10/02l201� INSURER pr s1,000,000 INSURERS: X COMaERC1AL mem LYtBq rtY REVISION NUMBER: INDICATED. CERTIFICATE .-u..4=o w USUMSATAX LeaTED ISELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTFBR DOCUMENT WITH RESPECT TO VVHSCH THIS MAY BE ISSUED OR MAY PERTAIN. TI4E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN t$ StELIECT TO ALL THE TEAMS, MONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPO 0FenuRAH6Eagirmtvvo swot INR p oCVEFP} tM QIYYYL') UNITS A o> LIABILITY GLP0180005 40/02/2014 10/02l201� EACH occunesucc s1,000,000 X COMaERC1AL mem LYtBq rtY �Q ...E1e.,p.i $300,000 a"' oocun SED ENP (My me Person) 510,000 X Pp Ded SO PFR.someks.ACV ewer $1,000,004 cru. AGGREGATE 52,000,000 —1GEM. AGGREGATE uharAPrues PER 1-1 PROWCTS - cauF/OP AGo s2,000,000 FDLICYnra LOC $ AUTOWOOLELRABIUTY — ,I MET e oxidiel) $ ARV AUTO BOLMYMARY (Par permit) $ AU1TiS EMILY INJURY par =Mag S `_— FUND AUTOS — AUTt10T0S E (PRORTRTY Per =ideal 5 s — 1MMIe8LA CNB =CM LMB ---- OCCUR EACH OUNCE 5 CLAWS-MADEAGGRUGAIE 1 S ow MORMON $ B WORKERS COMPENSATION OXY LIAeuYIN 052047936 06/0112014 061011201E yy� WNW- v- 1 1 gRISI- ANY Oi XCLI�@77 NIA RL. EA A tr 5100000 nRIPARiH)0eerE cataidataryinN li- cease -EA Emmet s100,000 E. mass -POUCYwar s500,000 OEsoSAFTION OF OPERATIONS 11ACAIIONS l VEIOXES Welch ACORD tel, AidMdge Reworks Schedule, R mac space Is ram " Workers Comp Information " Proprietors/Partners/Executive Officers/htembers Excluded: ROGER PARRIS-PEES, ELECOFC j _CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Deparbnellt 10050 NE 2nd Avenue SHOULD ANY OF THE ABOVE DESCRIBED POU CIES BE CANCELLED BEFORE THE MCMAi ON DATE THEREOF. NOTICE WIU. BE DEUVERED 04 ACCORDANCE WITH IRE POLICY PROVISIONS. Miami Shores, FL 33138 I AUTHORIZED l rrATIVE aintsw Fehr Apar,. 01868-2010 ACORD CORPORATION. All rigtstts reserved. ACORD 25 (2010105) 1 1 The ACORD name and logo are registered marks of ACORD #3138240811M1 EWA