MC-17-1446 Permit No. MC-5-17-1446
Miami Shores Village Permit Type; MechanicalReSidentlal
10050 N.E.2nd Avenue NE
r
I
Work Classification:;Addition/Alteration
Miami Shores, FL 33138-0000 Pe
Permit Status:APPROVED
"-. Phone: (305)795-2204
RCORIJID
issue:Date:61912017 Expiration: 12/06/2017
Project Address Parcel Number Applicant
373 NE 101 Street 1132060135230
Miami Shores, FL 33138-2424 Block: Lot: MELISSA& RICARDO MAZZITEL
Owner Information Address Phone Cell
MELISSA&RICARDO MAZZITELLI 373 NE 101 Street (319)321-1561 (319)321-1561
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 7,000.00
QUALITY COOL AIR CONDITIONING II (786)395-2188
w _...... w. Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:5TON AC REPLACEMENT,DUCT WORK,E Inspection Type:
Classification:Residential Final
Approved:In Review Rough Duct
Comments: Date Approved: : In Review Review Mechanical
Date Denied: Type of Work:5TON AC REPLACEMENT,DUCT WC Underground
Scanning: 1
a
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $4.20
DBPR Fee Invoice# MC-5-17-64154
$3.68 05/31/2017 Check#:3444 $50.00 $216.56
DCA Fee $3.68
Education Surcharge $1.40 06/09/2017 Check#:3448 $216.56 $0.00
Permit Fee $245.00
i
Scanning Fee $3.00
Technology Fee $5.60
Total: $266.56
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 perA I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECR CAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFID I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an z n Futhermore, I authorize the above-named contractor to do the work stated.
June 09, 2017
Authorize nature:Owner / Applicant / Contractor / Agent Date
Building epartment Copy
June 09,2017 1
�� � �cl� � � �'d .
, Miami Shores Village v .
1�1
Building De 011 2
partment MAY
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 $Y - —�—
INSPECTION LINE PHONE NUMBER:(305)762-4949 5fil
FBC 2014
BUILDING Master Permit Notl— —S 48S
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING XMIECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 373 NE 101 Street
city: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-013-5230 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Ricardo & Melissa Mazzitelll phone#:(319) 321-1561
Address: 373 NE 101 ST
City: Miami Shores State: FL . Zip: 33138
Tenant/Lessee Name: N/A Phone#:
Email: MAZZITELLI.MCL@gmail.com
CONTRACTOR:Company Name: `c Phone#:
Address: 12I0S St�)
City: M 6MNA- State: Zip: 133
Qualifier Name:ffim�( .� Phone#bok'
State Certification or Registration#: Certificate of Competency
DESIGNER:Architect/Engineer: Phone#:
Address: 4 0 City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition
^ ❑ Alteration ❑ New Id1"R'ep�aiir►/RReplace�/ ❑ Demolition
Description of Work: l �R,(J�G�CrPirrOd�� 6U C.-( U_Qr tic
Specify color of color thru tile:
Submittal Fee$ 50 1
Permit Fee$ y CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ / rr
TOTAL FEE NOW DUE$ 2-1/ b
(Revised02/24/2014)
t
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) PennyMac
Mortgage Lender's Address P.O. BOX 514387
City Los Angeles State CA ZIp90051-4387
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.....
J
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 a roved and a reinspection fee will be charged.
4kSignature - A.7-7,dignature
NER rAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument
was
/acknowledged before me this
day of 20 1 by 1�e day of 1" 1 20 l + by
I
ME"S A Rr� (LCAR;0 MAZ A11,04ho is personally known to m �erl rof.f14 ,who is personally kaomLcao
me or who has produced R—MAw£RS UU&--ISESas Tv or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: L Sign:
Print: Ct±A(I.tFNf. Print: V O� �I 1),0-?
.��av vie
Seal: CHARLENE ROSARIO Seal:,P,
YUDERKA RODRIGUEZ�' ''•`�O
a Notary Public,State of Florida * MY COMMISSION I FF 205561
Commission#FF 977345EXPIRES:March 24,2019
My comm.expires Apr.9.2020 `aa rioV' B.dEd Thm Budget Notary Services
********* ****************************************************************
APPROVED BY �� Plans Examiner Zoning
` I
Structural Review Clerk
(Revised02/24/2014)
i
F STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (350) 437-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
FERNANDEZ, OSCAR
QUALITY COOLAIR CONDITIONING INC
1571 SW 153RD PATH
MIAMI FL 33194
Congratulations! 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 STATE'C3F FLORIDA.
from architects to yacht brokers,from boxers to barbeque ...DEI'ARTMEN OF•BUSINESS AND°
AE-
restaurants,and they keep Florida's economy strong. PROFESI(7faIAL REGULATION
Every day we work to improve the way we do business in order CAC181857! _ # aU06/12/20 96
to serve you better. For information about our services, lease _ - ••,
_ � ..
log onto ww.myfloridalicense.com, There you can find more CE,RTIFtEt3 AIR IdC)C N
information about our divisions andthe regulations that impact FERNAND_EZ 05�� t , ^^
you, subscribe to department newsletters and learn more about, QUALITY COOL�Alt C tOITD1fING IMC,`
the Department's initiatives. ' ;i
Our mission at the Department is: License Efficiently,Regulate
Fairly.We constantly strive to serve you better so that you can
�S G1 aMc Eder tJe arou,sv S 6i
ftTIFIE0i.4JD8,r5,
serve your customers. Thank you for doing business in Florida, y i
Expii�Eraes CBIS'RUG`31,2616 -+. L Bcrt^OOiBt .' .
and congratulations on your new license!
i
i
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY
•STATE-:OF FLORIDA.,
_. ..- _,.DEPARTMENT OF BUSIPIESS AN'D PROFESSIONAL-REGULATION
mm "-CONSTRUCTIQN,INDUSTRY,LICENSING BOARD;w ,. I
.» ... 4
SO
N
The:CLASSAAIR'CONDIT,IONING,C'CONTfRAC`IO az: y w
:Named below IS:CERTIFIED _ �� ��-....,•:,--:,,. ' „�.�,�:��� ,,••;- �' ��
Uhder the,pravrsions of Chapter 489 FS "'�*+.
Explratohi.date AUG 31,2018 a`
ji f FERNANCOEZ OaC,AR,
0UA0TY'COO AIR-.CONDf iL))NING INC
" 15 1'SW3 53RD PATt•I
i M1Atvtl �f33194
_
tea::_.. •• i
�'-or-s+•'" d .r_.... "'. wr,�,w`_ 2. k4.
-ILL
4 a
ISSUED: 0611212016 DISPLAY AS REQUIRED BY LAW SEQ# L1606120000818
} sir
gim
r
s
DATE(MMIODIYY)
,,.:. CERTIFICATE OF LIABILITY INSURANCE o5/2s/17
__.. .... __ .__..
j PRODUCER First Insurance Group THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
10967 SW 40 St ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Miami,FL 33165 n...--_.ALTER_THE_COVERAGE AFFORDED-BY.THE POLICIES.BELOW.
„ Phone (305)221-7878 Fax (305)554-7090 I INSURERS AFFORDING COVERAGE NAIL#
INSURED QUALITY COOL RIR CONDITIONING INC INSURER A UNITED STATES LIABILITY INS.
_.
12105 SW 129 CT #108 INSURER B; AM TRUST NORTH INSURANCE
INSURER-C:.. l
Miami,FL 33186 __ _ . _......__- .......
INSURER D-
... ..___. ._......
.. L. ......._.......
INSURER E.
COVERAGES __
,INSURER F: i
THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
NOTWITHSTANDING
i ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY RAVE BEEN REDUCED BY PAID CLAIM ...... _.........._:..
wsR'
ADD L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE f POLICY EXPIRATION
LTR 1NSRD .. .._-, .... _ DATE(MM/00/YY) + OATE,(MMIOO/YY)_ i LIMITS
_...
GENERAL LIABILITY I EACH OCCURRENCE
1,000,000
[�COMMERCIAL GENERAL LIABILITY I DAMAGE TO RENTED 1,QOO,400
G'L1742492A 03!31117 03/31!18 I PREMISES(Ea,occurence)...
_..
A I - Li CLAIMS MADE I j OCCUR MEd EXP(Any one person) 5,000
.IPERSONAL&ADV INJURY 1,000,000;
.....-
..................
(. s . GENERAL AGGREGATE
__. ....... 2,000,000'
.... _
I GEN'L AGGREGATE LIMIT APPLIES PER:, ( PRODUCTS COMPIOP AGG I2,000,0001
J POLICY L .l PROJECT I LOC
............. _....3 _..__. i _. ._..................... .. ..._.... .. _,, i
...
i AUTOMOBILE LIABILITY I...
._) ANY AUTO COMBINED SINGLE LIMIT
(I a accident)
C� ALL OWNED AUTOSiF
i
I...I :.� SCHEDULED AUTOS
BODILY INJURY
HIRED AUTOS (Per person)
...........
NON OWNED AUTOS BODILY INJURY(Per accident)
1 } PROPERTY DAMAGE I
.. ,._..
(Per accrdent)
GARAGE LIABILITY AUTO ONLY EA ACCIDENT
_ -_..........
ANY AUTO
OTHER THAN EA ACC
CI
__.._._. _ _ - AUTO ONLY. AGG
- ...
EXGE§SIUMBRELLA LIABILITY i I EACH OCCURRENCE
IJ OCCUR [_) CLAIMS MADE I AGGREGATE E
_.._
DEDUCTIBLE __ __
RETENTION $ ..........._. ..............
WORKERS COMPENSATION AND.. _ _... .. ..._.._.._A._._ __. _ ....._........
!EMPLOYERS'LIABILITY AWC1025721 10/05/16 10105/17 ' I WCSTATU- (_j OTH
I TQRY ER I ,,, .......
B I ANY PROPRIETOR 1 PARTNER I EXECUTIVE E C EACH ACCIDENT 500..
OFFICER/MEMBER EXCLUDED?
00
If yes,describe under £.L. DISEASE EA EMPLOYEE; 500,000 E
SPECIAL_PROVISIONS below €
- -- E.L.DISEASE POLICY LIMIT 500,000
......... .......
OTHER ..._..-... ..... _
__..
..._..__�.. _
DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ;
.AIR CONDITIONING REPAIR AND INSTALLATION. LIC# CAC1813577
I
t.. ........._...........
CERTIFICATE HOLDER _ CANCELLATION
....... . ........._ r,....
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
'+ MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
BUILDING DEPARTMENT THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
10050 NE 2 AVE OF ANY KINGI"OMN l`H�,INSURER,ITS AGENTS OR REPRESENTATIVES,
MIAMI SHARES FL 33138 AUTHOI62ED Rf PRESEN 71VE
:> a ) ) /
_... 5?. ........._.
--_. � c ..-._._-. _
.................
O ACORD CORPORATION 1988
trlil�3 a�rutµF��7
�1