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MC-17-2579Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Permit NO. MC-10-17-2579 • Permit Type:. Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Expiration: 05/02/2018 Applicant 9300 BISCAYNE Boulevard Miami Shores, FL 33138- 1132060141640 Block: Lot: GABRIEL COSENTINO Owner Information Address Phone Cell GABRIEL COSENTINO 9300 BISCAYNE Boulevard MAIMI SHORES FL 33138- (305)962-1893 9300 BISCAYNE Boulevard MAIMI SHORES FL 33138- Contractor(s) DEACO CENTRAL A/C Phone (305)443-9615 Cell Phone Valuation: Total Sq Feet: $ 4,900.00 720 Tons: Additional Info: DUCT WORK ON NEW ADDITION 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 Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.57 $2.00 $1.00 $171.50 $3.00 $4.00 $187.07 Pay Date Pay Type Invoice # MC-10-17-65497 11/03/2017 Check* 3624 10/31/2017 Check #: 3619 Amt Paid Amt Due $ 137.07 $ 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 ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accur. f and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -name • •ntra..r to do the work stated. November 03, 2017 Authorized Signature: Owner / Applicant / ac'T / Agent Building Department Copy Date November 03, 2017 1 6vv\\- Miami Shores Village Building Department -P?:7ry 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BUILDING, PERMIT APPLICATION INSPECTION LINE PHONE NUMBER: (305) 762-4949 Master Permit No. FBC20(u S"� RC/6 - 2 50s Sub Permit No. N' -t�254 - ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING Q MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9300 Biscayne Blvd City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-014-1640 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: OWNER: Name (Fee Simple Titleholder): Gabriel Cosentino Address:9300 Biscayne Blvd Phone#: FFE: City: Miami Shores State: FL Zip: 33136 Tenant/Lessee Name: Email: Phone#:, CONTRACTOR: Company Name: to %4CO CA(:)/ ene-- Phone#: 3OJ�7�5� -G 053 Address: /) . / / d I U City: t i,Aye 411 state: FL Zip: 330 /,3 Qualifier Name: D/cO 1--/e/exit) Dg Z Phone#: 30s-6 S8 e 58 State Certification or Registration #: CRC /8 /53 /6, Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ? r l ((:)• aiSquare/Linear Footage of Work: I itO s i7' Type of Work: ❑t Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: .DJ-c->er- t- ' C,J , /- J' / t» n4,-.1 Specify color of color thru tile: "� i %� Submittal Fee $ Permit Fee $ i V Y I 5V CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 9- • DBPR $ a . - Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ ff I TOTAL FEE NOW DUE $ t3. ' O: (Revised02/24/2014) 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 approve/�einspection fee will be charged. Signature //- NER or AGENT Signature CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3(0 day of 064V , 20 I 7 , by 9 day of % S , 20 (6 , by $.P 2f -& (2_ /11') , who is personally known to D; e0 / //E A)O#P - , who is(personally known to� me or who has produced ,A2(� . C-(CE'-Q identification and who did take an oath. Sign: Print: Seal: ***************** APPROVED BY as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NNN, Sign: (cFP Print: %ham' 7' Seal: ***************.****************************************************************** Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk ACOREP CERTIFICATE OF LIABILITY INSURANCE Ills......---.11/19/2018 DATE(MWDD/YYYY) 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 ROYAL CARIBBEAN INSURANCE AGENCY II 1772 WEST FLAGLER STREET MIAMI, FL 33135 FACT JUAN G TUNON y40.Extk 642 4541 uuc,Nor305-642-1087 A 'I 5,JTUNONROYALIIOGMAIL.COM INSURER(S) AFFORDING COVERAGE NAIC8 INSURER A : CAPACITY INS CO INSURED DEACO CENTRAL AIR CONDITIONING CORP 4730E 10 LANE HIALEAH, FL 33013 INSURERS; TECHNOLOGY INSURANCE CO INSURER C: INSURERD: 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 ADDLSUBR R WVo POLICY NUMBER POLICY EFF (MMIDWYYYY) POLICY EXP (MDD/YYYY) W LIMITS A t GENERAL LIABIUTY COMMERCIAL GENERAL UABILITY OCCUR HMH 11182015A 11/18/2017 11/18/2018 EACH OCCURRENCE $ 1,000,000.00 X DAMAGE TO PREMISES (EaENTED oo urrsnoe) $ 100,000.00 CLAIMS -MADE n MED EXP (Any ono person) $ 5,000.00 PERSONAL S AOV INJURY $ 1 ,000,000.00 GENERAL AGGREGATE. $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLES�PER: I I LOC PRODUCTS • COMP/OP AGG $ 1 ,000,000.00 n7 POLICY .. ERCOT• $ AUTOMOBILE LIABILITY ANY AUTO AU. OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ T BODILY INJURY (Phr4son) $ — ^ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per tuxWenn S _ S UMBRELLA UAB EXCESS UAB i OCCUR CLAIMS -MADE EACH OCCURRENCE . S AGGREGATE $ DEC RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' UABILRY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER MEMBER EXCLUDED? (Mandatory In NH) If Yes, dascnbe undor DESCRIPTION OF OPERATIONS N / A TWC3426595 09/23/2017 09/23/2018 Toav LI RB EA E.L. EACH ACCIDENT $ 100,000.00 ri I ' E.L. DISEASE - EA EMPLOYEE S 100,000.00 below E.L. DISEASE - POLICY LIMIT S 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule It more apace Is required) LIC. HOLDER- DIEGO HERNANDEZ LIC. # CAC1815316 AIR CONDITIONING CONTRACTOR EMAIL: DIEGO HERNANDEZ [DIEGO@DEACOAIR.COMJ CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, Fl 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN _-ACCtlbAWITH TIjEPOLICY PROVISIONS. 0i988f 2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/051 The ACORD name and loan are realstered marks of ACORD