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MC-15-1516
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Issue Permit NO. MC-6-15-1516 Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED e: 7/20/2015 Expiration: 01/16/2016 Parcel Number Applicant 1017 NE 95 Street Miami Shores, FL 1132060143580 Block: Lot: MIAMI PROPERTY SOLUTIONS 1 Owner Information Address Phone Cell MIAMI PROPERTY SOLUTIONS LLC 142 NW 100 Street MIAMI SHORES FL 33150- (305)807-4045 190 NE 111 Street MIAMI SHORES FL 33161- Contractor(s) Phone MASTER MECHANICAL HVAC CORP (305)394-6218 CeII Phone Valuation: Total Sq Feet: $ 5,200.00 00 Tons: 1.5 AND 4 Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved: : In Review Type of Work: INSTALL NEW DUCT WORK NEW A/ Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $3.60 $2.73 $2.73 $1.20 $182.00 $9.00 $4.80 Total: $206.06 Pay Date Pay Type Invoice # MC-6-15-56036 07/20/2015 Check #: 6814 $ 156.06 $ 50.00 06/19/2015 Check #: 6804 $ 50.00 $ 0.00 Amt Paid Amt Due 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 accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. )(I )3/4 July 20, 2015 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy July 20, 2015 1 Address: 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 FBC, 20 /O Master Permit No.7C /S- q3/ Sub Permit Nof/624 - %ci_o_ ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING JOB ADDRESS: City: Folio/Parcel#: ECHANICAL foR ,U E 49511' Miami Shores County: /1- 32o6 - ois'- 35-s-a ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Dade Zip: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: .33)3 8" NO BFE: FFE: OWNER: Name (Fee Simple Titleholder): i t'5 -74 a PS./d /tf L ( Phone#: la 5 --OV 7-401 q ? PioiU//l r S-62 el �2 2 City: �, ,i Sh. � € PS State: �� Zip: ,J 3/3 Tenant/Lessee Nam : Phone#: Email: �' 1 e m/r/ n Ur ( /es c a - CONTRACTOR: Company Name: / T Lia-{ �,4(. 'V I <, COO Address: eVSzi AA.A.) 33•te 1" City: /1j(¢ye// State: Qualifier Name: ii,e0e pzi-1d/ /tl 0 State Certification or Registration #: C',C /WA ..i -- DESIGNER: Architect/Engineer: Address: City: Phone#:3as'=.3fV-6 oil>. Zip: 33/4,1Z-J Phone#: 3Q>� .� (o 0/6 Certificate of Competency #: Value of Work for this Permit: $ Type of Work: 67,200 El[)? AdditionAlteration I] New ❑Repair/Replace Phone#: Square/Linear Footage of Work: State: Zip: El Demolition Description of Work:.. iza n0.-W Toci buvik 6' 7)(19,g L 44-4.2441 ,U9 nap')C/. at./ 415)-f EA4 rJ c/ei Specify color ofycolor thru tile: �-V Submittal Fee $ 'w Permit Fee $ V )_. 4 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ \e:1 . 0 XJ (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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ONER or AGENT The foregoing instrume t was acknowledged before me this I "- day of/ / , 20 lS , by 1 ' day of t' Z.c�-70/icf. z/. ' . ;------who is personally known to ate or who has produced_:-� 3o44-c-4-Y as me or who has produced Pf=rC$'1 4« as identification and who did take • oath. NOTARY PUBLIC: Signature The foregoing instrument was acknowledged before me this ,201.S ,by Sign: Print: Seal: L.r — • % Poe, Notary Public State of Florida Maxine Y Gomez My Commission EE 839239 riot nA. Expires 09/30/2016 *** Ile ************************************ APPROVED BY itLa` ft)� /Vlcy who is personally known to identification and who di NOTARY PUBLIC: Sign: Print: 0'4R Seal: ake an oath: otitSY°oi Notary Public State of Florida r sit^, Maxine Y Gomez 4` My Commission Et: 839239 or r•." F.,pires 09/30/2016 Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk STA1'E,0F'FL0RIDA~ `yk'` '• v DEPARTMENT:OF BUSINESS'"AND PROFESSIONACREGULATION e. - =CONSTRUCTION INDUSTRY LICENSING ° CIV L./iVVJIJIN, JCLA"CC INK CAC:1816537 The -CLASSAAIR'':CONDITIONING-CONTRACTOR' : }b -.`` Named: below` ISCERTIFIED. : . „ Onder,`the,provieions offChapterA89,FS:-- Ezpiratidh date:""AUG'311-2016 - r�,T. w, DE,EA7NUEZ,,RlbER R m` . •-."`--- MASTER,MECHANICAL y.'A'.0 CORP `°`- -- 4521'NV1l 33RD'io.a "2-, ' --- ` `., _4- •.r,„, MIAMI-"""`- ,,, FL-33142-4316--- -' 4. _ I ter— _ `= �6.5 ISSUED: 06/01/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406010002144 Local Business'Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL - DO NOT PAY 6637673 BUSINESS NAME/LOCATION MASTER MECHANICAL H V A C CORP .4521 NW 33 AVE MIAMI, FL 33142 MASTER MECHANIC ornomgov OWNER MECHANICAL CORP Worker(s) 1 MIAMIA RECEIPT NO. RENEWAL 6908405 SEC. TYPE OF BUSINESS 196 I SPEC MECHANICAL - 11 CONTRACTOR CAC1816573/ / 1 ECIHECK i14j 140160 EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter BA — Art. 9 & 10 This Local Business Tax Receipt only confnns payment oldie LocalBusine i Tali. . The Receipt is not alicense ` Permit, or" a certification of the hblder's qualifications, to do business. Holder must compljr with any governmental emmantal regulatory laws and requirements which apply to the business.-11 a � I 4 The RECEIPT NO. above crust be displayed' on all commercial vehicles — Miami -Dade Code Sec 8a=276 For more information, visit w w rpierj[dede.gireta ccoJJes .. !I J PAYMENT RECEIVED BY!TAX COLI!ECTOR' 75.00 0419/20114— -, AGORi© CERTIFICATE OF LIABILITY INSURANCE ....,"`. DATE (MM/DD/YYYY) 06/18/15 HOLDER. THIS POLICIES 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 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 Great Florida Insurance 8180 NW 36th St Ste 416 Doral, FL 33166 Phone (888) 913-6988 Fax (786) 456-9778 'CONTACT CONRAD FERNANDEZ NAME: PHO (NC No. Ext): (888) 913-6988 FAX No): (786) 456-9778 ADDRESS: CONRAD.FERNANDEZ@GREATFLORIDA.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FEDERATED NATIONAL INSURANCE COMPANY INSURED MASTER MECHANICAL HVAC CORP 4521 NW 33 AVE MIAMI, FL 33142 (786) 208-7469 INSURER B : PRGRESSIVE INSURANCE COMPANY INSURER C : MT. HAWLEY INSURANCE COMPANY INSURER D : INSURER E : INSURER F : RAGE 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 INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY 0 COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE d OCCUR ❑ Y Y GL-22545-00 06/02/2015 06/02/2016 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000.00 MED EXP (Any one person $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ►n PROT ►n LOC JEC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ B AUTOMOBILE LIABILITY • ANY AUTO ❑ AUTOS NED AUTOSULED NON -OWNED ❑ HIRED AUTOS AUTOS ❑ ❑ Y Y 02347264-1 08/09/2014 08/09/2015 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 10,000.00 BODILY INJURY (Per accident) $ 20,000.00 PROPERTY DAMAGE (Per accident) $ 10,000.00 $ C ❑ UMBRELLA LIAB ❑ OCCUR �/ EXCESS LIAB ❑ CLAIMS -MADE Y Y EMX0319655 10/13/2014 10/13/2015 EACH OCCURRENCE $ 1,000,000.00 AGGREGATE $ 1,000,000.00 ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE N / A n WC STATU- OTH- ❑ TORY LIMITS ❑ ER , E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Lisence num er CAC 1816537 ERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDIG DEPARTMENT 10050 NE 2 AVE MIAMI SHORES, FL 33138 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 C` ACORD 25 (2010/05) QF ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MASTMEC-01 AGONDOLI ,4` o�Ro" CERTIFICATE OF LIABILITY INSURANCE DAT/18/2D/YYYY) 6/18/2015 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 AP Intego Insurance Group, LLC 144 North Road Suite 2050 Sudbury, MA 01776 CONTACT Sharon Johnson PHONE 800) 274-4532 FAx lac, No, Ext : (A/C, No): E-MAIL info ante o.com ADDRESS: a p g INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Technology Insurance Company 42376 INSURED MASTER MECHANICAL H.V.A.C. CORP. 4521 NW 33RD AVE MIAMI, FL 33142 INSURER B INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. INSURANCE SUBR WVD LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 'NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE $ CLAIMS -MADE -DAMAGE TO -RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE LIABILITY SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE (per acddent) $ UMBRELLA LIAB _ EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N / A TWC3464632 02/11/2015 02/11/2016 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) license number: CAC1816537 CERTIFICATE HOLDER CANCELLATION MIAMI SHORE VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE Miami Shores, FL 33138 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 ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD