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MC-17-104Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 • Phone: (305)795-2204 Project Address P it Issue Data Permit'NO. MC-1-17-104 Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED 1/30/2017 Expiration: 07/29/2017 Parcel Number Applicant 444 NE 93 Street Miami Shores, FL 33138- 1132060140200 Block: Lot: SETH & LYNETTE LONG Owner Information Address Phone Cell SETH & LYNETTE LONG 650 W Avenue MIAMI BEACH FL 33139- (305)325-6976 650 W Avenue MIAMI BEACH FL 33139- Contractor(s) ABL CONTRACTOR CORP Phone (786)718-9935 Cell Phone Valuation: Total Sq Feet: $ 4,000.00 0 Tons: Additional Info: INSTALL NEW MINI SPLIT SYSTEM Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved:: In Review Type of Work: INSTALL NEW MINI SPLIT SYSTEM Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.10 $2.10 $0.80 $5.00 $140.00 $9.00 $3.20 $164.60 Pay Date Pay Type Invoice # MC-1-17-62616 01/13/2017 Credit Card 01/30/2017 Credit Card Amt Paid Amt Due $ 50.00 $ 114.60 $ 114.60 $ 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 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. January 30, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy January 30, 2017 1 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑PLUMBING ® MECHANICAL JOB ADDRESS: yyy yE 93 s / 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 Master Permit No. Sub Permit No. ❑ ROOFING ❑ REVISION ❑ PUBLIC WORKS ❑ CHANGE OF CONTRACTOR City: Miami Shores County: Miami Dade JAN 1 3 2017 s+- Fsc Zo ILA KO— 2 3gtn Mc CA-- t()Lt ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Zip: 33/3 Folio/Parcel#: Is the, Building Historically Designated: Yes NO Occupancy Type: Load: s[ Construction/Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): .P7'4 ahpc, .17 `yNeki 1-0", Address: ' 3 7 /!/ q t 5 a City: /t(eon (- C., ie?/Z-e5 State: /— BFE: FFE: Phone#:Td! 7-85-33P/ Zip: 3 / 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: A6L cp Dr? IZCfG Address: /' 7 O J)f.(% 14- 5 /L(f1 City: it it'cn to State:E Zip: 33/?5 Qualifier Name: ,�T /r0 /090 State Certification or Registration #: DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $ t/0 00, o 0 .Phone# 5'?' ` 7/ ! 7 3 S Phone#: CAC / 21 'Z Certificate of Competency #: Square/Linear Footage of Work: State: Zip: Type of Work: ❑ `Addition ❑ Alteration ❑ New ['Repair/Replace 1-7Demolition Description of Work: Trt-S> /( h/C w /'�1 (iv i G p/ 7/ cj )/ S ‘eirv, Specify color of color thru tile: Submittal Fee $ Permit Fee $ 1 U t CCF $ 2 . CA 0 /� Scanning Fee $ `3 1 Radon Fee $ DBPR $ • t Technology Fee $ Structural Reviews $ (Revised02/24/2014) . CO/CC $ Notary $ S Bond $ TOTAL FEE NOW DUE $ / lc(. 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: Asa 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 , ill not be approved and a reinspection fee will be charged. Signat OWNE R AGENT The foregoing instrument was acknowledged before me this / 3 day of 7Ati UH/R-�/ , 20 / , by 5Q T'4 Z Oh c� //, who is personally known to me or who has produced ,L )i2t 1/-e,C L I C 2SQ ,. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Signature The foregoing instrument was acknowledged before me this me or who has produced as identification and who did take an oath. NOTARY PU Sign: Print: Seal: **********************************p************************ ti APPROVED BY L L Mans Examiner LIC: 1111000 . 0lj��i _w:4-, , 3 cn ;,� • Zoning (Revised02/24/2014) Structural Review 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): LW City: Miami Shores Village County: Miami Dade Zip Code: 3 ' / 3'' 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 ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS 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 YE 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: A L Gfrt /aGc �(jIZ C o/cp Phone: '7Z ? (P State Certificate or Registration . C; C ' g2Z Certificate of Competency No. Signature /'. Date: o / 7(3// 7 (Qu i signature) (Revised02/24/2014) A� o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03/24/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE EXTEND OR ALTER THE COVERAGE AFFORDED HOLDER. THIS BY THE POLICIES AUTHORIZED A CONTRACT BETWEEN THE ISSUING INSURER(S), 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 Best Rate -Insurance Exchange Of America 8600 NW 17th Street Miami FL 33126 CONTACT Alejandro Moreno tac°. No. Exo: (866) 616-0065 FAX No): (305) 403 0801 E-MAIL brian@instantquotesdirect.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : PREFERRED CONTRACTOR'S ASSOC INSURED ABL CONTRACTOR CORP 1840 NW 16 ST Miami FL 33125 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 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 ADDINSD INSD SUER WVD POLICY NUMBER POLICY EFF (M//DD/YYYY) MM POUCY EXP (MM/DDIYYYY) UMITS A X COMMERCIAL GENERAL LIABILITY PCIC5026-PCA538737-02 03/16/2016 03/16/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES JEC7 I PER: LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE _ — LIABILITY SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PerAUTOS accident) $ $ UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached IF more space is required) Contractor License Number CGC-1523112 & CAC1818827 CERTIFICATE HOLDER CANCELLATION Miami Shore Village 10050 N.E. 2nd Ave. Miami Shore, 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 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 ALFONSO, ABEL ABL CONTRACTOR CORP 1840 NW 16TH STREET MIAMI FL 33125 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 from architects to yacht brokers, from boxers to barbeque ' restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CAC1818827 `; ISSUED:=12/13/2016 CERTIFIED Air? -COND CONTR' ALFONSO, ABEL..,;.. ABL CONTRACTOR "CORK" t IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2018 L1612130000582 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CAC1818827 The CLASS B AIR CONDITIONING CONTRACTOR' Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 ALFONSO, ABEL ABL CONTRACTOR CORP. 1840 NW 16TH STREET ..••- MIAMI FL•-33126 m.� a r., ISSUED: 12/13/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1612130000582 Local Bust ness Tax Fcei pt M iami-Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 7184282 BUSINESS NA M E/LOCA TION ABL CONTRACTOR CORP 1840 NW 16 ST .MIAMI, FL 33125 OWNER ABL CONTRACTOR CORP C/O ALFONSO, ABEL Worker(s) 1 MIAMI DADES RECEIPT NO. NEW BUSINESS 7500419 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 PAYMENT RECEIVED BY TAX COLLECTOR 45.00 12/30/2016 CAC1818827 0202-17-001543 This Local Business Tax Receipt only con^rms payment of the Local Business Tax. The Receipt pt is not a license, permit, or a certi "cation of the holder's quali "cations, to do business. Holder must comply with any governmental or nongovernmental. regulatory laws and requirements which apply to the business. The RECS PT NO above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more inforrretion, visit www.rriamidade.gov/taxcollector STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY EXEMPTION CERTIFICATE OF ELECTION TO BE ExBPPT FROM FLORIDA WORKERS COMPENSATION LAW EFFECTIVE DATE 4/21/2015 PERSON: ALFONSO FBN: 473369563 BUSINESS NAME AND ADDRESS: ABL CONTRACTOR CORP 1840 NW 16 STREET MIAMI SCOPES OF BUSINESS OR TRA E1lPIRATION DATE 4/20/2017 ABEL FL 33125 LICENSED GENERAL CONTRACTOR J