Loading...
EL-17-792Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address 790 NE 97 Street Miami Shores, FL 33138- Owner Information Address Permit Parcel Number 1132060142190 Block: Lot: Issue Dat Permit NO. EL-3-17-792 Permit Type: Electrical - Residential Work Classification: Addition/Alteration PermitStatus: APPROVED 41712017 Phone Expiration: 10/04/2017 Applicant ANN UENO Cell ANN UENO 790 NE 97 Street MIAMI SHORES FL 33183- Contractor(s) Phone US HEATING AND AIR CONDITIONING (954)626-0483 Cell Phone (312)305-0095 Valuation: Total Sq Feet: $ 100.00 0 Type of Work: INSTALL ELECTRIC TANKLESS WATER HEA Additional Info: INSTALL ELECTRIC TANKLESS WATER HEA Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Amount $0.60 $2.00 $2.00 $0.20 $5.00 $100.00 $3.00 $0.80 Total: $113.60 Pay Date Pay Type Invoice # EL-3-17-63421 03/22/2017 Credit Card 04/07/2017 Credit Card Amt Paid Amt Due $ 50.00 $ 63.60 $ 63.60 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W. W. 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 AFFIDA�/ T: 1 ceftiif that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and re.. I authorize the above -named contractor to do the work stated. utho zed Signature: Owner / Applicant / Contractor / Agent April 07, 2017 Date Building Department Copy April 07, 2017 1 BUILDING PERMIT APPLICATION ▪ BUILDING Q ELECTRIC ▪ PLUMBING 0 MECHANICAL 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 FBIIC 20 14" Master Permit No. PL 11 - / 31 R_ECI,r MAR 2 2017 BY: El ROOFING JOB ADDRESS: 790 NE 97 STREET PUBLIC WORKS Sub Permit No. t L. 1_79 Z REVISION EXTENSION 0 RENEWAL El CHANGE OF CANCELLATION El SHOP CONTRACTOR DRAWINGS City: Miami Shores Folio/Parcel#:11-3206-014-2190 Occupancy Type: Load: County: Construction Type: Miami Dade Zip: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder): RICK & ANN UENO Address:790 NE 97 STREET City: MIAMI SHORES Flood Zone: BFE: NO X FFE: Phone#: 312-305-0095 ;—i' ,state:-FLORIDA ;, . Zip: 33138 Tenant/Lessee Name: N/A Phone#: N/A Email: CONTRACTOR: Company Name: US HEATING & AIR CONDITIONING INC Address: 3721 SW 47 AVENUE SUITE 305 Phone#: 954-581-8333 City: DAVIE State: FLORIDA Qualifier Name: JAMES PHILLIPS Zip: 33314 Phone#: 954-581-8333 State Certification or Registration #: EC13006332 DESIGNER: Architect/Engineer: N/A Certificate of Competency #: Phone#: N/A Address: N/A City: Value of Work for this Permit: $ 50.00 Type of Work: ❑ Addition ❑ Alteration ❑ New Square/Linear Footage of Work: State: Zip: _. 1 Repair/Replace ❑ Demolition Description of Work: INSTALL ELECTRIC TANKLESS WATER HEATER Specify color of color thru .tile:. Submittal Fee $ EDO I C d Permit Fee $ /no , Ov Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) -r5•413 Radon Fee $ 2 Training/Education Fee $ CCF $ • CO-0 CO/CC $ DBPR $ Notary $ 1 5 Double Fee $ `ter Bond $ TOTAL FEE NOW DUE $ 5. 0,0 Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip " Mortgage'Lender's Name (if applicable). N/A 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 NOTICEr`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 absenceyof such posted notice, the inspection will not be a•proved and a reinspection fee will be charged. • Signatur OWNER or AGENT The foregoing instrumentnwas acknowledged before me this 22 day of 'v`!rCk ,20 t1 A-hn MOLY i t U c 4'LO , who is personally known to me or who has produce 1 V'Q V �'I C' vtS�e °- as identification and who did take an oath. NOTARY PUB Sign: Print: Seal: by 10'1.y YANADY PRIET MY COMMISSION d FF 214031 EXPIRES: March 25,1 20 0 `° �rFa ct� APPROVED BY '// -'4'A ' -" PIans Examiner The foregoing instr`uinent was acknowledged before me this yor •F OY - 20 [7 ,b ,n�,�p da -of `�-� y RI �-S Ph( 111 pS , who is personally known to me or who has produced • '' identification and who did take an oath. NOTARY PU�tLIC: Sign: Print: Seal: . `Ly, as Structural Review ralia i4/1 : ,1 VI41 °spav P„aee. AVRAHAM KALMIS * MY COMMISSION t FF 122440 EXPIRES: May 12,2018 Banded Thru Budget Notary Services Zoning Clerk (Revised02/24/2014) BROWARD • • ... - _ 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER"1, 2016 THROUGH SEPTEMBER 30, 2017 443 DBA �I Receipt #:ELECTRICAL/ALARMS/CONTRA Business Name: US HEATING & AIR CONDITIONING INC Business Type: (ELECTRICAL/CONTRACTOR) Owner Name: JAMES MICHAEL PHILLIPS Business Opened:10/31/2008 Business Location: 3721 SW 47 AVE #305 State/County/Cert/Reg:EC13006332 DAVIE Exemption Code: Business Phone: 954-581-8333 Rooms Seats Employees 10 Machines Professionals For Venoing Business Only • Vendlnct Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 3.00 0.00 0.00 0.00 0.00 30.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: US HEATING & AIR CONDITIONING INC 3721 SW 47 AVE #305 DAVIE, FL 33314 2016 - 2017 Receipt #158-15-00002006 Paid 09/12/2016 3.00 a OR RICK SCOTT, GOVERNOR r lit !ALM Ilt11.L KEN LAWSON, SECRETARY .......... .;,..,..- fir. *a^ ..-7- 7.:-ro-,,,� 7 ,? STATE of FLORIDA . R DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION , ,a .:ELECTRICAL CONTRACTORS LICENSING BOARt3 ,..,;. _.` �. 777, LICENSE NUMBER •. .. .....-•_ ».. .,,,.__ -_. ^-.' -a +. ",.. .`��' EC13006332 a ADDI'TIONA:L.-BtlsINEss-QUALIFICATION;'- ..:: `` s, The ELECTRICAL CONTRACTOR Named below ISCERTIFIED .. :Under the provisionsof Chapter 488 Ezpratlon'date: AUG.31`, 2018.-:. .PHILLIPS DAMES MICI-IAEL -U.S :HEATING AND AIR-CONDITIONING INC 624 DOUGLAS AVENUE S€ITE1402 ALTAMONTE SPRINGS; L 32z1.4' ISSUED: 07/05/2016 DISPLAY AS REQUIRED BY LAW • SEQ # L1607050002203 ACORD® �, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 3/14/2017 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 BB Insurance Marketing Inc 10167 W Sunrise Blvd, 3rd Floor Plantation FL 33322 CONTACT NAME: Bonnie Krigsman Ext 313 PHONE 888_728 0817 FAX 954 452 0450 (A/C No Ext) (A/C. No); E-MAILSS: bkrigsman@bbimi.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Ohio Security Insurance Co 3491 INSURED USHAC-1 USHAC of South Florida LLC DBA US Heating and Air Conditioning 3721 SW 47th Ave #305 Davie FL 33314 INSURER B :Ohio Casualty Insurance Co 24074 INSURER C :Normandy Insurance Co 13012 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1952801279 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY BKS55666863 10/11/2016 10/11/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE X LIMIT APPLIES PECOT- PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO A AWNED CHEDULED UT NON -OWNED AUTOS BAS55666863 10/11/2016 10/11/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) , $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE US055666863 10/11/2016 10/11/2017 EACH OCCURRENCE $1,000,000 AGGREGATE $ DED X RETENTION$0 $ C 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 N / A NHFL0043062016 10/11/2016 10/11/2017 X STATUTE OTH- 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) HVAC, Plumbing and Electrcial Contractor located at 3721 SW 47th Ave #305, Davie, FL 33314. Uninsured Motorist $20,000. PIP $10,000 w/ $0 Deductible. Comprehensive / Collision Deductible $500/$500. Certificate Holder is included as an Additional Insured on the policy with respect to General Liability, only as required by written contract. Waiver of Subrogation Applies. General Liability policy is primary and non contributory. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES FL 33138 I 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