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DEMO-18-1557Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address mit Permit NO. DEMO-6-18-1557 Permit Type: Demolition Work Classification: Mechanical Permit Status: APPROVED Issue Date: 61112018 Expiration: 12/04/2018 Parcel Number Applicant 9301 NE 2 Avenue Miami Shores, FL 33138- 1132060133650 Block: Lot: MIAMI SHORES VILLAGE Owner Information Address Phone Cell MIAMI SHORES VILLAGE 10050 NE 2 Avenue MIAMI SHORES FL 33138-2304 305/751-1271 Contractor(s) CHANIN MECHANICAL Phone (305)865-1729 Cell Phone Valuation: Total Sq Feet: $ 200.00 0 Type of Demo: Mechanical Additional Info: FREON RECOVERY FOR DEMOLITION Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO-6-18-67830 06/07/2018 Money Order $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical 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. F.�uuthermore, I authorize the above -named contractor to do the work stated. June 07, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 07, 2018 1 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 RECEIVED JUG 0 2018 BY: FBC 2011 1+ Master Permit No. bC1110 ISO-4 Sub Permit No. 1 JCY1'10 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: "1 0 \ /V E U City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: \ _ 3Z OLD " 0 \3 " S (0Sv Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): « Ia rn 1 5 1Or.Q,S I/ \ l\a�� Address: 100 SO ,() E Phone#: City: YYi IQ m 1 51\0 (LS State: L Zip: 33) S 46 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: CM'//✓//✓ /yam 9/V,C/ X- L Phone#: 3a ) 8(,S /70Z9 Address:,/ (965 77 S 7 ''C�T City: / %a%-/Y%/ C#9�'/ -/ State: �/t p Qualifier Name: /c-C� (� / �// -iv (/0 Phone#( ) 86 S / 7 State Certification or Registration #: Certificate of Competency #: C Cer)g6, P.19 2 DESIGNER: Architect/Engineer: /�/, Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Zo0.0(i Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace EiDemolition Description of Work: --1--Q o n re cowl Pb - c In 11 h v r1 Zip: 33 J 7 Specify,. color„ of color,thr'u'tile :,,' Submittal Fees— ' " "" "'Per`mit Fee $ t,a 9 v tg—DCCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) 1 Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address f City` i 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,jTANKS, 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 / O , Signa OWNER or AGENT CONTR°CTOR The forgoing instrument was �aacc�knowledged before memethis The foregoing instrument was acknowledged before day of Q� , 20 IFS , by � �`-a day of MOB 20 `` rOfek CJAMIA 10`I 1 ' WC,1 1 10Y-\ , who is personally known to , who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Si Print: Seal: I ,t. MAHARAI K. GONZALEZ •i` • MY COMMISSION # GG 044602 EXPIRES: November 2, 2020 ��`•'Pc nderwriters ***************************** APPROVED BY identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner CHAD CHETRAM E MY COMMISSION # GG070596 EXPIRES February 07, 2021 Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 ii 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CHANIN, DREW NED CHANIN MECHANICAL LC 6095 NORTH BAY ROAD MIAMI BEACH FL 33140 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 eque restaurants, and they eep 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 leam 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! STATE OF FLORIDA DEPARTMENTOFBUSINESS AND PROFE 1-4EGULATION CAC056292 '06/19/2016 CERTIFIED Al CHANIN, DRE CHANIN MEC1 IS GERftF.IED under the.provisions of Ch.44899FFS. date::AUG 31, 2018 DETACH HERE Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 5894317 BUSINESS NAME/LOCATION CHANIN MECHANICAL LC 1965 71 ST MIAMI BEACH FL 33141 OWNER CHANIN MECHANICAL LC Worker(s) 9 RECEIPT NO. RENEWAL 6148373 ILBT\ EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC MECHANICAL CONTRACTOR CAC056292 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/17/2017 FPPU06-17-014942 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www.mipmldgtow/taxcollector JRODRIG CHANMEC-01 T AC�RD `,-, CERTIFICATE OF LIABILITY INSURANCE . DATE (MM/DD/YYYY) 06/07/2018 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 have ADDITIONAL INSURED provisions or 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 International Insurance Center Inc 7990 SW 117 Ave Suite 209 Miami, FL 33183 CONTACT NAME: (A/CO No, Ext): (305) 279-5446 FAX No):(305) 279-4045 ADDRESS: info@iic.cc INSURER(S) AFFORDING COVERAGE NAIL # INSURER A : WeSCO Insurance Co 25011 INSURED Chanin Mechanical LC 1965 71st Street Miami Beach, FL 33141 INSURER B : Associated Industries Insurance 23140 INSURER C : INSURER D : INSURER E : INSURER F : VISION 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 POLIC ES 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/YYYYI POLICY EXP 'IMMIDD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X WPP1382481-02 06/20/2017 06/20/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea NTED ncel 100,000 $ CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ AUTOMOBILE _ LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY - � SCHEDULED AUTOS NON-OWNED CM Ea accident SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Peraccident) $ PROPERTY DAMAGE (Per accident) ) $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION$ B 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 s, NIA AWC1104824 04/28/2018 04/28/2019 X PER 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 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Mechanical Contractor License numbers : CAC056292 & CAC1819087 Certificate Holder is listed as an additional insured with respect to the General Liability I Miami Shores Village 9 10050 Northeast 2nd Avenue 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 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Day of By Vykvi (Seal) C'�tt'tty� STATE LICENSED AND INSURED CAC056292 EIi4NiNm LC Air Conditioning Contractor "SALES, SERVICE & INSTALLATION" Attn: Building Department City of Miami Shores 10050 Ne 2nd Ave Miami Shores, Florida 33138 Job Ref: 9301 Ne 2nd Ave - Miami Shores - Florida To whom this may concern: PH: 305-865-1729 FAX: 305-864-1354 1965 71 s'. STREET MIAMI BEACH, FL 33141 This is to certify that Chanin Mechanical, LC has recovered 8 lbs of Freon from (1) 3 Ton ac unit located at the above address on behalf of US Wrecking Services, on June 12, 2018 before the construction was demolished as EPA SECTION 608 Request. Any questions or •ncerns, please do not hesitate to call our office Drew Chanin, President Chanin Mechanical, LC /sa State of Florida, County of Miami -Dade Sworn to and subscribed before me this -Tog- , 20 f Personally known or Produced Identification, Type of Identification produced . . .. .. • .. • . • • • .. .. • • .•• . • • . • . • • . . • ... • .. •. • • . • • .. • . • • ... CHAD CHETRAM MY COMMISSION 1t GG070598. EXPIRES February 07, 2021 • ..•• • . • .