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DEMO-18-288Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Pe �m it Parcel Number Permit NO. DEMO-2-18-288 Permit Type: Demolition Work Classification: Mechanical Permit Status: APPROVED Issue Dam 212012018 Expiration: 08/19/2018 Applicant 1420 NE 101 Street Miami Shores, FL 1132050230050 Block: Lot: MATTHEW ALLEN Owner Information Address Phone Cell MATTHEW ALLEN 1420 NE 101 Street MIAMI SHORES FL 33138- (305)673-2847 Contractor(s) CHANIN MECHANICAL Phone (305)865-1729 Cell Phone Valuation: Total Sq Feet: $ 500.00 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-2-18-66345 02/05/2018 Check #: 10873 $ 50.00 $ 58.60 02/20/2018 Check #: 10872 $ 58.60 $ 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 for +nation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. u rmorrert'aUt t the above-rfamed contractor to do the work stated. February 20, 2018 Date Aut rized Signatlyre'Owner / Applicant / Contractor / Agent Building Department Copy February 20, 2018 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 FEB 0 5 1018 (ph FBC 201-1- GG BUILDING Master Permit No. -1..A.Y10 (�S— � O� PERMIT APPLICATION Sub Permit No. -en1 0 Ia - 238 ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I''1 Z O )U1 10 \5 \- Surer City: Miami Shores County: Miami Dade Zip: 331353 Folio/Parcel#: \ \ - S2.0 5 - 023 - 00 5 0 Is the Building Historically Designated: Yes NO ✓' Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 'm\t ) A-kVe Phone#: Address: 1420 /l%T, \Q \s k" 5 rt.tek City: (Y1\c.M\ 5Y\ State: L- Zip: 8313$ Tenant/Lessee Name: Phone#: ChSA-Ct q05— 299 -5 8 Email: CONTRACTOR: Company Name: CV\OM 1\ Y`AL(,V\0 "CC L L Address: j 0 (p 5 "Mks Phone#: 305, C(.05 1Zc City: 'CO\o fr beC. (X\ State: Zip: 33Iill Qualifier Name: -te,ki) C r \Gi1\(\ Phone#: State Certification or Registration #: C AC.-0 S (fl24E Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ sCoo.0 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ (N_ew ❑ Repair/Replace n Demolition Description of Work: (`e0 /\ -t-COV-CC1j %r t}tMoli h0 i Specify color of color thru tile: \jVJ Submittal Fee $ Permit Fee $ A CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ !E '. 00 (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 OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 21/45-day of , 20 i by Z_5 1 day of o n.xor20 t by ma 1At) A-11 en me or who has produced , who is personally known to fQ,W eVn' as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ,N•4V'¢,/,,, Crista Stefanick ,., r= Commission 1 GG167243 Expires: February 13, 2022 a,,,.° Bonded thru Aaron Notary * APPROVED BY CONTRACTOR , who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ; Ti/, , Cnsta Stefan) ,_ Commission # GG167243 Expires: February 13, 2022 '*%,,, ;; Bonded thru Aaron Notary as ************************************************************** Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDlYYYY) 8/2/2017 THIS 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: IT the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Ileu of such endorsement(s). PRODUCER International Insurance Center, Inc. 7990 SW 117 Avenue Suite 209 Miami INSURED Chanin Mechanical LC 1965 71st Street Miami Beach REVISION NUMBER: COVERAGES 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. __-__.._ .. ......._. - -POLICY iPOLICYEXP r —iSDOG �UBR` I_ LIMITS IR�� TYPE OF INSURANCE MO I WYp POLICY NUMBER ' (MMIDDIYYYYI . IMMtDDTYYYYI LTR FL 33183 CONTACT Paola Rossini NAME PHONE �((((305)279-5446 A REpaola@iiC . cc INSURER(SIAFFORDING COVERAGE INSURER A:Wesco Insurance Co INSURER B :National General INSURER c Associated Industries INSURER D _._._- _..__�...... ...... ...._._._...._.-_. INSURER E :._...._..____.. ...... .. _._... IFAX (305)279-4045 Insurance! 23140 FL 33141 INSURER F : 7 CERTIFICATE NUMBER:CL162303223 X I COMMERCIAL GENERAL LIABILITY A, 7w .. _ I CLAIMS -MADE Xi OCCUR GENII_ AGGREGATE LIMIT APPLIES PER: r J PRO- i X. POLICY I JECT � LOC OTHER: AUTOMOBILE LIABILITY B I ANY AUTO ~�1 ALL OWNED AUTOS } HIRED AUTOS SCHEDULED :AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR I EXCESS LIAR CLAIMS -MADE I DED 1 I RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ZANY PROPRIETOR/PARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED? C I (Mandatory In NH) Iit es, describe under DESCRIPTION OF OPERATIONS below A IWPP1382481-01 I2005200088 AWC1081783 6/20/2017 6/20/2017 EACH OCCURRENCE 6AMA6E-TU1YENTEO PREMISES {Ea occurrencel_,. 6/20/2018 : MEOEXP(Ally one person) PERSONAL & A0V INJURY LGENERAL AGGREGATE ( $ PRODUCTS COMP/OP AGO $ 1,000,000 100 000 5,000 1,000,000 2,000,000 2,000,000 COMBINED SINGE LIMIT $ S00 , 000 (Ea accident) __ _ ___... BODILY INJURY (Per person) i 5 6/20/2018 I BODILY INJURY (Per accident) $ PROPERTY DAMAGE - �5--- Medical Payments • EACH OCCURRENCE I' AGGREGATE, PER OTH- X_A ST ,T-ur _T....._ l.. a . 5,000 E.L EACH ACCIDENT I� 1000,000, 4/28/2017 4/28/2018 E.L DISEASE EAEMPLOYEdi $ 1, 000, 000. El. DISEASE - POLICY LIMIT I S 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Mechanical Contractor, License number : CAC056292 CERTIFICATE HOLDER ( ) - Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2014101) INS025 ont4mti CANCELLATION 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 � f r. jam- Edward CaL>assti,�i�F' �;:.� .- % � �.. ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 'J IMI C iJr re�Vl IL?% DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 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 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.myfloridaiicense,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! STATE OF FLORIDA DEPARTMENT°OF..BUSINESS AND PROFESSION L-REGULATION CAC056292 DES i0611912016 • CERTIFIED A!R C£ND CONY CHANIN, DREW NED CHANIN MECHANICALY ions of Ch,489 FS. yy L1606190000661 IS CERTIFIED under the pro Expiration date: AUG 31, 2018 DETACH HERE