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MC-14-1301Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL L/ Phone: (305)795-2204 Fax: (305)756-8972 — _ ISp Inspection Number: INSP-214491 Permit Number: MC-6-14-1301 Scheduled Inspection Date: March 16, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: LUND, KENNETH AND ALEXANDRA Work Classification: Addition/Alteration Job Address:1001 NE 96 Street Miami Shores, FL 33138- Phone Number (714)721-2270 Parcel Number 1132060143740 Project: <NONE> Contractor: ALVAREZ APPLIANCE Phone: (954)680-5658 3unainq uepartment comments RE INSTALL 3 AIR HANDLERS AND DUCTS. REMOVE 1 AC VENT IN MASTER BEDROOM REPLACE WITH 2 SMALLER VENTS. RELOCATE KITCHEN RANGE HOOD 03-11-15 Construction project is active. see inspections related under 14-744 INSPECTOR COMMENTS False <:�t z' � � (5 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 13, 2015 For Inspections please call: (305)762-4949 Page 3 of 36 6A 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 ❑BUILDING ❑ ELECTRIC ❑ ROOFING Fnv ECFTJUN 19 2014 : FFBC20) � Master Permit No. T ,01A ,- 13 D Sub Permit No. n-c-1 k4 — 1-301 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING M MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /dd ( /'ii I'-" {, S/- c City• Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder4""// /JNI) Phone#: Address: l004 yve Ste' City: z2e14 -' i S' a�PC State: % Zip: Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: A t I (jC'le'Z Address: 1<--% 00 Sw S G {' City: State: Zip: Qualifier Name: Phone#: O 'fir( 6 State Certification or Registration #: CAI✓) �1 Certificate of Competency #: i° A L IL 1 % b ;� � DESIGNER: Architect/Engineer: Atd/ /Q g- 0 Phone#: 3 ° r - 51y1 O/i/q/ Address: �� �tr �'� City: //p"favi State: �� Zip:' Value of Work for this Permit: $ �00- vv Square/Linear Footage of Work: Type of Work: ❑ Addition �ze"'o ❑ Alteration ❑ New ( / /Repair/Replac-eD �p ❑/.Demolition /� X Description of Work: d� r- Ce „ ' C- I �ti 3 /`.It- c- d'� �C '�` �TrN /N orjl t - -%° rP IGcC floor5. J(P� e /`C4nOV4 I v t! ej4'3 ,r /1C VP ;n, C tc �� CIIA? ica P fP�/ S �C �orc riJN C, Ck-, . —Cxod,lG.0 e M� dP Specify color of color thru tile: Submittal Fee $ Permit Fee $ ®� `� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ t 01 )2 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 ap ved and a reinspectio a will be charged. Signatur _ Signature ;&� OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this ���12 day of �_ 20 l`1 by IY/(Z�r`►�l�'� b- J , who is onal kno to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ���� tttt�III///,/ l en;, Sign: Print: The foregoing instrument was acknowledged before me this v day of �L6�� 20 (`� by y 4( -impersonally known to me or who has produced ^f�Z� L C,> as identification and who did take an oath. NOTARY PUBLIC: Print: \out .; I'D % es •• _ Seal: ' F` 4f°�d+ Seal: �n�„,nittHtt APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. _\ COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor licens mber_ BUSINESS NAME: A ✓G,-,eZ a� BUSINESS ADDRESS: !S 70 D -vj S% CITY STATE r( ZIP CODE 3 33 BUSINESS PHONE: ( A { i) 6 6 FAX NUMBER O CELL PHONE ) �`fsG �� - D QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: eX < le' '7 d 2- `� A�`� CERTIFICATE OF LIABILITY INSURANCE (SAYE(MMIOOlYYYY) 06/12/2014 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 endorsements . PRODUCER CONTACT ,PABLO M CONDE NAME........_...._....._...._................... ......... ... ........................ _.............................................................. ..................................... A&A Underwriters, Inc, (A",c y,. ><t 305- 20-T4A/ iarc,.Nol:,?05-220-4821 aria sw a St F•1Y1A1L ADDRESS: pmc(�aaunderwriters,com __...........—............._............_.........._....... ....... ....._..._.....---....... ---..... _........_..._.........._..._......... — — MIan11, FI 33174 INSURERlS) AFFORDING COVEf2AG[ NAIC ri iNSURER..A.; SCOTTSDALE INSURANCE COMPANY _ .......... ........... ....... ...... ....... _..... INSURED INSURFRO: INFINITY INSURANCE COMPANY Alvarez Appliance InStBUi�tIUn & Repair, Inc. _............... ......... _......... —..._._........_..............__.._.....__.._ _._�_... ......_._ ..........----........— ......... wsURERC: BRIDGEFIELD EMPLOYERS INSURANC CO ........._.......... ...._........................................................... ......... ......... .... ... ...... —...... ........ ..... _.... .............. ............... ........... 15700 SW 56 TFi ST INW!T! D iNaurtlaR L Southwest Ranches FL 33331 _.. _...----.............................................. ............................ ..... ....... ................................. —..................... _............. ................. ................. INSURER P : CUVFRAv:FR rcDTI9:Ie'Arc n111KA0120• t�C,.t.�,...1 .•„�..» ,,. 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 REOUIREMENT, 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 DESCR18ED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIQ CLAIMS. wssa...._.._.._..............................�i ;SD.t�.k......._.__..._.................._...._.................__.........._....._.. UTp TYPE OF INSURANCE - POLICY L-FF ^"POLICY E%F _ POLICY NUMBER :(MMIDU/YYYY�'. MM„lL')O/YYYY ....................................................................................... ""' LIMITS .................. X ,COMMERCIAL GENERAL LIABILITY EACH RE'NCE t 1,000,000 • CLAIMS -MADE L..x....i or:CUR AI ...................._ 0AM xru/rn:.F................._.. Prr Af .......... ...... > ......... ...................�QD 000......... _. _............. ._........ C PS1854036 08/31/13 08/31/14 rn1 gex.S...... .. Any on<i vetrwrp......._.. s 5,000 _................. !............................'..... ..................—....-........... -....................................... PEJzsnNAL A ADV INJURY $ 1,000,000 ......................2,000,,1]QQ....... G -N`L AGGREGATE LIMIT' APPLIES PER: ! GENERAL AGG'RECATE..._............$ PRO. '.._%�.. I'+171.J C;v i.......__I JIiCT I_.......I L.UC: I ...... .._... ..... ................... ..................- PR<)C)UCTS - C,0MP1gN AG ....._........_.—...._.— ...x ......................1,000,Q00....... ..............._ ....................................._.............. AUTOMOBILE LIABILITY OOMBINEL ? NOL `' LIMIT $ 100,000 :... 09 8000Q ANY AUTO --6325-01 Ub/30/13 06/3U/14 - ............. !,Io ii Y IN tt_i^Y far.. emr.,n ........_............... ALL OWNED X AIJT'O$ _.. ........................... AUTOS h10DII.Y INJLAY (Por accoont) $ X HIRED AUTOS ;. X, Ai IUtiWNfi:6 PRO�PEATYDAMAGE $ ............. X PIP $1000 D X Comp/Cull ..... ,,. UMBRELLA LIAR (Jt�t=Uf2 ............. - EACH OCCURRENCE S ;. ............. EXC[=R.R I.FAF! C:LAIMta-MA66 ... _.._,..._._......_........ ............i. ................. ...., ........ ........ .......... ...._ ................... AGGRGG ATE .....$ ........... _... ......—....._................ ._.................. ............................... ....... DED3C'lTE'NT'ION 5 .....,,.....,...J.�,,,,.....�...,„W.,�.�.,... ...................................................--- $ WORKERS COMPENSATION P�_ X ANd FMPLPYpfes' LIA0ILITY Q83O 36402 Y/N; ANY PtOPRierOR/PAr;TNLgq/t:xl:c U•rIVL: -- ; - 05/22/14 05/22/15 (. ;dF'FtG'�R/MEMAFFt E=YGLUOEn1Y7 Y :NIA; !' i TT'I.�TFE�R.................... .-E.L.._EiACI,i .ACCIDENT,,,,,, .. ... ..._ R .....100,000..... ._._..................... ���100,000���-�� (M�ntlatory In NW) -- It yHF, Uesr:YibO UnClef „E.L. DISEA,SE. � EA EMPLOYEE' ... DISEASE .................. ...... � $ ......................... ����SOO,OOO����� I')_,: RIPTION OF OPERATIONS FL . I-ne FASf.; - POI,IC;V LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rbmarks Schodufo, may bb atUdhod if MOM spaca is toquirod) Air Conditioning Contractors Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores Villages, Florida 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 w� Tr,aa-ZUls ACURD CORPORATION. All rights reserved. ACORD 25 (2013/04) The ACORD name and logo are registered marks of ACORD 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 Dme:ALVAREZ APPLIANCE INSTALLATION & Receipte"HEATING/AIRCONDITION C Business Name: REPAIR INC Business Type: (CLASS A AIR CONDITION CONTRACT) Owner Name: EDILBERTO ALVAREZ Business Opened:02/04/2009 Business Location: 480 W 84 ST State/County/Cert/Reg:CAC1817624 MIAMI DADE COUNTY Exemption Code: Business Phone: Rooms, SeatsIV', plyr esjylahi�, Professionals kFor Vend ing;Busin_ ess Only 9tl a Number of Machines: 'In "vo.,�r:,n T,.,o• Tax Amount Transfer Fee S ee - rao�"Y "'r k Collection Cost Total Paid 27.00 0.0 0.00 29.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT 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 WHEN VALIDATED 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: EDILBERTO ALVAREZ 15700 SW 56 ST SOUTHWEST RANCHES, FL 33331 2013 - 2014 Receipt #03A-13-00000275 Paid 10/10/2013 29.70 RICK SCOTT ISSUED: 09/2912013 SEQ # L1309290000753 KEN LAWSON GOVERNOR . nl,QPl AV Ac RGni ntaGn aV i AIAr gF(.PFTAPY