MC-18-1105sKQ1s L,�
Miami Shores Village
��
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
1 .1yfi
Phone: (305)795-2204
�OFRt
Permit NO. MC-4-1 &1105
tPermit Type: Mechanical - Residential
er Ktrk Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 5/8/2018 1 Expiration: 11/04/2018
Project Address Parcel Number Applicant
1121360110430
Miami Shores, FL 33161- Block: Lot:
owner mrormation Address Phone Cell
i (305)323-1964
Contractor(s) Phone Cell Phone
UNIVERSAL PLUMBING CORP (305)887-3131
Tons:
Additional Info: RELOCATE EXISTING AC UNIT, PROVIDE
Classification: Residential
Approved: In Review
Denied:
nning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$158.85
Valuation: $ 1,000.00
Total Sq Feet: 0
Date Approved:: In Review
Type of Work: RELOCATE EXISTING AC UNIT, PRC
Pay Date Pay Type Amt Paid Amt Due
Invoice # MC-4-18-67309
04/26/2018 Credit Card $ 50.00 $ 108.85
05/08/2018 Credit Card $ 108.85 $ 0.00
Avauaoie 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: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni g. F thermore, I authorize the above -named contractor to do the work stated.
PaJA N oT(,gN1 May 08, 2018
Auther[ii�,d Signature: Owner / Applicant / Contractor / Agent
Building(/Department Copy
May 08, 2018 1
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
PR 2 6 g
LEY__
tit*h
FBC20►,
Master Permit No. n9,C n - 'zzis
1v \ Sub Permit No. C is " 1 I V S
❑BUILDING ELECJF2IC ROOFING ❑ REVISION EXTENSION ❑RENEWAL
❑ PLUMBING MiMECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
- - �-
JOB ADDRESS: IDS
_ _ _'
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO x
Occupancy Type: Load: Construction Type
OWNER: Name (Fee Simple Titleholder):
Address:
City
Flood Zone: BFE: FFE:
ne#:
State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company
Name: 644,;V �o
Address:/ tW /i Io4Rs7—
hone#:
City:�, �e� state: C zip:
Qualifier Name: �(/�l`CG! e� ��a� Phone
State Certification or Registration #�/�Cri� �O� y7 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 000• Do Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
❑ New ❑ Repair/Replace
.. i ° A - ',1- �.
Zip:
❑ Demolition
Specify color of color thru tile: 1.
Submittal Fee $ 1 Permit Fee $ . ..Y ` �' D CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
W,
(Revised02/24/2014)
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 approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20, by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
Signature *J4(
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 20 I by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY
Sig
Print:
Seal: Notary Public Stato of Florida
Lourdes Marin Rivera
Ex Commission G1 124638
Expires 07/1812021
APPROVED BY L4tans Examiner Zoning
as
Structural Review Clerk
(Revised02/24/2014)
U
r-
Miami shores Village
uilding Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT
Permit N.!Kc .�10S
Owner's Name (Fee Simple Tide Holder): Phone #:
Owner's_ Address: _
City: _ State : I 2 Zip Code:
Job Address (Of where work is being done):_
City: Miami Shores
Contractor's Company Name:
Address: 5C1 L45 SKI
City: Wts4- Phf k
Qualifier's Name: C-1 e✓
Architect/ Engineer of Record Name:
Address:
City:
Describe Work:
State: —Florida Zip Code:
Phone #: A 5N - q lY G - As3
State: 1;1. Zip Cod
4 on Lic. Number: n
State:
Phone #:
Zip Code:
I hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. 1 hold the Building Official and the
Miami Shores harmless of all legal 'involy en .
Signature Signature
Owner or Agent Contractor or Architect
The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me
this _ day of ,20 by this L4 day of 2018b
r �
Who is personally known to me or who has produced who is personallyAknown to me ho hs produced
Notary Public:
Sign:
Seal:
as indentification.
Seal: lixullu Ivu MV11ty
�c ?► COWASSION 7=
RPM Noy dff5, 2018
.,.,..,..�``� www.AARoNNoTARY.0011
on.
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
f)
OCT tA_
18
..
�FBC 20
Master Permit No. IU S
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
❑PLUMBING ECHANICAL ❑PUBLIC WORKS VCHANGE OF
CONTRACTOR
JOB ADDRESS:
❑ EXTENSION [-]RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Folio/Parcel#: ' / - (P f/36 _(_) / / ` 0 V3 Is the Building Historically Designated: Yes NO !`
Occupancy Type: PIES. Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:_
Address:
City: State: �� cr) r �Q Zip:
Tenant/Lessee Name: Phone#:_
Email:
CONTRACTOR: Company Name: t nc
l® U-) 1 4
Phone#: 54- 4'6 ,X - V 0_5
Address: 5-9 ys- S C-'-'
% S T
City: %1.��a44L
State: Tri'!dIV
jOICJ
Zip: .3 30 04-2
Qualifier Name: / _(ld-�
44�
Phone#: qS'4' 962- --W(P3
State Certification or Registration #:
p�
C Pf(_ 0 1(P3V7
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City:
State: Zip:
Value of Work for this Permit: $
Square/Linear
Footage of Work:
Type of Work: X Addition ❑
Alteration ❑ New
❑ Repair/Replace ❑ Demolition
C. 6y,
nn,�,
con6cnt
q
Description of Wor :
C
V n i-} -f_ `e G
..
_ n J -1-,
-.
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
IID �y
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 approved and a reinspection fee will be charged.
Signature.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20, by
who is personally known to
i:11j
Signature 6V
CONTRACTOR
The foregoing instrument was acknowledged before me this
nZi-P day of nek*hw 20 L r , by
tU`'�. who is personally known to
me or who as produced AUb 1 VA(M) S 1 C • as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
r
Sign:
Sign:
Print:
Print: Y-OFIC— \
Seal:
Seal: u' 11,
commISSION # R1742M
EXPIRES: November 5, 2018
tNwAAMNOTARY.COM
APPROVED BY
Plans Examiner
Structural Review
Zoning
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
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 she is are not acceptable.
Job Address (where the work is being done):
City: Miami Shores Village County: Miami Dade Zip Code:
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
YES
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: A n /y /�/� f'
Contractor's Company Name: k0 E1 0 W 1 IC ' Phone: `7 A 0- 9845
State Certificate or RegistrationAg. l p t I l{! J� T Certificate of Competency No. 1 I
Sii?nature
(Qualifier's signature)
(Revised02/24/2014) I (' ; � � p J I—10
MIeM"_ KYLINE CONSTRUCTION
SERVICE CORP.
Phone: 305-899-9696 Fax: 305-899-8840
License: CBC 1260660
September 27, 2018
Universal Plumbing Corp.
Mechanical & Plumbing Sub -Contractor
141 E. 606 Street
Hialeah, Florida 33013
Attention: Osvel Castellon
RE: Project: All Smiles General Dentistry
12402-12404 West Dixie Highway
North Miami, Florida 33161
NOTICE OF TERMINATION AND CHANGE OF CONTRACTOR
Sent via: E-mail and Certified Mail Receipt #7018 0680 0000 9541 8191
Mr. Castellon,
This letter is to formally inform you that our agreement is being terminated due to
your decision to abandon the job causing serious delays to the project.
We have repeatedly requested for you to return to work and you have failed to do
so. With the numerous emails, countless phone messages, text messages and a 48 Hour
Notice of Intent to Terminate sent, you still refused to communicate with us and have
ignored our appeals. We requested several times your attendance at the jobsite to
complete work in progress and those requests also have gone ignored.
At this point we find no other alternative but to terminate our agreement. Please
be advised we will immediately replace. you with another Mechanical and Plumbing
Subcontractor to complete your work. All expenses incurred due to your abandonment
will be deducted from any balances owed to you.
Please let this serve. as notice that you or any of your representatives are not tc
. rty: Any attempt to do so will be considered illegal trespassing.
Sincer y/
Claudio Rodriguez;
President
Miami Skyline Construction Service Corp.
Sent via: E-mail and Certified Mail Receipt #7018 0680 0000 9541 8191
Cc:
Claudi o(a2Miami SkylineConstructi on. com
MariagMiamiSkylineConstruction. com
Office(c ,MiamiSkylineConstruction.com
universalpmsg=ail. com
MIAMI SKYLINE CONSTRUCTION SERVICE CORP.
-12864 Biscayne Blvd. # ,
Phone: 305-899-9696 Fax. 305-899-8940
Email: office(ii)miamiskylineconstruction.com
Website: www.miamisliylineconsruction.com
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: MC-4-18-1105 Permit IVR Number: 621408
Permit Type: Mechanical - Residential
Work Classification; Addition/Alteration
Permit Status: Approved
Issue Date: 05/08/2018 I Expiration: 10/23/2018
Location Address Parcel Number Project
25 NE 108 ST, Miami Shores, FL 33161 1121360110430 <NONE>
Contacts
Owner Applicant
25 NE 108 ST, MIAMI SHORES, FL 33161 25 NE 108 ST, MIAMI SHORES, FL 33161
KOOL FLOW INC Contractor
GERVAISE HYLTON
7021 SW 30 ST, MIRAMAR, FL 33023
Business: 9549628843
Description: RELOCATE EXISTING AC UNIT, PROVIDE NEW AC Valuation: $ 1,000.00 Inspection Requests:
DUCTWORK FOR ADDITION 305-762-4949
Total 5q Feet: 0.00
Fees
Amount
CCF
$0.60
Change of Contractor
$110.00
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$268.85
Building Department Copy
Payments
Amt Paid
Total Fees
$268.85
Credit Card
$50.00
Credit Card
$761.95
Credit Card
$110.00
Amount Due:
$-653.10
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
regulating construction and
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature:
/ Applicant / Contractor / Agent
October 09, 2018 Page 2 of 4