MC-19-926Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: MC-04-19-026
Permit Type: Mechanical - Residential
fLai work classification. Addition/Alteration
Permit status: Approved
issue Date: /02/2 19 Expiration: 10/23/2019
Location Address Parcel Number
270 GRAND CONC, Miami Shores, FL 33138 1132060136210
Contacts
ERHAN KOSTEPEN Owner FREEZE AIR CORP Contractor
78 NE 47 ST, MIAMI, FL 33137 REINERO ROSALES
Other: 7863190562 ERHANKOSTEPEN@GMAIL.COM
Business: 7864123308
Inspection Requests:
Description: NEW ADDITION AND REMODELING TO REPLACE
Valuation:
$ 4,000.00
305 i62 4949
PERMIT#MC-16-2158
Total Sq Feet:
2,600.00
Amt Paid
Payments
Date Paid
Fees Amount
100% Permit Renewal Fee $107.50
Total Fees
$157.50
Application Fee - Other $50.00
Credit Card
05/02/2019
$157.50
Total: $157.50
Amount Due:
$0.00
Building Department Copy
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. Futhermore, I authorize the above named contractor to do the work stated.
/ Applicant / Contractor / Agent
Date
May 02, 2019 Page 2 of 2
Permit Type: Mechanical - Residential Application Date:
08/24/2015
Owner:
ERHAN KOSTEPEN
Work Class: Addition/Alteration Issue Date:
08/26/2015
Parcel
1132060136210
Status: Expired Expiration Date:
06/05/2016
Address:
270 GRAND CONCOURSE
Miami Shores, FL
IVR Number:
622311
Subdivision:
113206013
Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete
Date Start Date Required?
10/28/2015 10/28/2015 Rough INSP-246649 Passed Jan Pierre Perez No Complete
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS Yes
April 26, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1
BUILDING
PERMIT APPLICATION
❑ BUILDING
❑ PLUMBING
JOB ADDRESS:
❑ ELECTR
ECHANICAL
76 �_
Miami Shores Village o
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
�j'F�BC 201j �
Master Permit No.:� C_N— i '�-✓2
3
Sub Permit No. I nC CH- c — TI
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
l.:e Inln1�C� 2 � �p
Countv: Miami Dade Zio"J : c� 3 O
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load
OWNER: Name (Fee Simple Titl
Address: Q Crtr
City: Q
Construction Type: Flood Zone: BFE: FFE:
er): �%'hA4 N3 �Pii'l Phone#: /O l9 3jq (D5;.2
State:
Tenant/Lessee Name: P
Email:
CONTRACTOR: Company Name: 46ee--L•P f "r, coY1 Phone#: ?0�37La��/
Address: .�/ (�� N f/2lfe°S &'l-i--t
City:�i--N.tii¢State: f .C.• Zip:_7i-39
Qualifier Name: pe,';g, �f Phone#:
State Certification or Registration #: z Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $
Type of Work: ❑ Add'ti n Alt ration
Description of Work: 7b ieu� S?
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF•$ �• � • • � ',PO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I S_� '4:_�
<4
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
- J:a— day of zt�&1 L_ , 20 ( I by
W.Nw who is personally known to
me or who has produced/ yy � ` `�
identification and who did take an oath.
NOTARY( PUBLIC:
Print:
Seal:
SINDIA ALVAREZ
MY COMMISSION # GG 238273
��EXPIIR�EES: September 3, 2022
#,t
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
aday of 4,01-I 20 � by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
as
Print: AJ &2 P U n e 2—
Seal: var Pir,, Notary Public State of Florida
?4 Nancy Nunez
N � My Commission GG 766008
Hof cu Expires 03128/2022
############### # # # #####
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
ACOR 7 0
`� CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
04/23/2019
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 endorsemen s .
PRODUCER
CONTACT NAME: Nadia Nicolas
PNONE : (305) 267-4541 A/C No):
G-MAR INSURANCE
EDORE : QUOTES@GMARINSURANCE.COM
9851 NW 58th ST #108
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: GRANADA INSURANCE
DORAL FL 33178
INSURED
INSURER B : ASCENDANT COMMERCIAL INSURANCE
INSURER C :
FREEZE AIR CORP
INSURER D :
5103 North Travelers Palm Lane
INSURER E :
INSURER F
Tamarac 33319
COVERAGES CERTIFICATE NUMBER: REVISION 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY Err
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE J OCCUR
N
N
0185FL00062766
09/15/2018
09/15/2019
EACH OCCURRENCE
$ 1,000,000.00
DAMAGE TO RENTED
PREMISES Ea occurrence)
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000.00
PRODUCTS - COMP/OP AGG
$ 2,000,000.00
$
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAR
EXCESS LIAB
CLAIMS -MADE
EACH OCCURRENCE
$
HOCCUR
AGGREGATE
$
DED I I RETENTION
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORMARTNERIEXECUTIVE YIN
OFFICERIMEMBEREXCLUDED? N
(Mandatory In NH)
H yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
AWC1094800
11/01/2018
11/01/2019
PER OTH-
STATUTE I 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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
AC Equipment Installation - Contractor License #CAC057312
..
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Building Department ACCORDANCE WITH THE POLICY PROVISIONS,
10050 NW 2nd Avenue AUTHORIZED REPRESENTATIVE A /�
Miami Shores FL 33138 1 NADIA NICOLAS
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
41-441-R55 PALM L"
Jw-
low'
d4-qLSTATE OF FLORIDA DEPARTMENT
b,'
Iz
r OF BUSINESS AND PROFESSIONAL
REGULATION
CAC0517312 ' ISSUED: 05/3112018
CLASS 8 AIR CONDITIONING CONTRACTOR
ROSALES, REINEIRO
FREEZE AIR CORP
UCENSED UNDER CHAPTER 489, FLORIDA STATUTES
EXPIRATION DATL: AUGUST 31,2020
W74,
Local Business Tax Receipt
Miami -Dade County, State of Florida
-THIS IS NOT A 1341,1. - DO NOT PAY
3852770
•U1111iR;1111B NAIVIVLOCATIOfy
FREEZE A!R CORP
Twit W 35 TH AVE 192
#4ft&W ft 33018
'7�
_ se
RECEWT 140 EXPIRES
RENEWAL SEPTEMBER 30, 2019
4022661 lu uC tm dispiayali az 111lme o' busengas
Pursuant lo County Cwe
Cliamor &A - A" 9 & 10
&NC_ TYPE OF BUSIr4rSe
196 SPEC MFC*IA1lIGAL CONTRACTOFI PAYMENT RECEIVED
CAC057311 By TAX CO«eCTDn
S4 5.00 0613 V 2018
tj FPPU03-18-020822
selivatia
Iasi Receipt only confirms payment of the local Business Tax The Rscolpl is not a liceeata.
ABal�off* bolder a qualihceUons to do business Holder must comply with tiny gnv*r mwnlal
haute and requirements which apply to the business
y iwYi atfatiba display" on ell commrrciai nehICfes - Mranh-D"I Cede Sec U-276.
hrown information, visit wwwffilear la19!