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MC-10-1684Inspection Number: INSP - 151522 Scheduled Inspection Date: October 21, 2010 Inspector: Perez, JanPierre Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Adrian Hall Miami Shores, FL 33138 -0000 Project: <NONE> Contractor: AIR SYSTEMS NC LLC Building Department Comments October 20, 2010 Inspection Worksheet Miami Shores Village (le 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Phone Number Parcel Number 5 Permit Number: MC -9 -10 -1684 Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: New 1121360010160 -07 Phone: (786)208 -3484 INSTALL NEW CENTRAL NC SYSTEM 5 TON 7 VENTS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 9 of 21 kit f Miami Shores Village Building Department SET 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. )Q - 1(4 PERMIT APPLICATION Master Permit No. Cc - 3 -,0 -a71 FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) ZQ - k \ e / U N 1\)E11T'/ Phone # Owner's Address Al c ME 2_ AvF_Nljg City 1111641 4 State Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Village County FOLIO / PARCEL # Structural Review. $ Contact Phone 3 O "ter 7 t 5-05-e) Submittal Fee $ Permit Fee $ Notary $ Scanning $ Radon $ Double Fee $ Training/Education Fee $ Is Building Historically Designated YES NO Zip all YS, Phone # Architect/Engineer's Name (if applicable) Phone # Contractor's Company Name / 1 i a� �' g , Lys .3 fie. (L C Phone # 36S C� . ) 1040 Contractor's Address 41b ci' A i ( S r% City o .1' it s. k- State P Zip �"`v',.t Qualifier Name 72 kb. Ivy ` Phone # Of' b 9 / 1 C •-1 0 State Certificate or Regis Xtion No '� 4 C 5-4`1 C ertificate of Competency No. g 0 F j `� w• etenc P Y ` J E -mail 4 , 4� C- (� S ` /.� PtJ-4 R-' Value of Work For this Permit $ 46 9, 1 :5 30 Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New El Repair/Replace El Demolition Describe Work: .T405TA 4 rS\r4 CAL A.0 SYSTEM - 1 T O J 1 1 4 Q•STS ******** * * * * * * * * * * * * * * ** * * * * * * * * * * ** * ** e es ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *** d C D CCF$ CO /CC$ Technology Fee $ DPBR $ Bond $ Violation date: Total Fee Now Due $ a l 5 ' 40. 4 See Reverse side -* 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 L ► ,20!0 , by Vika - b,Q ON IDS who is person to ally kno me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Jeffry J Yao My Commission DD613542 bExpires 11/12/2010 My Commission Expires: APPROVED BY Engineer (Revised 07 /10 /07)(Revised 06/10/2009) The foregoing instrument was acknowledged y before me this 16 day of c' , 20 / �' , by / ?61 - , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co TO ,, iftu 1AY COMMISS51 DU r1; W R S e 1 ( 398-o153 Flordarwmrysery .com Plans Examiner Zoning Clerk checked FROM Accurate A0610. CERTIFICATE OF LIABILITY INSURANCE 1 VA I t ;MMIUU►T TI 10/07/10 PRODUCER Accurate THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 8300 West Flagler Suite 114 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33144 ALTS THE- COVERAGE AFFORDE BY TH POLICIES BELOW. Phone (305)226 -8727 Fax (305)2268767 INSURERS AFFORDING COVERAGE NAIL 8 INSURED Air Systems NC LLC 4698 NW 133 Street Opa Locke, FL 33054 - COVERAGES THE POLICIES OF INSURANCE LISTED 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 SY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOm0NS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER 1�0 ELECTIVE LTR i �. �, DAT! INSR ADD'L GENERAL LIABILITY ❑/ COMMERCIAL GENERAL UABIUTY ❑ ❑ ❑ CLAIMS MADE +I J OCCUR A ❑ 0 GEM% AGGREGATE LIMIT APPLIES ❑ POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABIUTY ❑ ANY AUTO ❑ AU. OWNED AUTOS ❑ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS B OTHER 0 GARAGE UABIUTY ❑ ANY AUTO EXCESS/UMBRELLA LIABIUTY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR! PARTNER 1 E (ECUTNE OFFICER / MEMBER EXCLUDED? If yes. deacrlbe under SPECIAL PROVISIONS bebw CERTIFICATE HOLDER City of Miami Shores Village 10050 NE 2 Ave Miami Shores, Fl 33138 1 305 081 1080 ACORD 25 (2001108) CIF NPPO478707 -1 WC0145869 08/29/10 (THU)00T 7 2010 11:03/ST.11:03/No.7500000548 P 1 INSURER A: Western World Insurance Company INSURER B: North American Specialy Insurance Co INSURER C: INSURER D: INSURER E: INSURER F: poLcy DATE ' MTV) N 05/13/10 05/13/11 DESCRIPTION OF OFENATIONsILOCATIONs I VEHICLES 1 EXCLUSION$ ADDED BY ENDORSEMENT I SPECIAL PROVISIONS AUTHORIZED REPRESENTATIVE Lucia Estrella UNITS EACH OCCURRENCE 1,000,000 PREMISES .. =wince) 100,000 MED EXP (AnY One person} 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG 1,000,000 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Pet parson) BODILY INJURY (Per accident) PROPERTY DAMAGE (Par accident) AUTO ONLY- EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE 08/29/11 © v Y U 5 ❑ E.L. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYEE 100,000 E.L. DISEASE - POLICY LIMIT 500,000 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUGIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WWTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L EFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ® ACORD CORPORATION 188E