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MC-09-951 Miami Shores Village rid 1 .411 10050 N.E. 2nd Avenue � Miami Shores, FL 33138 -0000 Phone: (305)795- 2204A�� Sta>� � ': Expiration: 1 210712009 Project Address Parcel Number Applicant 8945 4 Avenue Road 1132060460380 MERLENE NEMBHARD E3 Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MERLENE NEMBHARD 8945 NE 4 AVE RD MIAMI SHORES FL 33138 -3180 Contractor(s) Phone Cell Phone Valuation: $ 4,533.00 SUNSHINE AIR INC (786)488 -1200 Total Sq Feet: 0 Tons: 2 For Inspections please call: Additional Info: (305)762 -4949 Classification: Residential Available Inspections: Approved: In Review Inspection Type: Comments: Date Approved:: In Review Ventilation Date Denied: Type of Work: Final Rough Hood Rough Duct Smoke Test Duct Detector Test Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $3.00 MC -6-09 -35038 $ 50.00 $ 50.00 $ 0.00 Education Surcharge $1.00 Permit Fee - Additions/Alteraations $176.00 Check #: 1025 Scanning Fee $3.00 MC 6 - 35066 $ 137.40 $ 137.40 $ 0.00 Submittal Fee $50.00 Check #: 1027 Submittal Reversal Fee ($50.00) Technology Fee Total: $187.40 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. June 10, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy June 10, 2009 1 LORD CERTIFICATE O F LIABILITY INSURANCE UATEeaMMOff,rYT, owls p$ 09 / THIS CERT09CATE IS IS'SitIED AS A NFORMATIO rsun InI � ONLY AND � (� RI6HT3 UPON THE CERTIR /��E Agency, �• HOLpfR. THIS CERTIFICATE DOES NOT AMEND, EXTRA OR 3333 PAIm ftach Boulevard 9A AL11:R THE COVERAGE AFFORDED BY THE POLICIES BELOW Fart Myers rL 33919 Phanw 239 - 693 -0400 Fax: 239 -693 MtSMRS AFFORDING COVERAGE _ NAIC 3 v4summ k old lea msaram e d 01573 INSUM & " 9 Air Ync. OMQ 45 19 �NS 3r Terrxc� n�auR a M Via= FL 31169 COVERAGES TM PCI.I U OF RJSURANCE LISTED 8MCW HAVE TEEN MEU ®TO TM MWJFW NRMM IVWW FOR TM P0UGY PERIQO RVD=TED. NOrA THS ANUM ANY RED . TeW OR coNaffmm AFANY comTRACT OR 07MM DOCUMENT TATfIH ROW EGT 70 VMM TM CERTIR=TE MAY 10 I MJM OR MAY PERTAIN. 7HH mmANM AFF 6Y THE POUKS ODD NoWN m S mmar TOALC THETERm. wcLuaaa AND CO OF SUCH F'OUC1ES. AWFWATE UMTS SHOWN MAY HAVE SEEN PMUM gY PAID CLATMls, Lm IIM=mm= P®LBCY NUIBl9eft g GEBTERALIwIi MY EA6H�0OC $106000 A x CwAwKw Nf w998A 02/27/09 02/27/10 Pmwdm.1£s�am�i% $ 50000 0 MAW UWE n CCCUR MW EIPV�rW $10000 PEM0NALaA0VftUW S ].000000 GHNM AL AGATE s2000000 c,w AGGRMATG L'ANIr APPUEB PER: PROnUCTS - COMI§OP AGG 22000000 ter M M 0 Loc - ABlr ORU LVM LUY Aalr Auto 3 (ES $ All OVVNM AUWQ SCHEDULED AUR9S HIRED AV= A as mt3= a a S •ARAGEtBi68tLm AMO FAACCOM TI =CH AIUV AUTO '11.3cir 0"WA TNAN ea ACC S 33= AM ONLY• AM s IuAt>BLIrY EACHOCCURR_eNM S 3 M M MAD$ 3 A ArE s DBXCMLE s RETEMION S 3 WORKMCOWIMATMAND TO1ZY LIMBS ER _ MPLOVEW LIABRITY ANY P C.B.. HACH ACCT Mff s xxm .ROPRIErORlPAR11TYE OFRt�uM6MBEgE7(C6.UDEfi7 3 &L FJLd1tPl.0Y6 $ - ' f�1y�e aes w� _ TRmAL aroe Txlcw EL W - POLICYuwr Is xxxxx DTMER �tOAIOPOPERAiI DNS/ I .00AilON9 /Yt3ftQe8 /8171�9.t1S�I8 91► /3PECULPR�SIOIBS Air conditioning system or equiptemsnt CERWICATE HOLDER CANCELLATION 9�iO09 5810460 ANY OF 7M ABOVE POLHYE38E CANCBIAD eE�RE T10E BRA GATE T#MVJ OF'. TMB t i VIVLL VCR *m "L *** OAY9 YMRITrm rAX: 305- 28 cgs 5-23 -733 7 39 C; NDLCE TO TM QERT*VATM HQV= NAM TO THE LET, euT FAsAm TO Bro s® amau L AZ: ***ADD=88 TM t ## WOW = 0 KJQXMN ORLIABILITY0P ONWDUPON"MNMnM' "S AM= OR AC00 25 (2007 ) OACOM CORPORATIO IM 0*q hPY` g Miami Shores Village Building Department X0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: 95.2204 Fax: (305) 756.8972 BUffiftWG � r_Cfl, ECIEIV O Permit No. AC ®a q _ T 51 @ 51 PERMIT APPLICATION JUN a ster Permit No. FBCJW Permit Type (circle): Building Roofing Owner's Name (Fee Simple Titleholder) M4gIC -N e AJG bY1614 jq 126 Phone # X 3 6 -2 SsL - 2 R Owner's Address g /u 6 A VE Rh- City MiAfni S[4046S State zip - 33 1 3 1? Tenant/Lessee Name N / A Phone # Job Address (where the work is being done) A] J-F Ay 1el) City Miami Shores Vill a County Miami -Dade zip FOLIO / PARCEL # u 3a ® 610 q ! ®3 a0 Is Building Historically Designated YES NO _-2S-- Contractor's Company Name � U 1\ 5 VA i n L? A� f . _T n L Phone # � U6 ' y � � � � � 0 0 t Contractor's Address 1 J n Le 1 ) 13 i f City (n i ck m i 6r&+ d eri s State L. zip 33J G y Qualifier Name � Phone # ? I a O d State Certificate or R ' 'on No. 1'61(2/58 C A C Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # �b5'� v aa Value of Work For this Permit $ ' Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration []New ®. Repair/Replace ❑ Demolition Describe Work: A, new G + 1 S i '� kiteardast ,t *aedcsEdrdciedrskdc9FdnBa+tr ets2 aYia *aY #iatean4int r4drdrtkF slairdeSc s trktEs4at�Pafadrdestdrdes ldr # #da &n8ikda@ta dn&aa #aeskkat4drtarksk Submittal Fee $ 50 Permit Fee $ " �" CCF $ CO /CC Notary $ Training/Education Fee $ o Technology Fee $ Scannin $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ AJ7, to See Reverse side -� G� Bonding Company's Name (if applicable) Bonding Company's Address City State zip Mortgage Lender's Name (if applicable) Uo/Yt f Fl tV to NCI Al C Tic r2 Mortgage Lender's Address 1? D (o b D LO QM 9 AOAb City e-©Rtl k G A & C — ° .'R State /mod zip 33/ 3 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 a 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 '�� Signature Owner or Agent Contractor p The foregoing instrument was acknowledged before me this Sf� The fore oing instrument was acknowledged before me this day of - J v ^e_ , 20 i,by Lle V/Vcn.6 day of n 2061 who is personally known to me or who has produced identific gn and who did take an oath. NOTARY PUBLIC: NO Y PUBLIC: nn Yor 6/ 1 S i g n: Si �� N # DD 578098 e EXPIRES: : u Y 10 Print: a L i ount gsyoc. Co My Commission Expires My Commission Expires: I WNW d¢tk4 &rkdrdat44etY�de J# �� APPLICATION APPRO Plans Examiner Engineer Zoning (Revised 07/10/07) ClJ� ` X51 z JUN 0 10 00 Tq 4s N E 4 AV1 , SUNSHINE AIR K (,0 `1 Mia i FL, 33197 �c U VE Tel. (766)4W1200, Fax (305)255 -7337 Email: info@Sunshineair.com M ® 8 2009 ,� �,,. Web: vmm aincom A/C, DUCT & INSULATION CAC1 S1 S1 58 CUSTOMER PHONE DATE STREET JOB NAME Al gr Len CITY, STATE AND ZIP CODE JOB LOCATION iLo rC- X 313 1 a 5 hones We, SUNSHINE AIR INC, propose to fumish, install and service under warranty mating and/or air conditioning products and related ui you In proposal. rdance with the conditions and specifications set forth In this eQ prner�t for SYSTEM EQUIPMENT AS FOLLOWS: Make Tons 2- Heat Kw. J Model S.E.E.R. Ductwork Number of Supplies: $ r:$ �( Note: $ °- Woo euva Attic Insulation: R- $ 5 k f L SID Feet x ¢ _ $ TOTAL COST $ INSTALLATION AS FOLLOWS: ❑ CONCRETE SLAB SASE REMOVE EXISTING EQUIP. ❑ METAL BASE ❑ REMOVE EXISTING DUCTWORK ❑ HEAT & COOL THERMOSTAT ❑ CUTTING HOLES ❑ CONDENSATE DRAIN LINE K-UP TO EXISTING ELECTRIC ❑ CONDENSATE PUMP ❑ NEW ELECTRICAL SERVICE ❑ REFRIGERANT LINES ❑ CONTROL WIRING ❑ OTHER ❑ OTHER ❑ OTHER ❑ OTHER COMMENTS: b4 10 den 0a rUn- !!j _rei( ) Aef f'j Ja ( — INSTALLATION SCHEDULE: We will be ready to begin installation approximately days. Authorized Signature BUYERS ACCEPTANCE: DATE: Dyer InviomMy eccepts eft detailed above and samim mspombft of sam and of pavmaft spwAed Mein, as of date of inatallatlon, and according to tine terms of this coat ua INSTALLATION DATE: SELLER APPROVAL: SELLER NAME: V1n M COPY: File YFUOW CO". Cuato , Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL s Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 116220 Permit Number: MC -6 -09 -951 Scheduled Inspection Date: June 25 2009 Permit Type• . Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: F Owner: NEMBHARD, MERLENE Work Classification: A/C Replacement Job Address: 8945 NE 4 Avenue Road Miami Shores, FL Phone Number Parcel Number 113206046038 Project: <NONE> Contractor: SUNSHINE AIR INC Phone: (786)488 -1200 Building Department Comments 6 �p Inspector Comments Passe 1/�, R9 Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid.