50 NE 96 St (2)o f:
Owner's Name and Address._..
Registered Architect and /or Engineer..._..
Name and address of licensed contractor
Chairman
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUOLDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Location and legal description of lot to be built on:
Lot Block Subdivision,
Street and Number where work is to be done 77_
s
Date..__
Date ' `d
V No Street
State work to be done and purpose of building (by floors)
Cam.
and for no other purpose.
New Bui'ding Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ __ .. / Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. l
Remarks (Signed) ! . -, <�
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No j.7 9 Disapproved _ _.. - ,y Dat
(Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Ins ector My Commission Expires
PLANNING BOARD DATE
Member
Member Member
Member . - . Member
Council Approved Date Disapproved Date
\;OTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Pl.tnning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
, Address of
Building
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder_
Legal
Description
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8797
ft r • __!.
Bl.
Work to be performed under this Permit_
Signed:
Subdi-
vision
Sq. Ft
Value of
Project $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
INSPECTOR
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, servant or employee.
DATE 195
Contractor's
License No.
Amt. of
Permit $
■ 4 e
BY
BY AUTHORITY
17
...
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ( - 2 Job Address 5 ) 4 ✓ E Ca S 7 Tax Folio
Legal Description
Owner Lessee / Tenant i `r C ' ' C fest Master Permit #
Owner's Address Phone
Contracting Co. A C A-t &/( R C 0
Address -7 7 °( w 6
Qualifier S r c p w i'r S - Phone & 3 C r f
State # F 7° Municipal # 5 ? Competency # ' 1 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBINMECHANI'ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 7 A / S e R EPL A e ' f T c° `- 0 f' ,L t '
Square Ft. Estimated Cost(value) � ��
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO 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).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * * * *
APPROVED:
Zonin f�
Mechanical
Dat ur pntractor or Owner- Builder
Notary as to
My Commission
•
pS T v1OTARY ;CAL
m ract6 ors eo e
. , �:. j : * COMMISSION NUMBER
CC255237
F � � MY CO?. MISSION EXP.
oFrk. 26 1997
«.. *--.. *_ � **
FEES: PERMIT 1 // 46 RADON C.C.F. (5 NOTARY 5,1 TOTAL DUE 111
Fire Other
Building j " �I/ Electrical
Plumbing Engineering
STATE OF FLORIDA
DEPARTMENT OF PROFESSIONAL REGULATIC
CONSTRUCTICN INDUSTRY LICENSING BOARD
DATE
LICENSE NO. BATCH NO.
LAWTON CHILES
GOVERNOR
F/w ,•■.'
06/22/91 RA' 0032612
THE C
NAMED BELOW/ HAS REGISTERED GT CONTRACTOR
UNDER THE PROVISIONS OF CHAPTER 489 F.S., FOR THE YE
EXPIRING AU6 31. 1993 (MUST MEET ALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CONTRACTING IN:ANY AREA
Metropolitan Dade County, Miami, Florida w !MECHANICAL
2UILL.)ING A N D £LINING DEPA:aT�`ENT I CCi�iIRACTUR
i TRADE CATEGORY(S)
t31�1 -ICATE m A/C — U�fLTa3
CE
CLiA'Pt ��EdICY w
EXPIRES UN tac /3) /9i x
ACME AIR C :N7I IIICN.Ct46 UP i)Av o
J ,
0'
LL
CC# : 00000u0:,
C..A. : Lk NS S1 Lt' -ti N A
SSD
OPENS' STEPHEN A
7701 C
NM36THDAVE CO INC
MIAMI FL 33147 •4403
•
Qualifying agent (Q.A.) must supervise, direct and control all work.
a.
4•
DISPLAY IN A CONSPICUOUS PLACE
Signature of Qualifying Agent
CARLOS F. BONZON, Ph.D., P.E.
Secretary, Construction Trades Qualifying Board
INSTRUCTIONS
1. SIGN — ATvALH PICTURE — ,:t.LLi — LAMINAR :
2. THIS DLPART MLRT LAN LAMINATE. EITHER CCM2 IN PERSwN
LSE S :ND C =R11i-ICATE(S) WITH PHQ1C(S) WI TH CHECK OR
XCNE'( LRI CR 1C •)JADL: CC JtITY 3UILCiNG E LLNIN
C[NTRAC1CR SECTICN, 111 Nw 1 Si�RE�T e101G MI rL
33126. r EE IS $3.ih) PER I AMI AT 1LN MARE CHECKS
PAYABLE IL GALE COUNTY 3U LL.ThC E :_i:N1NG. PHOIOS
NC [ THAN SPACE Cr'AOIDEu
Nrr m ° CCNI RAC1'CRS S :CT LN C: ANY CHAW;E ADIAESS.
talc THE RULtS AND R, :GULATILJNS OF CHAPTER 10
C.H CAL:: CGUN1 ti LDC,.
ACNE Ala CL NOI1 LLNANU ur JADE CCU
7701 Nip 36 AVE
MIAMI FL 3147
GEO E STU
SECRETARY
40478
T, JR.
.P.R.
PLACL
PHOTC
HERE
DADE COUNTY
TAX COLLECTOR
140 W. FLAGLER ST.
14th FLOOR
MIAMI, FL 33130
LICENSE Na 00-0227066 CC NO: 000000059
. IS HEREBY LICENSED TO DO
BUSINESS AS A CONTRACTOR
AS SPECIFIED HEREON.
BUSINESS NAME /LOCATION
ACME AIR CONDITIONING
OF DADE CTY INC
7701 NW 36 AVE
OWNER :ACME AIR CONDITIONING
NOV VALID IN
HIALEAH
VILLAGE OF KEY BISCAYNE
Licensee must
' register in the city
where work is to
be done.
PAYMENT RECD.
DADE CNTY TAX
COLLECTOR:
01/19/93
089386002
000175.00
BU INESS NAME /LOCATION
ACME AIR CONDITIONING
OF DADE CTY INC
7701 NW 36 AVE
03147 UNIN DADE COUNTY
ACME p eo R CONDITIONING
THIS Is AN OCCUPA-
TONAL TAX ONLY. IT
DOES NOT PERMIT THE
LICENSEE TO VIOLATE
ANY EXISTING REGULA-
TORY OR ZONING LAWS
OF THE COUNTY OR
CITIES,_ NOR DOES IT
EXEMPT THE LICENSEE
FROM ANY OTHER LI-
CENSE OR PERMIT RE-
QUIRED BY LAW. THIS IS
NOT A CERTIFICATION OF
THE LICENSEE'S OUALJFI•
CATION.
RAYMENT RECEIVED
DADE COUNTY TAX
COLLECTOR:
01/19/93
089386001
000056.25
SEE OTHER SIDE
1992 MUNICIIAL CONTRACTOR'S 1993
OCCUPATIONAL LICENSE
DADE COUNTY - STATE OF FLORIDA
PURSUANT TO DADE COUNTY ORDINANCE 66 -2
EXPIRES SEPT. 30, 1993
DO NOT FORWARD
ACME AIR CONDITIONING
OF DADE CTY INC
7701 NW 36 AVE
MIAMI FL 33147
SPECIALTY MECHANICAL
RENEWAL
UCENSE NO. 022706 -6
C C t 00000005
EMPLOYEES
196 SPECIALTY MECHANICAL 10
DO NOT FORWARD
ACME AIR CONDITIONING
OF DADE CTY INC
7701 NW 36 AVE
MIAMI FL 33147
FIRST CI A
U.S. POSTA
PAID
MIAMI, F
PERMIT NO
FIRST CLAS
U S POSTAG
PAID
MIAMI, FL
PERMIT NO. 2
TYPE OF POLICY
CERTIFICATE EXP. DATE
* CONTINUOUS
EXTENDED
POLICY TERM
POLICY NUMBER
LIMIT OF LIABILITY
WORKERS
COMPENSATION
05/01/94
WC2- 151 - 087021 -123
COVERAGE AFFORDED UNDER
WC LAW OF THE FOLLOWING
STATES:
FL
EMPLOYERS LIABILITY
Bodily Injury By Accdent
Each
$100,000 Accident
Bodily Injury by Disease
$100 000 Polilcy
'
Bodily Injury By Disease Each
$500,000 Person
GENERAL
LIABILITY
CLAIMS MADE
05/01/94
YY1- 151 -087021 -083
General Aggregate - Other than Products/Completed Operations
$1,000,000
Products/Completed Operations Aggregate
$500,000
Bodily Injury and Property Damage Liability Per
$500,000 Occurrence
RETRO DATE
Personal and Advertising Injury Per Person/
Organization
$500,000
fg OCCURRENCE
Other: FIRE LEGAL
$50,000
Other: MED PAY
$5,000
AUTOMOBILE
LIABILITY
05/01/94
AS 1- 151 -087021 -153
$1,000,000 Each Accident D- Single Limit -
Each Person
OWNED
Each Accident or Occurrence
NON -OWNED
Z HIRED
Each Accident or Occurrence
UI HEH
II IONAL COMMENIS
• Certificate of Insurance
, • THIS CERI IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CON, ERS NO RIGHTS UPON YOU THE GER I IFICAT HOWL I' HIS CERTIFICATE IS NOT AN INSURANCE
Pr1T ■CY AND DOES NOT AMEND. EXTEND. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW
This Is to Certify that
ACME AIR CONDITIONING OF DADE COUNTY, INC.
7701 NW 36TH AVE.
MIAMI, FL., 33147
is, at the date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is
subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other document
with respect to which this certificate may be issued.
IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED BEFORE THE
CERTIFICATE EXPIRATION DATE. HOWEVER, YOU WILL NOT BE NOTIFIED ANNUALLY OF THE CONTINUATION OF COVERAGE.
SPECIAL NOTICE - OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A ( RAUD AGAINST AN INSURER, SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD,
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS
ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT
CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL
AT LEAST DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO:
CERTIFICATE
HOLDER
DADE COUNTY BUILDING & ZONING DEPT
PLANS PROCESSING 10TH FLOOR
111 NW 1ST STREET
MIAMI FL 33128
;'[ •.1i is If:'... �.��;
Name and
Address of
Insured
04/25/93
DAIL ISSUEU
LIBERTY
MUTUAL.
AU I HUHILED HEPHESEN I A I IVE
Liberty Mutual
Insurance Grow
MIAMI 554 U
OFFICE
3,.
TYPE OF POLICY
CERTIFICATE EXP. DATE
* ECONTINUOUS
EXTENDED
POLICY NUMBER
LIMIT OF LIABILITY
• POLICY TERM
WORKERS
COMPENSATION
05/01/94
WC2- 151 - 087021 -123
COVERAGE AFFORDED UNDER
WC LAW OF THE FOLLOWING
STATES:
FL
EMPLOYERS LIABILITY
wily Injury By Accident
Each
$100,000 Accident
bodily Injury By Disease
Policy
$100,000 Limit
Bodily Injury By Disease Each
$500,000 Person
GENERAL
LIABILITY
CLAIMS MADE
05/01/94
YY1- 151 -087021 -083
General Aggregate - Other than Products/Completed Operations
$1,000,000
Products/Completed Operations Aggregate
$500,000
Bodily Injury and Property Damage Liability Per
$500,000 Occurrence
RETRO DATE
Personal and Advertising Injury Per Person/
$500,000 Organization
L OCCURRENCE
Other: FIRE LEGAL
$50,000
Other: MED PAY
$5,000
AUTOMOBILE
LIABILITY
05/01/94
AS 1- 151 -087021 -153
$1,000,000 Each Accident - SingleLimit -
B.I. and P.D. Combined
OWNED
Each Person
NON -OWNED
Each Accident or Occurrence
HIRED
Each Accident or Occurrence
OIHEH
.
ADDI1 ZONAL COMMENTS
This is to Certify that
ACME AIR CONDITIONING OF DADE COUNTY, INC.
7701 NW 36TH AVE.
MIAMI, FL., 33147
• Certificate of Insurance
T HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN D CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER THIS CERTIFICATE IS NOT AN INSURANCE
.11 POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW
Name and
Address of
Insured
is, at the date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is
subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of any contract or other document
with respect to which this certificate may be issued.
* IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED BEFORE THE
CERTIFICATE EXPIRATION DATE. HOWEVER, YOU WILL NOT BE NOTIFIED ANNUALLY OF THE CONTINUATION OF COVERAGE.
SPECIAL NOTICE - OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING AfRAUD AGAINST AN INSURER, SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS
ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT
CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL
AT LEAST DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO:
CERTIFICATE
HOLDER
DADE COUNTY BUILDING & ZONING DEPT
PLANS PROCESSING 10TH FLOOR
111 NW 1ST STREET
MIAMI FL 33128
• • LIBERTY MUTJAL INSURANCE GROUP as respects such Insu as .s afforder by Those Cc ar.es
04/25/93
VAIEISSUED
LIBERTY
MUTUAL
AU I HOHILED HEPHESEN I Al IVE
MIAMI 554 U
OH-ICE
Liberty Mutual
Insurance Group
BS":-_