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MC-10-148 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 134530 Permit Number: MC -1 -10 -148 Scheduled Inspection Date: May 06, 2010 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: NAVASCUES, AIME & CESAR Work Classification: A/C Replacement Job Address: 2 NW 109 Street Miami Shores, FL 33168- Phone Number Parcel Number 112136011017 Project: <NONE> Contractor: MASTER MECHANICAL SERVICES, IN C. Phone: 305 - 825 -3004 Building Department Comments change out a/c split system TRANE XL201 with 8 KW heater CD Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 05, 2010 For Inspections please call: (305)762 -4949 Page 2 of 17 i �! °Rte y Miami Shores Village'yl tl 10050 N.E. 2nd Avenue / "'- Miami Shores, FL 33138 -0000 d -' Phone: (305)795 -2204 Expiration: 08/ 021201 Proje Address _ Parcel Number Appli 2 109 Street 1121360110170 _ _ �� I Miami Shores, FL 33168 Block: Lot: AIME &CESAR NAVASCUES Owner Informati Addres Phone Cell AIME &CESAR NAVASCUES 501 101 Street MIAMI SHORES FL 33138 - Contractor(s) Phone Cell Phone Valuation: $ 4,800.00 MASTER MECHANICAL SERVICES, IN 305 - 825 -3004 Total Sq Feet: 0 Tons: 8 kw For Inspections please call: Additional Info: mechanical (305)762 -4949 Classification: Residential A vailabl e Inspections: Approved: In Review Inspection Type: Comments: Date Approved:: In Review Final Date Denied: Type of Work: a/c split system replacement Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $3.00 MC -1 -10 -36930 $ 179.00 $ 179.00 Education Surcharge $1.00 $ �•�� Permit Fee - Additions /Alterations $168.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $179.00 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. February 03, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Cop February 03, 2010 _ 1 Miami Shores Village , .. r ., Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY ......•••••.��.' Tel: (305) 795.2204 Fax: (305) 756.8972 'r� BUILDING Permit No. � V "" f PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type Mechanical r,� J Owner's Name (Fee Simple Ti tleholder) ((1 ( Phone # ` 1 q,57 Owner's Address 2-- "CL) i ()q City m Loa Y-)11 t n State _ � , Zip Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) ,Z N w 1 0 C 1 City Miami Shores Village County Miami -Dade Zip , FOLIO / PARCEL # 11 - )J " j)l I `)1 '7 C) Is Building Historically Designated YES NO Contractor's Company Name p Y qfl I 1 Cl`l C {��Q1 �.,_�'� Phone #�DJ, 8� Contractto Address N W j j i IL.t_c t- ` City f 1 L om I g State Ek Zip , Qualifier Name w L � ( l� t' 1 - � u&f4 � , Phone State Certificate qr Registr on No Certificate of Competency No. C 0�5 E - MAIL: L At Keh 1Yk15 n L< Y]i li ("Q l 0 �' Lv Architect/Engineer's Name (if applicable) ----- Phone # Value of Work For this Permit $ y Square / Linear Footage Of Work: Type of Work: ❑Addition []Alteration E]New Repair/Replace ° � ❑Demolition Describe Work: � 1 t l.�' - � �i ��* �x�x�x�xxx�x�x :�:�� *��x *xxxxxxxx�� lre � x� x�xxx�� *xxFnttYxxxxxxa4xxxn4 *xxxxxx F Submittal Fee $ Permit Fee $ CCF $ .�. 0� CO /CC Notary $ Training/Education Fee $ • (: Technology Fee $ t- A Q 0 Scanning $ l Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 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 Iaws 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 lt) f� Signature CIA Owne Agent / Contractor -y� The foregoing instrument was acknowledged Before me this - F The foregoing instrument was acknowledged before me his day of � C� 20 J D , byc " ". L i � . day o`1 jCjn , 20 I a , by (/( � 7 hh who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY P BLIC: NOTARY P BLIC: S,i n: ppy� ppJJ r Si = i11GptlfibPi: , �. Prjrj`t:' Print: u .............. u n u u i ad e®aoee.ea....sne... l�,eQM My Commission Expires: 11 . M Commission Expires a o \ \ " " ° ""+ r ?118/20 Y P r a ? Comm# DD0641388 r sav ri; axapEUl9i' *iel9sylA�Y! II �, > .' mme sepf�Yr�p6FWifYb7fAkapau: ..,.<<, APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06) Jan.29, 2010 1:05PM Master Mechanical Services No-3926 P, 1 Master Mechanical Services Inc. In voice 15181N'W33Pt Invoice Number: Miami, FL 33054 10-21824 Office 305/825 -3004 24 Hrs. 305/940 -6195 Invoice Date: Fax 305/825 -1607 1/2 CMC 056729 Page: CMC 057200 1 Sold Tor JESSE VALINSK Y 2 NW 109 STREET MIAMI SHORES, FL 33168 Customer ID: 'VALINSK'Y,JESSE Custom PO Pav Date Work Per Due Dat TRANS XL20i Net Due _ _ — '—• - " —" -- ° ••- 1/28/10 ~ � 1128110 _ Descri — — - -- - - — A Furnish and Install TRANS XL20i Split System —� 4TT20036A, 4TEE3C04A, BAYRTR1408POCC, TCONT900 Install New Condensor Slab and Airhandler Stand Start Up / Operational Check TOTAL AMOUNT DUE TO CONTRACTOR 52500 DEPOSIT - APPROVED 4,800.00 52900 DUE UPON COMPLETION Warranty: 10 Year Compressor/ 10 Year Parts / 1 Year'Labor ** "Labor Warranty: (1) Year Labor warranty not • including preventative maintenance issues such as clogged drain, change of filters /belts, etc. Please refer to Owner Maintenance and startUp'Information Sheet. I V/ 0�3r?VER Name on Card: a I.. Q 0 0 Q Billing Address: Card# uthorize payment of This invoice and agreo with terms and condt9ons.•.. Exp Dale AND CW #_ IGNATURE: ]'ARTS WARRANTY Subtotal 4, 800.00 All parts as recorded are warranted as per manufacturers specifications Sales Tax LABOR GUARANTY The labor charge as recorded here relative to the Total Invoice Amount 4,800.00 equipment serviced as noted, is guaranteed for a # 7 9 4 1 /2 B period of3O days. We do not, ofcourse, Check No: Payment Received 0.00 guarantyother parts then those the supply. If repairs later become necessary due to other TOTAL 2,300.00 detective parts, they will be charged separately. We accept MasterCard, Visa, Discover and American Express. i ORES ---_ 10050 NE 2 nd Ave Miami Shores, A 3313 Mt Phone 305 - 795 -2204; Fax 305 - 762 -5253 OR www.miamishoresvillage.com CONTRACTOR LICENSING/ REGISTRATION REQUIREMENTS FOR ALL CONTRACTORS TO REGISTER IN THE VILLAGE OF MIAMI SHORES THE FOLLOWING REQUIREMENTS ARE NEEDED: DADE COUNTY CONTRACTORS A. Certificate of Competency B. Dade Municipal Occupancy C. Dade Occupational Occupancy D. State Registration E. Liability Insurance Certificate F. Workers Compensation Insurance or Exemption STATE CONTRACTORS: A. State License B. Occupational License C. Liability Insurance Certificate D. I( Workers Compensation Insurance or Exemption * * * * * * * ** * ALL INSURANCE CERTIFICATES MUST BE MADE OUT TO THE FOLLOWING * * * * * * * * * ** Miami Shores Village 10050 NE 2 AVE Miami Shores, FI 33138 ALL PERMIT APPLICATION REQUIRE THE QUALIFIERS NOTARIZED SIGNATURE Business Name: Business Address: Lk1 Business Telephone: Fax Number �I I Qualifier Name: W111 5 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID AA DATE(MM /DD/YYYY) MASTE -2 07/23/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kahn- Carlin & Company, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3350 S. Dixie Highway A LTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami FL 33133 -9984 Phone: 305- 446 -2271 Fax: 305- 448 -3127 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: National Trust Insurance Co 20141 INSURER B: FCCI Insurance Company 10178 Master Mechanical Services, Inc INSURER C: Bridgefield Employers Ins co 10701 15181 NW 33 Place INSURER D: Miami FL 33054 INSURER E: COVERAGES 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 CO TIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER P LI Y VE LI Y EXPI LIMITS DATE MM/DD/YY DATE MM /DD GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIALGENERAL LIABILITY GL0008892 08/01/09 08/01/10 PREMISES (Ea occurence $ 100000 CLAIMS MADE FX7 OCCUR MED EXP (Any one person) $ 5000 PERSONAL &ADVINJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 2000000 POLICY PRO- JECT LOC Emp Ben. 1000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE s4,000,000 $ OCCUR EI CLAIMSMADE TBA 08/01/09 08/01/10 AGGREGATE $ 4,000,000 DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND TORY LIMITS 1 1 ER C EMPLOYERS' LIABILITY 83037562 03/14/09 03/14/10 E.L. EACH ACCIDENT $ 1000000 ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION MIAM -04 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION vt DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Miami Shores Village IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 10050 N.E. 2nd Avenue Miami Shores FL 33138 REPRESENTATIVES. AUTHO SENT YVE ACORD 25 (2001/08) 0 ACORD CORPORATION 1988 j �� d IRME STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Ym a� CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET wET TALLAHASSEE FL 32399 -0783 FLOWERS, WILLIAM SHAWN MASTER MECHANICAL SERVICES INC 15181 NW 33 PLACE MIAMI FL 33054 STATE OF FLORIDA AC# j &3-,4, S e Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. CMCO57200 07/01/08 078168546 Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. CERTIFIED MECHANICAL CONTRACTOR There you can find more information about our divisions and the regulations that 'FLOWERS, WILLIAM SHAWN impact you, subscribe to department newsletters and learn more about the MASTER' "`MECHANICAL SERVICES INC Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. .Thank you for doing business in Florida, and congratulations on your new license! '_ =s cERTxFZED unaer the provisio of cr,.489 ss E77ioa date: AUG 31, 2010 1.0807010101 DETACH HERE T , Ac #� 8 _S F-FL RIDA _\ I)EARTMg-N'I' \€ SSS AND FIZOFESSSONAL REGULATION 0N ONS' ' UC `2 -E U`STRY _LICENSING BOARD SEQ # LO6'7 �DATE _ BATCH NUMBER ICENS��BR, 07%07:/2 0781''6'846 CMCS� -` i,� '1` a MECHANICAL ,CO1�ITRACT iii Named,below Under the p`rovisib ns o Ghat 8 `S Expiration date AUG 3�3; 2010 � z FLOWERS T�F3LIiN! SHA ` MAST i+�ECIANI;CAL SERVICEB INS „a MIAMI > i'CHARLIE CRIB - CHUCK DRAGO = INTERIM SECRETARY �PLAA'�EQUIRED BY LAW DO NOT FORWARD MASTER MECHANICAL SERVICES INC JOANN PINNA PRES 15181 NW 33 PL MIAMI GARDENS FL 33054 $ 1kilf1ff �1£ Ii£ f!!1} j2I�2 £�!l12�f }} }t� }2ii}1£ii�!}jf i}f 19 f?iik� SEE OTHER SIDE