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MC-10-798Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 158279 Scheduled Inspection Date: April 13, 2011 Inspector: Perez, JanPierre Owner: SYLVAIN, FRED Permit Number: MC -5 -10 -798 Job Address: 9100 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: DANTINS SERVICES INC Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)759 -6235 Parcel Number 1132060133200 Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 12, 2011 For Inspections please call: (305)762 -4949 Page 17 of 21 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 5 Y:.. Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 76214949 pqRginn IV n 2002 119 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL / Zaty Owner's Name (Fee Simple Titleholder) /1/10%6% ✓ /`GGt Phony # Owner's Address elico 14 � City 11 State Zip I �� Permit No. GG/ o — /J3 Master Permit No. G --796 Tenant/Lessee Name Email Phone # Job Address (where the work is being done) 1'1 OD 'L 2 AAA.. City Miami Shores Village County Miami -Dade FOLIO / PARCEL # I` - .? LO(- Is Building Historically Designated YES NO Contractor's Company Name DI:14-34-1 $ 5 57--tri3 Contractor's Address 6-i,v'1\ 0 ei fl City r°A I'' Qualifier Name N-j∎ ers ' State Certificate or Registration No. I 14198 Contact Phone TZip 33 I �7 f) Flood Zone Phone # 3t ° '' 7.;)'9gi State C Zip 3 317 Phone #--)"' 3 ° 9"20- Architect /Engineer's Name (if applica Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: Certificate of Competency No. ❑Alteration 0 Phone # Square / Linear Footage Of Work: b, (-8.-O ❑New Repair/Replace ❑ Demolition © `h j ******** * * * * * * * * * * * * * * * * * * ** * * * * * * ** * F s******************************************** * * * * * * * * ** * ** * * *** * * * * * *** Submittal Fee $ Permit Fee $ / ly 0 r Notary $ Training/Education Fee $ Scanning $ 5100 Double Fee $ Radon $ •oo Structural Review. $ l2. DPBR $ Violation date: CCF $'I CO /CC $ Technology Fee $ 4K-00 Bond $ 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 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 a a r pection fee will be charged. Signature r Agent The foreg mg instrumen as acknowledged bre me this day of ,20j0 , by (i Cr bef who is personally known to me who has produce As identification a °x.,02" atch NOTARY PUBLIC: Sign: Print: My Comm' ion Exp an oath. 'r Contractor The foregoing trument was acknow; died before e this day of ,20l7%,by who is personally known to me or who has pro.uced as identification and who did t NOTARY PUB Sign: Prin My Commission Expires: th. L. its vex .0476 fovi r - Le) 1? * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * *�� //* ** * *************************** * * ** * * * * ** * * * * * * * * * * * * * * * * * * * ** % APPROVED BY v ans Examiner Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) t Clerk checked 01-11-2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual Iisted below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 01/11/2010 EXPIRATION DATE: 01/1112012 PERSON: DANTIN ABNER FEIN: 650920578 BUSINESS NAME AND ADDRESS: DANTIN'S SERVICES INC 12671 SW 190 ST MIAMI FL 33177 SCOPES OF BUSINESS OR TRADE: 1— CERTIFIED AC CONTRACTOR SO3IANeS 1.191.1120 :woJ j ZZ•9-9Z9 (V96)1.-1- IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer of a corporation who elects exemption from this chapter by tiling a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.0N11), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of elediea to be exempt shall be subject to revocation if at any time after the tiling at the notice or the issuance of the certificate, the person named on the aolke or certificate na longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate al nay time for failure of the person named en the certificate to meet the requirements of this section. DWC -252 CERTIFICATE DF ELECTION TO 3E EXEMPT REVISED 09 -06 LLZZ-L6£ (90£) L+ :xe j 40 :L 01022N9 4 ;o £ abed QUESTIONS? ' 50) 413 -1609 ZL689SL90E -1.+ :o1 (n) LL :LE :EL EL-90-01.0Z 13053972277 From: dayniel del Ilano 11 a SEE OTHER SIDE DO NOT FORWARD DANTINS SERVICES INC ABNER DANTIN PRES 12671 SW 190 ST MIAMI FL 33177 • Lieu lap jai ep :woad LLZZL6£90£ , To: +1- 3057568972 Page 4 of 4 From: Dantin Services Fax: +1 (954) 629 -5422 To: 2010 -05-13 13:37:11 (GMT) AVM, CERTIFICATE OF LIA t McCartney Insurance Agny, IBC 6739 Bird Road 160 avi I% 33155 -3705 Phone :305 -466 -4444 INSURED �,a67E1u Cxt Miama. FL tK27 • CAS 13053972277 From: dayniel del Ilano -Fax: -+1 (305) 397 -2277 'Page "4 'of 4 '.5112/2010 7:01 DATe miep ym IuTY INSURANCE ° i <_ 10 itmIS G'UTit°1L'AID IS ISSUED AS A MATTER OF DIFORNIATION ONLY AND CONFERS NO Mom UPON THE CERTIFICATE HOWER. MS CERTIFICATE DOES NOT AMEND, EMEND OR AMR THE Cov1RAt I AFFORDED SY THE FEES DEL.OW. INSURERS AFFORDING COVERAGE INSURER. k SocrStstaAla man® CAN NAIL THE FOXES OP ImixA1eS WOW J tliwc BEEN I£SUEOTC TFJE IMRED NN. 80 ABOVE PORME POUOYMERICIO @d0 AT NO TANNING NW( REQUI teMeNTI ItiRkit OR CO OP ANY CONTRACT OR OTHER Dom'3 WITH RESPECT TOM= TIM OERTIPICATE NAY BE ISSUED OA MAY PP3AYAWJ, T146 g48UJ AN a WORDED BY me POLICES UliSCANISDHARM 19 iiita ECT TI}ALL FE TERM ExcusuONs gm canton oP 3104 MEM "MK GATT MOTs 6 V*63AYHAVE 19TOJCIO BYPANSG l ummmy COMMERc IAiGENERAL ipourr EJ.AiMAMACE ! =?,1R CP91056513 07/22/09 07/22/10 mkummn MEN Era (Ally coy foram) PERSONAL 5 AIN WAXY GSM AGMACATE WAIT APPLES PAW PRODUCTS. CeWPIOP ADO $1,000,000 s$0,000 85,000 81 000,000 $ 2,000,000 9,1,000,000 GAFAAi45I4A93. t1Y ANY AUTO WPM Eta Acc 31 AC+Ci S VOloaMMMICZ 8 ASORREATE 1 EXCESSRAIRRIRIA [.1ABSA Y *MIR GLANS MANE muumuu.* RETENTION If Si- al BA UM * -7i:- +•. UPOPERA 1LOCAIWNa,' • CERTIFICATE HOLIER CANCI;t,I-AT U 04 sT ;woof ABOVE MuoRIBUP Kum us GAMALLED JAN T1 EXPNWROSI DATET ' EI v i thoRmuRio a►AIL 3,0 DAYSWIS/T6N auktK 70Ti* alwrinevra 1101.174k N3 3TOTMitrr BUT AIWA= T4naSin MALL USIKI8 N? 01/UGATIO/1 ORUAW1Y • ANY too: noon let eaukee ITS MUSTS OR RPRRIMIWIWRSL ACORD 26 (2001i06) AIORD CORPORAT 014 1985