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MC-11-966Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164043 Permit Number: MC -5 -11 -966 Scheduled Inspection Date: September 14, 2011 Inspector: Perez, JanPierre Owner: LONGMAN, JOHN Job Address: 333 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ALL AIR SOLUTIONS INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New A/C System Phone Number ()_ Parcel Number 1132060136370 Building Department Comments GARAGE CONVERSION NEW CENTRAL AC 2 TON Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 160286. need to seal hole in closet jpp September 13, 2011 For Inspections please call: (305)762 -4949 Page 13 of 30 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 333 NE 92 Street Miami Shores, FL 33138- 1132060136370 Block: Lot: JOHN LONGMAN Owner Information Address Phone CeII JOHN LONGMAN 333 NE 92 Street MIAMI SHORES FL 33138 -3133 U -- Contractor(s) ALL AIR SOLUTIONS INC Phone CeII Phone Tons: 2 Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: NEW AC SYSTEM Fees Due_ _ CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.37 $2.37 $1.00 $157.50 $3.00 $4.00 $173.24 Pay Date Pay Type Amt Paid Amt Due Invoice # MC-5-11 -41048 06/09/2011 Credit Card $ 173.24 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Underground 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 09, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 09, 2011 1 Miami Shores Village Building Department wwY 2 Pay 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 .V Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2000 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) Owner's Address City Tenant/Lessee Name Permit No. me — "I 1' Master Permit No. 1 `--S 3 _ )L 044 Phone # ‘3'T; 9 r Zip ?3f3S/ State �� f0 _ Phone # E -MAIL: Jobe Address (whore the work is being done) City Miami Shores Village County Miami-Dade Zip FOLIO /PARCEL# II 3 kp Is Building Historically Designated YES NO Contractor's Company N Contractor's Address City Qualifier Name State Certificate or Registration No.C. Lt, 57 /' Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ ,r Square / Linear Footage Of Work: Type of Work:. ['Addition ['Alteration ['New ❑ Repair /Replace ['Demolition Describe Work: (o cl��S. 44c.... 791 ...76,\Ls 'carat*** C 'clew xx'c'cwxxxx 'cY. Y.xx XxX xXlexwxY.Y.]C eesW Y.'c0lele W* wxx** "x "'cWWX xxx 'cWxlexxw Y.xx x'c xlexx Submittal Fee $ Permit Fee $ Notary $ Training /Education Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Total Fee Now Due $ CCF$ CO /CC Technology Fee $ Zoning $ Structural Review. $ See Reverse side —> 5f;5 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 1 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 toattachment. 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 j reinspectio ill be charged. Signature Owner gent The foregoing instrument was acknowledged before me this Z-7 day of , 20/%, by j-ke%A.-° /., ' A1*' -' who i ersonally known to me 9r who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ostik FLORIDA • Signature Contractor The foregoing instrument was acknowledged before me this day of �. � , 20// , by �',rit9 w personally known to �� a or who has produced as identification and who did take an oath. My Comptita o� tres ie,tixxx xxxxxx* ******%.** ** NOTARY PUBLIC: Sign: rmt: My Commission Expires: xxxdrxxxxxxxxxxxxxxxx,txxxxxx xx x >exxxx** ***xxx* NOTARY PUBLIC -STATE OF FLORIDA ' Dolores Lopez �� Commission #DD766456 xxxxxx% n. acipiresp* . 4_l2O12 BONDED TBRII ATLANTIC BONDING CO., INC. APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised-02 /08/06) 06/08/2011 07:43 3056513900 ALL AIR SOLUTIONS PAGE 01/01 A Ai CERTIFICATE OF LIABILITY INSURANCE DATE ;"YY) THIS CERTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED' REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If Ung Vdalrka L, huliv. I erl AMDIYIOIVAL [Amur -co, um JJuIIUy(Ibi) niuul, tic euUuru,d. 11 SYDRQCaATION 16 Mil 11 tu, EUDJeG[ to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certtfcate holder in Lieu of such endorsement(s). _ PRODUCER Dopazo and Associates 3900 NW 79th Ave Suite 70090000049 Miami FL 33166 Alexander Dopazo CIC LAIC Ne F,�), (305) 470 -8500 1, Nor t$05) 470-0111 ES :iri£o @dopazo.com CItS7'OMPR ID #. WSURER(SIAFFORGIN000VERAGE INSURER AI"tount: Vernon F .re Insurance Co NAlcil 26522 1N5 O All Air Solutions Inc 20429 NE 10th CT RD Miami FL 33179 INSURERE:Phoenix Insurance Co 25623 INSURE sa Business First Insurance Co. 11697 INSURER OF I CLAIMS -MADE INSURER E t ME€ElX€(eocaparson) MED EXP (AnY one parson) INSURER F t AGES COVER CERTIFICATE NUMBER:CL1133002234 • THIS INDICATED. CERTIFICATE EXCLUSIONS IN3R IS TO CERTIFY THAT THE POUCIEB OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE AD `L 1714K I , - WvD • POLICY NUMBER c.2346148C F'QUCY EFF JMM! bIYYYYLJMM/DDmYY) 3/27/2011 POLICY UP 3/27/2012 LIMITS EACH OCCURRENCE $ 1,000,00D A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY X DAMAGE TO RENTED 100,000 I CLAIMS -MADE X OCCUR ME€ElX€(eocaparson) MED EXP (AnY one parson) $ 5,000 $ PERSONAL AAOVINJURY s 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM. AGGREGATE UMpII.TAPPUESPER: POLICY n JECI PRODUCTS - COMP/OP AGG S 2,000,000 in n LOC s S AUTOMOBILE UA ILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ar►7349x697 3/27/2011 3/27/2012 COMBINED SINGLE LIMIT (Ea accident) S 1,000,000 X BODILY INJURY (Per person) S _ BODILY INJURY (Peraecde,d) $ -..Y PROPERTY DAMAGE (PeraocMenn E PIP -Basic $ 10,000 — S A UMBRELLA LIAR EXCESS LUIS _OCCUR CLAIMS -MADE 772118239 3/27/2011 $/23/2010 3/27/207.2 9/23/2011 EACH OCCURRENCE $ 2,000,000 X AGGREGATE $ 2,000,000 DEDUCTIBLE RETENTION $ �T -8 { (_TH- X I I ,l L.P6 S C WORKERS EMPLOYERS,' AND EMPLOYERS' LIABILITY ANY PROPRIETOR PARTNER/EXECLRJVE OFFICER/MEMBER EXCLUDED? (Mandatory in�NH) IDESSC�RIPTION OF OPERATIONS y / N N/A 0521 -04444 @,L, EACH ACCIDENT S 100,000 6 100,000 5 500,000 below E.LDISEA$E- EAEMPLOYEE E.L DISEASE - POUOY LIMIT DFSCRIP7[ON OP OPERATIONS f LODATION5 / VEHICLES (Mach ACORD 407, Additional Ramartts Schedu 5, If meta space 15 requited) Air conditioning sales, intonation and repair. CANCELLATION roly212L @gmail.com City of Miami Shores Bui].dind Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2009109) 1NS025 (20os05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR$ THE EXPIRATION DATE THEREOF, NOTICE WILL DE DELIVERED IN ACCORDANCE WITH THE POLCY PROVISIONS. AUTHORIZED REPRESEIVTATI VE felod..l.mv DukralAu crxelaL, 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD /27/2011 /27/2011 ' /27/2011 9/23/2010 Jun 07 2011 4:10PM ORONI INC 305- 688 -9550 CERTIFICATE OF LIABILITY INSURANCE p . 1 DATE (MWDDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such ondorsemsnt(s PRODUCER LIE" L .info @dopazo. nom P R Alexander Dopeso CIC .(305)470 -8500 FL 33166 00000049 FAX 130S)470 -0111 PRODUCER INSURER S AFFORDING COVERAGE NAIC 6522 5623 1697 COVERAGES FL 33179 CERTIFICATE NUMBERCL1133002234 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'1WTHSTANDINC3 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 1S SUBJECT TO ALL THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. ��; r,_,:BEEN REDUCED BY PAID CLAIMS. TERMS, 0 LIMITS SHOWN MAY HAVE BE q� 15 � AML MOLDY �� � -�' 7i COMMERCIAL GENERAL LIABILITY 1111 CLAIMS-MADE OCCUR ■ 0 GEM AGGREGATE LIMIT APPUES PER: © POL-!CY 100 AUTOMOBILE LIABILITY ANY AUTO ALL CANED AUTOS SCHEDULED AUTOS HIRED AIJrOS NON.OWNED AUTOS UMBRELLA LIAB EXCESS UAB DEDUCTIBLE RETENTION WORID:RScOMPENBAnON AND EMPLOYER, LIABIUTY ANY PROPRIETOR/PARTNERIVE a OFFICER/MEMBER OCCLUDED? U&andatory In NH) yeBSC4 DNDER OPERATIONS Ir Netov OCCUR CLAIMS -MADE 1 •• DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES ACORD AddUona! Remars Schedule, ► re epee le required) requdred) Air conditioning sales, intellatioa arid repa ir . L2346148C 7349X897 119239 •521 -04444 MOLD Y XP UAL/ /27/2012 /27/2012 /27/2012 /23/2011 CERTIFICATE HOLDER UNITS E.A_O.,� �O�CCURRENCE MED EXP v are • arson PERSONAL a ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO COMBINED SINGLE LIMIT IEa eocIdeat) BODILY INJURY (Per preen) BODILY INJURY (Peraoaltlenti PROPERTY DAMAGE (Per ecadenLl PIP -Baelo EACH OCCURRENCE AGGREGATE E.L EACH ACCIDENT E.L. DISEASE - EA EMPL E.L. DISEASE - POLICY OMIT a 1,000,000 S 100,000 $ 5,000 S 1,000,000 S 2,000,000 S 2,000 000 $ S 1,000,000 $ $ t S 10,000 S 2,000,000 S 2 000,000 $ S 100 000 S 100 000 8 5.0 00 roly2121 @gmail,00m City of )'liaai Shores Buildind Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD 26 (2009/09) INS025p2ocurs) C NCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORMBD REPRESENTATIVE Maximo Dopazo CPIA./AD •�" c--- The ACORD name and logo are registered marrkss ofACORDORD CORPORATION. All rights reserved.