MC-10-2156Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 154001
Permit Number: MC -12 -10 -2156
Scheduled Inspection Date: December 21, 2010
Inspector: Perez, JanPierre
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Wiegand & Annex
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: UNLIMITED SERVICES A/C INC
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -09
Phone: (305)796 -6642
Building Department Comments
INSTALLATION WALK IN COOLER
J
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
December 20, 2010
For Inspections please call: (305)762 -4949
Page 20 of 28
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Altmi Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
t Type: MECHANICAL
OWNER: Name (Fee Simple Titleholder):
Address: / 3 3 `rCSiy) A/ 2 v6 .
City: /6417( Acu 3
State:
1•
,„
6 2010 Ai)
Permit No. J V ""'f9
Master Permit No. (lc " C/ -,e- ,si 1
era _ Phope#:
Zip: 33/3r
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 11300 t✓ Avv JF ;16 6U-
City: Miami Shores County: Miami Dade
Folio/Parcel #: // 2/ ,3 6 0C /Q/66 °'�f
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: V i/I/J -Li cc id Ge /LC-/C _ :o "%q 6- WIZ-
Address: /�/� 610l SW 25 T
City: MIAMI- State: AM.i 611-01411 State: .,
Qualifier Name: —S-0.56 RA, )1 aU Phone#:
State Certification or Registration #: ( rfe Q (C6 T Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer•. Phone#:
hed Veir
Zip: 33/3t-
Zip: 33 c
71 -64q1
Value of Work for this Permit $ I eaa KS Sq e/Linear Footage of Work:
Type of Work: DAddress OAlteration ew ORepair/Replace ODemolition
Description of Work: i W741 / tt."4 l/L / 4.i e Cole%
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
ees********************************************
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL Mk NOW DUE $
1
Bonding Company's Name (if applicable)
SIP
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such i o Y % ', the
inspection will not be approved and a reinspection fee will be charged
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Contractor
The fo y ing instrument was acknowledged be re this 21
day of . r- 20 ( by cJ > T.i1.#&?
who is
. .� r who has produced
Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
NOTAR
Sign:
Print:
My Commission Expires:
vziw 1: '7, !,,d take anoath.
e. ., 81nn�.
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
GAMAZO, JOSE RAUL
UNLIMITED SERVICES AIR CONDITIONING INC
6101 SW 25TH STREET
MIAMI FL 33155
Congratulations! Witifthis license you become one of the nearly one million
Floridians licensed by the Department of Business and Professional Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restaurants, and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to serve you better$
For information about our services, please log onto www.myfloridalicense.com.
There you can fmd more information about our divisions and the regulations that
Impact you, subscribe to department newsletters and learn more about the
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!
(850) 487 -1395,
BATCH UMBE
BADE UN
TAX COLLECTOR
1 40 W RAGLER ST.
1st FLOOR
MIAMI, FL33130
46$942 -9
BUSINESS NAME # LOCATION
UNLIMITED SERVICES AIR
CONDITIONING /NC
6101 SW 25 ST
33155 UNIN DADE COUNTY
OWNER
UNLIMITED SVCS AIR GOND INC
Sec. Type of Business WORKER /S
196 SPEC MECHANICAL CONTRACTOR 1
mos IS ONLY A LOCAL
BUSINESS TAX RECEIPT. -. ..
DOS NOT PERMIT 711E
E» tEESRB,ATORY
ZOIENG'.._LAWS OF THE
COUNTY- 05 - -. CITIES. NOS
DOES IT E1IDAPT - THE
HOLDER OA MEI
PEIIMIT REQUIRED BY LAW.T1DS 1S
NOT A CERTIFICNBON, OF
THE HOLDEWS
BONS.
2010 IMCAL BUSINESS TAX RECEIPT
MIAMIVADE COUNTY STATE OF FLORIDA
EXPIRES SEPT., 30, 2011
MUST lE DISPLAYED AT PLACE OF BUSINESS
PURSUANT TO' (MUSTY `CODE CHAPTER BA- ARC 9 B 10
THIS IS NOTA BILL - DO NOT PAY
RENEWAL
RECEIPT WO. 250475 -2
STATED CAC051464
FIRST - CLASS
U.S. POSTAGE I
PAID
MIAMI, FL
PERMIT NO. 231
t UN1YTAX
COLLEC M
09/14/2010
60030000032'
000075.00
SEE OTHER SIDE
DO NOT FORWARD
UNLIMITED SERVICES AIR
CONDITIONING INC
RAUL GAMAZO VP
6101 SW 25 ST
MIAMI FL 33155
111II)I*III 11111111 atilt ALIIta1 ltlt F DlliIIII lifittll�
03 -02 -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 listed below has elected to be exempt from Florida- Workers' Compensation law.
EFFECTIVE DATE:
PERSON:
FEIN:
01/25/2010 EXPIRATION DATE 01/25/2012
GAMAZO JOSE R
651073670
BUSINESS NAME AND ADDRESS:
UNLIMITED SERVICES AIR CONDITIONING INC
8101 SW 25TH ST
MIAMI FL 33155
SCOPES OF BUSINESS OR TRADE
1- CERTIFIED AC CONTRACTOR 2- HEATING & AIR CONDITIONING
IMPORTANT: Pursuant to Chapter 440. 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this
section may not recover bandits or compensation der this chapter. Pursuant to Chapter 440.05(12), 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 440.05(13), F.S., Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person lamed on the notice or
certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person
named on the certificate to meet the requirements of this section.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
QUESTIONS? (850) 413 -1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORDS CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE 01/25/2010 EXPIRATION DATE: 01/25/2012
PERSON JOSE R QAM ZO
FEIN 651073670
BUSINESS NAME AND ADDRESS:
UNLIMITED SERVICES. AIR CONDITIONING INC
6101 SW 25TH ST
MIAMI, FL 33155
SCOPE OF BUSINESS OR TRADE
1- CERTIFIED AC CONTRACTOR 2- HEATING & AIR CONDmONIr1G
IMPORTANT
et Pursuant to Chapter 440.05 {14), F.S. , an officer of a corporation who
elects exemption from this chapter by filing a certificate of election
I- wider this section may not recover benefits or compensation under this
D chapter.
Pursuant to Chapter 440.05(12L F.S., Certificates of election to be
H exempt apply only within the scope of the business or trade listed on
Rthe notice of election to be exempt
E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt
and certificates of election to be exempt shat) be subject to revocation
if, at airy time after the filing of the notice or the issuance of the
certificate, the person named an the notice or certftcatte no longer meets'
the requirements of this section for issuance of a certificate. The
department shall revoke a certificate at any time for failure of the
person named on the certificate to meet the requirements of this
section.
QUESTIONS? (850) 413 -1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
PRODUCER
CERTIFICAllOOF LIABILITY INSURANdli OP ID JB
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
Tropical Insurance Agency Inc.
8824 Coral Way
Miami FL 33165
Phone:305- 221 -2400 Fax:305- 552 -5360
DATE (MM1DDivYYY)
11 19/10
INSURERS AFFORDING COVERAGE
NAIC L$
INSURED
2015 itWed Services Miami Air Conditi.
amiFL 3 155
INSURERA Granada Insurance Company
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAND ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCIM ENT 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 CONDITIONS OF MUCH
POLICIES. AGGREGATE LIMITS MOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TNSR
A
ADWL
�
GENERAL
TYPE OF INSURANCE
LIABILITY
COIMERCIALGENERALLIABRnY
POLICY NUMBER
0185FL00003045
°ECM
DATE (M8®#�TYYYYI
09/24/10
DATE
WITS
09/24/11
EACH OCCURRENCE
$1,000,000
R
URMALit
PN s I`t"ooa eI
$50,000
CLAIMS MADE I X I OCCUR
MED EXP (Any one person)
$ 1, 000
PERSONAL & ADV INJURY
$ 1, 000 , 0 0 0
GENERAL AGGREGATE
$2,000,000
GEM.
AGGREGATE UMRAPPLIES PER
I POLK:Y n n LOC
PRODUCTS -co MPAW Aso
$ 2,000 , 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIS AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LET
(Ea
$
BODILY INJURY
$
EM
PROPERTY DAMAGE
(Per W
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: -GG
$
ENCESSI
UMBRELLA A UABDJTY
OCCUR n CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
7
$
$
WORKERS
I�
ANY
OFFIRRII�/EMBER
(�Mpaensdatcty
SPECIALPROVISI
EMPLOY.
PROPRIErORtPARI
COMPENSATION
LIABILITY
NERIEXE
EXCLUDED?
WC STATW OTH-
[TORY LISTS I l ER
EL EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
In NH)
EL. DISEASE - POUCYUMIT
$
OTHER
DESCRIPTION OF OPERATION I LOCATIONS) VBIOLES I EXCLUSIONS ADDED BY ENDORSEMENT t SPECIAL PROVISIONS
Air Conditioning Service and Installation
CERTIFICATE HOLDER
CANCELLATION
City of Miami Shores
150 NE 2 Avenue
$iazai Shores FL 33138
ACORD 25 (2008101)
CITmS R
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRflTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO NO SO SHALL
III • y . TERN OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
's ' �� ' �� � REPRESENTATIVE
I:i s._ jon
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD