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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 "(\;-tp 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