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MC-11-350Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INS P- 156539 Scheduled Inspection Date: February 15, 2012 Inspector: Perez, JanPierre Owner: PORTNER, TINA 'U '0- Permit Number: MC -3 -11 -350 Job Address: 870 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: SM INTERCONSULTING LLC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060050140 Phone: (305)972 -2371 Building Department Comments INSTALL SPLIT AC SUSTEM DUCTWORK Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 14, 2012 For Inspections please call: (305)762 -4949 Page 1 of 24 Miami 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 Mal Permit No. I V l l Master Permit No. " 16 M.:, BUILDING PERMIT APPLICATION FBC 20 ZEVIr NOV 0 °9 2011 BY. Permit Type: MECHANICAL �r OWNER: Name (Fee Simple Titleholder): / 171) /9 " pd /2. tN G IZ Phone #: Address: 8 70 City: M r ,9P'r t .C6 B /Z e g State: .0 % Zip: 3 31 3 6' ° Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 43 7 O l• 9i 51 City: Miami Shores County: Miami Dade Zip: 33) 3 8 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone #: Address: City: Qualifier Name: Zip: Phone #: ($ 0;"31 14-1- 23 4-( 271 %V 59 St Hialeah State Certification or Registration #: /0 5 00'04-19 Certificate of Competency #: Contact Phone #: 019) S Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address Alteration Description of Work: 10111111•1111111110111111111111111110E200111 & UNew ❑Repair/Replace ❑Demolition etot .dlt sari 2nrotti mre;01 Vt) `•,1 Submittal Fee $ Permit Fee $ I 1 Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Yeat.c.7 ., 7 @ti ..o, s gHs$:s gaknk =kikak°k=k*$aHa$age$aag$asj *** * **** '4* CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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 no, be approve i and a reinspection fee will be charged. Signature er ., gent The foregoing instrument was acknowledged before me this day of 40141 20 I / , by P-0.. 6 r-41- who is personally to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commi _••__��� - - * �4 • RAQUEL A. SCARBOROUGH Notary Public - State of Florida My Comm. Expires Oct 18, 2015 �•; � s Commission * EE 13, 379 d+�kNk�ksNdsN�sN ska:+x**+k***N:******* ; *****8ik*sksk*+ksk**sk**** k****Ns**** Contractor The foregoing instrument was acknowledged before me this i day of A/01 14 Lett, 20 l , by S-4,114181 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign Print: My Co APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06/10 /2009)(Revised 3/15/09) '•• uUEL A. SCARBOROUGH Notary Public - State of Florida _ if My Comm. Expires Oct 18, 2015 •'•.4, �r• Commission # EE 132379 � ' • Zoning Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR I ARCHITECT Permit N. /G ( % — g5 Owner's Name (Fee Simple Title Holder): 101 ( e2 fi i &( Phone #: Owner's Address: 7 J(J City: DUI u vv1 h'6 ('es State : ( Zip Code: S 3 r' Job Address (Of where work is being done): ' g ` 6' 4) C1 ,d‘ ST City: Miami Shores State: Florida Zip Code: 531 3 Contractor's Company Name: t Phone #: Address: City: it 271 W 59 S ;rah FL, 33019 ! Zip Code: Qualifier's Name : Lic. Number: /0 .8 041 641,L Slid IiiicierConsttiting Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the ,,z40,_ Mi mi Shores harmless for all legal involvemert. did1�°® Signature Signature g ovur}�r or Age Co r rchitect The foregoing instrument was = nowledged before me The foregoing instrument was aknowledged before me thisagday of Oe .2011,by i7a 6.eAre,y•, this 7 day of dMbe<,.4, 2cWby 4 r Who is personally known to me or who has produced as indentification. Notary Pubi' Sign: y tat A. SCAREORO1t8N Notary Pubtic - State of ROWS xa .� My Comm. Expires Oct 1S, 291 Commission # EE 132379 who is personally known to me or who has produced •1 f4V7'A N4/fr,t t% asindentification. Notary Publi Sign: Seal: is * ,. L S ix►' MY .0 ISSION 1 EE r . •r EX �! Augu 014 Bonded Thru Budget Notary Services voze 00)? itatit'AZIFIA")2 ' 11.et vistow t EP tat) bolt, !Africa tel ),‘ Nov 0911 12:25p EJD Construction 305 - 981 -6715 p.1 State Licensed Contractor CACO 48110 Beach .Air NOV 0 9 2 Conditioning. Sales Service Installation 6988 Indian Creek Drive Miami-Beach, Fl-. 33141 (305) 672 -4100 November 9, 2011 To Whom It May Concern @ Miami Chores Building Deparkmante This letter is being written on behalf of Beach Air Conditioning, stating that we are no longer working with E & J Construction as a sub at the location below. Job Site Location: 870 NE 92" Street Miami Shores, Florida E & J hired us as a sub to complete the job for them, but we are no longer working on this project. Any questions or concerns please contact me. Harry epe a Pres. Beach A/C 6988 Indian C - k Drive Miami Beach, FL 33141 305.672.4100 beaehaemiami@aoLeom Nov 14 11 04:06p fta eSP91I. PRINTED WITH ENYIRONISENTALLY FRIENDLY GREEN INKS • FSC Ifitixed Salutes m...ascac+suss uswiscaqi w TAX Ca-LECTOR :..140 W_ -RABIES ST - :...- 1ST FLOOR MIA K'FL30130: p.1 •.2011 . LOCALBUIRNESS TAX RECEIPT .. ?1112. . M AM1 oAoE cou to STATE OF FLORIDA: --` " ••• : - •-• EXPIRES:St T. 30 202:- MUST BE ©ISPLATEI) AT-PLACE OFBUSINESS :.. - PURSUANT. TO COUNTY CODE-WAVIER 8A.- •• FIRST =C • 1JS: PO$ • F7.AII N14ghtl PERJIT N 466788 -6 IS:NO P;'411.1; L'-D°: - - 9_ 7 P:an!. _ Y : ..R. EN. E . A L .= . . 6939,2- -: 27.1'w.'59_ ST 33012 : H-IAL.EAH - INTERCONSULTIN6 =- LL 1 ENGINEERING-:°CONTRACTOR'- THIS;Ili ONLY ' A: LOCAI: BUSINESS TAR RECEIP.T..rt : • : .'00 9. 'NOR.,' FENLET :THE • .: :HOLDETL TO :VIOLATE ANY EXISTUt6 • REQU1ATORY OR- ..ZONING -TAWS': OF THE. 'OOLNR.OH-:OTOS; NON OOES' IT...EI�UW1 .THE. HOLDER RION ANY OTHER REOIRREED.BY LAW. THI5 -{B•• .:- NOY-A CERTIFICA110 N OF - .'THE- .HOLDER E.OUAL67CA, 1 AYLU€UT R$eE.YF.r .. WORKER'S :1 wrialiAnk CO JNTY: - TAX-COLLECTOR . . 140 W, FLAMER ST. '.. 1GttFL-00:-_..:..- ::.6726854- :.: ': 271= W 59. -ST- :33012 •- :HIALEAH :: DO NOT FORWARD SM INTERCONSULTING LLC JUAN J SANTANDREU 271 W 59 ST HIALEAH Fl 33012 LOCA -BUSLNE TAX RECEIPT 2012 -N AMI- DADEVOUATY - STATE OF:F!_ORIFIA EXPIRES'SEPT::30.2012 MUSFEEPISPLAYED.ATFI:ACEOF BUSINESS` PURSUANT TO COIUNTT:CODE CR(APTER HIa.1r Tr. El s:JT -PAY . :.: .:. :..:... 4A- . :...- - ' 700031- IMO -LLC ..INTERCONSULTING' 4, • SBC T ' c14r V -':MECHANICAL .,,CONTRACTOR" • : THIS. IS` ONLY A LOCAL • BUSINESS TAN AECQAY.PP. DOES. NOT"PEwatt THE- •' 'NOLUER TO. INMATE" ANY :.;•.: . E7ISF1iG REGULATORY OR • - • . ZoWlIO WS. CaIAiTY,-ow ENI,T.'TVOH .:'DOES `if -E EIAPT-- THE HOU ER ENOrt ANY-O'11{EYY: : PERMIT - OR LICENSE' REUUIREO BY.LAW.ILISIS' NOT A- CERRFICATISN. OF . :THE KOL ER :S •OUA[ifCA:: -noys.: ' • .. • PAY'( irRECEL EN : ARASAVOADECOURTIY TAIL 'WORKER/S. 1 • 09/,.20/20.11 • 09010373001 DO NOT FORWARD SM INTERCONSULTIN6 LIC JUAN J SANTANDREU NCR 271 W 59 ST HIALEAH FL 33012 of Hialeah Business Tax Receipt Mayor Carlos Hernandez :..81'2-.81.3 - : Amount" _ 1.613 ::0:0` -: .. `oroorF te d bvsmness x Fquued:tengagezm ortlperatrthebin speetfied atiots a>IO 're liictiaiifi.aPtiie City ofalia , Reirida ' °- ,, _' : :.::::': - �D = _ •.: Qi }der j[3:01 : ii#TAIiREIU Si :.WI'ER0;*44:4* —G, Business: A13. :.'Other :Personal :Services - I 2011 -12 .SK _INTERCONSULTING, LLC ;: 271 W'' 59 • ST. ': - :: . raaxr :EL 3301. C{aidatitngigQ,: 286399.: • • :frsfYrR•.ris are.s s . w•■ 211;.11 39 .59 S-T. Ts:pires September 30.; 2012:- A e CERTIFICATE OF LIABILITY INSURANCE R054 10-06 -201'1 THIS CERTIFICATE'S ISSUED1AS 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 certificata holder is an ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of they policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). APODUCER INSURANCE MANAGEMENT ASSC INC /PHS 263311 P:(866)4671-8730 F:(877)538-8526 PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME: PHONE i Ext)• (866) 467 -8730 FAX (A/C, (877) 538 -8526 M JL° PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC d /NAMED SM INTERCONSULTING, LLC 271 W 59TH ST HIALEAH FL 33012 - INSURER A : Sentinel Ins CO LTD INSURER B : INSURER C : INSURER D INSURER E : INSURER F : ,1r.ess.1 MI III AfC0. COVERAGES CERTIFICATE NUMBER: flCVIORJ rvvIYloGn. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L771 TYPE OF INSURANCE GENERAL LIABILITY —1 COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE X OCCUR 1i X General Lia1 ,-rn,r GEN'L AGGR ( UM PER: POLICY I I JECT X LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS IA HIRED AUTOS X NON -OWNED AUTOS UMBRELLA L EXCESS LL4B WYD POLICY NUMBER (MM/DD/YVYY/ (MM/DD/YYYY/ LIMITS 20 SBM AB0996 07/11/2011 07/11/2012 IEACH OCCURRENCE 1 DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) $1,000,000 $1,000,000 $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $2,000,000 $2,000,000 20 SBM AB0996 07/11/2011 COMBINED SINGLE LIMIT (Ea accident) $ 61,000,000 BODILY INJURY (Per person) 6 BODILY INJURY (Per accident) 6 PROPERTY DAMAGE 07/11/2012 (per accident) $ $ $ OCCUR CLAIMS -MADE • DEDUCTIBLE RETENTION $ EACH OCCURRENCE AGGREGATE 6 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBEREXCLUDED? (Mandatory hs NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N/A WC STATU- TORY LIMITS E.L. EACH ACCIDENT 0ER $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESZR/PT(ONOFOPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, AddNonal Ramaaks Schedule, It mere space It reQhh l Those usual to the Insured's Operations. Re: Engineer and General Engineering Contracting. City of Miami Gardens is named as an additional insured per the business liability form SS 0008 as per written contract agreement. CERTIFICATE HOLDER 1 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LCr,hl <xc" _ �. ■ j'or, { r c+ 7. di T 1i A l 3Ti--aFlITR33 t:. 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At, ail+ 3 ^nb .c;.. a; t7.Sng.sx n,cE.s t. xE ;i.uuuR ,Y, „ci �`ca° 3 :<i \2SIISSE'e �i':f'3,M \, aJl"�,°GQ�E�p apl �'.F•.,.. iii er°i i' �r ' i.i 11611 t aiYJT. j _dl R'j s 8030 fT1 To _ 6'if;tTA1J_t ?tiff!, �_ Ci I , 3L , i.?f_ICY4 DE .711_13H:_,!-Vi; 3 TAO At.)).-r.4.:;;;I'iX:i 31-1 7 "K:2111 .41 VI ^4V { ®lrt„ i3a'C. ff __ --_ .its:,SsYt':3 �.1•S= :is:crz - 4eYt;i> ! ,'+.Yi.itiF:i-i :? �F�i�: *- 8U'"'''�.. � �'.,• . ?•••-• b to' .t? r;.t ()Fr T 19.:;1(1.10-`, 3T, ^«?i:i1T .,13 , 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: 06/25/2010 EXPIRATION DATE: 06/24/2012 SANTANDREU FEIN: 272629353 BUSINESS NAME AND ADDRESS: SM INTERCONSULTING LLC 271 W 59 STREET HIALEAH FL 33012 JUAN J SCOPES OF BUSINESS OR TRADE: 1- CONSTRUCTION 2- PROJECT MANAGEMENT IMPORTANT: Pursuant to Chapter 440 .I 0504). F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election coder this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.06(121, F.S., Certificates of election to be exempt... apply only Wtthln 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 certfirate, the person named an 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. QUESTIONS? (850) 413 -1609 WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CETFIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 06/25/2010 EXPIRATION DATE: 06/24/2012 PERSON: JU AN J SANTANDREU FEB 272629353 BUSINESS NAME AND ADDRESS: SM INTERCON5ULTING LLC 271 W 69 STREET HIA EAH, FL 33012 SCOPE OF BUSINESS OR TRADE 1- CONSTRUCTION 2- PROJECT MANAGEMENT IMPORTANT Pursuant to Chapter 440.05(141, F.S.. an officer of a corporation who elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. H Pursuant to Chapter 440.05(121, F.S., Certificates of election to be 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(131,- FS, 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 named 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. QUESTIONS? (850) 413-1609 CUT HERE * Carry bottom portion on the Job, keep upper portion for your records. WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 Wai?'„ti JOL3VIAti1F-'. ; Wbi ACk114.01-11..114.37 ?.!,1 41t117..5,,,k • In ITAll'ir;!TII 131 aT IAA TAf.?„ • :?1?•5100--A C,- -E-MAJ4, arzakiZ2'&,:0 z_J omvuumnaniii. T3110771° ,-63. T2. :MT: -1i2E.90115•ER26..:10. AlittDi.1:71226371J rhoLt.s.N v..1 - . c. .3 7s, yyr, .0 ,AgEol 1-•,3ofti . ▪ .1 t 4.4.'411 7U1,11, ;*.G•'.: tiVa,03 ..,3t 376M ■1011:..F.,4. .1 ; .4 D 7- sfolt :",l'oRi2.4..1 ".0.1 - t 3 . 1'1 pRinl ,:ifoi; • r e* ;i344, - -: ' foL,T : ;U■ "'' .71111 1g Chi t4.33:1C.),3 :311 V.,melapal •:zio s'Ellitia::" ■.13?ItTi:1 La 'Air:3711.7° 3114719'• .01V Ti tk:17.*. E; '1'i 0, ti '": --TO'.?.LA,l'FIC.'' ..':i.if4,'".., ..-..,;(.•3'.4. • 1 "". . ---:: ..i• '-' i °.:.'%).i.i.N.t. 3.1; (.7,,,,..V.:" ,7.17 ,•-:••• . • • • ' ...,,,:f:. - '-i-r ,,is.',. sr i ::,.,•.:1'..-:,-.:.....:^ 3 ,:::,-;;.c". {,j•;') ".°.•-- g, ,•,.. ::.illiflao . •__,• 7 `,-, 7.- ; . •,,,sP, ,.; 7,i: ,3 ...,-,,,,,7.. • , '' i; , t-...777.'.:: ■ :,.rr ..„F., -7o - It3' ,.-,;,, •., ,.; isvir.„,..5-: ; „. ; •-fq...T: ,.."2:11",.F ;.:',19'it 1,:-3.-:,:li...1 ''‘':, " ',,,,,,3r-""•::,...•',.;,- '. , . 1 • ;"..B fri ° 347 '1,47i13019 t t1S,,i . nai.:37:,ov91 . rosn o :E. • !. te le t .-.-.;;;;-:s.:-..7";• '411 ▪ 2.!sti• !It 951: • fl 1.":".:jr=•• :1E•)ttli• 1"."713 • '.• 11%Vf8 nialVid14-.43CA fitt-117-:0243-1Tiflfn =-",0 VIUSIVIC1 :tiT -N-Amto i."41 CT( ocrrJa; .4.-rt•or,c11-Trta IYF • :TAa MV:7°.:4-1S1X Utile.WTVAa :., VA:2- ietn:>A:ii4 -..deaKIOA at7Y.7.1047r.7,1J0 3 142 7.0 77C,:Yar • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 SANTANDREU, JUAN JOSE SM INTERCONSULTING, LLC 271 IALEAH H 9 ST FL 33012 Congratulations! With this 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.cam. There you can find 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! DETACH HERE STATE OF FLORIDA AC# r 4 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION RM14016978 06/20/11 100484118 REGISTERED MECHANICAL CONTRACTOR SANTANDREU, JUAN JOSE SM INTERCONSULTING, LLC (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch.489 expiration date: AUG 31, 2013 L11062000298 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEW L11062000298 LICENSE NBR DATE BATCH NUMBER 06/20/2011 100484118 RM14016978 The MECHANICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2013 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) SANTANDREU, JUAN JOSE SM INTERCONSULTING, LLC 271 W 59 ST HIALEAH FL 33012 RICK SCOTT GOV ERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY TAG,'" T 1211; 7 -,.,r„tvre tL;.-60.1, 2Eaii!:;;;CIE 7.11Tilif.r.g.K.V.W1 717:.1"..A211^ESI .7)Y. Ammoii aTAT8 JAMOIEEZVOF GUA a a IQ TviairrriAcIarl Vq+TPAT1k1 YFIEU O) TTKI 7,f,.5EMOM AT*CW 01",e1 o v r , • 7...1101T-7,17 Ufk .111,2-1 .`7:7-A,111 ) • • 51C.,.7.!-74 TV1.2-;14i 161.: ee:-J • coe t , .171 r. 170;:ael, waY- • Y..77.:4P- FIOD WACJ7s ,UESUWATVAn ,DHIY:LIPMOOAJI-X*; TS CE;z•N !..:6c AXEJAIM WM! !e..ficqetvisiqfti.i':7' ..ic-!:..r,-#1.1q5C, Gilt '„tt,1 .:101t ...I-Jai1:01s moier rdci brie ibi zrr. d 1;1 16D1CJ 11: ob ow +(ow er'.7.64.01(iilii et'v Vit; Frz.r,Anisbholbtci•i.wr4w 97eisr:tici .zafras ir;;Ids noiicrric411: n.nitsfrno;!, ariprn tin nap Jrti eiorr rris-t_;1 un flUZ .kaz,prs • swi/sit;f1,.. etsto,,,?6,7; 01C. C.F?3;0 iio 6 uoy 'Ctdid « itov TL' (17,7.A. AOi D'YJIZu;•J VSIT:061 Z(71,.-J,;TzNO7) as-i5Ta 'J'-4atO° iTOTI7aAFTTUW E'AE, b6reF-..11 Fa.rvviz-:Ivo7 3A.72 ESJYL 7ATA -.1f2TOZ7 aaA Taam T2VM ,:,LAUGIVIrAki? (Aa7.A :T.1A 1;77 flOIAq 7 7.07g2-17..'-iA2. :73;2 IVY g 12 3-7)FF1.1F.TW TOTZ Rek';;EVO=D Nov 10 11 04:55p 0001 QUALIFYING TRADES) GENERAL (COUNTY) QUALIFYING TRADE(S) 0001 GENERAL ENGINEERING QUALIFYING TRADE(S) 0001 GEN'L MECHANICAL p.1 :Con canon Trades QUeifyi Board;.::.:. SiNES3 GERTIFIGATEOF.COMPETEVCY • .1OB00 INTERCONSULTlpJG LLC D.B.A.: DREU JUAN JOSE rs certified under the prOvisinnt or =Ch e0:10 of- MiarnMade County VAI JD-- FOR CONT.RACfIkIC -UNTI L Og430/2017 Sail INTERCONSU D.B.A.:. DREu 4URM40SE:.:.: Is certified under the pro kisiats of Chapter 10 of Miami -Dade Cour9ry DREU- JUAN :JOSE=. Is certified under the pnivistodis of Cha;iter 1Qei* fade County: HP Ofcejet 6500 E709n All-in -One series Fax Log for EJD Construction 305 -981 -6715 Nov 10 2011 10:50AM NOTE: Blocked calls are not displayed on this report. For more information, see Junk Fax Report and the Caller ID Report. Last Transaction Date Time Type Station ID Duration Pages Result Caller ID Digital Fax Nov 10 10:49AM Received 3059691418 0:33 1 Error 244* 13059691418 N/A *A communication error occurred during the fax transmission. If you're sending, try again and /or call to make sure the recipient's fax machine is ready to receive faxes. If you're receiving, contact the initiator and ask them to send the document again. Note: Image on Fax Send Report is set to On An image of page 1 will appear here for faxes that are sent as Scan and Fax. pVIM7T-rn) gt MAR 0 01 lit); 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 Permit Type: MECHANICAL Permit No. BY : ....f Master Permit No. raG I -goo OWNER: �NName (Fee Simple Titleholder): ¶ t eta `F'( '1 e C Phone#: S/ S g, i f E% 1 Address: d 7 0 city: ;et cvt G ! rn e.5 State: l Zip: '53 132 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: 70 N ST City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes County: Miami Dade Zip: 3-g r p NO Flood Zone: CONTRACTOR: Company Name: b eiv ry/� ed./IA/047 - ' Phone#: 30r- 6', 2-5770 p Address: 9 v Co N ' 7/41 /1/ X �. City: /1 /e,4 / State: F-7/04 /A A Zip: ?f / /e( Qualifier Name: /L/A/71/44-1 7° �LR/`l AP') Phone#: 2 491" 7 2- *-V/ c50 State Certification or Registration # : C /fit? ¥d // ® Certificate of Competency #: Contact Phone #: 3 6 7 Z 7`l ®0 Email Address: C/1 '®G/I /A11 de9 ,406- 201, 1 DESIGNER: Architect/Engineer: Phone#: * ** *a** *** * * ***** * ** * * *** **w*** **** * ** ees"'** *** ***************************P******** Submittal Fee $ Permit Fee $ i ® CF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Educ ation Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL I!'LE NOW DUE $ 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 110 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 Fl FCTRICAL 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. v Signature , or Agent The forego' g instrument w ' acknowledged before me this ‘3242- 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 coa mIsalan 0 00 12603 Ba dedT►rrwgh National Notary► Signature /' l/ �4e-1/ ontractor The foregoing instrument was acknowledged before me this Z day of Z6X- , 20/ by who is personally known to me or who has produced FL b,& as identification and who did take an oath. NOTARY PUBLIC: — Sign: Print: My Co ***** *** ***e•** ** * ** * ** **** � *** * *** ******w *a* *way *ass ****s* * APPROVED BY v 14 Plans Examiner 10 Or ."--Seit0S1 QoPkir Zoning Structural Review Clerk (Revised 07 /10/07)(Revised 0611012009)(Revised 3/15/09) Miami Shores village Building Department 10050 N. E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet Multiple units on single sheets are not acceptable. Job Address - e the work is being done): 5370 10 1 g,. 51 City: Mia'.4 i Shores Illage County: Miami Dade Zip Code: 2 1 S ALL + DENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AR] (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ARHI Sheet Attached: YEq NO ❑ Contract Attached: YES Q� UNIT BEING REPLACED DATA NEW UNIT ,A/ ' MANUFACTURER C a (r" C AHU or PKG. UNIT MODEL # r (� / COND. UNIT MODEL #`C_7: KW HEAT j NOM TONS 7., AHU CU PKG 1) M.C.A AHULyfiCU IS, gPKG AHU CU PKG 2) M.O.P AHUZS CU 73 PKG AHU CU PKG 3) VOLTS AHULD p 2.0 KG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES G— NO YES NO REPLACING THERMOSTAT YES L_% NO YES NO NEW 4 °CONCRETE SLAB YES v NO YES NO NEW ROOF STAND YES NO %C YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 410 &)) 2. Maximum Overcurrent Protection (Fuse/Breaker Size): Z /C0 3. Voltage of Circuit (208/240/480): Z. go 4. Size Disconnecting Means: Contractor's Company Name: Zeit& ti di/e, fie!` td o` c Phone: 3r9,5 4 7 9, -1 / 00 State Certificate or Registration N. C *CO 1-IS 16 Certificate of Competency N. Signature L . dr; %', - z Date: ZZ t tQu marl ' usex ?41 1`11.'+vd.ghri(1irecioI y,nrg Certificate of Product Ratings AHRI Certified Reference Number: 3693278 Date: 2/28/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number 24ABC624A*"30 Indoor Unit Model Number: FB4CNF024pTXV Manufacturer. CARRIER AIR CONDITIONING Trade/Brand name: BASE 16 PURON AC Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air- Conditioning and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh); 22800 EER Rating (Cooling): 12.00 SEER Rating (Cooling): 15.00 Ratings fattowed try an aeienak (7 indicate a voluntary feriae of pie"iausly pui6ahed data. unless accompanied wan a WAS. vuhlch Indicates an Imroiunta,y reMale. DISCLAIMER AHrtl does not endorse the product(s) listed as this CerpTkate and makes no rsprntatians. warranties or guarantees as to, and assmoes ea rentonsibilky for, the pradurt(e) fisted on this Certifies AHRI expressly d aataIms all tabNIY for damages of any kind arising out at the unwor parfwhraance of the pandtottis), orthe unauthorized alteration of data Instal on this Certificate. Certified ratings are valid only for mulcts and configutafions fisted in the directory at www.ahrldirectory.org. TERMS AND CONDITIONS This Cardficata and Its canteens are proprietary products ofAHRL This Carbt cats shall only be used for individual, personal and caMderdtsl reference purposes- The contents Of this Ceatlliealemay not in whole or in part, be reproduced; copied; dissemkrated; entered Irma air donnas*; or otherwise Waxed, in any form or manner or by any means, except forte user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The intomtaton tar the model eked on tints tore van be verified at wrew.ahru irectory.org, L Air - Conditioning, Heating, dick on "Verify Certificate" Bak and eider t he AKIN CebTre d Reference Number and the dam on AU 1M Ilk/ and Refrigeration institute which the certificate was Issued, vine h In listed above, and the Ceatdleate No., which is fisted below. 02010 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129434037321829438 ,wer. Tina Portner Consultants File No.: TP11152009 i install new HVAC system. M 1 p LS ' 3,550.00 3,550.00 p Interior/Exterior 7.0 %353.50 This work will be done by:: L Owner © Contractor ® Subcontractor $5,201.50 Sub -Total This Section: $5,201.50 Cost Estimate Attached [ Permit Required: Summary/Narrative Of Work To Be Done: Contractor Overhead & Profit included. Conform to Propose Building Plans Attach by ( Mark A. Campbell ) Architect # 11074 Install qty-1 with 2 -ton 15 Seer condensing unit Install qty-1 with 2 -ton 15 Seer air handler unit.. Including dryer,heat strip,float switc h,filter rack & filter with digital thermostat and conerete slab, metal stand ductwork and electric. All work perform must comply with current FBC Material/Labor/Permits included. 'Install ins ation R -38. ( Attic ) In or Level Qty Unit Material/ LS Total Labor Tax/Margin Grand Total M 5 7 0 . 8 7 400.00 7.0% 6 '' This work will be done Summ - /N : ❑ Owner © Contractor ® Subcontractor five Of Wo To Be Done: Contractor Overh Conform to Propose Bu Insulation will be install All heating,ventilation,ai Material/Labor included. $1,000.00 otal This Section: $1,000.00 Cost Estimate Attached Permit Required: Profit included ing Plans Attach by ( Mark A. Campbell ) Architect # 1107 installed walls and attic spaces. r con oning ductwork that passes through unheated ces will be insulated. Install New Kitchen Cabinetry r,._.� Kitchen Including Island Counter Install Travertine Countertops with 18° backsplash L Kitchen • nit Material/LS Total Labor Tax/Margin Grand Total LS 6,710.00 6,710.00 7.0% 679.70 I $10,001.30 LS 71400 714.00 500.00 10% 3 84.98 I $1,250.42-1 This work will be done by :: ❑ Owner Contractor ❑ Subcontractor Summary/Narrative Of Work To Do. Contractor Overh • Profit Included. Standard Grade ' • uct Wood Cabinets (Special Order Product ) Conform to Pro • • e Building Plans Attach by ( Mark A. Campbell ) Architect # 11074 Install Kltche - nd Bathroom Cabinetry. Cabinets wil installed plumb and level and fastened to wall studs with 21/2° minimum cabinet Install sland Counter per attach plan. Install vertine countertops with 18° backsplash. tenons will be installed per industry standards and caulked at all locations where tops abutt walls. inets will have one piece toe kick installed. Material/Labor included. Sub -Total This Section: $11,251.72 e Attached El Permit Required: 0 Copyright 2003 - Corporate Niche (406) 522 -8856 Document 9 - Page 12 of 15 05/13/2011 02:48 3054035044 CERTIFICATE OF LIABILITY INSURANCE PAGE 01/01 DATE (MMIDDIYYYY) 05/13/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder IS an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION I5 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 Lieu of such endorsement(s). PRODUCER Eng Insurance P.O. Box 841258 Pembroke Pines, Fl. 33084 Phone (305)420-6412 INSURED Beach AC SeNlce MO. 6988 Indian Creek Dr Miami Beach, FL 33141- Fax (305)403.5044 (305) 6724100 CONTACT JUAN G. CRUZ NAME: pnora tizr, eat !305)420 -8412 ADDRESS': LTALC. 11ol: 305)403 -5044 INSURER(S) AFFORDING COVERAGE INSURER A; NATIONAL GROUP INSURER B: INSURER a INSURER D : INSURER E: INSURER F: RAIDS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF 1NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION oP 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 I5 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN NIAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OP INSURANCE INSR�W VD POLICY NUMBER (MMIDDIYYYl1JMM p pDPt Yf LIMITS EACH OCCURRENCE $ 1,000,000.00 A GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY 02L000105801 01/21 /2011 01/21 /2012 DAMAGETO RENTED PREMISES (Ea occurrscel $ 100.000.0D Mm EXP (Any 0ncpemon) $ 5,000.00 ■ ❑ CLAIMS-MADE a OCCUR PERSONAL & ADV INJURY $ 1,000,000.00 M BI/PD $ 500 • GENERAL AGGREGATE $ 2,000.000.00 GEN'L AGGREGATE LIMIT APPuES PEW ❑ POLICY ❑ • LOC PRODUCTS - (:OMP/OP AGG s 1.000,000.00 i AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ALL OWNED SCHEDULED ALR09 ❑ Amos C€O�M�BIINMEDD� NGLE UMrr $ BODLY INJURY (Per person) $ BODILY INJURY (Par acaideri $ ��E Y 'DAMAGE $ UT HIRED ALTOS' ■ AUTos ❑ r:1 s ❑ UMBRELLA DAB 1 occuR LI EXCESS LIM; 0 CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ OED ❑ RETENTIONS $ WORKERS OOMPENEATION AND EMPLOYERS' LIABILITY Y / N PRO JET_O ECUs IVE N / A ❑ TORY I IMR3 = OTH- FR E,L. EACH ACCIDENT $ FNYYI RIPARTNE (Mandatory In NH) ❑ E.L. DISEASE - EA EMPLOYE $ ir yes, describe under DESCRIPTION OF OPERATIONS below E.L_ DISEASE - POLICY LIMIT $ DESCRIPr1ON OF OPERATIONS f LOCATIONS f VEHLOLES (Meek ACORD 101, Addittenal Remarks Scnodulu, if more space Is Mulled) CERTIFICATE HOLDER CANCELLATION VILLAGE OF MIAMI SHORES 10050 NE 2ND AVE MIAMI SHORES, FL 33138 FAX 305- 7588972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR2ED REPRESENTATIVE JUAN 0 CRUZ ACORD 25 (2010/06) CIF ®1818 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD