MC-11-1506Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
1t
Inspection Number: INSP- 163413
Permit Number: MC -8 -11 -1506
Scheduled Inspection Date: September 21, 2011
Inspector: Perez, JanPierre
Owner:
Job Address: 9501 NE 2 Avenue
Miami Shores, FL 33138-
Project: BENNETT BUILDING
Contractor: PALMETTO BAY AIR CONDITIONING
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)756 -3711
Parcel Number 1132060133920
Phone: (305)278 -2428
Building Department Comments
RECOVER REFRIGIRATION FROM AC UNITS TO BE
DEMO IN BUILDING
ctil 24 )1
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 20, 2011
For Inspections please call: (305)762 -4949
Page 13 of 34
10404 SW 187th Street • Miami, FL 33157 • T. (305) 278 -2428 F. (305) 278 -2429
CAC1814776
August 26, 2011
Attn: Glen Bolding
BBF Construction
10705 SW 216 St.#215
Miami, FL 33170
P: (305) 234 -4514
F: (305) 234 -4515
•
Recover Freon at 9501 NE 2 "d Ave Miami Shores
9501 — 3 AH Recover 23 Ibs R22
9519 —1 AH Recover 8 Ibs R22
9523 — None (Empty Unit)
9531 —1 AH Recover 44 Ibs R22
Thank you,
Ed Meerbott
President
Palmetto Bay AC
2011061308494580
r
Carlos Alvarez, Mayor
PATTER:
Mr. Edward Meerbott
PALMETTO NAY AIR CONDITIONXNG OWEIVICW
11271 SW 181 TEAR
PfIAD4T, FL 33157 -
Environmental Resources Management
Pollution Regulation & Enforcement Division
701 NW 1st Court • 7th Floor
Miami, Florida 33136 -3912
T 305- 372 -6600 F 305 -372 -6410
PERMIT NO; APCE- 003836 - 2011/2012 (CERT):
PAX 'zO BU AIR CONDITIONING SERVICE
10404 SW 187 ST
MIAMX, FL 33157-
�iamidide.gov
DESCRIPTION o, 3raellaTrizazonegrt ,
This document, issued under the provisions of Chapter 24, Miami -Dade County Environmental Protection
Ordinance, shall be valid from 01 -JUL -2011 through 30- JUN -2012. The above named permittee is hereby
authorized to operate the pollution control facility at the above location which consists of the
following:
STRATOSPIIERIC OZONE PROTECTION
ANNUAL OPERATING PiCRNIT
1 MICROVAC Recovery unit(s) model LMVOO2
1 NAT REFRIGERATION PRODUCT Recovery units) model ;ULVI
The permittee is authorized to purchase refrigerant(s) I -134A R -22 R -408A R- -410A from DERM
approved distributors. for use during service and repair of air conditioners, refrigerators, freezers
and chillers, etc. Bulk sale of refrigerants is not authorizedr only sale of refrigerant by the pound
during repair and service is acceptable.
This facility is subject to conditions listed below and in the following pages (if any) of this
permit.
SPECIFIC CONDIT/0MS
1. The permittee, by acceptance of this document, agrees to maintain the subject operation so as to
comply with the requirements and standards of the Florida Administrative Code 62-281, Sections)
608 /609 of the Title vT of the Clean Air-Act of 1990 and 58FR28660 and 57CFR:31241 in addition to
the applicable Miami -Dade County regulations.
2. Releasing refrigerant into the atmosphere during installation, service, repair salvage, or
dismantling of any appliance.. {including, but not limited to, air conditioners, refrigerators,
chillers & freezers) is prohibited. All refrigerants must' be recovered/recycled or recovered
only using 'tTSEPA approved equipment and stored in DOT approved containers for subsequent
reolarativn:- E> oegtLone to k.hiaventing --- prohibition are - covered: under, Section (.c) =-s -t r'
Clean Air'ACt.
3. All refrigerant recovery /recycling equipment must be properly maintained to ensure continued
operating efficiency of at least -908 refrigerant recovery. The permittee shall demonstrate that
the refrigerant recovery /recycling equipment is in good working condition, when requested by a
DERM inspector_
4. Equipment that is 'dismantled on -site must have the refrigerant recovered in accordance with EPA
requirements prior to dispersal. After removal of the refrigerant, a sticker Shall be attached to
the unit stating: i) the permittee name, address and phone number ii) the DERM perrit number
iii) the date of refrigerant retoval.
5. Records regarding the service and repair of air conditioning, refrigeration and small appliances
containing refrigerants must be maintainei for a period of at least two years. such records
shall include, `:but not be limited to thii following: i) Amount and type of refrigerant(e)
Miami -Dads County
Department o
Aug 051103:01 p BBF Construction 305 - 234 -4515 p.2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952104 Fax (305) 756.8972
INSPECTION'S PHONE NUMBER: (30S) 962.4949
BUILDING
PERMIT APPLICATION
FBC20
AUG 1 7 2011
Permit No. 111- C-A 1 1543
Master Permit No. (( SC1
Permit Type: MECHANICAL
OWNER: Name (Fee Simple Titleholdeerr V %..j LLt ... Phone#: 5 1.' D \\
Address: (ACS NE, a ck cote,
-
city: nor State: Crl.. zip: ?),5
Tenant/Le Name: Phone#:
Email:
JOB ADDRESS x501- '1546 N.C. ► a'
City: Miami Shores County: Miami Dade Zit): 33
Folio/Pared : 1� • 3' to - �
Is the Building Historically Dated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: as- rer \'It° coax .D d'o N Phone#: ' c� 'ea�y �4 $
Address: )09 b -6t
City: fl-+, & vet State � �- Zip: 51, S 1
Qualifier Nurse: ex O r D iT
Sane Certification or Registration #: C% =tC.. if) rt (.0 Certificate of Competency #:
Contact Ptrone#: 3tG -al -7, 3.9 Email Address: -V atilt. I Ai CA B1\ el c'S
Phone#: •��� -Q4��
DESIGNER: Architect/Engineer: Phone:
Value of Work for this Ram $ J QP Square/Linear Footage of Work:
Type of Work °Address °Alteration ONew CURepairlReplace
Description of Work: ereAsN.4 d vi co /\
Demolition
+ CSR ie 4F*t ?***** *t s**s iy 11e :11IP* * *** nkii #O Olt ************
Subudttal Fee $ Permit Fee $ /VCCF $ f:WCC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Traiaoinp{Education Fee $ Technology Fee $
Doable Fee $ Structural Review $
TOTAL FEE NOW DUE
\q)
Aug 051103:01 p BBF Construction 305 - 234 -4515 p3
Bonding Company's Name (if applicable)
le)
/Bonding Company's Address (��j}p
....'y Ste rip
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
eonstrcetion in thisJwisdretion. I understand that a separate pettnit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONBRS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in comp iance 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 conr!ition to the issuance of a building permit with an estimated value exceeding $23(10, 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 fob site
for the first inspe ) days after the budding permit is issued /sic the absence of such posted notice, the
inspection lli J f % I' a r N 1 _I + fee will be charged
or Agent
The foregoing instrument was acknowledged before e this / "73 The fo
day of o D . 20 jL, by c�(t' - (i ma 6,? day of
who is personally known to me who has produced
As idsntifiication and who did take an oath.
NOTARY PUBLIC:
Signature
Sign
Print:
My Commissi
a/ 0 �a
LIC -STATE OF FLORIDA
Yaniv Offir
Commission # DD795680
Contractor
instrument was ackno -. , before me
by
tat me or who has produced
as identification and who did take an oath
i10T�t� PUBLIC -STATE 0
.h+, Jennifer
NOTARY
Sign:
'l •
Irs,J',,,c■:n v,1
I Commission # Expires:
jt:m:;: / &R ires: )
;161:;) TTRU ATLANTIC BONDING
I
APPROVED BY
Qo l3
Examiner
Structural Review
(Revised ti7/H D7XRevised f6/10f20O9)(Revised311 )
Zoning
Qerk
Aug 051103 :02p BBF Construction
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PAGE. 2/ 2
CERTIFICATE OF UABILUTY INSURANCE °'°`""'°°""��'
8/8/2011
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PAGE:.
,mac ,i i? CERTIFICATE OF LIABILflY INSURANCE
NED AS OF INIFORISA
ONLY AND CORMS NO RIGHTS UPON THE OERTWHCATE
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11271 SO 1131S TER
WPM FL 33157 -4975
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Additional Insured
nasal Shores Vi1age
10050 North Welt god Avg
Miami Shores, FL 33139
CIERTFICATE HOLDER
Mia*1 Shores Village
10030 North Nest 2nd Ave
Miami Shores, L±7. 33139
SHOWS NO OF TIE NNW OEeossed RAMS ISCAapda6D ROM RN ANIAINTas*
boa tI P, ME asssao amain ram EmearNiPt TONAM -Mt OATS WIWI
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STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
MEERBOTT, EDWARD M
PALMETTO BAY AIR CONDITIONING SERVICE INC
10404 SW 187 STREET
MIAMI FL 33157 -4975
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.com.
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 Effidentiy, 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
MIAMI -DADE COUNTY
TAX COLLECTOR
140 W. FLAMER ST.
1st FLOOR
MIAMI, FL 33130
2010 LOCAL BUSINESS TAX RECEJPT 2011
MIAMI -DADE COUNTY - STATE OF FLORIDA
EXPIRES SEPT. 30, 2011
MUST BE DISPLAYED AT PLACE OF BUSINESS
PURSUANT TO COUNTY CODE CHAPTER 9A - ART. 9 & 10
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, MNO.231
•
568667 -1 THIS !$ NOT A BILL — DO NOT PAY RENEWAL
BUSINESS NAME/ LOCATION RECEIPT NO. 593124-2
PALMETTO BAY AIR CONDITIONING STATE* CAC1814776
SERVICE INC
10404 SW 187 ST
33157 UNIN DADE COUNTY
OWNER
PALMETTO BAY AIR CONDITIONING
Sec. Type of Business
m GAS FC MECHANICAL CONTRACTOR
MONNE= TM RECEIPT. IT
• DOES NOT PERMIT THE
HOWER TO A1
RREGU VIOLATE A
Y OR
MOM LAWS OF THE
COWRY OR tlt1E8. NOR
DOM IT EXEMPT 1118
HOLDER FROM ANY OTHER
PERINT OR LICENSE
MOMS° BY
NOT A T TIM OF
TM HOLDERS ovauPlcA.
P % TAX
08/17/2010
60030000553
000075.00
SEE OTHER SIDE
ti
t
WORKER /S
1
DO NOT FORWARD
PALMETTO BAY AIR CONDITIONING
SERVICE INC
EDWARD MEERBOTT PRESIDENT
11271 SW 181 TERR
MIAMI FL 33157
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