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MC-11-2209Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 167132 i Permit Number: MC -11 -11 -2209 Scheduled Inspection Date: February 27, 2012 Inspector: Perez, JanPierre Owner: Job Address: 102 NW 106 Street Miami Shores, FL 33150 -1248 Project: <NONE> Contractor: CENTRAL COMFORT AIR CONDITIONING CORP. Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Kitchen Hood Phone Number Parcel Number 1121360080010 Phone: 305 -598 -7575 Building Department Comments KITCHEN HOOD Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 24, 2012 For Inspections please call: (305)762 -4949 Page 13 of 43 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 BUILDING PERMIT APPLICATION FBC 20 M La ��� NOV 2 9 2011 BY:e Permit No. Pr/ ` ZO Master Permit No.2C (1- t l ZL ? Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): lkfa -W Phone#: 4'(3‘_ 335° 66iZ Address: t02 NW 1004 S1. City: ill 6;6..6 State: -F(. Zip: 3315 0 Tenant/Lessee Name: Phone#: Email: iNfo P tiviVai, jLAnJ . Ccrt JOB ADDRESS: 107— N) tOC14' 5k. City: Miami Shores County: Miami Dade Zip: 33150 Fouo/Parcel# i I- 2(3 i- CO 3— 00 i ■ Is the Building Historically Designated: Yes NO V Flood Zone: CONTRACTOR: Company Name: C12. :1-$4 Cc n' c :DA i II Phone#: `3 OS ;372'1575 S V oz.. & -L t2O State: V 10. zip: 331116 Qualifier Name: rf14,4 . Phone#: 0 21 1 1 5) 7 State Certification or Registration #: C-AC-c 515 t? Certificate of Competency #: Contact Phone#: 3- 2, S ;o 15 9 1 Email Address: DESIGNER: Architect/Engineer: Phone#: Address: 12� City: `1°1 4 A e Value of Work for this Permit: $ L\ 5a c." Square/Linear Footage of Work: Type of Work: ©Address DAlteration ONew ORepair/Replace ODemolition Description of Work: ** s***** ************** *** * * * *** * * * * **** **** a,******* *** * **** * ***** * ****** * ** * * ***s* Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUES 51 • I. 1. 1 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, BEATERS, 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 notke 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 notke, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before 'me this )-fn l day of Pave* lacy , 20114, by 1O r ( Rps who is personally known to me or who has produced D— As identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Co y omm. Commission # EE 12882 '''a,°; ; °` Bonded Tnrough National Notary Assn. ***** * * * * ***** * ***** * : ********** APPROVED BY The foregoing instrument was acknowledged before me this Al by e-33 day of who is personally known to me or who has produced VL 1 s as identification and who did take an oath. NOTARY PUBLIC: OA' 1-1 v Sign. Prm My t SHARON L. WILBANKS - State of Florida ... . : -r. et Co ,m. F�- p�t Through National Notary Assn. *** * * * *****sss* **ss ****ss* *****sss* * * ********esss aminer Zoning Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk O N co co 0 co 0 U U U 0. 0 vec Ut3 11 TAX "TM MIAMI-DADE R 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 387053 -3 "EMAr68410Y AIR CONDITIONING STATE rL!, , #7552 CORP 9721 SW 102 AVE RD 33176 UNIN DADE COUNTY whit TRAL COMFORT AIR COND CORP sec1ivgeIjen1MICHANICAL CONTRACTOR THIS 15 ONLY A LOCAL D 59 NOT PERMIT THEE HOLDER TO VIOLATE ANY 7Dt © LAWS OF THE it OR IT CINEB. NOR IXffiS EXE FT ThE HOLDER PERMIT PROM L OTHER REOtERE17 BY LAW. THIS 18 NOT A CERTIRCATION OF THE EFTS OUALIFICA- 2011 LOCAL BUSINESS TAX RECEIPT 2012 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 201E MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER SA - ART. S & 10 RENEWAL 1 404086 -1 PAYMENT RECEIVE& aIA1N ECOUNTYTAX &O1 07/12/2011 60050000465 000075.00 SEE OTHER SIDE WORKER /S 1 DO NOT FORWARD CENTRAL COMFORT AIR CONDITIONING CORP ALEX MARTINEZ PRES 9721 SW 102 AVE RD MIAMI FL 33176 FIRST - CLASS 1 U.S. POSTAGE PMD MAMI, Ft PERMIT NO. 231 I111 1,11111111111111111 111, 11111 1111,1N111111111It1111t t4 Dec 08 11 01:47p Central Comfort Air Condi i Li SJ /I AriIJ.A. FACOR 7'Y CERT" mammon (100225 -2280 Eastern United Insurance 175 Fontainebleau Blvd. Suite 2A-1 Miami. FL 33172 INSURE° CENTRAL COMFORT AIR 0721 SW 102 AVE. NO MIAMI. FL 33170 (305)281-7507 Eat. COVE3RA rEt` S THE POLICIES OF INSURANCE LISTED ANY REQUIREMENT, TERM OR MAY PERTAIN. THE INSURANCE AFFO POLICIES. AGGREGATE LIMITS SH WEN ADO I IMEIgALLtA81UTY COMMERCIAL. GENERAL LIAeLI .. LLV LLVJ 3055988210 p2 1--14 G. VA/ OY CATE OF LIABILITY INSURANCE ND1T1ONIN0, CORP. DATE (MIIWDef1'YyYI 12/7/2011 THIS CERTIFICATE IS ISSUED AS A MATTEL OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ALTER THE COVERAGE AFFORDED BY THE POLIC�f B OR INSURERS AFFORDING COVERAGE INSURe-RAe11ESTERN WORLD INSURANCE CO. INSURER II;;CASTLE POINT FLORIDA INS CO. NAAC M 13198 INSURER Q INSURER INSURER a FLOW HAVE BEENIBSUEO -' THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING • N OF ANY CONTRACTOR OTHER DOCUMENT WITH RE9P£OT TO WHICH THIS CERTIFICATE MAY BE ISSUED CR ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH V HAVE BEEN REDUJCEDSY PAID CLAIMS. POLICY Nu RUNNIER CLAIMS NAVE © oc c 14PP1322701 00/28/2011 09/28/2012 DEhi . A1313REGATE LIMIT APPLIES J1 I POLICY n n AUTSMOMMELIASIL07 ANY AUTQ ALL ammo AUTOS SCHEDULED AUTOS HIRED AUTOS NON- OYlMEOAUTOS OARAO6 UARILITY RANY AUTO EYD698AAA16RSI.LA UA@ILITT accup ED GO MB DEDUCTIBLE RETENTTWV S WORD OOMPEIi18ATION AIQ fie' u*I11LITY tl ANY wr-,IE RPp) ecunVE SPECIAL SONS Maw OTHER PREWSFS (Fp °miasmal U DEKE'(AllyorsPlasm) P6Re0N M. AACV IN.flARY NEMERALAeon :toe 100,000 s 5,000 s 1,000,000 $ 2,D00 000 1.000,000 PROOQCTS . CoMPIOP AGG $ W'700521900 OOM0IN ®SIMILE LIMIT (En eeaident) (PatPamon) RY ODDLYMNURY Per moiders) PROPERTY (Par =ANN) AWdIE AUTO ONLY - EA ACOtOENT AUTO OTHER THAN EA ACC E $ EACH OCCURR6NCG A OREOATE AGO 0 5 10/01 /2011 10/01F201a EL EACMAOCIDENT 1 e 100.000 W TL 11MTIYB i I ° $ E.L DISEASE- EAEa 100.000 EL DISEASE. POLICY LIMIT s ma, 000 DESCRIPTION OC OPERA/10NR / LOCATIONS / AIR CONDITIONING CONTRACTOR. $25 READ 30 DAYS IN LIEU OF 45. RAI PROVISION. BLANKET ADDITIONAL 1 CERTIFICATE HOLDER EJICLI SI ONS mow DV ®WOMBS A OPAL PNaingtrsmg 00 DEDUCTIBLE B.I. & P.D. PER CLAIN APPLIES. WRITTEN NOTICE FOR WORKER'S COMPENSATION SHOULD OF SUNROGATION APPLIES TO THE GENERAL LIABILITY POLICYY, PRIMARY AND NON CONTRIBUTORY MIAMI SNORES VILLAGE 10050 NE 2 AVE. MIAMI SHORES FL 33150 (305)758 -8872 Ext. PEHIIIr RUNNER RC1111- 37 AC OND 25 (2001108) CANCBAATION IsHOULP ANY OF THE ABOVE 0FBCRISED PDL IClEB 6E CAMXLLEn REFoRE THt EXPIRATION DATE manes, ma myna IME{IRCR WILL ENDEAVOR TO NAIL 145 DAVE AMMTEN NOTION TONE DBRHiROATE HOLDER MOVED TO THE LEFT, DDT FOILURE TO DO ec SHALL IMPOSE NOOSLIGA:IONORUAW . ,..- ,:r�:.. IMD Imam THE INBOREPL ITS AGENTS ON REPRESENTATIVE/A AuTACR48D REPHEBEEiTATNE CORD CORPORATION 1988