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ME-03-62�P_ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-198911 Permit Number: ME2003-62 Scheduled Inspection Date: September 11,2013 Permit Type: Imported Permit Inspector: Perez,JanPierre Inspection Type: Final Owner: OWNER,Owner / Work Classification: <NONE> Job Address:9233 N MIAMI Avenue Miami Shores, FL 33138- . Phone Number Parcel Number 1132060130210 Project: <NONE> Contractor: SOUTHEAST AIR CONDITIONING Phone: 305-769-9959 Building Department Comments INSTALL NEW 3 TON A/C AND 10 W HEATER EXACT I Passed Comments INNSPECSPEC TOR COMMENTS False REPLACEMENT � L Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 10,2013 For Inspections please call: (305)762-4949 Page 23 of 28 Miami Shores e Villa �C D Village SEP 0 9 Building Department BYE 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 No. PERMIT APPLICATION Master Permit No-MC-2-00,3 --b-2, . FBC 20 Permit Type: MECHANICAL OWNER:Name(Fee Simple Titleholder): / Phone#: ®�� 7 li Address: C 1 /U /0 i City: T P S State: Zip: 3 l Tenant/Lessee Name: Phone#: Email: JOB ADDRESS• City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: � Vl,I/F t���v�f- fC --a Phone#. 3 � '76 l � Address:] 3, ,!?1 o ✓t✓� 6C� City: P""K c r State: F 1 Zip; -'S 16 Qualifier Name: �l v A �- t�'I Ph e#: fie%) 7 6�" ST State Certification or Registration#: 04C-01,5-11Y-7 Certificate of'Com ten #: Contact Phone#g�Y7-9 631 ('°t � Email Address: _ Sf-"I- g �0<,W c ; � DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew ORepair eplace ODemolition Description of Work: 1 . o-3 o?6 03 —6,2 L r V Submittal Fee$ O 0 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ ' d 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 not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20_,by day of �7,,20 JJ,by PWCL C who is personally known to me or who has produced wh is personally kno o me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Si Print: Print: My Commission Expires: My Co L Commi On#EE 175883 ® /�® Expires March 24,2016 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10 107)(Revised 06/10/2009)(Revised 3/15/09) DATE(MNMD/YYYY) C AC40REP� CERTIFICATE OF LIABILITY INSURANCE 12/20/2012 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(S), AUTHORIZED -PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ' ...'PORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS 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 CONTACT NAME: Gateway Insurance PHONE At No: 2430 W. Oakland Park Blvd. E-MAIL Fort Lauderdale FL 33311 ADDRESS. INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:FCCI Insurance INSURED SOUA102 INSURER B:B ' eld Casualty n Co 0 5 Southeast Air Conditioning Inc INSURER C: Attn: Ms. Nancy Smith INSURER D: 13840 N.W.6 Court .Miami FL 33168 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:647815680 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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 POLICIES DESCRIBED HEREIN IS SUBJECT fO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR I S POLICY NUMBER MM/DD MMIDD GENERAL LIABILITY Y GL 0003774 08 10/1/2012 0/1/2013 EACH OCCURRENCE $1,000,000 DA E To X COMMERCIAL GENERAL LIABILITY P EMIS S Ea ocaa D $100,000 CLAIMS-MADE a OCCUR MED EXP one rson) $5,000 PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 EN'LAGGREGATEJ IMrrMPI.JES 0 POLICY X PRO LOC $ AUTOMOBILE LIABILITY BINED SING LE LIMrF Ea accident ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS N6N-0WNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION 198-33714 /1/2013 /1/2014 We STATU- OTH- AND EMPLOYERS'UABIL17 F ANY PROPRIETORIPARTNERIMCUTIVE� NIA E.L.EACH ACCIDENT $500000 OFFICERtMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500000 If D es,desalbe under DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT 10050 N.E.2 AVENUE AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138 i)40 90 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD I a 1 L l •;T 1 r q xpmPx�o f I ;s a r yZt :! 9 ��,,,x. 1.. r"ark.lj,y „^ mf z; �� s* �`a v✓t 3+7 �' ;d a y7! °'s ,- kJ 4-�, t v,:,, r,�"x i,n' � 1���' µ C F" r r: •t� a �. ��. �)y a',�� `w'gia��'�"s r{��>,'���x7YF�'� ��"±r ,�4ux � �f � ����r ��*�r� �("'� r t r t ti �^,� a1 J 'H?yp [; 47� F{Q, A`�: ^.``1�,�$�':1Y� �4 �k• zR + � qt si �*��us-�4{'ar.�;�a ��*,��4�✓�t }F �7�i"�.- zt�F����pv;r'� ,�,�'t+,s��`u �� r,, +.r" ✓ a -t :'.r k ."µ 2 r' >' , ��r ■/�■ (/ e ( "�{�, '2tt(+�','1. s p�('t}� pgeyg(,{ a � � w"ItION k ly 3rt7'r }r8s4,r"i 4��TF'T' atil7y J '� �Sx4. ye� Pde1f, w " i �A}y��.pyy QT t =1kC �Fy 3YfE r�a�'4h tfi '� p { 441", E. j S_yll F R,ll6' L3iTE1112� °�i� •T Ti? , .'�-` •:. �' H4 - t v^4 Zaf i'd ' agf Pa v Tai� LEC/IT V ES AYg I CE P {SEC A R O /31196 S q m $)CAL C o $45.06,07, CAC01 X:1D 3 10 TXHS1W.-13 1 is not license. < al Bust ess Tax.The�e Recel 4 confirms BI~ IlI1k R{ g q1�, arty g emmeMel or TIT} a al Busin Tt1x of they ualdic ahe xd d Less Ho� �p ay�t�Aa4I��1(µw! MRt® r see ha�dei a uirem whichilg to the bulF ato la A x� Itode Seas pgrme a N1 rY ` r+r`cial veh�cl x �RECEIP 0.abovet edisplay � `g;,.::' �;,, <Permorriinformanon�vibft __ I §e i 1 y MENEM= • 620115342 TATS F FLORIDA 0 t' D3PART O S, CUI6N$ NA-TRY NIGDS D T O s Q#L12071700853 I: I!!el LI E SE R 07 10 ? 1; aQ1A0>3 4•'A ,rte g=M, Tlae .CLASS A ATR CQlDI ' O I C "Named b w IS CBRT >E TED ge t Under the provision off.. hQt� r' x a. Expiratio date: AUG-31, 2 14 ¢ �� ��di z t; SMITI PAUL M z i SOUTH EAST AIR `eONDIT O ING jN� 13 8 4 0 `NW 6TH :'CT 's MIAMI F 3 316 8 RI K SI~�TT i R�'N LAWSON ! G..VERNOR SECRETARY ,:. T i DISPLAY AS REQUIRED BY lAW _._.__—._.__....._._.d____ a City of North Miami AM I 776 N.E.125 Street North Miami, FL 33161 . 305-893-6511 Business Tax Receipt/Certificate of Use Issued Di its: 10/1/2012 SALES/INSTALLATION/REPAIR OF A/C&HEATING EQUIPMENT Expiratio I Date: 9130/2013 Business Tax Receipt#: BT-002381 Business Name/Address: SOUTHEASTAIR CONDITIONING INC 13840 NW 6 CT UTHEASTAIR CONDITIONING IN NORTH MIAMI,FL 33168 1 1840 NW 6 CT N DRTH MIAMI,FL 33168 Michael A.Etienne,Esquire,City Clerk • • BUSINESS TRANSFERED MOVED OR SOLD. NON-TRANSFERAB E • P, ST IN A CONSPICUOUS PLACE • NON-TRANSFERABLE 1 j PERMIT APPLICATIONJOR MMNU NMRES VILLAGE 19050 N.E.2nd Avenue•Miami Shores Flo$idZ31 %*-thon®:345-795-2204• Fax:305-756-8972 Date Job Address / 3 P•M/ i AWax Folio ti Legal Description H 1 41V` ® � Pkir , ,..caI j•Desig.til: •.Yes No • ••• y� , Owner/Lessee/Tenet M ® Master Permit# Owner's Address 902 a3_3 t •�. : : Vhar�e �.� % — k 3 /� • • • • • • • ?ZW / Contracting Co. �� S Cn std Q� a4 ss -'1 1 /� 3 Qualifier ki , - ' SS# OMs!Z Phone S ?I IF State# C_l-C Q1__S-q,r-7 Municipal# Competency# Ins.Co. ?I IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION.RE-INSPECTION FEE IS$50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: ``� �4 /a /�'� J,0, �e� --� �r IC /1 /ma c Square Ft. Estimated Cost(value 3,ntjo WARNING TO OWNER:YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above,and on the attached addendum(if applicable).I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.I understand that separate permits are required for all disciplines. OWNERS 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.Furthermore,I authorize the above named contractor to do the work stated. 31iG /43 Sign a of owner an or ondo President Date Signature of ntractor or Owner Builder Date Notary as to Ow d/o Condo President Date Notary,as to actor or Owner Builder e Date My Commission Ex ices /°����®� My Commission E ' !NANCY LEE SMITH ,r � , NANCY LEE SMITH MY COMMISSI(?N#CC 897690 MY COMMISSION#GC 897690 EXPIRES:March 24,2004 EXPIRES:March 24,2& x BmWed Thru Notuy Public Un&rw tars , ' .' Bomled ThN N�h( UndeawAfer9 FEES:PERM C.C.F „I,� _ NOT APPROVED: TOTAL DUF1 h e. 8 b Zoning Building Electrical Mechanical � 7� !'O� Plumbing Structural Engineer AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, -THE OWNER'S NOTARIZED SIGNATURI�•Na. D� 10Z�•JE:£•fgS •Ej1T ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL TEM UNIT FEE ITEM •'• ' UNIT PEE •ITEW UNIT FEE ATH TL6 SWITCH OUTLETS SPACE HEATERS IOET LIGJT aJTLETS • • • • • • • CENTRAL HEATING /0 R'w ISHWASHER RECEPTACLES • • • A/C (WIND) ISPOSAL SERVICE TEMPORARY' • ' • •• A/C (CENTRAL) RINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK LOCK DRAIN SERVICE REPAIRAUER CWGE REFRIGERATION REASE TRAP APPLIANCE OUfl.ETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNOERGROtW TANKS AVATORY OVEN ABOVE GROUND TANKS AUNORY TRAY WATER HEATER U.F. PRESSLRE VESSELS LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS hi'OWER MOTORS OVER 1- 3 FP HOT WATER BOILERS INK, POT/3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES INK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS _MPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS RINAL MOTORS OVER 25-100 HP COOLING TOWERS ATER CLOSET MOTORS OVER 100 HP VIOLATION DIRECT WASTES A/C WINDOW REINSPECTION ATER SUPPLY TO:, AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER-NEW INST. GENERATORS TRANSFONERS HEATER40LACE GENERATORS TRANSFORMERS LAWN SPRINKLER-WELL SPECIAL PURPOSE SWIMMING POOL CUTLETS COWGCIAL HATER SERVICE SIGN TUBES WER CONNECTIONS SIGN TRANSFORMERS iILITY--SEWER SIGN TIME CLOCK 'ILITY-WATER FIXTURES TTIC TANK ANTENNA _LAY TELEVISION OUTLETS UINFIELO, 4" TILE/RES. VIOLATION J%P & ABANDON SEPTIC TANK REINSPECTICN )AKAGE PIT CU. FT. JCH BASIN SONGE WELL 'NEST IC WELL !EA GRAIN :OF INLET ;LAR WATER DATER RE STANDPIPE al PIPING WN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING I Miami Shores Village Mechanical Permit KAMM & 10050 NE 2nd Avenue fell Permit Number: ME2003-62 Phone: 305-795-2204 fi,+toRri�'► Printed:4/22/2003 Page 1 of 1 Applicant: MICHAEL O'HARA Owner: O'HARA MICHAEL JOB ADDRESS: 9233 N MIAMI AVE Contractor SOUTHEAST AIR CONDITIONING Contractor's Address: 13840 nw 6 ct Local Phone: 305-769-9959 Parcel # 1132060130210 Legal Description: 153 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 10&11 BLK 2 LOT Fees: Description Amount FEE2003-2296 Building Fee $75.00 Total Fees: $76.80 FEE2003-2363 CCF $1.80 Total Receipts: $0.00 Total Fees: $76.80 Permit Status: Approved Permit Expiration: 10/13/2003 Construction Value: $3,000.00 l� r Work: Install new 3 ton ac and 10 kw heter exact replacement # -Z If there is no permit package accessible on the job-site for inspectors to verify,there will be no inspections. Re-inspection fee is$50.00,which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,drawings,statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents,servants or employees. Sign (INSPECTOR) BY: In cons' eration of the issuance to me of this permit,I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself,my agent,servants or employes. Signed: (Contractor or Builder) BY: 5 OR93F Gr << sjwta L�` O��t• BUILDING DEPARTMENT �CORiDA 1Ooso N.E. SECOND AVENUE MIAMI SHORES, FLORIDA 33138-2362 TELEPHONE:(305)795-2204 FAX:(305) 756-8972 GENERAL INFORMATION • HAVE PERMIT CARD & APPROVED PLANS ON SITE • PLEASE CALL FOR ALL INSPECTIONS AT (305)795-2204 Leave a message in our voice ALL PERMITS REQUIRE INSPECTIONS Miami Shores Village Mechanical Permit 10050 NE 2nd Avenue "...:.. Phone: 305-795-2204 Permit Number: ME2003-62 Printed:4/22/2003 Page 1 of 1 Applicant: MICHAEL O'HARA Owner: O'HARA MICHAEL JOB ADDRESS: 9233 N MIAMI AVE Contractor SOUTHEAST AIR CONDITIONING Contractor's Address: 13840 nw 6 ct Local Phone: 305-769-9959 Parcel # 1132060130210 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 10& 11 BLK 2 LOT Fees: Description Amount FEE2003-2296 Building Fee $75.00 Total Fees: $76.80 FEE2003-2363 CCF $1.80 Total Receipts: $0.00 Total Fees: $76.80 Permit Status: Approved Permit Expiration: 10/13/2003 Construction Value: $3,000.00 Work: Install new 3 ton ac and 10 kw heter exact replacement If there is no permit package accessible on the job-site for inspectors to verify,there will be no inspections. Re-inspection fee is$50.00,which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,drawings,statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility fora thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents,servants or employees. Signe : (INSPECTOR) BY: In consideration of the ssuance to me of this permit,I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself,my agent,servants or employes. Signed: (Contractor or Builder) BY: