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MC-13-1562 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-195159 Permit Number: MC-7-13-1562 Scheduled Inspection Date: September 25,2013 Permit Type: Mechanical- Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: A/C Replacement Job Address: 10275 NE 2 Avenue Miami Shores, FL Phone Number Parcel Number 1132060134900 Project: <NONE> Contractor: MAGIC COOL AIR CONDITIONING Phone: 305-556-9620 Building Department Comments r CHANGE OUT 10 TONS UNIT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 24,2013 For Inspections please call: (305)762-4949 Page 11 of 37 t a Miami Shores Village 1 jU, 12 `�+� �3115 Building Department ` ooev000 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ���00000moomooe® Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 -- BUILDING Permit No. PERMIT APPLICATION Master Permit No. FsC ao Permit Type:MECHANICAL OWNER:Name(Fee Simple Titleholder): (' 14 E tri Lop p r"` Phone#: Address: City: ya.21 2>,Sc.0-4 r� State: Ft c d-r' b-CD Zip: TenanAxisee Name: Phone#: Email: x e , JOB ADDRESS: 10a--7'5 N 6, D City: Miami Shores County: Miami Dade Zip: 351 a T Folio/Parcel#: )I - 6" �� -let Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: .C'Oke 1- A -In a 1,-;t•'I f:!° Phone#:. 6-5 6t I k4-� Address: ! jJ City: o e- �fr b�w� State: Qualifier Name: 0£0...e t c. o C. Phone#:.45P5'-4J V 93� State Certification or Registration#: �� �'�p(®�I Certificate of Competency#: Contact Phone#s'06-65L -,v,a- Email Address: rnoo= O&' t �° • wry, DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ �°! 0 0. O® Square/Linear Footage of Work: Type of Work: OAddress- '}` :QAlteration ONew 11kepair/Replace ODemolition Description of Work: ®Lr t 0 '7ooa-� a 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 DUE$ ° I {� 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 tarn be approve and a�freeiinspection fee will be charged Signa Owner or Agent ontracto The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I day of---L—,20 -i3,by )Aft/m,A4 Nl 'I day of =1� ,20 -*>,by_�M A-40 CL y , who is pers nally known to me or who has produced who is personally known to me or who has produced ,f As identification and who did take an oath. y5prso as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign. s; � �: Print: is 1 V WAN DIVAN! Print: S C d-n-CeLs ., My Commissio ,ro � = Notary Public•State of Florida i My Comm.Expires May 29,2016 My Commission l� CARLASJ.tORRAI.ES Commission t/ EE 203163 . MY(�1MMISSION#EE 169478 s � '~rough Nat1ona�No!ary Assn EXThruNoMarch icUrde 8 Bonded ThN Netary!PUbIIC UrldBMllitBfB APPROVED BY 71/9 7 Mans Examiner Zoning Structural Review Clerk (Revised 07/10107)(Revised 06/10/2009)(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(where the work is being done): r of-7 S' IV E `�Ad c- City: Miami Shores Village County: Miami Dade Zip Code: 3.51--59 ALL CONDENSING 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 ARI(AHRI)DATA SHEET REQUIRED Change Disconnecting means:YES ❑ NO❑ ARHI Sheet Attached:YES❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG.UNIT MODEL# COND.UNIT MODEL# KA yfL- -I a0 KW HEAT Jv p"E- NOM TONS ?"or-. AHU CU PKG 1 M.C.A AHU CU PKG AHU CU PKG 2 M.O.P AHU CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / I PKG UNIT / I EERISEER YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YES aw YES NO NEW 4"CONCRETE SLAB YES N YES NO I NEW ROOF STAND YES N YES NO I NEW RETURN PLENUM BOX NO ..1 Minimum Circuit Ampacity(Wire Size): 3 P14 &0 A I T y 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 60 �9 1" 3. Voltage of Circuit(1480): 4. Size Disconnecting Means: 6 0 "qmp Contractor's Company Name:4Arac�Col- k%e &.%b Y Ser✓ ,�i�e_ Phone: _5 � 7 State Certificate or Registration N.eiC- J !to Certificate of Competency N. Signatu Date: 07 X uw e natwono MAGIC COOL AIR CONDITIONING &SERVICE Inc. 9821 NW 8&Ave Bay 5 L Hialeah Gardens,FL 33016 Phone:(305)556-9620 Fax:(786)664-6589 e-mail:magiccoolair @msn.com FAX COVER To: ev; From: 4N i 0,0,0/— A ✓�b+-n o �-° "� c e f 1 Fax Number: (�®6) 7 Phone Number: 0 �) -7 �` o Number of Pages including Cover: A/ Date: 0& Reference. Urgent: For review: Please reply: Comments: `d'/ -'• d� e 40� ,— ' Magic Cool Air Conditioning and Service Inc. 9821 NWt Mh Ave.Say SL Hialeah Gardens,FL 33016 PROJECT DATE ESTIMATE NO. 6151 2023 )P08/2126 NAME I ADDRESS Ship To AGM DEVELOPMENT AGM DEVELOPMENT 675 Harbor Dr 675 Harbor Or Key Biscayne,Fl.33149 Key Biscayne,FL 33149 DESCRIPTION QTY COST TOTAL JOB-10275 NE 2nd Ave 900,00 9,8W.Wr New split system of 10 tons p m 3pm 209 23o v with electronic damper and thermostat, Include-Hook-up to existent electrical,hook-up to existent ducts,, hook-up to existent drain lines Sales Tax 0.00% 0.00 Thank you for your review and approval TOTAL Magiccool Other None MagIcCool, Other None Plans Roof Cubs Permits Pitch Pons Equipment sleepers Crane&car Piping Rairis Duct&Grills Piping Cond Electric Power Air Bal.by Electric Con Cutting Foundation Patching Terms and Conditions of this Contract.all pens,materials,equipments and other property sold or supplied here under shall remain Personal property,and title shall remain vested In Magic Cool,until the purchase price has been paid in full,pursuant to terms above set fwth,or within(10)DAYS of rendering an Invoice. In the event custorner falls to make his payment by the due date,MAGIC COOL may,at its option are the entire purchase price due and payable, and can remove all parts,materials,equipment and property supplied. Customerwill hold Magic Cool harmless for anV damages resulting from such actlwL MAGIC COOL is not resoonsible for narts.materials.or eauloment not furnished by them.and all guarantees are limited to the manufacturees warrandes. Any labor at materials required in addition to the above proposal,due to reasonable changes in job conditions or for replacement of worn or defective parts that were not noticed at the initial inspection,shall 0 Invoiced separa*and In addition to the above amounts. in the event customer deftults,he shall pay interest on aid balance at the rate r annum from date of default,and all reasonable attorneys fees Incurred In the event an attorney is retain to eenfo collection. s distr ment c I e entire agreement between both parties and Is NOT affettive until acceptance by Magic Cool. MAGI ot ben stable r f !lure arnance occesioned by strikes.accidents or delays caused by conditions wood their control. Or, MAGIC OL CUSTOMER SIGNATURE A # .61569 STATE OF FLORIDA,. DEPART 0 � I ' , ROI r S� lNAL� TION SE CL12060800618 NBR,:,L 06 .08 zi012: 1104213 . : CAIr:059 4 The 'CLASS A AIR C QMITI ONING, C Named.below 13 CERTIFIED. UJnde* r the ,pr6visi6ris o£ Chept' r 4 Expiration date: AUG 31, 2014 PORTEL-T REII+AL O C MAGIC CpOL A/C"` i g5A' Cli` IN . 9821 NW 80TH AVENUR -<HA` 5r-L '. HIALEAH GARDENS Ft 330i6S `' U { K f RICK SCOTT+ ON GO -ERNOR ., CH Rr DISPLAY AS RE ,., x A� 152975-0 TM l$fWrA BU--10 NOT PAY Ct1NDITTIING STATE ti & SERVICE INC 9821 KW 80 AVE 5L 33016 HIALEAH GARDENS o IC COOL AIR COND &SERVICE INC '001VIAMCHANICAL CONTRACTOR WORK 10 g iS V A LOCAL. TAX rawsm.R cm wr PMW "m HOLM TO VMATE AM sxr . DO MOT FORWARD FMQLqM BY ANY 01111 LAW. MAGIC COOL AIR CONDITIONING NW A CERTW=T=OF UW HOUM" & SERVICE INC REINALDO C PORTELLA Mmirwowwmm 9821 NW 80 AVE 5L TAX HIALEAH GARDENS FL 33016 07/17/2012 60100000172 g 000045.00 �ISl�asellsltsss►ea� a� stsa�eItsflsss� stis���s111#11e�j P'Ll SEE OTHER SIDE _ Y a OP ID:C6 CERTIFICATE OF LIABILITY INSURANCE °A 6106/2 /3 06/06/2013 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 Phone:305.364-7800 CONEa BROWN&BROWN OF FLORIDA INC Fax:305-714-A401 PHONE FAX 14900 NW 79th Court Suite#200 Miami Lakes,FL 330164869 E-MAIL . House Accounts PRODUCER CUSTOMERID&MAGIC-6 INSURER(S)AFFORDING COVERAGE NAIL# INSURED Magic Cool Air Conditioning& INSURER A:FCCI Insurance Company 10178 Services,Inc. INSURER S; 9821 N.W.80th Avenue 0 5L Hialeah Gardens,FL 33016 INSURERC INSURER D: INSURER E INSURER COVERAGES CERTIFICATE NUMBER: 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBR TYPE OF INSURANCE CY N B POLICY EFF POLICY EXP LIMml GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMIS $ CLAIMS-MADE F—I OCCUR MED EXP one parson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY Jp L� $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea aaident) ANY AUTO BODILY INJURY(Per person) $ ALLOWNEDAUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY HIREDAUTOS (Per )AMAGE $ NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION WORKERSCOMPENSATiON X WCSTATU OTH AND EMPLOYERS'LIABILITY A ANY PROPRIEfOR/P� YIN 55201 03/31/2013 03/31/2014 E.L.EACH ACCIDENT $ 500, OFFICERIMEMBER EXCLUDED? F-1 NIA I(IfM�endatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500, describe-d DESCRIPTION OF OPERATIONS I I I I EL.DISEASE-POLICY LIMIT $ 500, DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLE$(Attach ACORD 107,Add UmW Remarks Sdmdut%M more apace is mW*od) CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shore SVilla a THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 Northeast 2nd Avenue AUTHOR¢EOREPRESEWATW Miami Shores,FL 33138 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD _._.....__._ _.. __... DATE 1Dm! CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A(MATTER OF INFORMATION PRODUCER Southem Star Insurance Agencq,Inc ONLY AND CONFERS NO RIt3H3 UPON THE CERTIFICATE OR 8338 SW 8th Street ( HOLDER.THIS CERTIF9E—:!rrn� NDBELOiAI I Miami,FL 33144 L ALTER THE COVERAL3 AIL# Phone (305)498-0079 Fax (305)262-2647 INSURERS A CENdANT _ __ ___�_-� INSURER A INSURED MAGIC COOL AIR CONDITIONING&SERVICE,INC INSURE ER 8 9821 NW 80 Ave SAY 51. INSURER C: Hialeah Gardens,FL 3301$- INSURER D: INSURER E: INSURER F: STANDING COVERAGES _ f THE POLICTERM ORLICONDrnON OF ANY CONTRACTOR OTHER NAMED N7 NTH FOR v*nCHH THIS CERTIFICATE NV1Y Be ISSUED OR ANY REQUIREMENT, I MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I5 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH i POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED .� ��CY ADO L TYPE OF INSURAt4CE EACH OCCURRENCE 1.000•0 GENERAL LIABILITY k ` 100,000.00 1 `®cana+nERCIAI.G�NERAL LwannY GL-20998 y 1210912 1 12AW13 PRENnSES E oo� nc� 8�(M.00 l MW EXP(Any one person) ❑❑ CLAD MADE l� OCCUR 1 PERSONAL&ADV INJURY 1.�0,�O.Od IA ❑ f - , GENERALAGGREGATE 1,OC�,oa_o.0o_� PRODUCTS-COMPIOP AGG 11,000, -00 ❑ , �-- GEN'L AGGREGATE LBAIT APPLIES PER:` �� W POLICY j PROJECT ❑ LOC II COMBINED SINGLE LIMIT I AUTOMOBILE LIABILITY I(ft accident? I { y❑ ANY AUTO I ( BODILY INJURY F ', ALL OWNED AUTOS 1 I I❑ SCHEDULED AUTOS I aODILY INJURY HIRED AUTOS ( I :pRopERTY aaident) S❑ NON OWNED AUTOS ( J !?A<1AAGE --JAUTO ONLY-EA ACCIDENT GARAGE LIABIU ITY OTHER THAN F.A ACC ❑ ❑ ANY AUTO AUTO ONLY: AGG EACH OCCURRENCE ---I EXCE �REL1A L � � � AGGREGATE O� ❑ C� DEDUCTIBLE ��- 1❑ RETENTION $ FE.L.WOR C�LbMp9 ATION AND T OF�Y PROPME�MaER l�(AC UDED? CUTNE MPLOYEE �y R yes,describe under E.L DISEASE.POLICY LTIAIT SPECIAL PROVISIONS below ------�'� OTHER y I DESCRIPTION OF OPERATIONS l LQCATiON8 J VEHICLES t p(CI„USIONS ADDED BY ENDORSEMENT!SPECIAL PROMS (_ CANCELLATION CERTIFICATE HOLDER — OI.IC*S BE CANCELLED BEFORE THE SHOULD ANY OF TF�ABOVE DESCRIBED P EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL H ENDEA VOR TO O 30 DAYS VRTN NO'nCE TO TE CERTIMCATE HOLDER NAMD T�\ MIAMI SHORES VILLAGE ` T LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO oWQATION OR LIABILITY y BUILDING DEPARTMENT ��7'IND UPON THE INS ITS AGENTS OR R(BrRESgdTATNEB. 10050 NE 2ND AVE RUED RE PRESiiT MIAMI SHORES,FL.33138 —�— ROBERTO OJEDA —_ _---- --_ ®ACORD CORPORATION61986 4 ACORD 25(20011118)QF