ME-02-99 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-196662 Permit Number: ME2002-99
Scheduled Inspection Date:August 07,2013 Permit Type: Imported Permit
Inspector: Perez,JanPierre Inspection Type: Final
Owner: IMPORT,IMPORT Work Classification: <NONE>
Job Address:41 NW 102 Street
Miami Shores, FL
Phone Number
Parcel Number 1131010180110
Project: <NONE>
Contractor: MONTESA SOLUTIONS ENTERPRISES INC Phone: (786)399-5406
Building Department Comments
INSTALLATION OF TWO NEW A/C Infractio Passed Comments
INSPECTOR COMMENTS False
permit renewed on 8/2/13
i
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-Inspection fee is paid.
August 06,2013 For Inspections please call: (305)762-4949 Page 27 of 39
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Named below IS CRRTIFXRD .0
Under the provisions of Chapter X199 'F �a
Expiration dates AUG 31, 2014 ;,.;�
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XONTkSA gOLUTXONS ENTMP=SSA t
501 SW 9 CT i �.
MIAMI FL 33174
RICZ SCOTT KEN�WON
GOVERNOR , DISPLAY AMSS..8�.�1R...€D BY WOW
07/26/2013 12:33 3056858056 GOLD COAST FREIGHT PAGE 01/01
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JEFF ATWATER
CHIEF FINANCIAL OFFICEg STA'L'E OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS`COMPENSATION
" CERTIFICATE.OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMt'EclvSATit'N LAW
CONSTRUCTION INDUSTRY EXEMPTION
This CErd ies that the itldivnibat listed Wow has elected to be exempt b6m Florida Workers'Cptti%pnn,k%(cr••Ir i=sw
EFFECTIVE BATE: 31112013 EXPIRATION DATE: 31111201-R
PERSON: CANO IA DUEL
FEIN: 208391714
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BUSINESS NAME AND ADDRESS
MONTESA SOLUTIONS ENTERPRISE INC
50 SW 80 CT
MIAMI FL 33174
SCOPES OP BUSINESS OR TRADE:
l• F-A- tN4.VENTILATION.
AIR-COND j
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per.on nmAw!On NM Cettt ootb t0 mW..the rNu ttr�,r nta a•htri�w•:Uor•
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07/24/2013 10:04 FAX Q001
CERTIFICATE OF LIABILITY INSURANCE 07/23/2013' '
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: If the Certificate older 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 enderst anent. A statement on this Certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
Cathy MCA& Insurance Agency Sac HONB (772) 934-6688 Fax ,(772) 934-6684
1046 UK Jeneen Bea b Blvd Atogmss,Cathy(Icathywftziux=anae.cm
INSUMM)AFFOROHNO COVERAGE tEc:S
Jensen Beach 1'L 34957- _ INSURM A REPUBLIC VANGUAVD INSURANCE CO
INSURED MpMMMY CONSTRUCTION LLC INSURER B;
200 SW >MONTMMY ROAD INSURER C;
INSURER D. _
INSURER E
STUART IrL 34994- 1 INSURER
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.
THIS IS To CERTIFY THAT THE MUCIES OF INSURANCE LISTED BELOW HAVE WEN ISSUED TO TI-F-INSURED NAMED ABOVE FOR THE POLICY PCRIOD
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.
T
LTR TYPE OF INSURANCE POLICY VUM99R UMITs
GENERAL LIABILITY 109902 7/2o/zoss 7 28/2013 EACH OCCURRENCE 1,000,000
X COMMERCIAL CENEP&UAML17Y ! / ! / PRIMIS IE S 100,000
CLAIMS.MADE Fil OCCuR / / ! / MEO EXN(Anv ona S 5,000
PERSONAL A ADV INJURY S 1,000,000
GEWRAL AGGREGATE _$ 2,000,000
N'L AGGREGATE LIMIT APPUC3 Pit: + ! ! / ! PRODUCTS-COMPION AGO S 2,000,000
7 POLICY PR LOC / ! / / NOVMD S
AUTOMOBILE LIABILITY �
ANY AUTO / ! / / BODILY INJURY(Per person) 5
All OVdvI-D SCHEDULED / / / / ( 1111 Y INJURY(Per ecddem) S _
A AUTOS
HIRED AUTOS NON-004(-M. / / / / pMer a firm DAMAGE _
UMBRELLA LIAR OCCUR / / / / IIACH OCCURRENCE S
EX015.W LIAR GIAIMS MADE / / ! / AGGREGATE 6
WORKERS COMP TION / / / / SLt TU
AND EWLOYERS'LUMaILnY
ANY PROPRIETORIPARTNGRf W9CUTIVE YIN / / ! / Ft. EACH ACCIDENT' S
M+tCktR1M EMBER EXCLUDED? n NIA _
(1110adatOry=NH' E.L,DISEASE-GA EMPLOYEE
IOEEC:RfPT 10 uOF OPERATIONS below _ / / / /
GJ..Offae-POLICY LIMIT
C GRiPTION OP OPERATIONS f LOCATIONS I VEMcL o(Atmah Aoow 101,AddManal Remeft seine.If more!:pace Is re uww)
CERTIFICATE HOLDER CANCELLATION
MIAMI SHORES VILLAGE BUILDING SHHW ILD ANY OF THE ABOVE DESCRIBED POLICIES ISO CANCELLED BEPOfm
THE EXPIRATION DATE THEREOF, NOTICE WILL BIM DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2ND AVE15M ®REPRWATATSVE
MXAMZ SHORICS IM 33138-
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Parcel Owner Report
Parcel Number: 1131010180110 41 NW 102 Street
Miami Shores FL
Tax[D: 1131010180110
Owner Information
FELIX REYES MARTHA HENRIQUEZ Current Owner: Yes Company: FELIX REYES &MARTHA HENF
Phone:
Related Permits Permit Number Application Date Expiration Date Status
Imported Permit BP2003-797 05/16/2003 01/01/2999 CLOSED
Imported Permit BP2003-968 06/16/2003 01/01/2999 CLOSED
Imported Permit ME2002-99 07/12/2002 01/08/2003 EXPIRED
Imported Permit BP2003-798 05/16/2003 11/12/2003 EXPIRED
Imported Permit EL2005-76 02/28/2005 01/01/2999 CLOSED
Residential Construction RC-3-06-696 03/16/2006 03/16/2007 APPLIED
Related Code Cases Case Number Case Status Case Date Compliance Date
Ordinance Violation CASE-5-10-7155 Case Closed 04/20/2010 5/22/2010
Ordinance Violation CASE-5-10-7156 Case Closed 04/20/2010 5/14/2010
Ordinance Violation CASE-5-10-7157 Case Closed 04/20/2010 5/4/2010
Ordinance Violation CASE-1-12-9488 Case Closed 01/19/2012 2/7/2012
i
Friday,July 26,2013 Page 1 of 1
a
Miami Shores Village
Building Department
10050 N22nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No -9 P,
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type:MECHANICAL
OWNER:Name(Fee Simple Titleholder): M A I-I-4h k2j fZl one#:
Address: 102 5'7_"
City: State: Zip:
Tenantl zisee Name• Phone#:
Email:
n
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historicaly Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: L�MJT(25A !�;O k V T1 OPO5 Phone#:
Address: 175 Z-S K)
City: ' A K6,1 State: 3�!1)
Qualifier Name:— 1.)6L 1C 0,�6 Ph ._=1 PS — 1107
State Certifi on or Registration#: CACQ 576'7<9— Certificate of Competency#:
Contact Phone i b i�--- Email Address:
DESIGNER:Architeaffingineer. Phone#:
Value of Work for this Permit:$ 1-60 f) Squam?IJinear Foo of Work:
Type of Work: Address OAlteradon ONew /Replace ODemolition
O
Des x*don of Work: TA.1 ,7-A6L&UQ,3 of) EM) AIL'.
w+�e+eaweee:r+s +x ee+swreev a e* s *ease a ----v*as
Submittal Fee$ Permit Fee$ I CCF$ C0 1CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ TrainingWAucadon Fee$ Technology Fee$
Double Fee$ Struemral Review$
TOTAL FEE NOW DUE$
- 131
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Tip
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 CONDITIONPRS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done m compliance with all
applicable laws regulating construction and zoning.
"WARMING 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 Si
Owner or Agent J� Contractor
The fore i g instrument was acknowledged be re me this �v The forego' strument was acknowledged before me this20'1-'
day of ,20 ,by day of 20 3 by__I' i JeSy�
o is nal <known to me or who has produced who is personally known to me or who has produced
gAs identification and who did take L- as identification and who did take an oath.
NOTAR P C. g�ti��F oS�aa NOTARY PUBLIC:
fill
to o� 2p15
e4 23.
Sign: E �2 P55° Si
Print: _env �omm�uu9�Nauo� Print:
My Commission Exp' °~' gQa
%;;�e of My Commission Nptary Public State of Fioflda
nen.r`'
Karen mmia
My Commission EE 847850
'W'r. Expires 10/30!2018
APPROVED BY P s Examiner Zoning
o.b.
Structural Review Clerk
(Revised 07/10/07)(Revised0611=009)(Revised 3/15109)
p a
Miami Shores Village
Building Department
g 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel:(305) 795 2204
AIR CONDITIONING REPLACEMENT DATA Fax:(305) 756.8972
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): y1 rJ LO S 1
City: Miami Shores Village County: Miami Dade ZIP Code:
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#
KW HEAT
NOM TONS
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 J / PKG UNIT
EERJSEER
YES NO REPLACING DUCTS YES NO
YES NO REPLACING THERMOSTAT YES NO
YES NO NEW 4°CONCRETE SLAB YES NO
YES NO NEW ROOF STAND YES NO
YES NO NEW RETURN PLENUM BOX YES NO
1. Minimum Circuit Ampacky(Wire Size):
2. Maximum Overcurrent Protection(Fuse/Breaker Size):
3. Voltage of Circuit(2081240/480):
4. Size Disconnecting Means:
Contractor's Company Name: Phone:
State Certificate or Registration N. Certificate of Competency N.
Signature Date: 7 b i
canner:slpawm o*)
July 26,2013
Miami Cool, Inc
2331 NW 39 Terrace
Miami, FL 33166
Re: Martha Henriquez and Felix Reyes
41 NW 102 Street, Miami Shores, FL 33150
Permit#ME2002-99(New AC Installation)
To whom it may concern:
This notice is to inform you that we have obtained a new contractor to service the above-mentioned
Permit. The permit mentioned above-has expired and we have decided to hire a new AC contractor.
Please note your file accordingly.
If you have any questions,please feel free to contact me.
Sincerely,
Martha Henriquez
Felix Reyes f.
41 NW 102 Street
Miami Shores, FL 33150
(305)788-2948
Cc: Miami Cool, Inc.
10980 Biscayne Blvd
Miami, FL 33161
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