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MC-13-2444Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 203468 Permit Number: MC -10 -13 -2444 Scheduled Inspection Date: November 25, 2013 Inspector: Perez, JanPierre Owner: EDELMAN, ALEX Job Address: 9999 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: Fire Suppression System Phone Number ()_ Parcel Number 1132060134490 Contractor: MARMICH AIR CONDITIONING INC Phone: (786)416 -4=491 Building Department Comments INSTALLATION OF NEW FIRE DAMPER Infractio Passed Comments INSPECTOR COMMENTS False f Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 202076. install screws as per plans 6" oc Failed Correction ❑ Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 22, 2013 For Inspections please call: (305)762 -4949 Page 24 of 33 Miami Shares Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (3055) 762.4949 BUILDING PERMIT APPLICATION OCT 2 9 2013 FBC ?6 IV zi Permit No. M(, / 3 Master Permit No. O C- J Permit Type: MECHANICAL JOB ADDRESS: 47 93 11 V e_ 2 City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): AIe_7L F4, enetG° Phone #:7 s 9,7 _ 03 �S' Address: F / s 2 % IV r:! z Ave City: r A C �� ®6�5 State: Zip: �?3l ? p Tenant/Lessee N Email: 1 col .S d CONTRACTOR: Company Name: / Aam i c-h Alit, 4)/017-10M MM M Phone #: 7d yl10 W`V1 Address: , /72 'S GJ 3 2 A "sle- City: t 1,r,,141gLj State: Zip: ;3 12- Qualifier Name: (L' A/49/e.67 '91)d AZ4 6,09F-r— Phone #: 305' X04' V 0' L1 State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engineer: 8 14 i 4- Certificate of Competency #: Email Address: lY14 rl)" ! C k 61 i a ella /too. E O 10, Value of Work for this Permit: $ a7- `0 0a �e-_- Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ONew ORepair/Replace ODemolition Description of Work: -i' A4TA -t (ATLVvi OF NCB 7=1;2-e PAM Ug r^ Submittal Fee $ Permit Fee $ 1,159 o CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE 45- V VVJ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address zip 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 Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY �� Signature (�:, ? Contractor The foregoing instrument was acknowledged before me this 2V day of 000�. , 20 t?3, by 0.�.A't 45 c2o 4Y1GW who is parsonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: � WSAHMW * * MY COMMISSION # EE 021558 EXPIRES: September 10, 2014 al ,. N ovr Bonded Thru Budget N* q Services Sign: Print: 2A I 1 t1 via K JA NJ My Commission Expires: 10 t p— i L/ Plans Examiner zoning Structural Review Clerk Revised 3/12 /2012 )(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Miami Shores village Building Department 90050 N.E.2nd Avenue Miami Shores, Florida 33938 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): 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 I I PKG UNIT I I EER/SEER 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 Ampacity (Wre Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature (Qualifier's signature only) Date: Local Business Tax Receipt Miami-Dade County, State of Florida 11 '1 ') W 8 BUSINESS NAME/LOCATION ,MARMIC-H AIR CONDMONING INC 25 �,V 32 ST HIALEAH., FL 33012 RECEIPT NO, EXPIRES RENEWAL SEPTEMBER 307 201 6917126 MU-st be PlaCe Of Pur,,tuw)l to (�'ouf)TY COd-? OWWR SEC, TYPE OF BUSINESS PAYMENT RECEIVED 7ON'l N C, A i 'E C M, E CHAN I 0 1_ BY TAX COLLECTOR 0DN1R-\C70R 41950 10/1! C14 C This L*cal Busimess Tax Rtc*01 only confirms payment of the Local Bilsiness Tax The Receipt is not a licenser # e ruit, or a C#46cation of the holder's qualifications, to do business, Holder must CONFIV WA ANY or son,# -,je tna#ntal r&jgIAt#ry laws and reqviromentS Which aPPIY to the "Sill "s, Tire RECEIPT N 0 above 0"t b# displayed 60 an co aearcial vehicles — M1,401—u4st tAge b0c *a—,c For more is4ruatJOR, vir,1t',N`Nw ""An"A" A.r**# :6.350121. -DZPA STATE T. QF FLORIDA niM OF � ' US1 SS AND PROFESSIONAL` R13 G.0 MRSTMC TION I RY: LTCENSTN7 BOARD 109/09./20 112:867449(6 CAC181479 5 The CLASS A..'AIR c k Named below 10 C-RITIFT'On' prov i.*ons r the st Unde hi of "Chapt Expiration date: AuG 31, 1014' -T �c RODRIGUE Z 'ES - X&RKICH' AIR:' CONDITIONING INC 725 WEST 32ND STREET.- HIALEAH FL 3301i"-2"%�- GOVERNOR DISPLAY AS REQUIRED BY LAW, N SEW L1209090012 KEN LAWSON SECRETARY R 01 -18 -2013 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION ATIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW ION INDUSTRY EXEMPTION that the individual listed below has elected to be exempt from Florida Workers' Compensation law. DATE: 01/18/2013 EXPIRATION DATE: 01/18/2015 RODRIGUEZ CHARLES 203051329 3 NAME AND ADDRESS: 4IR CONDITIONING INC ST FL 33012 i OF BUSINESS OR TRADE: ING, VENTILATION, AIR —COND IMPORTANT: Pursuant to Chapter 440 . 05041, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05031, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -161 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 CERTIFICATE OF LIABILITY INSURANCE F °A-M("""'�°'�"""' -- 1 10/29/13 THIS �C�RTIFICATE IS ISSUED AS A W-- ATTER OF INFoRIVIA TION ONLY AND CONFERS NO RIQHTS UPON THE Ct?RTIFfCATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEQATIVEI;Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT t JONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICA'11E HOLDER. _ IMPC>� NT: If pre cerElBCate holder Is en ADDITIONAL INSURED, I Ile pdiey(tee) mutt be endorsed. If SUBROtiATION 13 WANED, subject to the terms and conditions of the policy, certain policies may require in endorsement. A statement on this eRM11100e does not confer rights to the certificate holder In lieu of such andorsement(a). PRODUCER .. —• • -- N�E�T•. —. -- ... —.a. - ,I South pacific Professional Iris. PHONE �_(30S)825 -3535 — �iur�„ Nol:_— (300)825 - 5884 -- 500 K W. 49th Street p" SI?ETs lance{ hatrnail.cxrm Hialeah, FL 33012 — tNSURB) A oRDINa tRAVe — — ,• NUC a Phone (305)825-3535, —. .— Fax (306)825.5894 — — INSURER A I GRANADA INSURANCE COMP_ — - - —. — — i NWIREP INSUREk IS — —• — — —. —. .I MARMICH AIR CONDITIONING, INC. e48URER C 725 West 32 St ��� � • - .-- .--.. --. .— —. '. —' I Hialeah, FL 33012 305 INSURER E: L INSURNA L-_ i COVt:RAGES — —_ CERTIFICATE NUMBER _ _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF IN5URANGE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FUR I HE POLICY PERIOD INDICATED, NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT151CATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANC E AFTORDED BY THE POLICIES DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHCI' HAVE BEIlN REDUCED BY PAID CLAIMS. — UK - TYPE OF INSURANCE_ — — P �LICY NUMBE'!t POLICY OFF (M Y _ —, — LIMITS. ! i GENERAL L.IASILITY EACH O CgU—R $ 1,000 =OCQ.W DAMAGE TO R[=NTED S 1 DO_000.00 —_ L,1 COMMERCIAL GENERAL LIABILITY REMti+SS LF8 . M-- ` �] Ll CLAIMS -MADE [� OCCUR GL -0186F L00030778 MED EXP Imo— POET) $ 5,000.00 i A Ll — — — — 10127/2013 10/27/201 PERSONAL &ADVINJURY $ �.1000,ow•00 ❑ — — — — OENSRAL AGGREGATE s 2,000,000.00 OWL AG13RtGATE LIMIT APPLIES PGR PRODUCTS - COMP /OP AGG ¢ 2,0001000.00 U POLICY .. Cppq ®iIVED 8ING6.� LuND , AUTOMOBILv LIABILITY Ee aSnt•) -- I U ANY AUTO BODILY INJURY (Per POM-) S _ T- 1--� ALL OWNED r i SCHEDULEP BODILY INJURY (Par ecddsnt s LI AUTOS U AUTOS PRR0 �AWIAOE ❑ HIRE �,J AUTp WNED — — — ❑ _ _ C-1. -- — — . —.. — . -_ — __. — — — S . —. umBRELLA LIA6 ]OCCUR EACH OCCURRENCE .— i- ❑ EXCESS Lt" — n GMM -MADE L L DED u RfiT@N'I ION• —, WORKERS COMPENSAVOIN AND EMPLOYERS' LIMILITY YIN ANY PROPRIErORIPARTNERIFXECUTIVE MIA O ICERIMRMBER EXCLUDED? (eatery in NMI .� B x, �rlbe under' U SCRIPTiON OF QECRA rM§ below AGGRILGATE If &SSTAL jjjj��jjpp p E1. EACH ACC=M- T _ E.L•, DISEASE " PLOYE S — E.L_D�SUSE- POLICY LIMIT $.. „— J_ _ _ 1 L l— _ _ _ I — —. .L —. I -- —• — • —• —.. DESCRIPTION OF OPEkATIONS I LOCATIONS / VEHICLES (%+Nch ACORD • Al, AdfiBenal Remarlas Schedule, It mars epe0a Is requimd) CERTIFICATE HOLDER — — —_ — — — — CANCELLATION — CITY OF MIAMI SHORES 100 NE 2 AVE MIAMI SHORES, F1.33138 SHOULD ANY OF THE A THE EXPIRATION DATE ACCORDANCE WITH Th AUTHORIMD 1WRESE _ —1300- 756-8972 01988 -20' ACORD 26 (201 0106) OF The ACORD Td Wd8S:tiT RTOZ 6Z '1.00 t769SSZ8S02: 'ON XUJ I CIES 13E CANCELLED 13EPC V. lL BE pELtVi;R6D IN IS. r — — — �- i PORATION—All fights rose 1,10d- are reglstwed marks of At I I:)RD i I I 80NuanSN I ddS : W0Nd W) Miami shores Village Building Department RECEIPT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 PERMIT #: 0 e- (3 — c0 DATE: / ®�� /�� W 71A o Contractor o Owner o Architect Picked up 2 sets of plans and (other) Address: ff F rG - '2-,+ Vic �� o -3//" From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAI Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 October 30, 2013 Permit No: CC13 -2444 Mechanical Critique — Jan Pierre Perez need Miami Dade Fire approval Plan review is not complete, when all Items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from plans . replace with new revised sheets and Include one set of voided sheets In the re-submittal drawings.