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MC-13-1140Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 196067 Scheduled Inspection Date: July 31, 2013 Inspector: Perez, JanPierre Owner: BLANCO, CHRISTIAN Job Address: 1360 NE 103 Street Miami Shores, FL 33138- Project: <NONE> C� r Permit Number: MC -5 -1.3 -1140 Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: A/C Replacement Phone Number (754)214 -2875 Parcel Number 1132050300070 Contractor: NAVARRO PLUMBING & MECHANICAL CO Phone: (305)244 -5832 Building Department Comments REPLACE TWO AC UNITS Infractio Passed Comments INSPECTOR COMMENTS False _Z 3 111,3 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 195237. CREATED AS REINSPECTION FOR INSP - 194425. CREATED AS REINSPECTION FOR INSP- 191992. 1] new a/c system installed for east side of house need plans 2] c /u's install below flood levels jpp need revised plans Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 30, 2013 For Inspections please call: (305)762 -4949 Page 18 of 31 Miami Shores Village_ Building Department Ln Y I 2glg � 10050 N.E2nd Avenue, Miami Shores, Florida 33138 Te l: (305) 795.2204 Fat: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 2011 Permit Type: MECHANICAL Permit No.M C) 3 -119 0 Master Permit No. OWNER: Name (Fee Simple Titleholder): l ail AtJ ZLA+3C,-9 Phone#: 7S`'- 41 i4- Address: I o cz W3 ST_ City: C�1► 9�1► --ko State: VL404t DA gip; , 313 � Tenantllessee Name• Phone#: Email: JOB ADDRESS: City: Miami Shoes County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Company Name: �0; l d �o d Address: City: a Qualifier Name: NO Flood Zone: It" Zip: P'hone#-. -05 2 U41 State Certification or Regist ation #: OZ91C /G ;� _Certificate of Competency #• Contact Phone#: ( Email Address: DESIGNFRe ArchitectlEngineer: Phone#: A Vaib a of Work for this Pe idt .- I Square/Linear Footage of Work: Type of Work.: ;13Address ( Alteration ONew epair/Replace ` DDemolition x Submittal Fee $ Permit Fee $ 190 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ _ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ X17-1 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 dip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or iyfstaliadi n 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 WO1�K, PJ,UMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIO�TW, 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 oft ' e of commencement and construction lien law brochure will be delivered to the, person whose property is subject to attac nt. Also, a certified copy of the recorded notice of commencement must be posted at the jolt site for the first inspe ion hick occurs seven (7) days after the building permit is issued. 1 the absence of such posted notice, the inspection wildio fb roved and a inspection fee will be charged Signature Signature or Agent Contractor The foregoing ins mebt was acknowledged before me this The foregoing instrument was acknowledged before me this day of aQ% 20/3 by day of 20 /, �, by / C who is sonally kno to me or who has produced who i erson�ly kno to the or who has prodooed_ As identification and who did take an oath. NOTARY Print: — ),O-se- 25I�G� My Commission Expires: APPROVED BY Notary Public - State of Florida My Comm. Expires Nov 27, 2013 Commission # DD 912225 (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Plans Examiner Structural Review NOTARY Sign: X--l' Print: ' My Commission Expires: JOSE EIRIZ Public- e of Florida w-Ekpires Nov 27, 2013 nission # OD 912225 Zoning Clerk r � Miami Shores Village Building Department 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) :_�> City: Miami Shores Village County: Miami Dade Zip Code: 4 / 9 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 I3 ARHI Sheet Attached: YES NO ® Contract Attached: YE fEk ��.. `Minimum Circuit Ampacityr (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (20812401480): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration��° Signature (QuaWs signature only) -�r— Phone: of Competency N. Date: , 0 UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER t- o C Q 14 AHU or PKG. UNIT MODEL # COND. UNIT MODEL # L V4 M f 221 -1 A KW HEAT NOM TONS AHU CU PKG 1 M-CA AHU CU PKG AHU CU PKG 2 M.O.P AHU CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / / PKG UNIT I I EERISEER REPLACING DUCTS S NO YE 0 REPLACING THERMOSTAT YES NO 11WS NEW 4 °CONCRETE SLAB NO I NEW ROOF STAND S N YES 0 NEW RETURN PLENUM BOX YES lf� 71 ��.. `Minimum Circuit Ampacityr (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (20812401480): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration��° Signature (QuaWs signature only) -�r— Phone: of Competency N. Date: , 0 030 -- 00 JUL 1 0 2� AIiani Shores Village `II 13 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (3�0S) 762.4949 BUILDING Permit No. PERMIT APPLICATIO t Na. //7P' F ZC 2 0 . a u3 ai'a PerMit Type: MIECHANICA OWNER.- Name (Fee Simple Titleholder): 2 Addre ss: 105 5-!r city: /7 State: Tena4.eksde Name. Phone#-. Email:, e JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Foliolpamit 3 Is the Building HistoritaIly Designated: Yes NO Flood Zone: Name: City: -3z)5 �sj Sf('3Z-- Zip: 33 z -2i Qualifier Name: Uh Phone#. 3:6�,e 5k 2/7 State Certification or Registration 2-5 00 q 5,—cerdficate of competency ContactPhone#. 305 Zq(t 5 &)Email Address: DESIGNER: Architect/Engineer: Phonet "New Mepaidlkepkc& -TOWWork: bAddr, UAlteration CIDemolition. 4)!*a*0d1iof'Woz* ..� I 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 $ 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 7,1&? ' of commencement and construction lien law brochure will be delivered to the person whose property is s * ct to attachment Also, a certified copy of the recorded notice of c nvneneemeni must be posted at the job site for the first inspecti which occurs seven (7) days after the building permit is issu In the absence of such posted notice, the inspection will no�be proved a��n44d /reinspection fee will be charged. or Agent Contractor The foregoing instrument was acknowledged before me this day of : 201-3—,by ly known to me or who has produced As identification and who did take an oath. NOTARY Sign: Print: My Commission APPROVED BY JOSE EIRIZ Comm. Expires Nov 27, 2013 (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) The forego' g instrument was acl¢m ged before me this day of U 20 a by 1 who is personally known to me or who has produced, as identification and who did take an oath. NOTARY LI :�r�ivaat� Sign: Print: My Commission Expires: Examiner Zoning Structural Review Clerk Miami Shores village Building Department 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): 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 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Mean; Contractor's Company Name: State Certificate or Registratio N. A Ll 12,5 6e9Ci'1' C)rWcate Signature (Quenees signature only) of Competency N. Phone: y S �C 5,f3'l,,, Date: 6> r 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 1 / PKG UNIT EERISEER 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- I YES. . . . NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Mean; Contractor's Company Name: State Certificate or Registratio N. A Ll 12,5 6e9Ci'1' C)rWcate Signature (Quenees signature only) of Competency N. Phone: y S �C 5,f3'l,,, Date: 6> r ril X� 9 I Miami shores.viflae'le I �w APPROVED aY DATE- lb 'CiNIIVG DEPT 0, IG !-� E ?" T GT M "()MPI. IANICAE)AYITH ALL FEDERAL 1! T! 0 N 9 Js -Fd RVIZu bDk]Li %O tia'a . 0:6ftl - I.A01y Pl DDLum . -f® E ,orjiP Lf-4o d e AiLI k9 i 6 L BOX D,O,U I T© Glo.40 Foa. ko7nRsi fag 60,t it LI SOO to Rift E) J AOUJn1 PIFRlI, &UA1OYLi DJU T Vit Zd 14��j tS U!�a,-ni Shores villafla P P- !--i OV 17 D BY DATE I rN T Cleo �b LN WA. tz CB Tc _ .eo cl, 4h l Ica-" e� Zt 6N 046 .4 14��j tS U!�a,-ni Shores villafla P P- !--i OV 17 D BY DATE I T Cleo WA. tz CB Tc 4h l 14��j tS U!�a,-ni Shores villafla P P- !--i OV 17 D BY DATE I T WITH ALL FEDERAL ---------- dSFJ Poralz N ,OD&JIJ 70 LIn4E� PIP doruR, . ?® r�llra7P< M -� i it I a 1. ft►O f xl/Tlxv� 07rrald ,Ivmcu 71 $O9 5P1avj. rm17tNT '8°.4 41791.7 ®1. rwmvgP X08 P►O�X�C►no� ,u�r/p. %JIAVARRO PLUMBING & MECHANICAL CONTRACTORS, Residential - Commercial Miami Dade - Broward - Palm Beach CMC1290045 7445 SW 153 PL. PHONE: 305 - 244 -5832 MIAMI, FL. 33193 Proposal To: CHRISTIAN BLANCO Date: May 15, 2013 Address: 1360 NE 103 ST. Phone: 754 - 214 -2875 MIAMI SHORES, FL. 33138 Project Name: We propose to furnish all material and perform all labor necessary to complete the following: INSTALL 2 RHEEM 3.5 TON A/C REMOVE EXISISTING A/C INSTALL 2 NEW DIGITAL THERMOSTATS We propose to furnish material and labor, complete in accordance with above specifications, for the sum of: THREE THOUSAND SIX HUNDRED 00 /00 Dollars $ 3,600.00 Payments to be made as follows: 50% do 50% upon completion Contractor's signature: Date: .f 7 !3 Acceptance of proposal - The above price, specifics ' and conditions are satistactory and are hereby accepted. You are authorited do the as specified. Payment will be made as outlined above. n Owner's signature: IL4p Date: -rz /7/ /3 OP CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: (f Vi tZ1 PERMIT # rn c�' I ADDRESS: I Y., P I fJ,� .S + (' 1 S go uz t f.. S`3 k 3 FOLIO NUMBER: r (� 2' ®�'' �° 3 ® FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) —� TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed):, VALUE OF PRINCIPAL STRUCTURE a ach a raisal): OWNERS SIGNATURE: DATE: `, J)3 PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 a - t r Property mtormation: Primary Zone: 1300 SGL FAMILY - 2801 -3000 SQ CLUC: 10001 RESIDENTIAL -SINGLE FAMILY Floors 2012 1 Living Units $299,633 1 Adj Sq Footage: $353,949 3,513 Lot Size: $653,582 10,170 SQ FT Year Built: $653,582 1956 $0/$605,792 County: REPLAT OF TR B MIAMI SHORE BAY PARK ESTS PB 63 -17 LOT 7 Legal Description: $0/$605,792 LESS El OFT & El OFT LOT 6 BLK 5 LOT SIZE 90.000 X 113 OR $0/$653,582 18115 -1853 0598 4 Assessment Information: Year: 2012 2011 Land Value: $299,633 $249,694 Building Value: $353,949 $356,098 Market Value: $653,582 $605,792 Assessed Value: $653,582 $605,792 Taxable Value Information: Year: 2012 2011 Taxing Authority: Applied Exemption/ Applied Exemption/ Taxable Value: Taxable Value: Regional: $0/$653,582 $0/$605,792 County: $0/$653,582 $0/$605,792 City: $0/$653,582 $0/$605,792 School Board: $0/$653,582 $0/$605,792 06 03 13 06;04p ariel monte de Oca F r ov : 305 6405116 p.1 0610312013 16:05 #730 P.0011001 CERTIFICATE OF LIABILITY INSURANCE VAM D61=I`�"'Y""�` osrosrls THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA71VELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER., AND THE CERTIFICATE HOLDER - TANT: Ifthe coWleats haEdarts an ADDITIONAL INSURED, the porNy(ks) must he endorsed. If SUBROGATION IS WAIVED) subjed to the terms, and conditions of the port", certain policies may require an endorsement A statement on this cartBkate does not confer night to the certificate holder in lieu tdsuch endorsement{ PRODUCER Accurate 8300 West Flaglar Suite 114 Miami. FL 33144 Phone C1105j226 -8727 Fax (395)226-8767 xMp I.Uc is Estrada PHONE (3= 226 -8727• F N . (305) 226 -8767 luciac*Wla @behoWh.net PRODUCER 'J419 auSUR AFw IC covERAC£ NAIQ 9 INSURE6 Navarro Plumbing & Mechanical Contractors Inc P.O. Box 226285 Miami, FFI. 332224288 - INSURER A. National Iftsurance ggTtp$ny k 0S1112B4 i IN u Epe: Ascenc>anl Insurance Co. 12.812013 INSURER c: 3 1,000,000.00 iNSURE11I0 S 100.009.00 INSURER E: S 5,000.00 INSURER F : S 1.00000.00 r'.AVFRdf3FR r:FRTIFIrATF NiIMRFR: REYIZ§v-M nFLUIS8EFC THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE us m, BELOW HAVE BEM DIED TO THE INSURED NAWD ABOVE FOR THE POLICY PERIOD INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHFR 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. LIAIUTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �Tg 7TPEOFINSURANCE AUM PDLICYNUMSER Vdage of Miarrd Shores et L"Iffm A 6151MRAL 1.111SAM ® COM ERCfAL GOW -RAI. LtAB:i.ITY ❑ ❑ CLAIMS4M06£ R,I OCCUR ❑ I Y f k 0S1112B4 12/18f2Q12 12.812013 EACH OCCURRENCE 3 1,000,000.00 EWS S 100.009.00 MEOExPfAnrcns I S 5,000.00 PE.RSONALSAUVrNaM S 1.00000.00 F G"BRA . (sATE $ ZOID0,040.00I GENE AC.Gftr RTE LWrT APPLIES PER: ® POUCY CI PRO ❑ I.00 PRODUCTS - CUMPIOPAGG 4 2,040,040.40 S _ ALITOIeotb< p LIABfL17Y ANYAUTO [1 ALLOLUNEDAUTOS L SCHEDULED AUTOS ❑ MMO AUTOS ❑ NoN-owlW AUI'Ds ❑ 1 i COMBINED on= U MIT tEs 8=111020 $ i BOWLYIN.AMY(Perpwam) S 800t1Y LVJURY (POI eceldant S PROPEFVY DAWGE (Per awderttl s s I UN8RELLALM8 rJ OCCUR C] L_- I❑ EXCESS LIA6 tri CLAIMS -WOE I EACH OCCURRENCE S AGGREGATE S �i 46DUCTItEF REiENTI S _ li WORRERSCCOPENSATION ANDE�CYM'LtABtLER Yt ANY pROPWETOFbPARnVEWEXE (AUZ R EXCLUDED? Y DE PT(Of+t OPERA NIA (x"38281 I 03124/2013 ©312012014 WGSTATU OTH- E.L EACH ACCIOENT S 140,wo E.L DISEASE_EAEtdPLOYE s 144.000 I E.LDISEASE- POLICYLUTI S 504,000 I i DESCLBPTiON OF OPERAT"O 1 LOCATIONS f VEHICLES {Anath ACORD 101, Addigard Remaim 30hodure, U more vpwae is nequifadj ULK-vI lr.; l^ r1L7LUCK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN Vdage of Miarrd Shores ACCORDANCE WITH THE POLICY PROVISIONS. 19050 NE 2nd Ave AJANOR�O North Memi, FL 305- 640 -5116 Lucia EsVe91a iSS8.2009 A'LORD CORPORA110N. AN rights; reserved. ACORD 25 (2008(49) OF The ACORD name and logo are reghftred marks of ACORD