MC-13-617i
/ J
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miaml Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 188234 Permit Number: MC- 3- 13-617
Scheduled Inspection Date: December 18, 2013
Inspector: Perez, JanPierre
Owner: ARRONTE, MIGUEL & CARLINA
Job Address: 890 NE 92 Street
Miami Shores, FL
Project: <NONE>
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number
1132060050130
Contractor: AIR CONDITIONGING FOR ALL INC Phone: (561)364 -5011
Iswiamg uepanment comments
RELOCATE AC HANDLER Infractlo Passed Comments
INSPECTOR COMMENTS False
Passed
Inspector Comments
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
December 17, 2013 For Inspections please call: (305)762 -4949 Page 5 of 31
Miami Shores Village
Building Department
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 APPLICATION
FBC 20
Permit Type: MECHANICAL:
Permit No. ryAC- 1 `V
Master Permit No. C.\ S n I I
OWNER: Name (Fee Simple Titleholder): (�fL,�ir1 A �� APPIc71(TE Phone#: _18� ' c3g5 - 1440 if
State: zip: 235140
Tenant/Ussee Name: Phone#:
Email: 424LVv1&_ 4Q-r Q nTe_G) `e rj "cp • �-v�
JOB ADDRESS: ,F%% 111- eqZ- S%
City: Miami Shores County: Miami Dade zip: 3313
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood zone:
(,Fj
CONTRACTOR: Company Name: )rC"C� t A/ �r tePhone#:r6� 384( -�f_/
Address: "0 % /Vw Z-C/ 5'% 7 iLj-
City: (—Gfi( e4/0
Qualifier Name: 72t 0.
State C catia �o$�` RS, istre
�G ,rziip: 330 /x-
Phone#:t �/ 39069//
#: r- 4C 1,F1,6'2- 1C 7—certificate of Competency #:
/I
Address:
V.
Valuo?1' = kermit: $ C�C�. Square/Linear Footage of Work:
Work: l]Addriss+ DAlteration ONew l]Repair/Replace. ODemolition
v Work:
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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
zip
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 properly 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 tie approved and a re'nspectio a will be charged.
Signature Signature 10092ZR�!:
Owner or Agent 'f 1�
The for oing instrument was acknowledged before me this v d
day of rw 0 20 L 3 , by CPQ,(.._t r- N Uzrzc r n dL,
who is personally known to me or who has produced r--1�
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My C
,A
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15109)
Contractor
The foregoing instrument was
day of 20
%
who is personally known4A
NOTARY PUBLIC
Examiner
71 WE
peo~ 2% W
No. SE 90M
this�O
an oath.
My Commission Expires: ba�e;) l ba
Zoning
Structural Review Clerk
DBPR - STEELE BARRIOS, JUAN R; Doing Business As: AIR CONDITIONING FOR ... Page 1 of 1
3.00:21 PM 312812013
Licensee Details
Licensee Information
Name: STEELE BARRIOS, 3UAN R (Primary Name)
AIR CONDITIONING FOR ALL INC (SBA Name)
Main Address: 6407 NW 201ST TERRACE
HIALEAH Florida 33015
County: DADE
License Mailing:
LicenseLocation:
License Information
License Type:
Rank:
License Number:
Status:
Licensure Date:
Expires:
Certified Air Conditioning Contractor
Cert Air
CAC1816267
Current,Active
06/11/2009
08/31/2014
Special Qualifications Qualification Effective
Class B 06/11/2009
Construction Business 06/11/2009
View Related License Information
View'License Complaint
1940.NCIEWAonroe atr * Tallahassee Fr :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395
The State of Florida is an AA/EEO employer. Coovriaht 2007 -2010 state of Florida privacy Statement
Under Florida law, email addresses are public records. If you do not want your email address released In response to a public- records request, do
not send electronic mall to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact
850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must
provide the Department with an email address if they have one. The emalis provided may be used for official communication with the licensee.
However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address
- which can be made available to the public. Please see our Chanter 455 page to determine if you are affected by this change.
https:// www. myfloridalicense .com/LicenseDetail. asp ?SID= &id= CCF5BB227C9AC06811... 3/28/2013
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5/13/13 11:50AM PDT Air Conditioning For All, -> Building Department 30575688
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5/13/13 11:50AM PDT Air Conditioning For All, -> Building Department 30575889
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JEFF ATWATER
CHIEF FINANCIAL OFFICER
• • CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW •"
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law,
EFFECTNE DATE: 8/29/2013 EXPIRATION DATE: 8/29/2015
PERSON: STEELE BARRIOS JUAN R
FEIN: 284548388
BUSINESS NAME AND ADDRESS:
AIR CONDITIONING FOR ALL 1
8407 NVV 201 ST TER
HIALEAH FL 33015
SCOPES OF BUSINESS OR TRADE:
HEATING, VENTILATION,
AIR -COND
Puraiont to Chapter 440.175(14), F.S, an officer of a caporetian who sleds ecemptian from thie chapter by filing a oertificate of election under this section may
nat recover benefits or canpon®tion under this chapter. Pursuant to Chapter 440.05(12), F.S, Cerfificstes of election to be exempt... apply only within the maps
of the business or trade Usted on the node of election to be exempt. Pursuant to Chapter 440.06(19), F.S„ Notias of eleedon to bs exempt and Certificates of
election to be exempt shop be "set to revocation If, at any time altar the AAng of the nodes or the Issuance of tine artincets, the person named an the nodes or
ardAab no longer meet the raWlrements of tills sedan Ibr Issuance of a altideaW The department shalt revoke a certiffats at any time for (allure of dre
person named on the ovrtificuts to meet the requirements of this section.
DFS -F2-DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1eW
5/13/13 11:50AM PDT Air Conditioning For All, -> Building Department 30575689
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