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MC-13-727Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 211151 Scheduled Inspection Date: April 23, 2014 Inspector: Perez, JanPierre Owner: GRIFFITH, WILLIAM Job Address: 795 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: ALL AIR SOLUTIONS INC Building Department Comments Permit Number: MC -4 -13 -727 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)401 -6279 Parcel Number 1132060142360 REPLACE AC UNIT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed / CREATED AS REINSPECTION FOR INSP- 189082. ok to cover hood duct in existing kitchen Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 22, 2014 For Inspections please call: (305)762.4949 Page 23 of 37 Miami Shores Village Building Department APR 10 ?Ot 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (MS) 762.4949 BUILDING Permit No. hl L 13._ 12-+" PERMIT APPLICATION Master Permit No. I FBC 20 kt-_�4 Permit Type: MECHANICAL OWNER: Name (Fee City: NAe a TenanAzMee Name. Email: State: r' Zip: JOB ADDRESS: c� to S City: Miami Shores County: Miami Dade Zip: �S Folio/ParceW l s ki•• - Q1q oC Is the Building Historically Designated: Yes NO i® Flood Zone: M CONTRACTOR: Company Name: Ake A:. a SAokcnwo s4w, Phone#: A g y ' %tm, (4,96 S Address: slewVAL�r LJvw^AC City: �..�� o-�* -� —state: _ : acA gyp: 31 %'}R Qualifier Name: SvaraL% Phone#: ZoR- Su--L State Certification or Registration #: C.& C- le Certificate of Competency #: Contact Phone#: 1% -2.o% ° S. L7- Email Address: @ Ye,tki-z , y_0e4 DESIGNER: Architect/Engineer: Phone#: Value ..gf,Work for tW Peft*:= _ t9f Square/i inear Footage of Work: Type of Woit:° DAdit"' ' OAlteration ONew ' OR air/Replace ODemolition Description of Work: Submittal Fee $ i% Permit Fee �Vl / CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Thdning/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ III A 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 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 Qosted notice, the inspection will not be approved and a reinspection fee will be charged Own&.br Agent ( J V `° Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of - L— , 20 E3, by day of 20 a by 0 who is personally known to me or who has producedA who is personally known to me or who has produced AP'Vi� °�° �� Diden iiQn and who did take an oath. �� L � as identification and who did take an oath. DECA X PASTRANA colorirsae72su H=: Fdn=y07, 2017 My Commis Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10n009XRevised 3/15/09) Plans Examiner Structural Review NOTARY Print: My C i UM4 07.2017 Zoning Clerk Miami Shores Village Building Department 10050 N. E.2nd Avenue Miami Shores, Florida 33138 Tel. (305) 795 2204 : (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA Fax 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): 41% r -e clu �a0 3. Voltage of Circuit (2081240/480): ago 4. Size Disconnecting Means: Contractor's Company Name: A1\ �,,. Phone: 4 S IrA2° G'9 (z State Certificate or Registration N. Certificate of Competency N. Signature Date: zoi'y (Qualftes signabn cng ) 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 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 YES, NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 41% r -e clu �a0 3. Voltage of Circuit (2081240/480): ago 4. Size Disconnecting Means: Contractor's Company Name: A1\ �,,. Phone: 4 S IrA2° G'9 (z State Certificate or Registration N. Certificate of Competency N. Signature Date: zoi'y (Qualftes signabn cng ) From: Maximo Dopazo Fax: (866) 647 -9673 To: +1$067668972 Fax: +13067668972 Page 3 of 3 416120133:06 AFRO CERTIFICATE OF LIABILITY INSURANCE 14/5/2013 °�/`M2'°°"'""' TYPE OF INSURANCE THIS CERTIFICATE IS ISSUED AS A NATTER 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 holder is an ADDITIONAL INSURED, the policypes) 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 Ileu of such endorsement(s). PRODUCER Dopazo and Associates 3900 NW 79th Ave Suite 700 Miami FL 33166 CONE MACT Alexander Dopazo CIC FAX PHONE (305)470 -8500 WC No: (305)470 -0111 E-MAIL info @dopazo.camd INSURERS AFFORDING COVERAGE NAIC INSURERA MSSeX Ins Co 39020 INSURED All Air Solutions lac 1101 NE 191 Street #408 INSURERB:PrO ressive Express Ins CO 10193 wsURERCMDunt Vernon Fire Insurance Co 26522 INsuRERD:Buslness First Insurance Co. 11697 INSURER E: Miami FL 33179 INSURERF: ■\G�IVIV 1• IVVIYI�GR. 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. LLTR TYPE OF INSURANCE INSR POLICY NUMBER PQ(,( u �/pp/YYy LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CIAIMS -MADE ® OCCUR 0014040 /27/2013 /27/2ola EACH OCCURRENCE S 1,000,000 S PREMISES a occurrence) S 100,000 MEDEXP (AM one person) S 5,000 PERSONAL &ADV INJURY S 1,000,000 GENEW AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: B POLICY PRO LOC PRODUCTS - COMP/OP AGO S 2,000,000 S B C D AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTN� OD$D HIRED AUTOS AUTOS UMBRELLA uAB I B I OCCUR EXCESS uAB cxluM>s MwDE NIA 2132056 -0 118239s 521 -04444 /27/2013 /27/2013 /23/2012 /27/2014 /27/2014 /23/2013 COMBINED SINGLE LIMIT (Ea sociderd) $ 1,000,000 g BODILY (NARY (Per pin) S BODILY INJURY (Per eaider� S PROPERTY DAMAGE er aceiderd S PIP-Bask; EACH OCCURRENCE E 8 10,000 s 5,000,000 g AGGREGATE S 5,000,000 DED RETENTIONS VuORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIErOR/PARTNERAD<ECuTIVE YIN OFFICER/MEMBER EXCLUDED? � I(fM�ansdatory In NH) DESC�21�P1 M OF OPERATIONS belay g WC STATLL OTh4 TORYLIMITS; ER S El. EACH ACCIDENT $ 100 000 E.L. DISEASE- EA EMPLO S 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace is required) Air conditioning sales, inballation and repair. CC77TIC1rATC un1 nro 1 (305) 756 -8972 City of Miami Shores Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ef'n0n'M PIMMInalk INS025 mmoom m SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dopazo CPIA/MD W I UM -201 U ACORD CORPORATION. All rights reserved. Tha Arnpn name anri Innn okra raniatararl marls of Arnpn