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MC-12-621Inspection Worksheet Miami. Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 195937 Scheduled Inspection Date: July 29, 2013 Inspector: Perez, JanPierre Owner: SFARA, VERONIQUE Job Address: 1080 NE 105 Street Miami Shores, FL 33138- Project: <NONE> Permit Number: MC -4 -12 -621 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New A/C System Phone Number (305)799 -2006 Parcel Number 1122320280090 Contractor: SEER AIR CONDITIONING Phone: 305 -552 -9810 comments NEW AC INSTALLATION OF 2 5TON UNITS AND NEW DUCTWORK, 5 VENTS IN BATHROOM AND KITCHEN HOOD. INSPECTOR COMMENTS False Inspector Comments Passed ® CREATED AS REINSPECTION FOR INSP- 195743. CREATED AS REINSPECTION FOR INSP- 172179. missing bathroom exhaust fans and redo kitchen exhaust duct Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 26, 2013 For Inspections please call: (305)762 -4949 Page 31 of 33 y Miami Shores Village Building Department APR 1016% 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 Permit Type: MECHANICAL JOB ADDRESS: �.CJ FBC 20 Permit No. Master Permit No. k S City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Address: �7 I t' 1'1C NO Flood Zone: ?s_s - Phone #: 03 'I— Nq -� c✓ to City: �-A I 4/A � State: Zip: 1 Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name:�� Address: __!70 S 4�v City: Qualifier Name: e ✓XJ3 �- �- f, State Certification or Registration #: Certificate of Competency #: Contact Phone# Email Address: ' �� "t-i 0/. "L,= DESIGNER: Architect/Engineer. Phone #: Value of Work for this Permit: $ 1 Cl c°d° Square/Linear Footage of Work: "I Type of Work: ❑Address ❑Alteration ew ORepair/Replace ODemolition Description of Work: �— S -To.-,j k_'N @� AND iLl' I) Oc_--t VAA-k� a S VIEW ®tJ WH A,N D , rAr-uj,_J AAQQC). Submittal Fee Scanning Fee $ Notary Radon Fee $ Training/Education Fee $ DBPR $ Bond $ Technology Fee $ Double Fee $ Structural Review $ k�� (aj 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 State Zip 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this day of _Qltan 120 1Z, by S p1✓o" tA.Q USb7k who is personally known to me or who has produced S I h-) - P 3" SS' S Is identification and wee. dj&W m S^ tea&. NOTARY PUBLIC:r ° Notary Public State of Florida ' CWI$sa Egane a My Commission 00940681 ` Expires 11/18!2013 Sign: S ..' , Print: My Commission Expires: 1 I l I IG 110 13 The foregoing instrument was acknowledged before me this day of ®ti u ® 20 i -, by W n G 6 t1 who is personally known to me or who has produced as identification and who did take an oath. APPROVED BY y/" I V1 /1/'I Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOT Sign: Print: My Commission Expires: I l %I l® /7 ©13 Zoning Clerk 04/10/2012 02:25 3054850285 SEER AC PAGE 05/06 AC IG'0• SEERAIR -01 GAST `..� CERTIFICATE OF LIABILITY INSURANCE F DA'rEjM=°'"'M pRODUeER 41012012. THIS CERTIFICATE. IS ISSUED AS A MATTER OF INFORMATION kut0matic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I ADP Boulevard HOLDER, THIS CERTIFICATE DOES NOT AMEND EXTEND OR Roseland, NJ 07068 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURE INSURERS AFFORDING COVERAGE NAIL 0 90 SW 132 Ave Seer Air Conditioning Corp INSURER A: Hartford Underwrltans Insurance Compan 30104 Miami, FL, 33184 INSURER 0. INSURER G: INSURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTMITH8TANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEb OR MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN 16 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ia'aamn--- mERCIAL GENERAL LIABILITY CLAIMS MADE F-1 OCCUR GENL AGGREGATE UMITAPPUES PER: POLICY M 29 LOC AUTOMOHILY LIABILITY ANY AuTo AL,I. OwN @O AUTOS SCHEDULED AUTOS HIREDAUTO$ NON-0WNEDAUTOS GARAGE LIABILITY ANY AUTO EXCESS / UMUNEU.A LIABILITY OCCUR Q CLAIMS MADE DEDUOrme A IAND ANY DESCRIPTION OF YD I EXCLUSIONS ADDED BY 3Jlarzol3 I 3/10/2013 I SPECIAL PROVISIONS EACH OGGUKRENOE $ PREMI ES Ea owunslrs S MEOEXP 0(18OeN0n) $ PERSONAL &AM INJURY $ GENERALAGOREGATE S PRODUCTS - COMP/OP AGO 3 tCw� �SINGUE LIMn $ BODILY INJURY S BODILY IN"Y (Pt>reLZlOent) S ,, )RAMAOE s pn�" 7�I� EA AUTO ONLY: $ 3 BHOULDANYCW McABDVEDESC RIByDPOMMSBECANCELLEDBWMWEWK; TWN Miami Shore V;IIAge Buliding Doparfinent DATE THBREOr, T"'I a%WM INSURER WR& E7WMVOR TO MAIL 10 DAYS WRITTEN 10050 NE 2nd Ave NOT" To THE CW IF"TE HOLDER NAMHD TO THE LEFT, BUT FAILURE YO DO so SHALL Miami Shores, FL 33138- IMPOSE No OBLIGATION OR UAEffL LY OF ANY KIND UPON THE INSURLiR, ns AGENTS OR REPRESBNYATNES. AUT iORCMD REPRESE'NTA ME 28 (2005 107) ..._TL..,�,�- • . -� : _ -... _. -._ ... ®191-2009 ACORD CORPORATION. All rights reserved. Ths ACORD name and logo are (registered marks of ACORD 04/10/2012 02:25 3054850285 SEER AC PAGE 04/06 OP ID• TO CERTIFICATE OF LIABILITY INSURANCE �" " r-8 OF 04/1Q/12 041101" T1419 CERTIFICATE 13 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 cadifIcate holder Is an ADDITIONAL INSURED, the policy(iss) must be andorsed. If SUBROGATION IS WAIVED, eubjeot to the terms add conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). ur rance Brokers 306-223-2633 !Sma re su 2700 SW 137 AVE 305220 -0765 Miami, FL 53175 Tema R. rwarmona3 Agent N Te PHQIVE FAIL No_ EMAIL ADDRESS: - Pao ,gEERA -1 INSURED Seer Air Conditioning Corp Roberto Mondes. INSURE101AITORDINORMRAGS NAIL 0 INSURER A IN9URERB: GFL- 1007012 -02 90 S.W. 132 ND AVE. INSU C: RYPI895 - CORlmeM181 10963__ MIAMI, FL 33184 INSURER D s - 50,00 MED W®(Anyunc rq INSURER E t INSUREItF: BAVCOwfSeG ___ KCYIOWN NUNIMMKI THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'1WITHSTANDINU ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VWICH THIS CERTIFICATE: MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS suBJI =CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r-8 OF JOK POLICY NUMBER MID LIMITS C GENERAL LIABa,IIY X COMMERCIAL GENERALUA9IUTY CWMB -MADE 7 GFL- 1007012 -02 07h10111 07/10112 EACH E4CH000URRENCE pREM18ES s - 50,00 MED W®(Anyunc rq 3 1.00 PERSONAL 3, ADV INJURY 3 1,000,0 pBNBRALAGOttGATE $ 2,00010 CiEN1A[3GpE[IATEUMRAPFLIESPEt3: Loa PRODU,MS- PAMPIOPAGG 3 1.000100 S AUTOMOBILE UABiLrIY ANY AUTO COMBINED SINGLE LIMIT me aca%nq 3 BODILY INJURY (Perpenw) 3 ALL OWNED AUTOS BODILY INJURY(PeraoMmU S SCHEDULEDAUTOS PROPERTY VAMA06 (Pei aoOdeot) HWED AUYOS 3 NON.QWNED AUTOS e S' UMBMLIALIAS Excess LIAR BUR cLAIMfi�MAOE . eACH OOOUR"OE a AGGREGATE S �DL�..TIBLE 3 RErpNTION $ WORKERS COMPENSATION AND EMPLOYER LWBILRY YIN oFFroP�ERI BERR EXE7fO�LU O E❑ i��lHyyegqedaMry ippn��NH) DESCRI iQN OF OP6RA7tONS NIA NC STATIJ 01H. 3 E L EACH ACCIDENT S G.L. DISPASE . GA EMPLOYE E F-L POLICY umrr S t> r A CO REPAIR�8sNi11bfALA77b HECLE4 (Aftch ACORD 101, Additicrol Rmns" SChed^ if (Nero ap"a 1a -qubw) CERTIFICATE Hnl nRD MIAMSHV Miami Shores Village Building DepaivnenL 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELI-@D BEFORE THE EXPIRATION DATE THEREOF, NOTICES WILL BE U91- 111ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988.2009 ACORO CORPORATION_ All rinhfe rpwamAd "ter ^" Alp k4vV V1VY) The ACORD name and logo are registered marks of ACORD 04/10/2012 02:25 3054850285 SEER AC PAGE 03/06 1 MIAMI,DADE COUNTY 0 W. �OLSR ST. mi LOCAL. BUSINESS TAX RECEIPT 21YI2 MFAMI -DADi2 COUNTY Y - STATE OF FLORIDA FLRST- CLASS 1st MI, FL MIAMI, FL 33130 MUST 82 DISPLAYED AT FACE OF 1USINESS U.S. POSTAGE PAID PURSUANT TO COUNTY CODE CHAPTER BA - ART. 8 & 10 PERMIT NO 231 487726 -3 THIS IS NO i A BILL — DO NO Tt PAY RENEWAL 8 �H� ��1Y YONING CORD STATN9FXE1gi3305509037 -8 SW AVE 33184 N3 INDADCOUNTY "VER AIR CONDITIONING CORP 'YTWIPE&VCHANICAL CONTRACTOR WORKER /S ISM TAY A LOCAL WhEss 1 EL NOT PE YtO1ATE ANY STW R ST WO iA OF rHE Us � � 7�ORR DO NOT FORWARD � FROM ANY OTNBR . E"'�°v � SEER AIR CONDITIONING CORP ROBERTO M MORALES PRES 90 SW 132 AVE _ n es l "rrAx MIAMI FL 33184 0 010022°001 Q Q Q Q7S. O Q iit�ittt�ifi +i���ff�tfitf�fsti1f tff�Iil /fft�lliai +. i�::�A..� SHE OTHER SIDS 04/1012012 02:25 3054850285 SEER AC PAGE 02/06 ........... -'m