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MC-13-2878Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 205163 Permit Number: MC -12 -13 -2878 Scheduled Inspection Date: February 26, 2014 Inspector: Perez, JanPierre Owner: , Job Address: 35 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: FELCO AIR CONDITIONING INC Building Department Comments Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060130240 REPLACE 4 TON AC SYSTEM Infractio Passed Comments INSPECTOR COMMENTS False February 25, 2014 For Inspections please call: (305)762 -4949 Page 10 of 28 Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 25, 2014 For Inspections please call: (305)762 -4949 Page 10 of 28 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 GU. LaY. ------------- _ Permit No. Master Permit No. M CAT- Permit Type: MECHANICAL r OWNER: Name (Fee Simple Titleholder): CJM IS MAIEW o T ®L,')1 V-L phone #: Address: 35- fie- 99— ST- City: Mimi . w afl Tenantll.e9see Name: Email: Kt JOB ADDRESS: q 9— City: Miami Shores County: Miami Dade Zip: f 3 Folio/Parcel#:c►% Q �' Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 6 ® Ari 4— 0w✓J Phone #: 1✓��iZt 1 1 Address: � 14:4 -SID �u , 123 [%%-6, City: 401 % state IF) Zip: '3-3 l �p Qualifier Name: IF rr, 1 i Co v1 0- 4A Phone#: -3 0 �) 2 A -t L4 -1 1 State Certification or Registration #: 02)) C O's -7 zoo Certificate of Competency #: Contact Phone #: Email Address: Foq L e 0 A t �2- 41-1 (?7 161 iA 1 L CPYV1 DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Srd"00 Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew ORepair/Replace ODemolition Description of Work: Err— L A Ci- li`( `15 1 "j #A/ ly 4' 20 IV A Le— 4'= Z /a,'V% 1Jy761 Submittal Fee $ Permit Fee $ V/ I UU CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $1) l Bonding Company's Name (if applicable) ' e 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 WOW 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. "WARMNG 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 I deliveN to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be p y,fWd at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of s posted notice, the inspection will not be approvpMInd a reinspectio fee will be charged Sig. Signature 0 O er or Agent �'Q - Contractor The foregoing instrument was acknowledged before me this �"� The foregoing instrument was acknowledged before me this —31 day of De(ew 20 L I, by OIU (2o blede 5, day of 40 fC _ , 20 ' by r=10=1K C��, who is personally known to me or who has produced ��� "� who is personally known to me or who has produced-6-1-1-0 Gcee As identification and who did take an oath. as identification and who did take an oath. , Print:��1'1tCy M Commission Expires: act' RTOAUGRALL Y P * * WCOIY# INION #FF045174 EXPIRES: August 13, 2017 �' +'roF�.�°�� tiondedThruBu�'flo}aprSetvil� Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOT Sign: Print: My C 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): 2< f ice,. City: Miami Shores Village County., .,:Miami Dade ZIP Code: _� 1: 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 t@ NO ❑ Contract Attached: YES 9 UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER r. ® 'T 6 7,49'A i,00 A Cr AHU or PKG. UNIT MODEL # COND. UNIT MODEL # 9 A 10 KW HEAT t i-1 NOM TONS Ai AHUSS" CU '$' PKG 1 M.C.A AHU CU-1,5 PKG AHU o CU PKG 2 M.O.P Ukn CU PKG AH CU KG 3 VOLTS AHU M CU 24OPKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES N YES NO REPLACING THERMOSTAT E NO YES NO NEW 4 °CONCRETE SLAB YE N YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES - 1. Minimum Circuit Ampacity (Wire Size): A/tA ' 11, ( C/V -= *E5 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): `zq!o 4. Size Disconnecting Means: Contractor's Company Name: C -btJIQ 1"1C1�? 112 Phone: State Certificate or Registration Signature Certificate of Competency N. Date: 1 3 v 13 TM �DEPAR ENT. 'Col TION SEQ#L12060101125 KEN LAWSON SECRETARY 0310 of SEC. 196 mKd the teval Be s, to da busuiess. arhioh "to the all commercial vel CFN: 20131010387 BOOK 28967 PAGE 3938 DATE: 12/27/2013 10:48:55 AM DEED DOC 2,160.00 HARVEY RUVIN, CLERK OF COURT, MIA -DADE CTY This Instrument Prepared by: Albertetli Low 5404 Cypress Center Drive, Suite 30 Tampa, Florida 33609 PAO Our File Number. TPA13 -36454 as a necessary incident to the fulfillment of conditions contained in a title insurance committnew issued by it. Property Appraisers Parcel I.D. (Folio) Number (s): 11-3206-013-0240 SPECIAL WARRANTY DEED This Special Warranty Deed, made this 1 x013 i3betwean Raukunited, N.A., formerly known as BankUnited, having its place ofbusimss at 7815 NW 148th Street, Miami Lakes, Florida 33016 thereby called the grantor, to CJM Strategic Holdings, LLC a Florida Limited Liability Company, whose Post Offue address is: P.O. Box 521155 ,Minnd, FL 33152 hereinafter called the grantee, II IN E S S E T H:That grantor, for and inconsideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, by rhea presents does gram, bargain, sell, aliens, remis, releases, conveys and confirms unto grantee, all that certain land situate in Mintni -Dade County, Florida, viz: Lois 15 and 16, Block 2 of AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the Plat thereof as recorded in Plat Book 10, Page 70, of the Public Records of Miami -Dade County, Florida. Property address: 35 NE 92nd Street, Miami Shores, Florida 33138 SEE ATTACHED EXHIBITS TOGETHER with all the tenements, hereditamcnts and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD the same in fee simple forever. GRANTORS WILL WARRANT AND the said party of the first part does hereby covenant with the said party of the second part dial, except as above noted, that at the time of the delivery of this deed the premises were free from all encumbrances trade by it, and that it will warrant and defend the same against the lawful claims and demands of all persons claiming by, through or under it, but against none other. (Wherever used herein the rem °grm ue mtd "gantee" included all the parties to this insmaoent, amt the heirs, tell representatives amt assigns ofiadividasls, mw the slice ors and assigns of cotporationl IN WITNESS WHEREOF, the grantor has caused these presents to he executed in the name and its corporate seal to be hereunto affixed, byits proper officer's thereunto duly authorized, the day and year fast above written. DATE 12/30/2013 Phone: 305 - 221 -4471 — Fax: 305 - 221 -5471 Residential — Industrial — Commercial Sales — Service — Installations Preventive Maintenance State Licensed A Insured — CAGO57200 SUBMITTED TO: JOB NAME: CJM STRATEGIC HOLDINGS, LLC 35 NE 92 ST MIAMI SHORES, FL 33138 CUSTOMER PHONE CUSTOMER FAX CUSTOMER E -MAIL 786- 261 -4920 jcmederos@aol.com We hereby submit specifications and estimates for. RUUD 4 -TON VALUE SERIES AIR CONDITIONING SYSTEM FEATURING R-41 OA REFRIGERANT. MODELS: 14AJM49A01 & RHLLHM4821JA. RUUD 10 KILOWATT HEATER WITH DISCONNECT (MODEL RXBH172410). TOTAL COOLING CAPACITY: 46,000 BTU'S SEER RATING: 16 EER RATING: 13 PRICE ALSO INCLUDES A NEW: DIGITAL, HEAT AND COOL THERMOSTAT. CONDENSATE OVERFLOW SHUT -OFF SWITCH. REFRIGERANT LINE & DRAIN LINE FLUSH. REBATES: FPL RESIDENTIAL A/C REBATE OF $780 FOR ABOVE SYSTEM HAS BEEN DEDUCTED FROM TOTAL. REBATE WILL BE SENT TO FELCO AIR CONDITIONING, INC. WARRANTIES FOR SYSTEM: 10 YEARS ON COMPRESSOR BY MANUFACTURER. 5 YEARS ON SYSTEM PARTS BY MANUFACTURER. 1 YEAR ON SYSTEM LABOR BY FELCO AIR CONDITIONING, INC. PAYMENT SCHEDULE: 50% DOWNPAYMENT, 50% UPON SETTING EQUIPMENT. PRICE DOES NOT INCLUDE PERMITS, PERMITS COST, SMOKE DETECTORS, TEST AND BALANCE, NEW ELECTRICAL HIGH OR LOW VOLTAGE WIRING, HEAT LOAD CALCULATIONS, ARCHITECTURAL DRAWINGS, OR IMPROVEMENTS REQUESTED BY MUNICIPALITIES BUILDING DEPARTMENT. We hereby propose to furmh labour and materials complete m accordance with the above specifications, for the sum of 1 $2,780.00 Services performed under the warranty policy will be provided by Falco Air Conditioning, Inc. during normal business hours, Monday thru Friday Sam to 5 pm. Warranty does not cover or include routine maintenance such as changing/clearft filters, drain fire cleaning, breaker tripping or replacing fuses. it shall be at the discretion of Fek:o Air Conditioning, Inc. to repair or replace defective parts, units, or materials whenever it is necessary. Any, nuisance calls beyond the scope of this agreement wig be charged at our normal service rates and/or emergency service rates. Any alteration or deviation from the proposed specificatons or conditions involving extra cast of materials or labor will only be executed upon the written order of the same and will become an extra charge over the sum mentioned in this contract. The conditions set forth in this are the only agreement between the parties. Any irtconsistent term or conditions is not part of this agreement unless it Is In writing mid signed by the customer and Falco Air Conditioning, Inc. Title to the equipment and materials will remain with Falco Air. Conditioning, Inc. until all sums have been pail in full. All balances not paid within 30 days of the bill date will be subject to a monthly service charge of 1.50% of the outstanding balance. Customer is responsible for all cost of collection, including reasonable attorney's fees in the event of nonpayment in the event that any person and/or customer files writ against Falco Air Conditioning, Inc. N such case is found in favor of Falco Air Conditioning, Inc., customer will pay all cost Including reasonable attorneys fees. Customer In solely responsible to provide for the safely of all persons, pets, and things at the job site. Customer is solely responsible for any harm suffered by any person therein. Customer egress to hold Falco Air Conditioning, Inc. and anyone employed by Falco Air Conditioning, Inc. harmless for any damages related to the cleaning, removal, or replacement of ducts, registers, or other equhpmentFelco Air Conditioning, Inc. warrants existing drain gyre hookups for 30 days with new equipment installations. Falco Air Conditoning, Inc. and those employed by Feld Air Conditioning, Inc. are not responsible for any wag painting, door framing, drywall repair, -Mng repair, or water damage due to removal or installation of equipment or parts. Feloo Air Conditioning, Inc. has ire right to stop all work if payment as set forth herein is not made as scheduled. Once any equipmeWmaterials have been delivered to the job sits, it is the residentlaVcwmmercial property owners or the general Contractor's responsibility to care for them. Falco Air Conditioning, Inc. can and has the option to pickup any parts, equipment, units, etc. if payments as set forth herein are not made upon the due data from arty and all properties, where such parts, equipment, and units exist. Any and all parts, equipment units, etc. that have riot been paid for shag remain the property of Feloo Air Conditioning, Inc. until the balance is paid for. Upon acceptance of this proposal, this proposal sets forth the entire agreement between both parties. Any job that requires a permit will be subject to a $290 permit fee over and above the total contract price unless it is in writing stating otherwise In the above contract Customers will be subject to a minimum $100 re Inspection fee if any Inspection fable due to customers negligence (Example: No one home or no access to Inspect). THE LIABILITIES SET FORTH ABOVE ARE IN LIEU OF ALL OTHER WARRANTIES AND LIABILITIES EXPRESSED OR IMPLIED, IN LAW OR IN FACT, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY FOR PATICULAR USE. THIS PROPOSAL IS SUBJECT TO ACCEPTANCE WITHIN 30 DAYS AND IS VOID THEREAFTER. Customer. Falco Air Cond. Inc. Date: This combination qualifies for a Federal Enen Efficiency Tax Credit when placed in ser" between Feb 17, 2009 and Dec 31, 201 Certificate of Product Ratings AHRI Certified Reference Number. 3788429 Date: 12/30/2013 Product: Split System: Air - Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number. 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL44 *4821 Manufacturer. RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD, WEATHERIONO Series name: Manufacturer responsible for the rating of this system combination Is RHEEM SALES COMPANY, INC. Rated as follows in accordance with AHRI Standard 2101240 -2008 for Unitary Air-Conditioning and Air -Sauce Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, Independent, third party testing: Cooling Capacity (Btuh): 46000 EER Rating (Cooling): 13.00 SEER Rating (Coolingr 15.00 IEER Rating (Cooling): 'PhWnp0WWwW by an a lc r) hWWata a w4admyrereta at prevmu* pubfiMed data. urdm accwmpwded a M a WAS, edddr kWkaWs an bwakmwyreram @2013 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1303293488MW631 02123/2014 23:39 3052645382 JIMENEZANDCO PAGE 01 ` W® CERTIFICATE OF LIABILITY INSURANCE Y I 02/24/14 THIS CERTIFICATE IS ISSUED AS AA MATTER OF INFORMATiON�ONLY AND CONFERS'NO RIGHTS UPON THE CERTIFiCA— HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR Ni^GATIVELY AMEND, EXTEND OR ALTER T14E COVERAGE AFFORDED 13Y 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. IIIAPORTAIVT; if tllo eerfl8tate Nobler fs en ADl)1T10NAL INSURED, Bte pollrsy(les) must be endorsed. tf SUBR03ATtON iS WAIVED, stlb]0Ct Fx the terms and conditions of the polity, certain policies may require an endorsement. A statement an this Ri certificate dons not I 6, rights to the CeRlflCate holder in lieu of such Cridersomeritls)• PRODUCER _ .CGNTAG"r ...._ NAMED, JULIO_ JIMENEZ Jimenez & Co. , Inc. P13oiad 305 x6g ®� • -_._ .... _ ._. ___ . -. 2xU; , ) _ (yC, HoJ: 4305) 284- 5382-- 5000 Coral Way 8D.DRt:sBS_ Jullo@jfmen=wW�omparty.com Miami, FL 33155 _ INSUREt(S)AFPORDING COYERAM I AIC If — Phone 305 764 -9900 Fax (305)264 -5382 _..(.._ ) - _— _..... _._ _ INSUaeR a :_ MSCENDANT COMMERCIAL INSURANCE INSURED _.._.... ... INSURER D: FELCO AIR CONDITIONING INSURER C 11030 SW 128 aVe INSURER D i Miami, FL 33188 S SUR R E 1 ....__ ___._— ....... ... ,.— _.— _.�_.._.._— __.-- _._.•..._ INSURER _ —_ COVERAGES CERTIFICATE NUMBER: - -• -- -- - - - -.— REVISION NUMBER: THIS IS TO CERTIFY THAT THE I�OLICiPS OF INSURANCE LIs tb 9F.LOW HAVE BEEN ISSUED TO THE INSURED N gib AEft7VE FOR tHE Po-1Jd PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wii hl RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SuSJF_CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. fIN9RI ADDLISUBR __..._........._.- -..._.. . L�R TYPE OF iNSURANC£ INSR 11yW r'04dCY NNMB POL EFF PO _. --- ._.. .. .— ...— __.._. —. M?. (;MfD�fYW1� (AA LMETS GENERAL LIABILITY - -- -- EACHOCCURIiENCE b 1,000,000.00 ❑/ COMMERCIAL r.8MAL LIABILITY DAMAGE TO RENTED ❑ ❑ CWMSdW1DH [�] OCCUR M]l111P_[Ea ogmtrn,ct, $ 100,000.00 —_ A ❑ OE_- 39354 -2 01/11/7.014 01/11/2015 MW EXP (An one person B 6,000.00 -- _._._....._.._...._.. .... —.__ PF_RSPNN. &ADViUMY 1,000,000.00 _ U -- -- GENERAL AGGREGATE $ 7.,000,000.00 GENLACC+REGATELIMIT APPLIES PER! — PRODUCTSS—COMP/OPAeG S 1,000,000.00^ ❑ POLICY _ ❑ .IPE"G0T -_� 1C_. - a -- AuTotaootr.M l.Iastr.Inr coMBlNla� alniote tiMrr .......... _(I�e_seolaeoti... ....._ � ❑ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per person) ❑ AUTOS ❑ AUTOS BODILY INJURY (Per mWdent S ❑ HIRED AUTCO E:] AUTOSW Pk9MR�'YDAHWOE._ —_ •.__-- . - - - - -. 11 E LL AL AO 0 OCCUR .... WORKERS COMPENSATION AND 11UPLOYP.RS' LIAatL,ITY YIN OFFICER R �XC1�1,1Dpq� NIA (Mondatory In NH) `.. iR�41RIPT�iON u F er ERATION& below F„ACH OCCURRENCE AGGREGATE S I @,t, EACH ACCIDENT 6,1.,. DtSEAS� - Fp EMPLOYS4 $ — G.L. DISEASE. POLICY LIMIT , S DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional itenfarks SattedLila, iI moo epode to raquhud) CAC # W7200 AIR CONDITIONING INSTALLATION, SERVICE & REPAIR CERTIFICATE HOLDER - -- VILLAGE OF MIAMi SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 FAX: 305.758.8972 ACORD 25 (2010/05) QF _ CANCELLATION SHOULD ANY OF THE AROV@ DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF CE WILL BE DELIVERED iN ACCORDANCE THE P OVISiO (1. � t 3-- z�r�-- A798$ -2 A J36RD CORPORATION. All rights reserved. s ACOL04Wme and logo are registered marks of ACORD VC- /Ll -3 I CERTIFICATE OF LIABILITY INSURANCE I 'w f'' GL FIGUEREDO STATE FARM 7950 W F'1„ AGLER ST SUITE 103 MIAMI, FL 33144-2206 (13) 305-262-0"0 (F) 305 - 2622008 WAUR® FELCO AIR CONDITIONING INC 11930 SW 128TH AVE MIAMI FL .33186-4557 ONLY AND CONFERS NO RIC;!•ITS UPON THE CERTIFICATE BOLDER. THIS CERTIFICATE DOES NOT AMEND, FXMND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NA1C S INSURLR A Btea Fenn Fire and Casually Cc "Ww=4s 25143 INSURER B: THE POUCIFS of INSURANCt= LISTED BELOW HAVE BEEN 1 LIED TO THE IN URED 1;D Ai3oVE FOR THE Pt ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR MER DOCUMENT WITH RESPECT TO WNC MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL T14E TER POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. pMcr NUMEER EPfECrNR Foue+r E1�RA 1. IN TYpSOFE+I8URANCE DATE oAT'8 MId+D GENERAL UABILRY COMMERCIAL GENERAL. UAB dry CLAIMS MA68. F. I OCCUR LAGGREOATE LIMFrAPPUES PER: .N.1cw I 1 Pier n LOC AUTOMOMAIJAPILM ANY AUTO ALL OWNED AUTOS scHF.DULED AUTOS HIRED AUTOS NONO 019DAUT08 AGE LIABILITY ANY AUTO &9 / uMBRELLA UMUTY OCCUR 7 CLAIMS MADE DEDUCTIBLE A 6MFLOY6RILIABILrTY,..,,- .. no- SK -MM-6 P ANY PROPRIkYORIPARYNEWEXECUiNEY /N 0111312014 01/1312015 OpFICERlMEMEER ExCLU�D7 Q �°° �d°akdYesafdeNu+ der FELIX CORREA (PRESIDENT) I$ EXCLUDED. FELIX CORREA AN Air Condltloning 1100 PERIOD INDICATED. NOTWITHSTANDING 3HHIS CIWIFICATE MAY BE ISSUED OR AS, EXCLUSIONS AND CONDITIONS OF SUCH LEE EACH OCCURRENCE $ 90= 962!L 62! $ MEDEXP(A onapown) S PERSOTWL & ADV 1RJURY 118 REPRESENTATIVEL "'AN GENERALAGGREGATE S PRODUCTS- WMPMPAGG $ CONoINm ENQLB LIMIT g (6a arcldaII) BODILY INJURY $ (Far P"M) BOMY INJURY g (P- accidwd) PROPERTY DAMAGE $ (Per accidem AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC S $ ALrro ONLY.. AGC EACH OCCURRENCE 9 AGGREGATE S S a X TORY LIMITS ER E.L., EACH ACCIDENT S 100,000 E,L. DISEASE - EA WeR24 S 1001000 E.L DISEASE - POLICY LIMIT I s $00,000 ;ontractor - -- SHOULD pHY OF'rFfE AHC'VE D DATE THEREOF, THE ISSUING INWFWR W village of Miami Shoves NOTICETO THE CERTTFICATEHOLDERW 10050 NE 2 Ave IMPOM WO ORUGATION OR LIAWLIT "I Miami Shores, FI REPRESENTATIVEL "'AN ACORD 25 (2009101) 0 1NO'2 TITS ACORD nam® and 1090 are registered marks Of ©E9 Ee caNCO,t.EO e�ORe TNra EXPr17A'ITON 4 NfIFAVOOO MAIL 30 . DAYS V wrmN TO LEFT, BUT PALM TO DO 90 BNALL UPON THE MUFAK rT9 AGENTS OR kTION. All rights mmyved. 1001486 132845.3 04-00-2009 UNIFORM NOTICE OF A LOW - VOLTAGE ALARM PROJECT PERMIT LABEL # (IF REQUIRED) A -13 -013 DATE 2124/14 PROPERTY ADDRESS: 56 NW 93 St CUSTOMER'S NAME Thomas Theus CUSTOMER'S ADDRESS 56 NW 93 St CITY: Miami Shores STATE FL ZIP CODE: 33150 TELEPHONE: 786- 374 -5616 EMAIL ADDRESS: thomastheus@gmail.com CONTRACTOR: SAFE STREETS USA ADDRESS: 5660 W CYPRESS ST STE G TAMPA FL 33607 TELEPHONE: 919-861-8521 FAX: 866-651-3858 EMAIL: IMANSFIELD@SAFESTREETS.COM QUALIFIER: WILLIAM ALAN PEACOCK STATE LICENSE #: EG13000404 DATE PROJECT COMPLETED 2/18/14 SCOPE OF WORK: Wireless Burglar Alarm - 1 Cell, 1 Panel, 1 Button Fob, 4 Door - Window, 1 Motion NOTICE IS HEREBY GIVEN THAT A LOW VOLTAGE ALARM SYSTEM PROJECT HAS BEEN COMPLETED AT THE ADDRESS SPECIFIED ABOVE. I CERTIFY THAT ALL OF THE FOREGOING INFORMATION IS TRUE AND ACCURATE AND IS IN COMPLIANCE WITH ALL APPLICABLE CODES AND STANDARDS. d4l- I P�U� QUALIFIER'S SIGNATURE 5660 w Cypress St Local 919.861.8521 Suite G Toll free 866.774.7635 Tampa, FL 33607 MR