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MC-13-27421. 7' • Inspection Worksheet. r Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL ' Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 204085 Permit Number: MC -12 -13 -2742 Scheduled Inspection Date: April 21, 2014 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Owner: NORA LANGE, KENNETH LANGE Job Address: 70 NE 96 Street Miami Shores, FL 33138 - Project: <NONE> Inspection Type: ruaw Work Classification: A/C Replacement a-49� Phone Number Parcel Number 1132060130620 Contractor: HVAC ENERGY SOLUTIONS Phone: (954)391 -7029 tiuuaing uepartment comments REINSTALL UNIT FOR ROOF REPAIR. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 18, 2014 For Inspections please call: (305)762.4949 Page 5 of 117 Print Page 3 of 4 https: / /us- mg205. mail. yahoo. com /neo /launch ?. partner =sbc &.rand= 9537ffuoa2O57 4/21/2014 Print Page 4 of 4 https: / /us- mg205.mail. yahoo .com /neo /launch ?.partner =sbc &.rand= 9537ffuoa2O57 4/21/2014 Print Subject: Pictures From: Perez977 (perez977 @bellsouth.net) To: perez977 @bellsouth.net; Date: Monday, April 21, 2014 11:49 AM Page 1 of 4 https : / /us- mg205.mail.yahoo.com/neo/ launch ?. partner =sbc &.rand= 9537ffuoa2O57 4/21/2014 IV Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 211219 Permit Number: MC -12 -13 -2742 Scheduled Inspection Date: April 23, 2014 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: NORA LANGE, KENNETH LANGE Work Classification: A/C Replacement Job Address: 70 NE 96 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HVAC ENERGY SOLUTIONS Phone Number Parcel Number 1132060130620 Phone: (954)391 -7029 tsuiming uepartment comments REINSTALL UNIT FOR ROOF REPAIR. Infractio Passed Comments INSPECTOR COMMENTS False q4 A W �� /� April 22, 2014 For Inspections please call: (305)762 -4949 Page 37 of 37 Inspector Comments Passed 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 37 of 37 r� Ve 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 Permit Type: MECHANICAL Lou b FBC 20 LL'--' Permit No. Master Permit No �Z,_7 `i JOB ADDRESS: 70 K.5- 160 +h 6� City: Miami Shores County: Miami Dade Zip: 331,31b Foho/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Nop. tel Phone#:® r,- -7 ii — 5 4'� j Address: JA Ate' R j city: tag' r14t � hgLesl R State: rc Zip: 33 2 Tenant/ .essee Name: Phone#: Email: CONTRACTOR: Company Name: Q4 Address: 6�✓7t City: 1VV "1' nC P..BA 1�1{/AanM'1 Phone #: �.7- Z ei -0(050 "VtZ Qualifier Name: SAAtrl Phone#: 0(6;0 State Certification or Registration #: G' 9 Certificate of Competency #: ++ __ Contact Phone#: ��(� �'� Email Address: �V74W Q kVO4- ?i'1C'T_S ®W yn6. C�1 n DESIGNER: Architect/Engineer: Ph" ne#: Value of Work for this Permit: $ Z, 57x. Square/Linear Type of Work: OAddresqs t OrAI oration Description of Work: Vw -1 ts'61 �tL m A" ptn n► AIM Submittal Fee $ Scanning Fee $ nel Ci �+ Cn t V't C01� of Work: ';E�W Ave -b iCjohpcG wut ank emran e O _D4-A { r+Ci q4 Q$ Permit Fee $ 1 ZeC4 l "L/CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $_ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ TV e u I ,A ��_l I W 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 EMPROVEMENTS 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 ex eeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure wil b delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be a 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 n tic , e inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day o ti who i ersonally known to me r who has produced As identification and who did take an oath. NOTARY PUBLIC: Print: My Commission Expires: APPROVED BY The foregoing instrument w acknowledged before me this 'd day of"�� bye who i so y known to me who has produced as identification and who did take an oath. m VVI 411 �ans Examiner Structural Review Revised 3 /12/2012)(Revised 07 /10/07)0tevised 06 /10/2009)(Revised 3/15/09) ARY PUBLIC: My Commission Zoning Clerk &R Exit Pan n Air Condrtoning Viewr unlsntalled and reinstalled on new roof curb I m route actrical ring from Itch as 4ulred Tudi Lange Air Conditioning Detail MECHANICAL CONTRACTOR Residence �A CMC- 1249713 Project number Project Number 6575 W 4th Ave. 406 Date Issue Date M —1 Hialeah, Florida 33012 Air Conditioning nit Drawn by Author Phone 305-219 -0650 g Checked by Checker Scale 12B/1013 7 :39:36 AM A 6 6 8 �. 8 9 sraT� of FLOR�oa DEPART OF ��ISI�TESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICEN�INts� BOARD SEW L12081402232 003561 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6004212 LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES HVAC ENERGY SOLUTIONS RENEWAL SEPTEMBER 30, 2014 6575 W 4 AVE 406 6264709 Must be displayed at place of business HIALEAH FL 33012 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS QUALITY FLOW COMFORT INC 196 GENERAL MECHANICAL CONTRACTOCA T= REECTOR CEIVED CMC1249713 Y TAX COLL Worker(s) 1 $45.00 08/05/2013 CREDITCARD -13- 004827 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or n ngovemmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami —Dade Code Sec Ile -2711 For more information, visit www.miamidede.novAncollector co � CEl�TlFICA,TE THIS CERTIFICATE 1S ISSUEd A$ A MATTER OK INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATWELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the aartlflaate ho der is an ADDrE10 INSURED, the pollcypes) the tarma and conditions of the pogr�r, tannin pop*W may require an endorsem , .avrwraa Excellence In9umnes Agency 3801 SW 107 Avenue ANiami, FL 33165 Phone (305)226 -3900 Fax (305L26.3997 INSURED Quality Flow Comfort, INC DBA Hvac Energy Solutions 6575 W 4 Ave Unit 0408 Miami, FL 33012• 305. 219.0650 COVERAGES ...- ......�._ . .... -- INDICATED, NOTWITHSTANDING ANY CERTIFICATE MAY BE ISSUED OR MA1i EXCLUSIONS AND CONDITIONS OF SU GENERAL LIACIUTY ® COMMERCIAL GENERAL LIABILITY A 0 ❑ CLAIM&MAOE 10 OCCUR GEWL AGGREGATE LIMIT APPLIES PER ® POLICY El P ❑ LGC AUTOMOBILe LAGII F] ANY �AjyUyT�O ❑ AkUTOS ED ❑ SCHEDULED ❑ HIRED AUTOS ❑ 110 AUTOS ❑ UMBRELLA LIAR OCCUR I EXCESS LIAR H — .,....1..- rl 1 AND IN INIA ABILITY INUUKANCE DATE(M DD/YYYY► A1V1) CONFERS NO RIGHTS UPON THE CER'fYFIQATE HOLDER. T THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES JRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 1 rM OLICY PERIOD IENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY NUMBER POLICY ERFFp uamrs OURRENCE ti 1000 0 4 V io RENTED 8 100,00( 0186FL00050285 06111/2013 0$/1112014 MaD IV dmq scion s 5,000,0 PERSONAL a ADV INJURY S 1,000,0 GE RAL AGGREGATE 6 2,000,0 PRODUCTTat - OOMP P At;,C, 8 2,000,01 a dud D IN6LE LIUM rmr BODILY INJURY (Per pawn) t; BODILY INJURY (Per accident I EACH E S S OCCURMNCE AacaiEGATE $ ❑ 8TAYLL* ►* E,L FACH AOGIDEMr 8 FLLDt8EA8E -III O1rE $ I L Die -POLICY - POLICY LIMIT I D MRIPMN OF OPERATIONS / LOCAt10MS / vwCLlB (Attach ACDRD 101, Addigonal ftuwt a schedule, H More apace is required) CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd. Avenue Miami Shores, Florida 33138 Fax 305. 758-8972 ACORD 25 (2010108) QF L001 L00'd AD THE SHOULD 1T THVEEWI�L E3 BEI.� AN10�DdE NM 13EFORE AUTHOR2ED 10 ACORD CORPORATION. All rights reserved. name and logo are registered marks of ACORD VOM E LOZI L LIZ L JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * 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. EFFECTIVE DATE: 5/26/2013 PERSON: PASCUAL FEIN: 201726189 BUSINESS NAME AND ADDRESS: QUALITY FLOW COMFORT INC HVAC ENERGY SOLUTIONS 6575 W 4TH AVE APT 496 HIALEAH EXPIRATION DATE: 5/26/2015 ENRIQUE FL 33012 SCOPES OF BUSINESS OR TRADE: HEATING, VENTILATION, AIR -COND Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS- F2 -DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1609