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DEMO-14-107V Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-205971 Permit Number: DEMO -1-14-107 Scheduled Inspection Date: July 09, 2014 Permit Type: Demolition Inspector: Perez, JanPierre Inspection Type: Final Owner: PALMISANO, INGRID & ERIC Work Classification: Mechanical Job Address: 1035 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060143730 Project: <NONE> Contractor: DADE SUPER COOL AIR CONDITIONING Phone: (305)233-3915 sunamg uepartment comments DEMOLITION MECHANICAL Infractio Passed Comments INSPECTOR COMMENTS False 1� T 4 -1 �' July 08, 2014 For Inspections please call: (305)762-4949 Page 5 of 34 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 08, 2014 For Inspections please call: (305)762-4949 Page 5 of 34 .. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-205971 Permit Number: DEMO -1-14-107 Scheduled Inspection Date: July 09, 2014 Permit Type: Demolition .Inspector: Perez, JanPierre Inspection Type: Final Owner: PALMISANO, INGRID & ERIC Work Classification: Mechanical Job Address: 1035 NE 96 Street Miami Shores, FL Phone Number Project: <NONE> Parcel Number 1132060143730 Contractor: DADE SUPER COOL AIR CONDITIONING Phone: (305)233-3915 Building Department Comments DEMOLITION MECHANICAL Infractio Passed Comments INSPECTOR COMMENTS False July 08, 2014 For Inspections please call: (305)762-4949 Paae 5 of 34 Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 08, 2014 For Inspections please call: (305)762-4949 Paae 5 of 34 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 JAN SS 2A14 FBC 20 Permit No. QC12IQ Master Permit No.aeflx� JOB ADDRESS: 1035* City: Miami Shores County: Miami Dade Zip: c3 13 Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): diet DI 9 I 0"IS440 Phone#: &5 Address: 1035 A16 96 STAT City: MW 1 AfMRF-s State: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: bw Syea4 bol kQ e4lb zoNt& Phone#:«365-033-391 Address: /-%05 SW /44 15 City: HtA-" i State: FL- Zip: 3z 1 l eo Qualifier Name: AAHDAIt AI D 5 UA -U Phone#: 30 r'-.2, 33 - 3d/ / r State Certification or Registration #: '0000 ' 14-14-0 Certificate of Competency #: Contact Phone#: Email Address: . Q (f4 L do -Al ht. MWO • C-0''" DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 366• 66 Square/Ianear Footage of Work: Type of Work: OAddress OAlteration ONew ORepair/Replace Description of Work: Z)CMD RFEC NICAL- Demolition ^^��s�a,s�aaa�s�,��aas: *Fe assn raw&*a,s*e�*ae�aa�a�*�,ras�aawa Submittal Fee $ U ' 0 / _ Permit Fee $ �9t CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ 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 CONEHENCEMENT 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature _—* Owner or Agent Contractor The for oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of nj.20 1� by ?AGMl SAw,) day of who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. was identification and who did take an oath. NOTARY PUBLIC: SPrint SPM My Commission SNELLIE L. FULFORD • c My Comm. Expires Feb 28, 2017 '. ate= Commission #r EE 849356 Bonded Through National Notary Assn. NOTARY PUBLIC: Sign: Print: My Commission Expires: ExPtrtEe: JUN 23, 2014 d �� ✓� — �'�.$"K wwwAARONNOTARY COM aaaaaaaaaaa&&�aaaaaaaaaaaaa&curt& aaaaaaaaa ss1saafest*&fl�&�oka#r�e�ir&9o&aasT�&sY&ara&�&s4&s&&Rar&ara&�Srer�rr�ssra&&st&i�eiesa�a�&arfa APPROVED BY v v r dans Examiner Zoning Structural Review Clerk Revised 3/12/2012)Revised 07/10/07)0tmised 06110/2009)atvAsed 3/15/09) M . 4 f Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel. (305) 795 2204 Fax. (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA 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 ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1 MCA AHU CU PKG AHU CU PKG 2 M.O.P AHU CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EERISEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW VCONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity Office Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature (Quallflees signature only) Date: D�PAJR F B i u�T1 atf�t. u c e aS ' AtR eOhfWTI- IN caN �Ac�of� � � .n*J bq,Ov IAS; i1 fST f2FA... Uri l e Irr�viswgs" if -Cha t�sr 469 S, y.! Expatatloa date: AUG.31; L015 (tNDIVIDUAI IVlUST ��E f0 LitR#sG`� N ING Y, AREA,., R. f�LItRENIEI�TS,.IRE I C N A(d } q •SOAV.ARTONINOeA -14 .f: f I for• 'S+ } .Y F4 }y 1q �" '°-. `"b"ti�. MnA 't �,a `' � .�iks% } .�.a � �` b � �e„�sA'+•,� r� .�L4t 1 Y`` ,g .` � � ; �iP y t . n iq +s .". '..r ,2Rt�'' M�� ' � xa 6• v +�� ` ,y�..,`t �.�.'h ..,o- �1 'i 47..I.'9 '.3.,.Be� .. � . �,.. e.. .. ,sYt LARICK SCOTT MD: 10192 013 �®� L131� 1CDi SECRETAGRY IS GOVERNOR DISPLAY AS REQUIRED BY LAW CCNO, 000014748 ACORD CERTIFICATE OF LIABILITY INSURANCE d., 01/14/14 PRODUCER Financial Insurance Brokers 5805 Blue Lagoon Drive #400 Miami, FL 33126 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED Dade Super Cool Air Conditioning 13605 SW 149 Avenue #13 Miami, FL 33196 INSURERS AFFORDING COVERAGE MAIC # INSURER A: Wesco insurance Co. INSURER B: INSURER C: INSURER D: INSURER E: IiVYCTWfiCa THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PRETAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ENCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �m � TYPE OF INSURANCE POLICY NUMBER POUCYOTEMA vola;v+wh LIMITS GENERAL LAITY EACH OCCURRENCE 1.�.� DANIAGE TO RENTED PREMISES (Ea o=Mw) 100.E A 0 COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS MADE 0 OCCUR [�] B/i DED $500 Q PID DED $500 WPP1126038 00 11/15/13 11/15/14 MED EXP (Any an peroon) 5.000 PERSONAL a ADV INJURY 1.000.000 GENERAL AGGREGATE 2r=�M GEN'L AGGREGATE LIMIT APPLIES PER: [D POLICY ❑ PRO -SECT ❑ LOC PRODUCTS - COMPJOP AGG 2.M.GOB AUTOMOBILE tJAS LITY FIRE DAMAGE LIMIT COMBINED SINGLE LIMIT ❑ ANY AUTO ❑ ALL OWNED AUTOS (Ea nI) BODILY INJURY ❑ SCHEDULED AUTOS ❑ HIRED AUTOS (Perp—) BODILY INJURY ❑ NON OWNED AUTOS ❑ (PIN eaabdenn PROPERTYDAMAGE (Pet a=lderd) In GARAGE LIABILJTY UTO ONLY • EA ACCIDENT ❑ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AMA ❑ EXCESS / UMBRELLA LM18%" OCCUR AIMS MADE 0 ❑ CL (D WUM129433 00 12/16/13 12/16/14 EACH OCCURRENCE $2,0004100-00HA AGGREGATE S2.a8oAo0•40 ❑ DEDUCTIBLE ❑ RETENTION WORKERS COMPENSATION AND ❑ WC STATU OTHER EMPLOYERS, LIABILITY TORY LIMITS ANY PROPRIETERWARTNEWEXECUTIVE E.L. EACH ACCIDENT OFFICERMEMBER EXCLUDED? It yes, desalbe under SPECIAL E. L. DISEASE - EA EMPLOYEE EL. DISEASE - POLICY LIMIT PROVISIONS bebw OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT t SPECIAL PROVISIONS CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2 AVENUE MIAMI SHORES, FL 33138 ACCORD 25 (2010/W ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION -REOF, THE ISSUING INSURER WILL ENDEAVOR TO MIAI. 30 DAYSWRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACCORD CORPORATION 1988 A(f5---7'-'AD- n -12-. ACORD CERTIFICATE OF LIABILITY INSURANCE allow" 727 938-5562 LION INSURgNC� COMPANY 2739 U.S. HIGHWAY 19 AI. 'HMIDAY, fl, $4891 Tm GERTEFIE;ATF tS f9S M AS AMATTER OF IWORMATM pt>8.YAND CONFER$,NOR 4TSUMTMCORTIFICA7E HOiL1Eb2. THEECMFMTEDNS NOTA ,EM MOOR •ALTOR THE COVERACO AFFGR60D SY THE POLICIM BELOW. Rasum DADME SUPER COOL AIR CONDITIONING 13608 SW 149 A'VE, #13 MIAMI, FL 33996 INSURERS APFOPMW CDVERAGE AEAEEY iI NVSORIiRA: UON INSURANCE COMPANY 11075 iEMRTCR E3. ROWPXR Q D=RER D. RER 6:1 LJ IM POUOIF.S OF MMMM U87ED BELOW HAVE BUN 133iied TO"RMRED KAME A90VE FOR T14F POLQY P€REOD K$IIrA-MD, NOTWMWANOM ANyW-QMaTKT' YEM t>R COND=N QFAKy C0WrR'kCT OR OTHER DOCIRdIM WITH RESPECT TO vvr CH 7tM tMUWIC.A M MAYBE wUED OR WAY PWAIN, TETE= IN WXEAF [ib 6yj' M POI,M.DE6CREBEO wwN ES majEG77Q ALL THE Tmon. mmumEUNS AND CQm'j m of SUCH POLICII $. AOGRFAi6 i.WM WOMB MAY HAVE OWN BEOY= BY PAD CLAM . TMPOUOYNUDIm po1XfYEPiEmm DAIS 't POtiGYLkVUPA'PbN DAN (fit tRetts Lvapm ❑ OE> I4VfflTALLbVftM q❑ . CLAM amgpOWAJR EM�IoxtA Agee $ DAMSA46TOREMM ff PFAWAMOA 8@NtA GMA'i'8LWTAM=PM ❑ iY PRtr LCc Pt�9bWi.&At3VlNAJRY 8 GENERALAGGRM7 S PROIZIlCYS.lOPA¢0 AUTGROKEUMMM ANY AUTO L� ALL OMED AUTOS ❑ 569MU D AtlT✓195 llEiIItE3Dwros NOMI oftra Atl= $ $ Y ny tY g Y1NRiftY $ E7AU09 S s . ELlAt71lt1Y ANYAu El ro OONLY•lTAACCfDt$Ir ;t '�+N FiAj4CC S AUTOC LY., ACO $ 4MMIUMEMIAMARMW . Q OOWR ❑ CEAiMS EyADEd Acy9Rtn4gz6 1 Q DEtltkCf� a•�E • A�EAND a!IMLOY> iFl�lUtY PRMRI6E�RN O � 9W0. Wn vompwmm wow WC 79849 09/01114 01/01/16 ❑ Y+�gi'fsSU• A:.i +D?�R inr:Yttuns 6A�HAtrCdtl):IV: BA Ott-FAp�t,7Yp� �.P�S-Pa13CrspAT $i f�.tm 9 S1.t10b.0iiD.00 MOPIEtATtOhl81E.OGA'ftOM6�v�t'dE8ii�1�lONS+C[iDEDSf F�(DOi/8P�iCtAi.PROVE�ONS Fii+Blkm Radarstlon iso IMI UM east'Company Is A.M. Bm CQ ' A- Eic mI!g! t AM13 # 13616 MIAPdff SHORES VILLAGE 1 OM NE 2 AVE=NUE MIAMI SHORES, FL 33138 cmij") Ua w,�YOF'tE�Aeonr��w�P�rs�cA�gs�e�'ywEp�rtrA'rwti+1 ?MMM THEMAO tN MOtW LENDLAVftTOUWL29AAYSWR t M FgNAplAnTn'(w€tFFj: tu,TFAriue�rn�sosriAu a MW,U§DrcORUASWW(FAWMMUPO -MM fTiAWNMOR Im