MC-12-1832Inspection Worksheet
Miami Shores Village l
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-179389 Permit Number: MC -10-12-1832
Scheduled Inspection Date: May 15, 2013 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre Inspection Type: Final
Owner: SUAREZ, ALEJANDRO Work Classification: Kitchen Hood
Job Address: 85 NE 110 Street
Miami Shores, FL 33161- Phone Number 954/961-1400
Parcel Number 1121360040240
Project: <NONE>
Contractor: AIR KING MECHANICAL CONTRACTOR, INC Phone: 305-823-5888
duuamg oepanment comments
INSTALLATION OF NEW KITCHEN HOOD
INSPECTOR COMMENTS False
May 14, 2013 For Inspections please call: (305)762-4949 Page 5 of 45
Spector comments
Passed LO/
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
May 14, 2013 For Inspections please call: (305)762-4949 Page 5 of 45
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Nov,13. 2012 11:51AM TORRES INSURANCE AGENCY
12-® IYZq
No. 1421 P. 1
AV-0—RD, CERTIFICATE OF LIABILITY, INSURANCE
I1 3i2°o 2
PRODUCER (305) 512-5880 FAX: (305) 512-5881
Tomos I>IaSluranoo Inc
Agency .
6135 NSP 167 STREET # E25
Miami Lakes F,L 33015
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.
INSURERS AFFORDING COVERAGE NAIC 8
INSURED
Air king Mechanical Contractor, Inc
3381 SW 137th Avenue
Miramow FL 33027
INsumR A. Century Surety Conp=y A
64WRORR
INSURERG
INSURER D!
INSURERS:
(305) 756-8972
MIAMI SHORES VILLAGE
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
23
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCRII BEFORE THE
EXPIRATION DATE THEREOF, THE IBSIANG INSURER WILL ENDEAVOR TO MAIL
10 DAYS wRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PUT
FAILURE TO DO SO OU" IMPOSE NO OBLIGATION OR LIABILITY OF ANY KM UPON THr
less
THE POLICES F INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE MORE=O 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 DESCRIBER HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES,
RELIE LIMITS SHOM-FAA-YNREQUM BY PAID CLARIL
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1A00%am TYPE OF INSURANCE POLIOY NUMBER DATE EFS DATE D LmI9
GENERALLIABILITY
OCCI IRRIMMS 300,000
E RENTED S 100,000
D g 5,000
A
X COMMERCIAL GENERAL LIABIU Y
CLAIMSMWDE � OCCUR
COP 797947
11/8/2012
11/8/2013
$ 300,000
x �1,aoo WP Dad/claim
GENIRALAMUgM g 300,000
GEN'L AGOFtROATE UMITAPPLIES PER
p 300,000
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AUTOMOBIL9-UASLITY
ANY AUTO
COMBINED SUIGLE UMIT
(S0 Aameno
BOOLY INJURY S
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ALLOWNED AUTOS
SCH®ULEDAVTOS
BODILY INJURY
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MIRED AUTOS
NON•OWNED AUTOS
PROPERTYDAMAGE $
(Per aCC14enU
""GELU18IL11Y
AUTOONLX-EAACCIDENT 5
OTHERTWIN FAA
ANYAUTO
AUTO ONLY AGG 5
EXCE68d URRELLA LIABILITY
OCCUR ❑ CLAIMS MADE
EACH 0CMAMENIZ5
AGMS
DEDUCTIBLE
S
S
RETENMN f
WORIC:RB COMPENSATION AND
j1f3a&j O
EMPLOYERS' LIABILITY
ANY PROPMETONPARTNER/EXECUTNE
EACH ACCIDENT
E.L. DOEME - FA ELI 5
0FFICEPA4WBER EXCLUDED?
Ryes, destFOe under
CIAL av
E.L. DPOLICY LIMIT 5
OTNER
DESCVMON OF OPERATIONII&OCATIONSNENICLENEXCLUSWNS ADDED BY ENDONSEMENTISPEOWL PROVISIONS
A .r Con"timang Serv3ao and R"air
(305) 756-8972
MIAMI SHORES VILLAGE
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
23
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCRII BEFORE THE
EXPIRATION DATE THEREOF, THE IBSIANG INSURER WILL ENDEAVOR TO MAIL
10 DAYS wRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PUT
FAILURE TO DO SO OU" IMPOSE NO OBLIGATION OR LIABILITY OF ANY KM UPON THr
less
* as CERTIFICATE OF ELECTION TO 81 EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
'10,141iI
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE-- 02/22/2012
PERSON: AMARAL
KIM 6W937960
BUSINESS NAME AM ADDRESS:
AIR KING MECHANICAL CONTRACTOR INC
3361 SW 137TH AVE
MIRAMAR FL 33027
EXPIRATION DATE—' 02121/2014
SCOPES OF BUSINESS OR TRADE
I- REPAIR SERVICE 2- SALES
3- CERTIFIED AC CONTRACTOR
IWWAXT- P111`1I to Chapter 440 - 0604l, F.S,, an officer at a corporation Who $facts exemption from thin Chapter by filing a certificate of election under this
section may not recover bevallis of compensation under this ClISPIST. Pursuant to Chapter 440.8502), F.S., Certificates of election to be exempt.. apply only within the
scope of the business or trade listed an the notice Of election to be exempt Pursuant to Chapter 4.40.06113), F.$., Notices of election to be exempt and certificates of
election to be exempt sball be subject to revocation It, at my time dief the filing of the notice or the issuance of the certificate, the parson atmed on the maice or
certificate no longer meets the requirements of this section far Issuance of a cartiflimte. The 4eparlmool shall revoke a certificate at MY time for failure of the person
owes an the certificate to meet the tatlaframents of this secdoo.
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIOW (850) 413-1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
ativism OF vioRkens, COMPENSATION
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TORE EIMPT FROM FLORIDA
VM(ERS` COMPENSATION LAW 0
EFFECTIVE 02/22/2012 EXPIRATION DATE. 02/21/2014
PERSON. ANGEL AMARAL
FEIN SSM379130
BUSINESS NAME A10 ADMESS.
AIR KING MECHANICAL COWMACTOR INC
335 SW 137TH AVE
MRAMAR FL 33027
SCOPE OF BUSINESS OR TRADE
I- REPAIR SERVICE 2- SALES
3- CERTIFIED AC COWRACTOR
OWC-252 CERTIFICATE OF ELECTION TO SE EXEMPT REVISED 01-11
F IMPORTANT
Pursuant to Chapter 440.06(14), F.S., an officer of a corporation who
0
elects exempition from this chapter by filing a certificate of election
L under this section may not recover benefits or compensation under this
D chapter.
Pursuat to Chapter 440,0(12), F.&, Certificates of election to be
H exempt.. apply only within the scope of the business or trade listed on
R E he notice of election to be exempt
E Pursuant to Chapter 440.05(13), F.S. Notices of election to be exempt
and certificates of election to be exempt shelf be subject to revocation
if, at any time after the filing of ft notice or the issuance of the
certificate, the person named an the mice 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.
QUESTIONS? (850) 413-1609
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