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RC-13-1748tet, 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 Permit Type: MECCAL Permit No.PW, / 3 r / 7 C Master Permit No. C. /. / 7W OWNER: Name (Fee Simple Titleholder): Phone#: 3o5'- 5-q?, Address: 12 city: �`.� 1 + ' S +.roq,C—� State:-{ c- Zip: '� 01 3 3138 . Tenant7lessee Name: Phone#: Email: JOB ADDRESS: 1208 NE 49 5k, City: Miami Shores County: Miami Dade Zip: -53+1s Folio/ParceW Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: PI,k Axa Phone#: 9 e&4 - 4 ct2- b U-5 Address: \\o v ors X4X g�: 401R City: __ V - ,: M% -z State: F l zip: 7 31'-x q Qualifier Name: Sera;..? 5ar.ci:!U phone* 18(6- Zz8- SnZL State Certification or Registration #: CAC %'8 l S $ Certificate of Competency #: Contact phone#: `lam' -49(.-7-a8- Sm2-Z. Email Address: 1A gk scL,, 4- c,' 0 Y q WA 60 c.n v� DESIGNFRs ArchitectlEngineer: Phone#: 305. 5,2 8. 50 3-t- Value of Work for this Permit: $ 35� Square/Linear Footage of Work: Type of Work: ❑Address DAlteration UNew 2(Repair/Replace ODemolition Descniptlon of Work: i2�wcAIT-- we �s=<<a C� tfi/� 0-4+7,_' >oL491N N Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Doable Fee $ Structural Review $ 77 TOTAL FEE NOW Dim dL/i Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 7i 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 COM IENCEMENT 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 a posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such posted notice, the inspection will not be approved and a reinspe 'on fee will be charged P� Signature Signature Owner or Agent Sr - The foregoing instrument was acknowledged before �rI me this � day of 0MAS4 ,. 20 ]?i, by , ho is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: P v Contractor v The foregoing instrument was aclmo�de/dged before me this!— day his tday of \ 20 by who isp sa at�Ty?rn�i o me or who has produced j r a as identification and who did take an oath. NOTARY Sign: / / - Sign: 01 Print: ow of Florida My Commission Expires: g`j9/ hAaridai GOMM= outlwM ' C My Commbsbn DOM717 ?a a Expims 08/19/2014 �a�s+�e+�*e��a��+��s*�+sa�a*�**��*s***+�*��* �e**ee�+s*•x*+s�*a��*e�*+s�eeee APPROVED BY lillb )Rens Examiner" Structural Review (Revised 07/10/07)(ReviwJ 06/1=009)(Revised 3/15/09) ILIC• �� O •xPires•..•� ,� Pd TARY PUSUC Expires:�A% EE173059 Q. Zoning Clerk ZAA CERTIFICATE OF LIABILITY INSURANCE 7DATMEM/DD/YYYY) 2013 THIS CERTIFICATE IS 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 certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and 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). PRODUCER NAME: Alexander Dopazo CIC Dopazo and Associates PHONE (305)470-8500 FAX Rol: (866)647-9673 8725 NW 18th Terr Ste 300 E-mAL.info@dopazo.com ADDRESS INSu 8 AFFORDING COVERAGE NAIL 0 Mit FL 33172 INSURERA E'ss6X Ins Cc 9020 INSURED All Air Solutions IAC INSURER B:PrO ressiv@ cess Ins Cc 10193 INSURER C -Mount Vernon Fire Insurance C c 6522 1101 NE 191 Street #408 INSURER DBusiness First Insurance Co. 11697 OCCURRENCE $ 1,000,000 INSURER E Miami FL 33179 PERSONAL & ADV INJURY $ 1,000,000 COVERAGES cEwTIFlr_ATa til undo rr.1 i, n, neena INSURER F: __..._.__. _..._____ -- REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE POLICY POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR NBOOD14040 /27/2013 /27/2014 OCCURRENCE $ 1,000,000 PREMISES Ea nce $ 100,000 MED EXP Any one Peen) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: X POLICY S F1 LOC PRODUCTS - COMP/OP AGO $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOSAUOSSCHEDULED HIRED AUTOSNOJTN03WNED 02132056-0 /27/2013 /27/2014 COMBBIINE IN LIMIT 1 '000,000 BODILY INJURY (Per Person) $ BODILY INJURY (Peracddent) $ PROPERTY DAMAGE Peraaident $ PIP -Basic $ 10,000 EACH OCCURRENCE $ 5,000,000 C X UMBRELLA B ]( OCCUR EXCEL LIAR CLaMs-MADE AGGREGATE $ 5,000,000 D DED RETENTION WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY Y / N ANY PROPRIETORMARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? [YK]NIA (Mandatory in NH) If describe under DESCRIPTION OF OPERATIONS below 1182398 21-04444 /27/2013 /23/2013 /27/2014 9/23/2014 WC STATU- OTH- X I TORY LIMITS 1 FR E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Air conditioning sales, intallation and repair. rCnTICUrATc unr nes _ (305)756-8972 City of Miami Shores Building Department 10050 HE 2nd Avenue Miami Shores, FL 33138 Arman 9r ion-inntta SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR&" REPRESENTATIVE Dopazo CPIA/MAD - v I VUtl-zUIU AGUHD CORPORATION. All rights reserved. INSD25 r7nim m m Tho annran name onrl Inn- are ronlefororl marlre -f Arman a k Miami shores V11age Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT :Permit N. ci 3 — n L4 C� Qi rler's Name (Fee simple Title Holder)-' �- f- -,M Phone #: Owner's Address: t -®� '14 � -1 City: B c S S 1-�-p state: 1— Zip Code: 3► 3 Job Address (of where work Is being done):_ City: Miami Shores State:_Florida Zip Code: 3 $ Contractor's Company Name: Aa �;� se4�, e -u a Phone#.- gs "t- 812 Jr. Address • d o► 0 S t q t' g e yo$ City:,). - �: a•-�:, State:_ IC_ Zip Code: `3 Qualifier's Name: S t,, Z:�, Sone Lic. Number: c ks d s Q Architect/ Engineer of Record Name: Phone #; Address: City: State: Describe Work: Zip Code: I hereby certify that the worts has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official, and the Miami Shores harmless for all legal involvement. Signature h owhe%rAgeM The foregoing instrument was aknowledged before me this L day o 013,by Who is personally known to me or who has produced Seal: as indentiflcation. Notary Pulte State or Florida Mandel Gonzalez Gutierrez: My commission DD999717 Expires 08/19/2014 Signature 'Q_ ceororArcjlit�ct o The foregoing Instrument as aknowledged before me this .P day of e7 200by 5fif-70 who isrsonally know��toor has produced Seal: A (." - (6 - v3 - �i49. October 16, 2013 M&C Contractor"s Attn. Alberto Leal 2400 S Red Rd Miami, FL 33155 REF. Hvac work at 1208 NE 99 ST, Miami Shores, Fl. Dear Alberto, This letter is to let you know that for financial reasons the owner has decided to go on a different direction and requested us to find another HVAC Contractor. You will no longer be enlisted or your services required for the job referenced above. ° We hope to use your services in the near future. Sincere LJW C Joaquin Pineros M2 Construction Group 440 NW 90 ST El Portal, Fl. 33150 MIAMI SHORES POST OFFICE MIAMI SHORES, Florida 331539998 1156540118 -0095 10/22/2013 (800)275-8777 11:25:27 AM Sales Receipt OTT Product Sate Unit Final Description Qty Price Price PVI Refund - Label Available -$J.bo Cash MIAMI FL 33155 Zone -0 $0.46 First -Class Mail Letter 0.60 ox. Scheduled Delivery Day: Wed 10/23/132.553.10 Return Rcpt (Green Card) @@ Certified Label #: 70123050000132418605 oe��eeca Issue PVI: $6.11 Totals $2.55 Paid by: $2.55 MasterCard Account #: XXxxXXXXXXXx9260 Approval #: 05474E Transaction #: 36 23 903520633 @@ For tracking or inquiries go to USPS.com or call 1-800-222-1811. Order stamps at usps.com/shop or call 1-800-Stamp24. Go to usps.com/clicknship to print shipping labels with postage. For other information call 1 -800 -ASK -USPS. wwwarwaawwwwwwwwwwwwww*wwwwwwwwwwwwwwwwwww wwwwwwwwwwwwwwwwwwwwwwwwwwarwwwarwwwwwwwww Get your mail when and where you want it with a secure Post Office Box. Sign up for a box online at usps.com/poboxes. wwwwwwwwwwwwwwwwwwww,awwwwwarwwwwwwwwwwwww wwwwwwwwwwwwwwwwwwww.�wwwwwwwwr.wwwwwwwwww Bill#: 1000502963142 Clerk: 04 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business wwwwwwwwwwww,rwwwwwwwwwwwwwwwwwwwwww*wwww awwarwwwwwwwwwwwwwwwwwwwwwwv„vwwwwwwwwwwww HELP US SERVE YOU BETTER Go to: https://postalexperience.com/POS TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS wwwwwwwwwwwwwwwwwwarwww,awvrww+er.wwwwwwwwwww wwwwwwwwxwwwwwwwwwwwwwnawwwwwwwwwwwwwwwww Customer Copy u7 C3 ti ren 0 C3 0 L, 0 Fri ti rq a N ■ Complete Items 1, 2, and 3. Also complete Item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse k so that we can return the card to you. K Attach this card to the back of the mailpiece, or on the front N space permits. f1. Article Addressed to. A. Signature / / . Agent B. 5eceived by (Pdnfed D. Is delivery address different from (tem 1? u Ye: If YES, enter delivery address below: ❑ No C�. j 1 13 Exprew Mail 'tTRegistered C3 Return Reoeipt for Merchandise insured Mail O C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Tiansierfrom San 7012 3050 0007 3247 8605 PS Form 3811, Fl...._j z vomesnc Return Receipt 102695 -02 -M -154c 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 mg;r_ gra t r_,KL, Permit Type: - JOB ADDRESS: 1208 NE 99TH STREET FBC 20 AUG G Permit No..M C � I—)] go/ Master Permit No 13 `" V1 LI City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3205-009-0200 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER: Name (Fee Simple Titleholder): Daniel N. Berger and Hara R. Berger Phone#: 305-542-6098 AAA,- 1208 NE 99TH STREET City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: N/A Phone#: N/A Email: dnberger@gmail.com CONTRACTOR: Company Name: �"I R &M� �� j(iNyjjt'i"j•J►� & Phone#: -' - . - .• • ' - - Address: City: WAKi B9AC1A State: T Zip: 331 3cl Qualifier Name: C, OR ,Qll%$bo:''l j Phone#: 91g 2 7 41(.3 State Certification or Registration#: 48%r/62 Certificate of Competency #: Contact Phone#: 7& RA60f'V 37 Email Address: MOM%OWOr. & 46Aew !WZ (Pd s"Mst rr .GoMIr • DESIGNER: Architect/Engineer: Phone#: I cJ� - Value of Work for this Permit: $ 6 � 6 0 Square/Linear Footage of Work: Type of Work: ❑Address Altejjration ONew ORepair/Replace ODemolition Description of Work: 010Ggt' b ft go - Submittal Fee $ Permit Fee $ b � 00 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ Pq TOTAL FEE NOW DUE $ dj • U V 0 « - 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 absen-/I f such posted notice, the inspection will not be approved and a reinspection fee will be charged I In -� Owner or Agent V Contractor The foregoing instrument was acknowledged before me this day of 0 , 20 M by � V"%- e-1 6e�� who person 1 known to me or who has produced Pe Y As identification and who did take an oath. The foreg�g i strument was acknowledged day of eJ O' 20 by me this Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 000/2009)(Revised 3/15/09) DBPR - PREVISDOMINI, GERMAN ALEXIS; Doing Business As: M & C CONTRAC... Page 1 of 1 11:19:32 AM 9/10/2013 Licensee Details Licensee Information Name: PREVISDOMINI, GERMAN ALEXIS (Primary Name) M & C CONTRACTORS (DBA Name) Main Address: 1424 COLLINS AVE MIAMI BEACH Florida 33139 County: DADE License Mailing: Lice nseLocation: License Information License Type: Certified Air Conditioning Contractor Rank: Cert Air License Number: CACIS15162 Status: Current,Active Licensure Date: 08/25/2006 Expires: 08/31/2014 Special Qualifications Qualification Effective Class A 08/25/2006 Construction Business 08/25/2006 View Related License Information View License Complaint 1940 North Monroe Street. Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mall to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(S), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine if you are affected by this change. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=748BE56EBCD373ADE... 9/10/2013 mechanical need heat load calcu and plans to show all existing work to remain (`' ��` �N ` tel/ /h✓) CAT C OP -26.1 2 I t =x� U 0 im