Loading...
MC-14-419Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-208352 Scheduled Inspection Date: September 24, 2014 Inspector: Perez, JanPierre Owner: ADAM SHEPARD, ALISON ANTROBUS Job Address: 295 NE 95 Street Miami Shores, FL 33138 - Project: Contractor: <NONE> FLOW -TECH AIR CONDITIONING CORP Building Department Comments Permit Number: MC -3-14-419 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New A/C System Phone Number Parcel Number 1132060133970 HVAC AND DUCT WORK AS PER PLANS Infractio Passed Comments INSPECTOR COMMENTS False (: g If /amt I q Passed Inspector Comments Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 23, 2014 For Inspections please call: (305)762-4949 Page 2 of 25 Miami Shores Village Building Department 10050 N22nd 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: MECHANICAL OWNER: Name (Fee Simple MAR 0 6 2014 Permit No.1—iC I LI — Mester Permit No.RL- ( e-2 77,E Tu A J'5 Address: City.. Vo 01 S State: E Zip: 3313? Tenantlessoe Name: Phone#: � � � t _ � J� 0 Email: JOB ADDRESS: 'ZC '5T City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: F -1 '�4 A,<— Phone#: '-30S "2(-4 S Address: '1 `1-6 4!:? "3 t'b %f? . City: '1-t 114 t -t l State: Qualifier Name• #d4 '+=- -Z -O SC -=1 zip: _- 3.5 14 4 -5o'3 34s- tlq2t State Certification or Registration 0 `2,4 3"i 1 Certificate of Competency#: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Pennit:' $ � °CSU �. o Square41near Footage of Work: Type of Work: []Address []Alteration []New []Repair/Replace ClDemolition Description of Work: t4 V 41, Submittal Fee $ Penult Fee $_ V v V : vL/ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Ttaining/Fducation Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $.1_ �tv Bonding Company's Nand "(if applicable) Bonding Company's Address ; City state Tip 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 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 EAPROVEM ENTS 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 co cement must be posted at the job site for the first inspection which -o�c s seven (7) d after the building pennit is issued.r In th dbsenre of such posted notice, the inspection will not be appro� reinspeoi n fee®will be charged I / Owner r Agent The foregoing instrument was acknowledged before me this ?� day of , 20 ,Lo , by SA®'a yM1W S , who is onally kno to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: JENNIFER AUILES _* *€ Commission # EE 878845 My Commission Expires Sign: '•a;,� ;,; February 27, 2017 Print: CVIL4 VO My Commission Expires: APPROVED BY cam, Contractor The foregoing instrument was acknowledged before me,this �Z4L> day of 20J , byLlA1240,C� wh is ersonally known orae or who has produced as identification and who did take an oath. NOTARY PUB JENNIFER AUIlE3 -' Commission # EE 676845 ?�•P pPo�; My Commission Expires Sign: February 27, 2017 Prin, t y ® it C � Plans Examiner Structural Review (Revised 07/10/07)(Revised 06/1=009)(Revised 3/15/09) My Commission Expires: ?"f ° r I n Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel. (305) 795 2204 AIR CONDITIONING REPLACEMENT DATA Fax: (305) 756.8972 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 ❑ Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration N. Certificate of Competency N. Signature (ousmses signature only) Phone: Date: UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1 M.C.A 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 / / EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4000NCRETE SLAB YES NO YES NO I NEW ROOF STAND YES NO YES .. _ ..... NO. I NEW RETURN.PLENUM BOX _ ....._ --j-YES. ... NO Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration N. Certificate of Competency N. Signature (ousmses signature only) Phone: Date: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION AJ 4a BUSINESS NAME: r _�I� C CUSP BUSINESS ADDRESS: -7613 SW (3 t UC CITY (,d l , � ( STATE C L- ZIP CODE BUSINESS PHONE:( G' )���' - 12 FAX NUMBER(__) CELL PHONE3( 0- ) Z-bLf MS061 QUALIFIER'S NAME: d QUALIFIER'S LIC NUMBER: C° N to () Z4 3 i l Created on 3119109 BY MLDV I RV 3126109 MLDV 1 RV 6127111 AS FL0WT-1 OP ID: GBG '`►� RD� CERTIFICATE OF LIABILITY INSURANCE03/005/201 51201'"' 4 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 policy(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 endorseme s . PRODUCER Phone: 305-364-7800 BROWN & BROWN OF FLORIDA INC Fax: 305-714.4401 14900 NW 79th Court Sulte0200 Miami Lakes, FL 33016-5869 Carlos L Lacasa, Sr NE PHONE Fnx No . -MAIL: GLOO1092244 10/06!2013 INSURER S AFFORDING COVERAGE NAIL d TNSURERA:National Trust Insurance Co. 20141 DAMAGE A ET R NTED cs $ 100, INSURED Flow -Tech Air Conditioning Corporation 7023 SW 13th Terrace INslmER B:FCCI Insurance Company 10178 INSURER c:Philadelphia Indemnity Ins Co 18058 GENERAL AGGREGATE $ 2,01XI, Miami, FL 33144 INSURER 0. INSURER E: C INSURERF: LIABILITY ANYAUTO ALLOWNEDSCHEDULED AUTOS AUTOS HIRED AUTOS AAUTOSWNED COVERAGES CERTIFICATE NUMBER: 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. NLTR SR TYPE OF INSURANCE ADDL Miami Shores Village POLICY N MBER POLICY EFF POLICY EXP UNITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IF -7y OCCUR Miami Shores, FL 33138 GLOO1092244 10/06!2013 10106=4 EACH OCCURRENCE $ 1,000,004 DAMAGE A ET R NTED cs $ 100, MED EXP (Any one n) $ 51 PERSONAL & ADV INJURY $ 1,0W,04 GENERAL AGGREGATE $ 2,01XI, GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS - COMPIOP AGG $ tow, Emp Ben. $ 11000100 C AUTOMOBILE LIABILITY ANYAUTO ALLOWNEDSCHEDULED AUTOS AUTOS HIRED AUTOS AAUTOSWNED PHPKI084719 101MM3 IOIMO14 =INGLE LIMIT 110001 X BODILYNJURY(Perpe—) $ BODILYNAM(Pere ) $ (Per �d�DA AGE $ $ UMBRELLA A LIAR EXCESS LIAB HOCCUR CLAIMS -MADE FJ\GH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ B WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUi1VE YIN OFFICERIMEMBER EXCLUDED? El (Mandatory In NH) W yyas describe under DESGtRIPTI0 OF OPERATIONS below N I A MWC13A62015 06r29M3 M1012014 X I WCSTATU ETR EL EACH ACCIDENT $ 1,ow E.L. DISEASE - EA EMPLO $ 1'0W'00( E.L. DISEASE - POLICY LIMIT $ 1,000. DESCRIPTION OF OPERATIONS I LOCATIONS I VEMCLES (Attach ACORD 101. Adit"a l Remarks Schedule, U mare space Is required) Certified Mechanical Contractor CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 Northeast 2nd Avenue Miami Shores, FL 33138 AUTHOR®REPRESEWAlWE ©1980-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD Local Business TaxReceipt = Miami -Dade County, State of Florida THIS IS NOT A BILL- CO'NOT PAY 2303824 BUSINESS N"E/LOCATION RECEIPT NQ FLOW TECH AIR CONDITIONING CORP RENEWAL 7023 SW 13 TERR 2421660 MIAMI FL 33144 EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant to County Code Chapter SA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED FLOW TECH AIR CONDITIONING CORP 196 SPEC MECHANICAL CONTRACTOR BY TAIL COLLECTOR Worker(s) 10 CACO24371 $75.00 07/12/2013 TXHSI-13-025735 This Local Busing Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license. Permit ar a ceMeadoe al the hoMei's gaalWmWam to do hnakwm Holder most comply with any governmental or nongovernmental regulatory [am and requirements which apply to the business. The RECEIPT N0, above mustDe displayed on all commercial vehicles - Miami -Dade Code Sec ea -M For more information, visit www.miamidade.aevftaxcallector THIS DOCUMENT HAG A COLORED BACKGROUND • MICROPRINTING • LINEMARK`°' PATENTED PAPER l 1 OF • DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SE00L12062500510 The CLASS B AIR CONDITIONING CONTRACTAF Named below IS CERTIFIED Under the provisions of Chaptet;489 FS;. Expiration date: AUG 31, 2014 PEREZ-VELASCO, MARIO J FLOW -TECH AIR COND CORP 7023 SW 13 TERRACE MIAMI FL 33144 RICK SCOTT REN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW