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MC-13-1948i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-198039 Scheduled Inspection Date: December 10, 2014 Inspector: Perez, JanPierre Owner: CURZON, ANDREW Job Address: 10050 NE 12 Avenue Miami Shores, FL Permit Number: MC -8-13-1948 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132050190370 Project: <NONE> Contractor: S&K AIR SERVICE Phone: (305)710-2654 Building Department Comments REMOVE AND REPLACE WITH NEW EXHAUST FAN Infractio Passed Comments OVER OVEN INSTALL BATHROOM EXHAUST FAN INSPECTOR COMMENTS False Inspector Comments Passed MI Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 09, 2014 For Inspections please call: (305)762-4949 Page 1 of 43 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: MECHANICAL OWNER: Name (Fee Simple Titleholder):, Address: City: k Tenanth..esseo Name: ----�� Email: e r o0 - 0, . rD U 55 M Permit No. K 13 I —I � S Master Permit No.�Sk 3 _119 Z 3 State:_ zip; �t='Ti��"•� JOB ADDRESS: City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: S i Address: �O City: ' c�iU Q State: Qualifier Name: M2NLQ Ur, -S State Certification or Registration #: CA(2- fid, 2 Contact Phone* -' Email Address: DESIGNER: ArchitectlEngineer: lU Of Competency #: Phone#:�—i0 Value of Work for this Permit: $ 4yD > ®c-�:) SquarelLinar Foo a of Work: Type of Work: OAddress OAlteration ONew /'air/Replace Desaftflon of Work: 12V r A nVe- 42 5k- 0 P - A /i Vl en -1 /a4 .. /')k/0V'1 ODemolition ev;-r Submittal Fa $ Permit Fee $ r,Uy CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Educ atiou Fa $ Technology Fee $ Doable Fee $ Structural Review $ TOTAL FEE NOW DUE $ '1__1 /� Bonding Company's Name (if applicable) Bonding Company's Address City State A Zip 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In theab ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged �" Owner or Agent Contractor The foregoing instrument was acknowledged be me this ZIL The foregoing instrument was acknowledged before me thisd3 day of A 920 0 by f hlT22C�c c> day of f 20 4-'�, by id l�-�yheC�U�S Who is perso ly known to me or who has produced who is person me or who has produced RAAXAA identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print -e Print: M Commission. ;Darr P �ry Public State of Florida Y ExP \, Diane Sdmairtz My Commission E F d� Ex ires 0 isaw*612 EE 198526 Expires 05108/2018 ✓/ 0 ,p,.►R* %* Notary Public State d Florida Diane Schwartz *` MY COmmissl= EE 196928 '' m ti Expires 45/08/2016 APPROVED BY 414 -Z�p�L— flans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 0 i/10/2009)(Revised 3/15/09) 2013-08-26 10:29 Lakes Insurance 3055126468 >> 1 800 685 7530 P 2/2 F LIABILITY' INSURANCEQW2W ) Tt +ca icAYs is i (Mb ASA A i` ik 46i' i0 t6kMAT' gM ONLY AND a Oi FERS NO RlIGHTS UPON THE CERTIFICATE t XORK THIS CERT FICATE DOES NOT AFFIRM TIVe#.'Y OR t+li;GA'i`#'4 ELY AMM,1;XTEW OR ALTER '# w coveRA E AFPOti i i�'t T$�l �;.tfi�1 L4 . Ti�ta i�Bl Tv'lCAT9: OF ii t�i� lea t�itTlr Ct#?iatSTt CUTE A �°flia MACT MEM Ti F� €S�SUM iPdgiaRelgp, ,�lhi`rM=gid j as i ispRee VT k rivi'r +C R l ,cap, Amo Tw cgRTiFlcATle wL=x IMPORTANT,. 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ND7'yeapWANONG ANY hiNO€liiWW9W, ' 9AM OR �#t�io1131't ION OF AW CONTRACTOR OR OTHER 00CWENT WIT �� s:i T� W Ei�i I TPft3 f 6tiIF TS (moi' : ISS6d I :JR4 f Y PERTA N, Tt INSURANC r AFFORWO BY THE POLICIES OBS�t Bi3;�iBRE1 tS ;�6d13.€i �;9 T�! AtL THB 7SEtta�S, SX0LU0"S G ITma or wOm �'�bi.ICES, LUTS MOWN +Y IiA Sats DUC SY'SpCI Cf.�, OLW ( Tvaatwileatt t8 �l6kl.LileRfLlTY � Pfi #;?PNitL9i t �p a �GyYY9'1} i YAPli .. LiARtFB ® W toLdelkt8.89#C!� OCCUR rl 10M4=14 j 6 .tTtl �il# tlitti N N i�9 SSF'! 3 1799 3 OF-44. A401WvAi'SppL�1�itY A&rtR,ti. Rt 3f ;!0Lit.Y ® f62 ®GtiO 0 AWf AWO f C7 4:.. OWNED Mn" La er uaaat o knot � +sra,�arzise UMBROUA L" [3 acem OXON i UAB 0 mu"I. 81LE f jgET1�M{YfY.b>•i •iq ... NO COVERAGE i NO COVERAGE i f# i AJ NO COVERAGE t NO COVERAGE CSSti�'fli9ld iaF C4P�'6taY1'Y4�8t l LAYti�in r i�b17�l.it�'I f ..:..... f�AW'6 Sd` 9¢i+ ."�tpilttdil6tr M" DPW* P,,,4V , Alt C19ti0j $ hit Md iftfiS{fl 10", MRSCNAI. A ACV 1tiARV QEiAEivtm a alafts hta i NA lcwawrto emote � btkst BaE511.y:8hlmy tter pgmw, ! tiL'P fibdtJ�`? 1 an�Ndar,!� .=OA104" 04 OCCtRAPNC4. AWftes,X t 13 I I� s a 3 Ej 110MR4'ssat7S I i CR ' i ML t AC" RCC10 NT t 6 I!& MWAIM, ZA VAPLOM S B.L, fl1.A � #3tfC'� 1,3l�AT S CERWWATE i41 wen CANCELLATION i r ' SHOULD ANY OFTHS ON B SB CAUMLLM Waft, Miami t"'Erre � `14M UPIRAW010ATe TfjWftp, W rKg W LI,. �1E i3ELtitS DIN vi tdilsv nl *PSE WITH ftLICY te, 9 NE. 'td Avory MbfM idea. FL 33935 Pax 33Ei-:a -4t ACMD 26 "f t� 12F 4i #�ttv A .. CORPO K AIl aaartired T h6 ACOP me ltd lavas as 8Mdwupk..11A00M " rTHIS`DOOUMENT HAS A COLORED BACKGROUND; -'N IICROPRINTING.- LINEMARKTMPATENTED. ,APER °i „ y„. .AC# 6221886 STATE OF FLORIDA .ate Q DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12072300684 .. - LICENSE NBR 07/2 /20121120037790 CAC058735 The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 MARQUES, PAULO JORGE S & K AIR SERVICES, INC 18001 N. BAY RD#506 NORTH MIAMI BEACH FL 33160 RICK SCOTT GOVERNOR 11 DISPLAY AS REQUIRED BY LAW REN LAWSON SECRETARY MIAMI-DADE COUNTY 2012 LOCAL BUSINESS TAX RECEIPT 2013 FIRST-CLASS f TAX COLLECTOR MIAMI-DADE COUNTY - STATE OF FLORIDA U.S. POSTAGE 140 W. FLAGLER ST. EXPIRES SEPT. 30, 2013 PAID 1st FLOOR MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL MIAMI, FL 33130 PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 PERMIT NO. 231 THIS IS NOT A BILL — DO NOT PAY 481243-5 BUSINESS NAME / LOCATION S & K AIR SERVICES INC 18001 N BAY RD 33160 SUNNY ISLES BEACH OWNER S & K AIR SERVICES INC Sec. Type of Business IM IS M16A W MECHANICAL CONTRACTOR WW,Mss TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR RENEWAL RECEIPT NO. 502325-4 STATE# CAC058735 506 WORKER/S 1 zONM LAMS OF THE DO NOT FORWARD COUNTY OR CRIES. NOR DOES R EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE og�DRn caiTINIONN o S & K AIR SERVICES INC THE HOLDER'S OuaLIFlra- Wows. PAUL MARQUES PRES 18001 N BAY RD #506 PAYMENT RECEIVED MIAMI FL 33160 MIAW-DADE COUNTY TAX COLLECTOR: 07/13/2012 60050000329 000045.00 SEE OTHER SIDE ol Id ' y a JEFF ATWATER CHIEF FINANCIAL OFFICER �-�&ham STATE F FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION 07-10-2012 * * 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: 07/09/2012 PERSON: MARQUES FEIN: 651133182 BUSINESS NAME AND ADDRESS: S & K AIR SERVICES INC 18001 N. BAY RD. #506 SUNNY ISLES FL 33160 SCOPES OF BUSINESS OR TRADE: 1— HEATING, VENTILATION, AIR—GOND EXPIRATION DATE: 07/09/2014 PAULO i IMPORTANT. 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. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIONS? (850) 413-1609