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MC-15-226
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227513 Permit Number: MC -1-15-226 Scheduled Inspection Date: February 04, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: MARKUS, DAVID Job Address: 1190 NE 92 Street Miami Shores, FL 33138 - Project: <NONE> Work Classification: A/C Replacement Phone Number Parcel Number 1132050270460 Contractor: HARPERS AIR, INC. Phone: 305-266-1040 Building Department Comments CHANGE OUT 4 TON SPLIT SYSTEM IN 2003 WAS mtracao Nassea comments NEVER FINAL OUT ME2003-110 1 INSPECTOR COMMENTS False February 03, 2015 For Inspections please call: (305)762-4949 Page 17 of 33 Inspector Comments Passed L Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. February 03, 2015 For Inspections please call: (305)762-4949 Page 17 of 33 Miami Shores Village JAN 3 0 2015 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 P YNr I T1F %n F- 2,003-110 Tel: (305) 795-2204 Fax: (305) 756-8972 f INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 i U BUILDING Master Permit No. MCI �n tCI PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION (aRiINEWAL ❑PLUMBING [M MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS !OB ADDRESS: 1190 NE 92 Street City Miami Shores County- Miami Dade Zip: ?, Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): David Markus Phone#: 786-897-4790 Address: 1190 NE 92 Street city. Miami Shores State: FL Zip. 331�,3G8 Tenant/Lessee Name: Phone#: �(D d 14190 Email: DSMarkus@aol.com CONTRACTOR: Company Name: Harper's Air Inc Phone#: 305-266-1040 Address: 1031 SW 0 74J9 -- City: L,/ 't CA ► Ytl State: EID h ca 0— Zip: S3 1g4 Qualifier Name: Terry Harper Phone#: 30S. of (40(V - 1040 State Certification or Registration #: CC A-0-0 a3 '44-1 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ C),3 - o9 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New © Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ �% .00 Permit fee $ � 00 - CC CCF $ CO/CC $ Scanning Fee $ ( Radon Fee $ DBPR $ Notary $ Technology Fee $ Structural Reviews (Revlsed02/24/2014) Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ �� , Ni _ {"i 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. 1 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. 1 understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 absence of such posted notice, the inspection will not be approve nd a reins ection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of �Gl''�L `�t^ ' 20 IS by �i�IB► tt(� who is rsonally kn wn to me or who has produced V-� L c" as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: hj `' t Ck e_ \4 Lt0r-p,� Seal: `.�osiv'P�,% Neyda Victorero ex; �_COh1!Y11SSI0N#EE088142 9 EY"r' REQ: APR. 26,2015 ''•a°u;;o•�� www.AARONNOTARYcom f APPROVED BY IRevisedO2/24/20141 The foregoing instrument was acknowledged before me this 3 D day of��C-420 % 5 , by T-P,�Q 'i"�1 qm," ,I who ' ersonally kn n to me or who has produced ►!1 LL-_ as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: -- l_A C a.1!'"1 Seal: :ion'A v a� n+ Cot!?YS ON # EE0881 2 'R EXPIRES: APR. 26,2015 XZ0FF-S'0' www. AARONNOTARY.com Examiner Zoning Structural Review Clerk PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 20850 ME 2nd Avenue - Miami Shores, Flor�id ja �33138 - Phone: 305-779e55-2204 = Fax: 315-756-,8972 Date %' ® Job Address 1 190 t't,Q � dC, - T,. Folio' /E#-3CDO5 ' C>o�-7 —C>�i9too Legal Description Owiler+Lesseetl�et �_.HistoricalIy Designated Yes ,n No DA-o ibJ ( 3 —aen� � l Qwn,,, A&h,,s i i'"[ ®10 a q vp io d s Pham 305-r7!5-7 ." qq ;q g Contracting Co. tqL3L b :---I j m :r00C - Address 1031 5 LD (Q-9 Qualifier -ter SS# Phone _' — 2-AP & —) Qq State # Municipal #; Competency # Ins. Co. IF THERE .IS NO PERMIT PACKAGE ACCESSIELE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE-INSPECTION FEE IS 550.00 AND MUST BE PAID IN "VANCE BEFORE CALLING FOR ANOTHER. IlYSPEenoN. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING CHANICAL ROOFING WORK DESCRWI'ION_ �` ffYt J %t � 1. Y?t..: s Square Ft. Estimated Cost (valva;) cI cloy j,- -- WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IR YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application isherebymade to obtain a permit to dD work and installation as indicated above, and on the attached ad dura (if applieabk). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction- i vaderstmd that sepwate permits are required 1 for all OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cotmuc do n and zoning. Furthesvuore, I authorize the above named contractor to do the work stated. Signature of owner and/or rondo President a Signature of Contrafor ar Owner Bttitder a Date �' J�n ' tv)$b Notas**ner r �i°Date Notary ash e9' j-1nV-11 r Date My My mort 2003 sl , $on3ed Thr 'rnrea•` Atlantic BoMdang Cas., lno rrrar�•� 0.f,?sntieBondi�eGc FEES: PERMIT 71' RADON C.C.F NOTARY BOND APPROVED: TOTAL DUE--2-4—"JP "JP 0 Zoning Building Electrical Mechanical4+?!s'- Plumbing Structural Engineer QTY FLAT RATE / MATERIAL PRICE AMOUNT i o a CufDio mor P4 tz Rte®, a4 -L60 O° Do ' l E CU MAKE/MODEL# ►"TZ W$4 100A tER. # � 3—j at 1•� j-ri g � F I I'g AH MAKE/MODEL # 6 04 613 ER. # LABOR HOURS RATE AMOUNT DIAGNOSTIC ='� FLAT R/7E TOTAL '_ABOR -------------- TOTAL MATERIALS !a� �'~ rhanr 'you :�! 2 00 dZ PAY THIS AMOUNTS j WORK ORDERED BY DATE COMPLETED WE APPRECIATE YOUR BUSINESS Payment is due upon completion of _ a,IIuuits not paid when due shall accrue interest at the rate of 11/2% per month. i i':e to all equipment, materials listed above remains Harpees Air, Inc., until fully paid. Harpers Air shall recover from Customer all expenses, including attorney fees incurred in collecting amounts due or in repossessing the above equipment and materials. '. arranty period begins upon completion of service but Client not entitled to benefits until full paynien: is received. Late payment will not extend warranty period. Customer by signing below accepts the above terms and acknowledges satisfactory irsta:laticr, cf above equipment and completion of above service. CUSTOMER SIGNATURE HARPER'S AIR, INC, 1031 S.W. 69th Avenue MIAMI, FLORIDA 33144 (305) 266-1040 FAX 262-2219 CACO23492 A harrpersair com TO: A V 10 fi-' -�-3 TERMS - 11 W 1)YYVQ91' 1.1 ♦ • JOB PHONE DATE OF R �.it iCt `CI 3 JOB NAME/LOCATION M3 PHONE ORDER TAKEN BY fl 1 i o a CufDio mor P4 tz Rte®, a4 -L60 O° Do ' l E CU MAKE/MODEL# ►"TZ W$4 100A tER. # � 3—j at 1•� j-ri g � F I AH MAKE/MODEL # 6 04 613 ER. # LABOR HOURS RATE AMOUNT DIAGNOSTIC ='� FLAT R/7E TOTAL '_ABOR -------------- TOTAL MATERIALS !a� �'~ rhanr 'you :�! 2 00 dZ PAY THIS AMOUNTS j WORK ORDERED BY DATE COMPLETED WE APPRECIATE YOUR BUSINESS ,a16. R CERTIFICATE OF LIABILITY INSURANCE `►� DATE(MMlDD014 12/15/2014 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 BOX 3608 Lakeland FL 33802 CONMTA NAE: CT Belinda Farris PHONE ( (863)688-43448 E-MAIL ADDRESS:belinda.farris@stahlinsurance.com INSURERS AFFORDING COVERAGE NAIC q INSURERA:FCCI Commercial Insurance Co INSURED Harper's Air Inc 1031 SW 69 Ave. Miami FL 33144 INSURER B AutO Owners Insurance Co 18988 INSURERC:FCCI Insurance Group INSURERD:SOottsdale Indemnity Company INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:15/16 w/c master 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M DD POLICY EXP MM LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxO OCCUR 3L0008756 6 /1/2014 /1/2015 PA MI EMAGET Ea occRENrr $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per a 'dent HIRED AUTOS NON -OWNED AUTOS X UMBRELLALIABX OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 B EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 730457400 /1/2014 /1/2015 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) N ! A 01WC15A63217 /1/2015 /1/2016 WC X nRSTIMIT OIR E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Excess Liability CXS0004862 /18/2014 /18/2015 Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) Mechanical contractor #CACO23492 lMIA :a1"1Lefa\I:11111Lei 14ala: ef_1CL"RIIIW tEl Miami Shores Village 10050 NE 2nd Avenue Miami shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gerald Powell/FARRI ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9Mnn51 m Thea Or:nRr1 name and Innn aro rnnie4arar( marks of OrnRrt STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ;s CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HARPER, TERRELL LEE HARPER'S AIR INC 1031 SW 69 AVE MIAMI FL 33144-4732 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487-1395 STATE OF FLORIDA DEPARTMENT 17 BUSINESS AND -�' PROFESSIONAlEOULATION GACO23492''' SSUE©''07/01 /2014 CERTIFIED A194 HARPER,TERRE HARPER'S AIR"I `IS GERTIFJED=nnc _,Fatp date ? AUG 31, ix t NDCO_ r the provisions of Dh.469.FS. is r 1,1407010000M RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CACO23492 The CLASS AAIB •CONDITIONING CONTRACT( Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016, HARPER, TERRELL LEE { iARPL;F_% R INC..r ''I031 SW 69 AVEC -'.MIAMI-fL33144 4732 isgi iFn- minl/2014 DISPLAY AS RFOt11RFD BY LAW SEQ # L1407010000898