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SNG-14-2483Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225913 Permit Number: SGN-11-14-2483 Scheduled Inspection Date: January 09, 2015 Permit Type: Sign Inspector: Rodriguez, Jorge Owner: , TROPICAL CHEVROLET Job Address: 8880 BISCAYNE Boulevard Miami Shores, FL Project: <NONE> Inspection Type. Final Work Classification: Addition/Alteration Phone Number (305)754-7551 Parcel Number 1132060200880 Contractor: U S HEATING AND AIR CONDITIONING INC Phone: (407)774-9850 comments NEW PAVEMENT MARKS AND SIGNAGE, FURNISH & INSTALL NEW SIGN POST & DIRECTIONAL SIGNAGE. INSPECTOR COMMENTS False NO ELECTRIC Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-225761. PERMIT IS ON LIGHT �WL I POOL TO THE FRONT RIGHT OF THE BUILDING. Failed Correction ❑ Needed Re -inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid January 08, 2015 For Inspections please call: (305)762-4949 Page 10 of 17 Miami Shores Village Building Department l NOV 12-20% 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 i Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No _c j 03 `2-( PERMIT APPLICATION Sub Permit No. SCN�ly P'ZH�--s ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �,,, f Blvd. CONTRACTOR DRAWINGS JOB ADDRESS: Trio � 15&4�1my. City: Miami Shores County: Miami Dade zip: 3313T Folio/Parcel#: 11•,Uft- C.1O" 0%70 is the Building Historically Designated: Yes NO - Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):lft0 t e, j • �Y rQ �':�C XJ%30. Phone#:..x05 "961'5540 Address: !aero i5eca"!e tAyp City: t sjftitas State: L Zip: 6346 V Tenant/Lessee Name: Phone#: Email: S '� a CONTRACTOR: Company Name: 11.E AIC- Phone#:'io-t-7th-44SD Address: 6;1(4 bOOR145 AMA 540 Cyd a. City: �i�.%Nlbi1'1'ii 5�,#'1n1�S State: � ZIP �t Qualifier Name: /^� n p State Certification or Registration #: 4 at C- A� �143Certificate of Competency #: hone#: 440?_-nq- C1766 DESIGNER: Architect/Engineer: hone#: Address: City: State: Value of Work for this Permit: $S K, Square/Linear Footage of Work: Zip: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: b(@' A &vell �6 iMQI'KS Ofi-O .5iQAQQ4t �L-Sk LtJSbAi1ti I�Q� Staff INST 41 'big -Oft 16&114411 i�krt -e � Specify color of color thru tile: (13 0 E c Submittal Fee $ 66 Permit Fee $ Q ' °`` CCF$_2 G—fQ CO/CC $ Scanning Fee $ l 2 - tl� Radon Fee $ - ��DBPR $ - G 1 Notary $ Technology Fee $4- 9 Training/Education Fee $ �� Double Fee $ Structural Reviews $ Bond $ _ TOTAL FEE NOW DUE $�_ (Revised02/24/2014) 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 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 appr ved and a reinspection fee will be charged. ,, Signature � �. ��V`�:� Signatre OWNER or AGENT The foregoing instrument was acknowledged before me this day of!;'r� v,', 20 by who is personally known to me or who has produced A as identification and who did take an oath. NOTARY PUBLIC: 1 Sign:_ Print: YANILIS ALEMAN My Comm. Expires Apr 13, 2015 CONTRACTOR The foregoing instrument was acknowledged before me this R day of MAX&ef J 20 IW by - s who is personally known to me or who has produced �e ll.I Ki &A4 as identification and who did take an NOTARY PUBLIC: Seal: Seal: JUSTIN KONFORTE MY COMMISSION # EE193572 EXRIRES AW 29, 2018 � Zoning APPROVED BY Plans Examiner � � � g eCPcs �� Structural Review Clerk (Revised02/24/2014) �,qyeq Miami shores Village Building Department CONTRACTORS' REGISTRATION IF CONT CTOR 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* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. .......................................................................................... BUSINESS NAME: 05 :t*4 G BUSINESS ADDRESS: 664 bbQtQ.S 1-40— CITY A95;/i STATE f t ZIPM7# BUSINESS PHONE: i y94$D FAX NUMBER ffA1 77V—W/9 CELL PHONE () QUALIFIER'S NAME: 811eaA1 *Sins QUALIFIER'S LIC NUMBER: C.ditC OSq 5q5 .�e�►i�a$�j{"fe5•#;�.�",'� wiz. •4�`�`b�o�-�''=^:i�W �:o...-aAiS�.YJEAotr:tiarR•_w:vnsr� .rmac.�myc.r•---"- - - I ,. 225 Newburyport Avenue ' Altamonte Springs Florida 32701-3697 Altamonte Springs Altamonte Springs —� 407-571-8116 BUSINESS TAX RECEIPT Provision: Ordinance No. 1570-07 Business Control 0007444 No.: Business Name: U S HEATING & AIR CONDITIONING INC ARIE KONFORTE Expires: September 30, 2 015 Business 624 DOUGLAS AVE 1402 Address: ALTAMONTE SPRINGS FL 32714 RECEIPT NO. CLASS DESCRIPTION REE PENALTY 15-00088236 CONTRACTORS -HEATING WOR AIR CONDITION $ 120.75 $ 0.00 15-00095880 SEMINOLE COUNTY REGULATED $ 45.00 $ 0.00 15-00099561 CONTRACTORS -ELECTRICAL $ 120.75 $ 0.00 15-00099571 CONTRACTORS -PLUMBING $ 120.75 $ 0.00 Restrictions: OFFICE ONLY -NO OUTSIDE STORAGE WARNING • THIS W1CUMEN i IS PRI VT�VI9 ' 1 WATERMARKED PAPER AND CONl4fn< iE•' 7All 1IRERS DO NOT ACCEPT NnTHOUT 'JERIFYING THE PH:-$EN(;E OF THE : ATERMARK THE OOCuMENT FACE CONTAINti A SECURITY BACKGROUND THE FACE .-NE /.11H TE.T •:.111V OF AETAMONTF SPRINGS Aco " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY �h - 1n/91/gnia THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE 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 terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to th certificate holder in lieu of such endorsementkV PRODUCER Blackadar Insurance Agency, Inc. 1436 N Ronald Reagan Blvd Longwood FL 32750 NAIC # INSURED US Heating & Air Conditioning Inc 624 Douglas Ave Ste 1402 Altamonte Springs FL 32714 USHEATI-01 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2127255295 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI; CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR,' ADDL LTR TYPE OF INSURANCE UBR POLICY EFF POLICY EXP - INSR WVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS A GENERAL LIABILITY I 0423933 1/1/2014 /1/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY I DAMAG TO ELATED I PREMISES Eaoccurrence $100,000 MED EXP (Any one person) $5,000 _ —i CLAIMS -MADE OCCUR I ! i PERSONAL &ADV INJURY $1,000,000 I GENERAL AGGREGATE 1 $2,000,000 i G_EN'L AGGREGATE LIMIT APPLIES PER: I i PRODUCTS - COMP/OP AGG $2,000,000 i X-; PRO- !%( $ POLICY LOC ! B AUTOMOBILE LIABILITY ! 01C174519110 9/2014 x/9/2015111N - D SIN IMI I X �(E'acadent $1,000,000 ANY AUTO I DILY INJURY (Per person) S __ y ALL OWNED SCHEDULED . _ AUTOS BODILY I NJURY (Per accident)! S X XAUTOS NON -OWNED I HIRED AUTOS AUTOS I PROPERTY DAMAGE S I (Per accident) I ig C i UMBRELLA LIAB X OCCUR -� BE02(0694333 /1/2014 /1/2015 EACH OCCURRENCE $5,000,000 X I EXCESS LIAB CLAIMS -MADE --- AGGREGATE $5,000,000 _ DED RETENTION $ !$ D WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY C84000175532014A /25/2014 /25/2015 X WRYTAMTU- 0TH -I Y / N i ANY PROPRIETOR/PARTNER/EXECUTIVE I OFFICER/MEMBER EXCLUDED? NIA, A N� E.L. EACH ACCIDENT $1,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - EA EMPLOYE $1,000,000 DESCRIPTION OF OPERATIONS below ! E.L. DISEASE - POLICY LIMIT $1,000,000 E Business Services Bond 150172597 10/7/2014 hIW7/2015 ;Limit 100,000 DESCRIPTION OF OPERATIONS I I nrnnnme , vvwro ve ,. -- - ----- - --• ••---� y..wm, r wmw , u 1, NaalUVnei RemarKs Scneouie, If more space Is required) ficate Holder is included as Additional Insured and Blanket Waiver of Subrogation applies; with regard to General Liability and Business when required by written contract. Waiver of Subrogation applies to Workers' Compensation when required by written contract. License #CGC059395 Miami Shores Village Building Department 10050 NE 2nd Ave Miamia Shores FL 33138 ACORD 25 (2010/05) CAN 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 ©1988-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD RICK SCOTT, GOVERNOR LICENSE NUMBER KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 BUTTS, GLENN C U S HEATING AND AIR CONDITIONING INC 624 DOUGLAS AVE SUITE 1402 ALTAMONTE SPRINGS FL 32714 ISSUED: 06/11/2014 DISPLAY AS REQUIRED BY LAW SEQ it L1405110000915