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MC-15-256Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227703 Permit Number: MC -2-15-256 Scheduled Inspection Date: May 13, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: , Work Classification: A/C Replacement Job Address: 1030 NE 105 Street Miami Shores, FL 33138-2106 Phone Number (305)420-6611 Parcel Number 1122320280040 Project: <NONE> Contractor: AIR MIKE A/C, INC. Phone: (305)970-5833 Building Department Comments CHANGE OUT OF A/C CONDENSING UNIT. Infractio Passed Comments INSPECTOR COMMENTS False q/ 513 May 12, 2015 For Inspections please call: (305)762-4949 Page 4 of 30 Inspector Comments Passed `/� 1: EDDY 305-505-0871 Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 12, 2015 For Inspections please call: (305)762-4949 Page 4 of 30 �s t Miami Shores Village 10050 N.E. 2nd Avenue NE CCF Miami Shores, FL 33138-0000 DBPR Fee Phone: (305)795-2204 Project Address Parcel Number Applicant 1030 NE 106 Street 1122320280040 105 INVEST LLC Miami Shores, FL 33138-2106 Block: Lot: Owner Information Address Phone Cell 105 INVEST LLC 100 N BISCAYNE Boulevard (305)420-6611 MIAMI FL 33132- 100 N BISCAYNE Boulevard MIAMI FL 33132- Contractor(s) Phone Cell Phone AIR MIKE AIC, INC. (305)970-5833 (305)685-2815 Tons: 4 Additional Info: CHANGE OUT OF A/C CONDENSING UNIT. Classification: Residential Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Scanning: 3 Fees Due Amount CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 Valuation: $ 1,300.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -2-15-54367 05/12/2015 Cash $ 66.20 $ 50.00 02/05/2015 Cash $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical Review Mechanical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLlJMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS g AFFIDAVI cej * all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a ni Lre, I authorize the above-named contractor to do the work stated. 12, 2015 �Auat� C Owner / Applicant / Contractor / Agent Building Department Copy May 12, 2015 r BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING ❑ ELECTRIC ❑ ROOFING 05 2015 FBC 201()- Master 0(GMaster Permit No. L�Q-- I 5L 25G Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL F-IPLUMBING adECHANICAL E] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION r-1 SHOP CONTRACTOR DRAWINGS 10B ADDRESS: I cis ('� /�4 �^ ,r)s 5� City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):O c57 ( "\&: S -F )--L C_ Phone#: Address: .Y City. Tenant/Lessee Name: Email:- CONTRACTOR: Company Name: Address: /.4,(J -a City. —®.rL Qualifier Name: v State Certification or Registration #: State: Zip: one#: C 3.? l• Zip: 9303 -_� Phone#: 73 d T;7 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: OOM City: State: Zip: tlalue af,W.,ork for this Permit: $Z3 Square/LMtiat Fbo4age of Work:', Type of Work: ❑ Addition ❑ Alteration ❑ New tkdplace, Demolition ,/Description of Work: IJ Gr✓ }- 9 1= f Specify color of color tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ . 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 Zi Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation ha commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatin, construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, 'PLUMBING, SIGNS, POOL 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 al applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MA) RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTENC 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 $2500, the applicant muse promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the persor whose property is subject to attachment. Also, a certified copy of the recorded notice of commence t ust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. /n the bsen a of such posted notice, the inspection will not be apprcl\ed o�d a�&spection fee will be charged. /7 01VNEA-AGENT CONTRACTOR The foregoing instrument was ac nowledged before me this The foregoing ins wase� a""ckn ledged before me this' day i'LLl4A LZ 20 L5-� by ay f -� // 20 by ho is personally known to is personally known to me or who has produced as me or o has odu d as identification and w�h4id take an Bath. . identifica ' n did tak an oath. t• ** 0 W�RITZI►IM NOTARY PUBLIC _N0%WFUkX-$yM(WpL0RftNOTARY PUB NCOryPubftSUM OfPAY" L COMMSSIONS IFFUM11 Jlreter O Azocar L' %t 7/Z8/Ip1a ,} My Comwlssion EE 189259 s' 7i8iU 1NO1riYl1I7 �j, pd� Expires 0411512018 Sign: Sign: Print: +� Print: Seal: �'/`dmf �f Seal: a�w«****«***�*+z***s******�*** ***��+** •*res* **r**�+�er�****+�*�******t�***�**�*******s*«********s****r*�+�*** APPROVED BY �v ns Examiner Zoning Structural Review Clerk (Revised02/24/2014) r Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation ha commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatin, construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, 'PLUMBING, SIGNS, POOL 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 al applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MA) RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTENC 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 $2500, the applicant muse promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the persor whose property is subject to attachment. Also, a certified copy of the recorded notice of commence t ust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. /n the bsen a of such posted notice, the inspection will not be apprcl\ed o�d a�&spection fee will be charged. /7 01VNEA-AGENT CONTRACTOR The foregoing instrument was ac nowledged before me this The foregoing ins wase� a""ckn ledged before me this' day i'LLl4A LZ 20 L5-� by ay f -� // 20 by ho is personally known to is personally known to me or who has produced as me or o has odu d as identification and w�h4id take an Bath. . identifica ' n did tak an oath. t• ** 0 W�RITZI►IM NOTARY PUBLIC _N0%WFUkX-$yM(WpL0RftNOTARY PUB NCOryPubftSUM OfPAY" L COMMSSIONS IFFUM11 Jlreter O Azocar L' %t 7/Z8/Ip1a ,} My Comwlssion EE 189259 s' 7i8iU 1NO1riYl1I7 �j, pd� Expires 0411512018 Sign: Sign: Print: +� Print: Seal: �'/`dmf �f Seal: a�w«****«***�*+z***s******�*** ***��+** •*res* **r**�+�er�****+�*�******t�***�**�*******s*«********s****r*�+�*** APPROVED BY �v ns Examiner Zoning Structural Review Clerk (Revised02/24/2014) I -V Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA 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 AHRI DATA SHEET REQUIRED Change disconnecting means: YES NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ 1. Minimum Circuit Ampajcity (Wire Size): 2. Maximum Overcurrent, Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration No. Certificate of Competency No. Signature Date: (Qual flees signature) UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER L AHU or PKG. UNIT MODEL# COND. UNIT MODEL # KW HEAT NOM TONS AHU s9i2PKG 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 REPLACING DUCTS YES NO YES REPLACING THERMOSTAT YES NO YES NEW 4"CONCRETE SLAB YES NO YES NEW ROOF STAND YES NO YES 0 NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampajcity (Wire Size): 2. Maximum Overcurrent, Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration No. Certificate of Competency No. Signature Date: (Qual flees signature) vvtv.� I rtv%.. I Ivlm 1119000 i KY LII;tNbINU BUAKU ;k°65 we1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 LOPEZ, MIGUEL AIR MIKE A/C, INC. 1800 NE 197TH TERRACE MIAMI FL 33179 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 OF BUSINESS AND ;t IYAfatF 'REGULATION PROFES$I CAC1813867 4 SUEI ": 08/27/2014 CERTIFIED AIR 0 Nb CbNT1 .K a LOPEZ, MIGUEf,. AIR!MIKEA/C,'INlat,K IS CERTIFIED under t6iVr'ovigions of Ch.468 FS. Expiation date AUG 31, 2018 L140827CM2709 KEN LAVI/SON; SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC1813867 I The CLASS AAIR CONDITIONING CONTRA Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 LOPEZ, MIGUEL AIR MIKE A/C, INC. 1800 NE 197TH TE MIAMI FL 3 ISSUED: 08/27/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408270002709 + y From: 02/04/2015 16:08 #684 P.001/001 AC CO® CERTIFICATE OF LIABILITYDATE(MWDDNYYY) INSURANCE 02/04/2015 zomw IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS TE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED NTATIVE QR PRODUCER, AND THE CERTIFICATE HOLDER. T; If the t srfificate holder is an AD01T10NAL INSURED, the poiic)(00s) must be endorsed. If SUBROGATION IS WAIVED, subject to nd conditions of the policy, certain pottcles may requlr®an endorsement A statement on this certificate does not confer rights to the older in lieu of such endorsement(s). PRODUCER CONTACT JOHN BARNES Gruber S AssociatesE` PHONE (305)248-5453 (305)248-7090 Homestead, N.st Kroad, FLAve. JOHN.BARNESCGRUBERINSURANCE.COM Homestead, FL 33030 INSURED MIKE LOPEZ DBA AIR MIKE 1800 NE 197 Terr Miami, FL 33179 305 970-5833 CERTIFICATE NUMBER GRANADA INSURANCE COMPANY 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. iLT R TYPE OF INSURANCE ADD POLICY NUMBER QW EFF POLICY EXP LIMITS GENERAL LIABILITY 66 EACH OCCURRENCE $ 1,000,00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED A ®occuR ❑ El PREMISE occurrence),S 100,000. ono ❑ MED EXP • - 0185FL00038405 08/15/2014 08/15/2015 $ 5,000.00 ❑ PERSONAL& ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEITL AGGREGATE LIMIT APPLIES PER W " '_ n PRO- ri ___ PRODUCTS -COMP/OPAGG $ 2.000.00 13 AUTOMOBILE LIABILITY ❑ ANYAUTO ❑ bOWNED SCHEDULED ❑ AUTOS ❑❑ HIRED AUTOS ❑❑ AUTOS ❑ UMBRELLA LiAB ❑OCCUR ❑ EXCESS LIAR ❑ CLAIMS -MADE ❑ OED ❑ RETENTION$ WORKERS COUP ITY Y / N describe BODILY INJURY (Per person) $ BODILY INJURY (Per accident $ PPROERTYPAMAGE $ $ N / A I I WCV 0011432 00 108/1512014 108/15/2015 E.L DISEASE- EA EMPLOM $ 500,000.00 E.L. DISEASE -POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is nxpAred) A/C INSTALLATION AND REPAIR. $500 DEDUCTIBLE PER CLAIM, CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE SECOND AVE. MIAMI SHORES, FL 33138-2382 FAX 305-758-8972 CANCELLATION 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 ACORD 25 (2014101) QF ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and 1090 are registered marks of ACORD Detail by Entity Name y; `,• &�14, Florida Limited Liability Company 105 INVEST LLC. Filing Information Document Number L13000119186 FEI/EIN Number 41-2282671 Date Filed 08/22/2013 State FL Status ACTIVE Effective Date 08/22/2013 Principal Address 44 W FLAGLER STREET SUITE 1100 MIAMI, FL 33130 Changed: 04/22/2014 Mailing Address 44 W FLAGLER STREET SUITE 1100 MIAMI, FL 33130 Changed: 04/22/2014 Registered Agent Name & Address MASSAT CONSULTING FLORIDA LLC 44 W FLAGLER STREET SUITE 1100 MIAMI, FL 33130 Name Changed: 04/22/2014 Address Changed: 04/22/2014 Authorized Person(s) Detail Name & Address Title MGRM DARGENCE, MARC 44 W FLAGLER STREET SUITE 1100 MIAMI, FL 33130 Title MBRM Page 1 of 2 http://search. sunbiz. org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/5/2015 va S !I � I/ .:�i