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DEMO-15-1332 (2) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 -� �/!�� ( t-)- ij 29 Inspection Number: INSP-235936 Permit Number: DEMO-6-15-1332 Scheduled Inspection Date: August 19, 2015 Permit Type: Demolition Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: Mechanical Job Address: 1151 NE 99 Street Miami Shores, FL 33138- Phone Number (786)253-2869 Parcel Number 1132050180070 Project: <NONE> Contractor: RESULTS AIR CONDITIONING CO Phone: 305-886-2534 Building Department Comments DEMO 1 REFRIGERATOR RECOVERY Infractio Passed Comments INSPECTOR COMMENTS False Ed Inspector Comments Passed \ Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 19, 2015 For Inspections please call: (305)762-4949 Page 14 of 39 N1GAL Miami Shores Village Building Department 10050 N.E.2nd Avenue,Mml Shores,Florida 33138 n ✓ �� 2 S3 S�-Q Soq Tel:(305)795-2204 FaA(305)756-8972' INSFECWN LINE PHOK WUli BER:(300)762AM9 FBC 2010 BUILDING Master Permit No,��P�� PERMIT APPLICATION sub Permit No�C' grSUILt)INti -ELECTRIC ❑ RC1Qi=tNG R"irlfiS{L3[V n EXTi NSION Q R NEWA,L [DPLUM LING ®MECHANICAL �Pt1BLIC V11QRK5 [� CHANGE al= E]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS r' A 1151 NE 99 Street City: Miami r s n : MIaLN Dagg Zip: 33138 i Folio/Parcel#t:. 11-3205-018-0070 is the Wilding Historically designated:Yes No X I Occupa,ncyT pe: SF Load:_Construction Type: CBS Flood Zone: BEE: FFE: CHER.Name(Fee Simple Titleholder)': Shima V 11 LLC phone#: 305-796-4922 Address: 1235 NE 100 Street City Miami Shores State Florida Z;,p: 33138 Tenant/Lessee Name: Phone#: Email: shimavltd@gmaii.com - 1 AIr �' Q ol1t'0n 14� LJ0_5)jT6-,*'� .CONTRACTOR:Company Name: C n Phssne# Address: 0 NUL) City CA le v State: Fl o e'Oa Zip 3(&(p ..J m �O r C-3� Phane#' W 5. - 4ualifier.Name: �) /_ State Certt�lon or Registration : C I/►�(Oa &/ � Gertfficate of Competency l#: DESIGNER:Aritect/Engineer: Phone#: Address: City- State; Zip: Value of Wo*forthis permit.$ $100 squwW dear Footage of work: Type of WbAl. Addition ❑ Alteration F1 New ❑ Repair/Replace Demolition Descriptionof Work» Demo Spedfy+color of color thru We — U $Fee$, Permit Fee$ V CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Tee'u,610 y Fee$ Training/Ed tkm Fee$ Double Fee$ Structum ev lews$ _ Band$ - T `AL NClW dtsE i4teQ"d0Z2a/1P41 Banding Company's Name{if applicable} Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City state Zip Application's 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 aft work will be performed to meat the standards of all laws regulating construction in this Jurisdiction. Iunderstand that a serrate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS; FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS ETC..... QWilWS AFFt0AV1T:, I certify that all the foregoing information is accurate and that all work will be done In compliance with all applicable lavas regulating construction and zoning: y "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT°A ' RESULT'IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERLY., If,YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORQI YOUR NOTICE OF COMMENCEMENT.0 Notice to Applicant: As a condign 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'0corded notice of commencement must be pasted at the Job site fort lrst inspection which occurs seven (7) days after the building permit is Issued. In the absence of such posted notes, the inspectr n w t be approved and a re4inpeInn charged. Signatu Signature Louis de 1homas for Shima V II LLC. OVAER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before ale this _.a day of—1 Yl f 20 ,by day of V1 c ,20 ,15 by m061A who is personally known tolyknow (c C'c�lbr.G who is personain to me or who has produced ¢�� as or who has produced as identification and who did take an oath. identification and who did tak an oath. NOTARY PUBLI ELIZABETH RODRIGUEZ : C;' T+tCIT'AttY PUBLIC: _�• '!' •W: ;°"s MY COMMI&SION 9 EC-205307 EXPIRES JOY 08,201 $IgCi: Sign; C409j3B8-01S3 FiOrICPNoBarySaNie .eam P , Pring Notary POW Stats of Florida 7 Seal: ��''� Joanna MF 800 Seal- My Commissi°n FF 092753 jam* ExPiros01112r2019 ♦ri+k+k,t►+t+k+t+Mi•4tir�� _ - 1 !♦•irY�Y►M♦ 4�•* **#" #� * #F � 'k +M3Ysl�c'k'MwaKkslttirMlt+k itftjkiki*�ICs�i+r#+►I�`+lak+k+R.+!$+wR+r Mkakkai�alrsltltlG+r�rk�Y V APPROVED BY Pians Examiner Zoning Structurew Clerk (ReviSed02/2412014) STATE OF FLORIDA - DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 " ,W 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CORBERA, JOSE ALEX RESULTS AIR CONDITIONING COMPANY 7451 NW 72ND AVENUE MIAMI FL 33166 Congratulations ,With this license you become one of the n'earl one million Floridians licensed b the Department of Business and Professional Regulation. Our professionals and businesses range � STATE OF FLORIDA �I from architects to yacht brokers,from boxers to barbeque restaurants, DEPART BUSINESS AND and they keep Florida's economy strong. PROF ULATION Every day we work to improve the way we do business in order to il CAC057653 d. . = 07/27/2014 serve you better. For information about our services, please log onto 'r vvww.myfloridalicense.com. There you can find more information CERTIFIED about our divisions and the regulations that impact you, subscribe ' »- t CORBERA,J " to department newsletters and learn more about the Department's t RESULTS AIRS ( ANY initiatives. �I: Our mission at the Department is: License Efficiently, Regulate Fairly. ` We constantly strive to serve you better so that you can serve your you for doing business customers. Thank s In Florida, I S CER y your neg I TIFIEDunder the provisions ofCh.4.89FS. and congratulations on w license. Explrehon date . AUG3t,2016 L1407270001587 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF"BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION,1NDl STRYLICENSING-BOARD CAC057653 w. The-CLASS B-AIR:CONDITIONING CONTRA. Named below;IS CERTIFIED Underthe pF©trrsions.of Chapter 489 FS:-- •••'" � Expiratiandate: AUG 31; 2016, , .CORBERA,J;OSEAALEX. .. RESULTSAIR COLI, T7, �3 M[A�1I r 4 5 M1001 AV AC OC/11 IIOCn OV I AIA/ CCn4 11An797nnn1AQ7 RESUL-1 OP ID: MIAC ACORa►" CERTIFICATE OF LIABILITY INSURANCE DA 0 1 12 6/2 0 1 Y) 01/26/2015 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 CONTACT Allsafe Insurance Group dba PHONE Jorge Pena, PIAM CPIA FAX ASI Florida A/c No Ext:305-262-5244 A/C No:786-388-7244 7171 Coral Way#209 E-MAILI Miami,FL 33155 forge@asiflorida.net Jorge Pena,PIAM CPIA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Western World Insurance Compan 13196 INSURED Results Air Conditioning Comp INSURERS:Bridgefield Employers Insuranc 10701 7451 Nw 72 Ave Miami,FL 33166 INSURERC: INSURER D: INSURER E: INSURER F: 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. INSR EXP U LTR TYPE OF INSURANCE POLICY NUMBER MM DBR ID//YYYY MM/DDCY EFF Y/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTEY— CLAIMS-MADE a OCCUR NPP8213329 01/26/2015 01/26/2016 PREMISES Ea occurrence $ 100,00 X Deductible$500 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY 1 JECT D LOC PRODUCTS-COM P/OPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY MAGE AUTOS Per accidentDA $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER 5TH- AND EMPLOYERS'LIABILITYSTATUTE I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 0830-35672-0 01/26/2015 01/26/2016 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) AIR CONDITIONING INSTALLATION, SERVICE 6 REPAIR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. FAX:305-576-8972 10050 N.E.2ND AVENUE AUTHORIZED REPRESENTATIVE MIAMI SHORES, FL 33138 r ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD W6237 Local Business Tax Receipt Miami-Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY 323923 BUSINESS NAPAE/LOCATION RESULTS AIR CONDRIONING CO RECEIPT No. EXPIRES 7461 NW 72 AVE RENEWAL92SEPTEMBER 30, 2015 MEDLEY FL 33166 . Must be displayed at place of business Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS RESULTS AIR CONDITIONING CO 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED Worker(s) 10 CAC057653 BY TAX COLLECTOR $45.00 07/18/2014 CHECK21-14-026349 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit ora certification of the holder's qualifications,to do business. Holder must comply any governmentallilicense, or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami—Dade Code Sec 8a-276. For more information,vis+tBtNoer misreida eov r