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MC-15-1981
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240829 Permit Number: MC-8-15-1981 Scheduled Inspection Date: August 26, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: PERATICOS,VICKY Work Classification: A/C Replacement Job Address:672 NE 98 Street Miami Shores, FL 33138- Phone Number (305)439-0062 Parcel Number 1132060171780 Project: <NONE> Contractor: LANDY'S A/C INC. Phone: (786)286-6391 Building Department Comments A/C CHANGE OUT Infraction Passed Comments INSPECTOR COMMENTS False TO CLOSE PERMIT#MC13-1222 Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 25, 2015 For Inspections please call: (305)762-4949 Page 27 of 48 Permit At 5198 �3 .• ,x �sNORES r, Miami Shores Village Pettt?tt hahi��tl 10050 N.E.2nd Avenue NE "' Miami Shores,FL 33138-0000 'Al 1J • = o� Phone: (305)795-2204 A117?l fGOR1Dp' Ex iration: 2/14/2016 Project Address Parcel Number Applicant 672 NE 98 Street 1132060171780 �..w.......�_�. ._._..r_._____.___....._._�� VICKY PERATICOS Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell VICKY PERATICOS 672 NE 98 Street (305)439-0062 MIAMI SHORES FL 33138-2472 Contractor(s) Phone Cell Phone Valuation: $ 2,500.00 LANDY'S A/C INC. (786)286-6391 Total Sq Feet: 0 Tons: Available Inspections: Additional Info:A/C CHANGE OUT Inspection Type: Classification:Residential Final Approved: In Review Review Mechanical Comments: Date Approved: : In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# MC-8-15-56627 DBPR Fee $2.00 DCA Fee $2.00 08/18/2015 Credit Card $ 117.80 $0.00 Education Surcharge $0.60 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $117.80 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. Z&, _ August 18, 2015 Authorized Signature:Owner / Applicant / Contr ctor / Agent Date Building Department Copy August 18,2015 1 i Miami Shores Village Building Department artment AUG 7 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. � _ U PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING X MECHANICAL ❑PUBLIC WORKSCHANGE OF ❑ CANCELLATION ❑ SHOP c CONTRACTOR DRAWINGS JOB ADDRESS: (O N E ciO' City: Miami Shores County: Miami Dade Zip 33 3 8 Folio/Parcel#: 3,106 -01-4 - 1 9,0 Is the Building Historically Designated:Yes NO_X _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): V 1 C VGV 14p!(Ql�i Cp S Phone#: 3o5-L139 - Oy (oa_ Address: 1400 U0L01 t% Rd 4 MMI qa— Oscar RIN ON City:- M1om'% State: F L Zip: 33139 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:-__L.Qt1dy "5 ai'c G(N&bioNr'�Q Phone#:3$(o - ,Z$(� Address: 15833 SW ►53`d Cour City: M\b.M'\ state: Zip: 3 3 k$+ Qualifier Name: Rclayvdc-� MPhone#: State Certification or Registration#: _ G KCI p5�$1 L} Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ o[C7��J Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New L epair/Replace ❑ Demolition Description of Work: 'r6ssue [� L Ghr►(1oP -OV.�, peilC(1\� # M -(0-13 laaa -- E i n FA ec,*;CK\ And c,\o S e. U Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 4y , Revised02/24/2014) Bonding 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 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. 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 a prov nd a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 4— !dray of Ar. /n � 20 �:5 by day of LIC �s� .,__,2.0___�� by C eCGI1CL SrJ who is personally known to 6l1g„/£�(2 ' ho is personally known to me or who has produced FL bf�VeJc C<-f\Sf- as me or who has produced �r(Jr/T, Lt Cr%AA eas identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: _ - QE"NAYO Print: t Print: CommN sim Seal: Comm.E>IE=M y 11,!01! Seal: CMv o m.Expires xpUa fF 5 �'� salo�d IMraO ANII. NN ° NMionr may i110VyAp' Pq APPROVED BY �1`p**�*I**s,Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MARTINEZ, ROLANDO JESUS LANDY'S A/C INC 15933 SW 153RD CT MIAMI FL 33187 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 STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFES610NAL-REGULATION Every day we work to improve the way we do business in order to CAC057814 ;SUED 07/15/2014 serve you better. For information about our services,please log onto www.rnyfloridalleense.com. There you can find more Information CERTIFIED AIR, ;wCONTR about our divisions and the regulations that impact you,subscribe MARTINEZ, RO ESUS to department newsletters and learn more about the Department's CANDY'S A/C IWC initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constant) strive to serve you better so that you can serve your customers. lank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! Expiration arae'AUG 31,2016 L140716=779 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC057814 The CLASS AAIR CONDITIONING CONTRACTOR R Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2018 MARTINEZ, ROLANDO JEST LANDY'S A/C INC 15933 SW 153RD CT MIAMI FLIffli Wit.I- 1 C ISSUED: 07/15/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1407150000779 001579 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY 5577524 ES BUSINESS NAME/LOCATION RECEIPT NO. EXPIR LANDYS AIR CONDITIONING INC RENFWAL SEPTEMBER 30, 2016 15933 SW 153 CT**** 4218020 Must be displayed at place of business Pursuant to County Code MIAMI FL 33187 Chapter SA-Art.9&10 SEC.TYPE OF BUSINESS PAYMENT RECEIVED OWNER 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR LANDYS AIR CONDITIONING INC CAC057814 $75.00 07/21/2015 Worker(s) I CHECK21-15-101117 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holders qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ba-276. For more information,visit www•miamidade.aov/tazc,o-hector DATE CERTIFICATE OF LIABILITY INSURANCE i 08/04/15 � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the I j certificate holder in lieu of such endorsement(s). f { PRODUCER CONTACT- EIDY C DIAZ NAME. _— A-1 Stop Insurance i (A/C, Ext): (305)441-7100 I � ,No). (88$}908 3629 S.W.8th St. eidy�insuranceladies.com { ADDRESS: i � ! Miami,FL 33135 INSURER(S)AFFORDING COVERAGE a MAIC# i Phone (305)441-7100 Fax (888)9084)449 i INSURER A: SCOTTSDALE INSURANCE COMPANY a { INSURED INSURER B LANDY'S AIR CONDITIONING INC. I INSURER c 15933 SW 153 Ct INSURER D MIAMI,FL 33187 (786)286-6391 INSURER E: j r, 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. I - --- .- - -- —-- - -- - - -- -- - -- -- - '1NSR IADDLSU-D POLICY EFF POLICY EXP ( LIMITS LTR _TYPE OF INSURANCE _'INSR L�WQ —_- POLICY NUMBER __.... - MMJDDlYYYYj GENERAL LIABILITY BEACH OCCURRENCE i $ 1=0000.00 { I { { ! �/ COMMERCIAL GENERAL LIABILITY I DAMAGE TO RE Eaoccurrences 100,000.00 CLAIMS-MADE OCCUR E CPS2206521 i MED EXP(Any one person $ 5,000.00 t A { -i -_ -. I N { I06t24/2015 106/24/2016 PERSONAL&ADV INJURY $ 1,000,000.00 i GEN ERAL AGGREGATE $ 2,000,000.00 1 ! I GEN'L AGGREGATE LIMIT APPLIES PER: } I I PRODUCTS-COMP/OP AGG $ 2,000,000.00 POLICY 11 I LOCAUTOMOBILE LIABILITY L--' ± i ! CO $ I _ ---- - - -------- -- -- MBINED SINGLE LIMIT t I (Ea arrirlentl $ ( i I ANY AUTO i j BODILY INJURY(Per person) S :--- ALL OWNED - SCHEDULED f BODILY INJURYPes accident $ I AUTOSI AUTOS1 I INJURY(Per I I NON-OWNED } I E PROPERTY QAMAGE S I I ! HIRFO AUTOS gLiTnc t I /Per accident UMBRELLA LABf:ii OCCURi {i �EACH OCCURRFNCF $ I I EXCESS LIAR ; !CLAIMS-MADE { AGGREGATE ; $ -- i DED ` RETENTION S —_ I S- I WORKERS COMPENSATION .- -- -t _------------_.. .. __-_-- -_�--- j t" WC ITA OTH- C AND EMPLOYERS'LIABILITY i ( TORY LIMIT YIN N'r FR, ; ANY PROPRIETOR/PARTNFRIFXECUTIVF I 1 I ? I F.L EACH.ACCIDENT ' S OFFICER/MEMBER EXCLUDED? r—JN!A{ I 1 {---- ----- -.--- }-------- j (Mandatory in NH) I ' I ! G L.DISEASE EA EMPLOYE S I If yes,describe under ( I I I DESCRIPTION OF OPERATIONS below I I t ! El..DISEASE-POLICY LININT 4 S -I i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES'(Attach ACORD 101,Additional Remarks Schedule,.If more space is required) AIR CONDITIONING REPAIRS,SERVICE AND INSTALLATION I � I a I i I I I { J CERTIFICATE HOLDER CANCELLATION 4 � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT 10050 NE 2 AVENUE 3 AuTHoRizEO REPRESENTATr4E MIAMI SHORES VILLAGE,FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and logo are registered marks of ACORD ACC) CERTIFICATE OF LIABILITY INSURANCEF8/6/2015" °" ' 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 pollcy(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 the certificate holder In lieu of such endorsement(s). NTCT PRODUCER NAME: Construction Pros Insurance LLCPHONE FAX (At N E)a)*800 685 0027A/C No PO Box 186 E-MAIL 12054 Curley Street ADDRESS: San Antonio FL 33576 INSURERS AFFORDING COVERAGE MAIC# INSURER A.TeChnOIOQY Insurance Company 42376 INSURED LANDACI-01 INSURER B: Landy's Air Conditioning Inc. INSURER C: 15933 SW 153rd Ct INSURER D: Miami FL 33187 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1409737215 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INR WVD POLICY NUMBER MM/D MM/D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE RENTED— COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE FIOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SING -LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY TnDAMAGE $ HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AWC1049780 6/12/2015 6/12/2016 WC STATT:S OTH- AND EMPLOYERS'LIABILITY EIR ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE,$100,000 If yes,describe under DESCRIPTION OP OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Qualifying Individual: Rolando Jesus Martinez-CAC057814 Please review named insured's policies referenced in this document for complete list of all applicable coverage's, limits,endorsements, exclusions, deductibles, and their respective terms and conditions they contain. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD