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MC-15-1416 (3)
z 3� 7 Miami Shores Villagei>1n#t1erCs"i 10050 N.E.2nd Avenue NE � 4Nt rk sl t Ac:��ltlitlA 0 Miami Shores,FL 33138-0000 Phone: (305)795 2204 � . 7021 Expiration: 1 1 1 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Landon Studer 1121360010160-32 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 41,000.00 CLASSIC AIR INC 305-825-2486 Total Sq Feet: 00 Tons: Available Inspections: Additional Info: Inspection Type: Classification:Commercial Ventilation Approved:In Review Final Comments: Date Approved::In Review Rough Date Denied: Type of Work:HVAC SERVING LINE REMODEL Rough Duct Scanning:3 Review Mechanical Duct Detector Test Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $24.60 DBPR Fee Invoice# MC-6-15-55921 $18.45 06/10/2015 Check#:13006 $50.00 $1,291.50 DCA Fee $18.45 Education Surcharge $8,20 06/17/2015 Check#:13016 $ 1,291.50 $0.00 Permit Fee $1,230.00 Scanning Fee $9.00 Technology Fee $32.80 Total: $1,341.50 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 AFFIDAVI I certify that all the fo oin information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo in Fut ermore, th ize t above-named contractor to do the work stated. ( ' June 17, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 17,2015 1 CF C T7U UN, 2 0 15 P47,L�6 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)7952204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F 20 (-' r- �2 BUILDING Master Permit �� a. PERMIT APPLICATION Sub Permit NO-HL15 [-]BUILDING ELECTRIC r--j ROOFING f7 REVISION 0 EXTENSION [:]RENEWAL []PLUMBINGECHANICAL 7PUBLIC WORKS F1 CHANGE OF CANCELLATION ❑ SHOP Xm CONTRACTOR DRAWINGS JOB ADDRESS: City: _ Miami Shores Co n Miami Dade Folio/Parcel#: s the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type;—Flood Zone:_BFE:_FFE: a;or r L.", It CX-5 - Phone#..3-0 Jam— 199�- 3 OWNER:Name(Fee Simple Titleholder). Address: Av'c City: State: Phone#: Tenant/Lessee Name: Email: 3Q�-�19 2�5 -2=4&62 CONTRACTOR:Company Name: ;P 14 L Ll-� Phone#: Address: • zip. City: State: Qualifier Name: Phone#* State Certification or Registration#: Certificate of Competency#' 0 Phone#-, DESIGNER:Architect/Engineer:—H,,C���,,,,,:,:,,,:= 11 ' t Address: LQI'� *-J00 City: U . A/nha47 state,r4-- Value of Work for this Permit: Square/Urlear Footage of Work: ❑ Demolition Type of Work: 0 Addition Alteration ❑ New Repair/Replace r Description of Work: e4*kj/."-N ALI Specify color of color thru tile:._ Submittal Fee$ Permit Fee ErCCF CO/CC$ Scanning Fee$ Radon Fee DBPR$ Notary Technology Fee Training/Education fee$ Double Fee S Structural Reviews$ Bond$ TOTAL FEE NOW DUE (Revised02/24/2014) Bonding Company's Name(if applicable) QZk Bonding Co enysAddress City 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. 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 on estimated value exceeding$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also,a certied copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature . OWNER or AGENT 4,48NTRAcroll The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �®day of _ . ..,20 day of ,20 ;l 34 who is ersonall know to _ f IA.AptsonaEly know,Ll,10 �me`or who has produced as me or has produced as identification and w Identification and who did take an oath. NOTARY PUBLIC: �is °rF °um NOTARYPOM MY C0mffd53 at EE 881664 *►� 0311712097 Sign Sign:Print: �6 sv-tI Printlka� Seal: Seal: V APPROVED BY Plans Examiner Zoning Structural Review Clerk (Rewsed02/24/2014) n STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION <'. CONSTRUCTION INDUSTRY LICENSING BOARD (880) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ROSS, TERRY L CLASSIC AIR INC 7801 W 75TH CT HIALEAH FL 33018 Congratulatianst With this licarnse yyou became one of'be nearly one milfion Floridians licensed by Me Depertrr�ent a#Business and TomProlar!onet Regulation. Ourprofesslonals and businesses range from srchileots to yacht brokers,from boxers to barbeque restaurants, '' STATE OF FLORIDA and they keep Florida's econa.My strong, I3Ef}ART�l1-N OF B13SlN>=$S AND. Every day wowork to improve the way we da business in order R F'RQFES C7►f ADRF�GULATION serve you better. For Wbrrnation about our services,please ld�tonto F .,,f�� , caco2�aoo 1161 .I�sUEE);os/24r�Q9a www rnYlloildikilconse.com. There you can find more frrfarmation � � < •;�'�+` about our divisions and the ragu!stians that 1 •v Yflv,subscribe s; CERTIFIED Al'."'sip Ira�ltdet�ve meat navvsl®ttais and learn more about the Department's „ ROSS,TEh#� p ? CLASSIC AIR!N " ... , t•P•„• V Jam. bur mission at the bepattment Is:License Effclentl R We COMStantl stHve to serve u better so that Y,Regulate Fairly, cu§tarners. Thank yo you can serve your i ” •„sp,,w :Z-'4 you for doing business in Florida, ti•, and congratulations onyour new license! r'. ••`• 8.,CERTI�!1a0 uhdar thg,pravtalarts of Ch_48s K5•' ��••' ndatv,'AUGaq,�R18• , ��a�eodaoaea' DETACH HERE RICK SCOTT, GOVERNOR KEN L.AWSON . •• ,. .. . .' .,...,. ,Sl=CRI=fARY STATE OF FLORIDA DIEPARTMEN7 OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CACO21300 :.w:� •. The CLASSAIR CONDITIONING CONTRAC Named below IS CERTfl=1l;© r •, Under the provisions of Chapter 489 EXPIretion date: AUG 31,2816 - ^ <,; .j •_ �ry„ y,;.•° Ser ROSS,TERRY L �” CLASSIC AIR INC \.64.,, r . .^•,, 0 A 471 78DI W25TH CT y��p 141A-EAH <.<a.m::.'i.'�°y�s:.;.;h�"�''?"+,8�",'!� .s-•rx,��ti�y. .1''a?:,.,, .L,� .. - •, � •°"Fl_•3,301 :�wa• ,r4•.:'y:� ~�'� 7�j2�:�9y�•/g, ` ,y ti, a`. ' •• „,�,•::�,P ':Sgtr.S,�r,. •+..:��A,i, .=:S,uD`y,1 .7��y'�':1�6��'��• �'.,' •., � L ` • • , °'•-• e;,.ytie�..,y,�i ,;,,a a• /ti.y, ant;• .''A;h�if.,.. �•_ � L .. . w: �r.� v�",.,,-,,a =:fir:: �'",�', •:.°"z'+`"ke�'•`�'tn.%t .•• • ISSUED; Q6M412014 '"" -' •• -- :.�':..'';``'�-;; os�'+i. `s.•.: . DISPLAYAS REQUIRED BY LAW SEO# L140240=898 Loc $tlSirtl es s Tax_ i! iami-Dade=County State - -mss IS iv ' ofi Tforid-z:' NUT BILL 00 NOT FAY 436501 CLASSIC Alit INC O. 'EXPIRE-A;.- 7801 a z5 CT :=�R1S+orai. SEPTEMBER 30 �0'f5': HIALEAef ki 33U16 ; . 6609 . Muscas d "Jud at pleas©r buslans . .-t�: - �!►ausnt to Coucly Code - Chepitsr 9A-ArL 9 9'fo OWnsaN SES TYPE OF BUSINESSCE�kSSdC;uit+htt 796 SPEC MECHAMrALCOWflV TOH PAYL41MTMOVED Wark�r:�, II} CACO21M : 9Y TAX COL.I.ECTOIt $45.00 07/25/2014 Th"LucidoWulir CHECK21-14-036190 NC uLurnr�wti n lbs oasq t�Gepaito ths dBWO Tm-DOAac*iisaWsi�mrsa. v+aw�gore���galtaguie7anWxwaaA►agof[reneNawlfiekaPpllla16e4emi�s: h+WlkanYs°uar�aeral - - TO�aBECF.tPFN0.akoreatuu5edisptayeHaaallcCialraL6efa-Miami-p®deCo�Seese a6. Foramre9�armedne.visp - DATE(MMMDNYYY) '4C�'R�' CERTIFICATE OF LIABILITY INSURANCE 5/22/2015 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(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 j certificate holder In lieu of such endorsement(s). PRODUCER NCONTACT AME: Bateman Gordon and Sands PHcON o Ext: - 1- AX Ne: 1- 3050 North Federal Hwy 2006 E-MAIL Lighthouse Point FL 33064 ADDRESS: h n B A INSURERS AFFORDING COVERAGE NAIC# INSURER A: r Co. 4 INSURED CLAAI1 INSURER B:Ameris re Mutual Insurance Co. 23396 Classic Air, Inc. INSURERC: 7801 W25 Court INSURER D: Hialeah FL 33016 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1097161727 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 EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMMfDD EFF POLICY LIMITS A GENERAL LIABILITY GL20431240801 1/2015 1/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PE PREMISES(Ea occurrence) $100,000 CLAIMS-MADE 15c]OCCUR MED EXP(Any one person) $5,000 X Contractual,XCll PERSONAL&ADV INJURY $1,000,000 Per CG0001 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY X PRO- 171 LOC $ A AUTOMOBILE LIABILITY CA20066271201 1/2015 1/2016 Ea accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS OWNED SCHEDULED AUTOSBODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ B X UMBRELLA LIAB X OCCUR CU20066351302 1/2015 1/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION WC20066171302 1/2015 1/2016 X WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS E ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K more space Is required) State License#CACO21300 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 NE 2 Ave Miami Shores Village 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