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DEMO-15-2098
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL LZ Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241684 Permit Number: DEMO-8-15-2098 Scheduled Inspection Date: August 31, 2015 Permit Type: Demolition Inspector: Perez,JanPierre Inspection Type: Final Owner: DUQUE, CHRISTOPHER Work Classification: Mechanical Job Address:361 NE 101 Street Miami Shores, FL 33138-2424 Phone Number Parcel Number 1132060135220 Project: <NONE> Contractor: PHOENIX COOLING SYSTEMS CORP Phone: (305)744-2145 Building Department Comments DEMOLITION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 28, 2015 For Inspections please call: (305)762-4949 Page 11 of 26 41 to �eH°SEs y Miami Shores Village 10050 N.E.2nd Avenue NE a\ ca Miami Shores,FL 33138 0000 z\ \ Co Q# � e� t � ` E k l t I aSt81 f$ A�►PROVE Phone: (305)795-2204 `^ \ , >1111 I Expiration: 02/2712016 Project Address Parcel Number Applicant 361 NE 101 Street 1132060135220 CHRISTOPHER DUQUE Miami Shores, FL 33138-2424 Block: Lot: Owner Information Address Phone Cell CHRISTOPHER DUQUE 361 NE 101 Street MIAMI SHORES FL 33138- 361 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $~2,500.00 PHOENIX COOLING SYSTEMS CORP (305)744-2145 Total Sq Feet: 0 Type of Demo:Mechanical Available Inspections: Additional Info:DEMOLITION Inspection Type: Classification:Residential Final Scanning: 1 Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# DEMO-8-15-56763 DBPR Fee $2.00 08/19/2015 Credit Card $50.00 $61.80 DCA Fee $2.00 Education Surcharge $Mo 08/27/2015 Check*378 $61.80 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $111.80 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 zonir Futh rize the above-named contractor to do the work stated. August 27, 2015 Authorized Si ature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 27,2015 1 Miami Shores Village r-- -- Building Department AUG 1 21 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 --� Tel:(305)795-2204 Fax: (305)756-8972 M - INSPECTION LINE PHONE NUMBER:(305)762-4949 ((� FBC 201 BUILDING Master Permit No.-T)F--NO r5--16513 PERMIT APPLICATION Sub Permit No.1�tAcC •- 1S Zq;_i BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING (' MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP g c CONTRACTOR DRAWINGS JOB ADDRESS: iv I o I �� ► City: Miami Shores County: Miami Dade Zip: 3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): �(li(Ci C� Phone#: Address: �;Tjv-� �fzt> 4-00 C) xjc ie(r City:rr(Cl(6( State: �-- Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: AIMCAIl X 60 q yY�T�M,S Phone#: 305) 7114',2146 Address":: 2221 Vat �O�J �r Uel f / City: 141,1 Aoh State: Zip: 133010 Qualifier Name: �;�y 0/20ZC0 Phone#: (305 -7gL1g5 z State Certification or Registration#: CAC 1917 1.35 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition Description of Work: Dcrn C) C'( CA—) Specify color of color thru tile: ,�/� Submittal Fee$ Permit Fee$ //w•Q0 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ff11 TOTAL FEE NOW DUE$ (Revised02/24/2014) f , 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. 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 approved and a reinspection fee will be charged. 4 1 Signature X 'V 1 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _day of -lay 20 �� by day of� 20 v f by 1&� J ,who is personally known to who i ersonally kno�o me or who has produced � _ UMN25s me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: r AllifeiIN MY COMMISSION#FF228453 Seal: Seal: EXPIRES May 07,2010 ;ospstt ou��l+ Notary public State of Florida �' Sindia Alvarez y� c� My Commission FF 156750 '�toFr`o� Expires 09103!2016 * *********************************** ******************* ** * * * * ****************** *** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 0812612015 09:35 (FAX) P.0011001 A Q�Rlr CERTIFICATE OF LIABILITY INSURANCE °"TE( °'"'�'"' 088/28/26/15 THIS CERTIFICATE lS 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 pollcypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certeln policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In!leu of such andorsement(a). PRODUCER NAME: Lucia Estrella Accurate (305)226-8727 RAX 8300 West Flagler Suite 114 weiaealrella®oelle0uth net (303)226-9767 Miami, FL 33144 INSURERIS)AFFORDING CovERAGE MAIC# IN8UR6b Phone (305)226-8727 Fax 305 226-8767 INBURfiR A: COVIR9lOn Specialty Insurance Company iNBUkCR ti Phoenix Cooling Systems Corp INSURER c: 2221 West 89th Street Apt 1 INSURER D: Hialeah,FL 33016- INSURER 9: COVERAGES CERTIFICATE NUMBER; INSURER F 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, N�BgEXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR WFS OF INSUKANCK INM-MM Abot BU13R POLICY NUMBER POLIC Yes POLICY LIMITS t35NBRALIJAatU7Y EACH RRE $ 1,000,000.00 0 COMMERCIAL GENERAL UABILITY IJANIAUft IV RENTED S(Ea oo s 100,000.00 A ❑❑ El CLAUs9.1AADE © OCCUR VBA406452-00 08/21/2015 08/21/2018 MED EXP(Any ons arson $ 5,000.00 -PERSONAL SADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPt-LIIIES FIER PRODUCTS-COMPIOP AGO 1,000,000.00 B POLICY ❑ P,Z U LOC $ AUTOMOBILE UABILITY PliMBI NGLE LIMIT ❑ ANY AUTO ALL BODILY INJURY(Per person)OWNa ❑ AUTOS ED ❑ AUTOS�� BODILY INJURY(Per 60dent 5 ❑ HIRED-AUTOS © AUTOS WNW eOPER GE a S ❑ UMBRELLA uqB El OCCUR EACH OCCURRENCE a EXCESS LIAe -M CLAIMSADE S OED RETENTIONS AGOREOATE WORKERS COMP&MAT10N S AND EMPLOYERS,LIABILITY Y/N f ST OTH MR ANY PROPRIETOMPARTNERIEXECUTIVE OFFICERIMEMBBR EXCLUDED?atory In NH) ElN/A E,L EACH ACCIDENT $ IFye�edsscr,bs under I-L DISEASE-EA EMPLOYE $ DHSC:RIPTION OF OPERATIONS below E.LDISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I V9HiCt.E8 (Attach ACORD 101,AdditnMl RemgHts aohodule,If more apace Is required) License#CAC1817135 CERTIFICATE HOLDER CANCELLATION Miami Shoran Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g THE EXPIRATION DATE THEREOP,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY P 10050 NE 2nd Ave AUTHORIZED R8PR6'B@NTAYIVE 'Miami Shores,FL 33138 305-758-8972 Lt,cla Estrella ACORD 26(2010105)OF ®1988-2010 TION. 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