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MC-15-1251
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-235377 Permit Number: MC-5-15-1251 Scheduled Inspection Date: August 10, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: SUPREME, GERARD Work Classification: Addition/Alteration Job Address: 535 NW 112 Street Miami Shores, FL 33168-3317 Phone Number Parcel Number 1121360210900 Project: <NONE> Contractor: MIAMI MECHANICAL CONTRACTORS INC Phone: (786)402-4457 Building Department Comments INSTALLATION OF COMPLETE DUCT WORK AND NEW Infractio Passed Comments A/C UNIT INSPECTOR COMMENTS False l� Inspector Comments Passed El— Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 07, 2015 For Inspections please call: (305)762-4949 Page 7 of 29 MC eK°REs y Miami Shores Village � ; lc 'Res�n�� 10050 N.E.2nd Avenue NW IIVt?rL1.+ t3ClA1�tj1 i - Miami Shores, FL 33138-0000 Parti Status:API/E© ' Phone: (305)795-2204 �20RWp w• l 512812015 Expiration: 1112 /2015 Project AddressParcel Number Applicant 535 NW 112 Street 1121360210900 GERARD SUPREME Miami Shores, FL 33168-3317 Block: Lot: Owner Information Address Phone Cell I GERARD SUPREME 535 NW 112 Street MIAMI SHORES FL 33168-3317 Contractor(s) Phone Cell Phone ,� MIAMI MECHANICAL CONTRACTORS (786)402-4457 Valuation: $ 4,000.00 Total Sq Feet: 00 Tons: Available Inspections: Additional Info: LInspection L]Classification:Residential Approved:In Review Comments: Date Approved:: In Review Date Denied: Type of Work: INSTALLATION OF COMPLETE DUCT Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# MC-5-15-55707 DBPR Fee $2.10 05/26/2015 Credit Card $ 50.00 $ 109.60 DCA Fee $2.10 Education Surcharge $0.80 05/28/2015 Check#:357 $ 109.60 $0.00 Permit Fee $140.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $159.60 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 certi that I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin or ttiorize the ove-named contractor to do the work stated. May 28, 2015 Auth edSign r "Applicant / Contractor / Agent Date Building Department Copy May 28, 2015 1 Miami Shores Village P cEC g MAY 2 6 2015 Building Department BY: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC20eC� BUILDING Master Permit No. /-k1-H--- PERMIT APPLICATION Sub Permit No. BUILDING r--� ELECTRIC ROOFING REVISION EXTENSION ❑RENEWAL ❑PLUMBING ECHANICAL PUBLIC WORKS F-1 CHANGE OF E] CANCELLATION SHOP (( CONTRACTOR DRAWINGS JOB ADDRESS: Clvtar- ,l I S JOr<P_1''"`e- S 35 n/(,O /l '1 City: F S Miami Shores County: Miami Dade Zip: +4/ Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �e rG.' S✓�rt `�`'�--- Phone#: Address: -50 /mow /l 2 f4- City: M State: FL Zip: 3-7/L Y Tenant/Lessee Name: Phone#: 7 4, 4,`l fSa Email: CONTRACTOR:Company Name:m(a&y1 COc-6r— Phone#: Address: 56K W(Gets A v-,t- lk/b/Y city: State: FC- Zip: Qualifier Named C_ rJ sib Phone#: State Certification or Registration#: Certificate of Competency#: 1.2M 40 oo L 3 DESIGNER:Architect/Engineer: Phone#: Address: a 4 , City: State: Zip: quare/Linear Footage of Work: Addition F-1AlterationENew ❑ Repair/Replace ❑ Demolition f Descriptioq of Work: 64- C�n•�Q�L-�{ AJ c- u,�,L /Lftyv J4 c. Specify color of color thru tile: Submittal Fee$ Permit Fee$. F" ) CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 161 (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. 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. Signature �F Signature Ll OWNER or AGENT CONTRACTOR �The foregoing instrument was acknowledged before me this The/for ing instrument was acknowledged before me this _ day of 20 �� by ! 7X day of 20 by C9hLo is personally known to ho is personally known to me or who has produce as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY BLIC: NOTARY PUB Sign: Sign: Print: L Print: ►�Y�"''•ate PERLA M.GARCIA Seal: ;p Not P Seal: , ,� orl' f�NC-aft d Flotlda ;:.�• '4. PERLA M.GARCIA 1• My COMM-E1111111111191111 JO 7,2010 '?: WWy Public-State of]��ssn. COMWISion I FF 074462 __,• My COMM.Expires Jan 9100 Through NetiOffal Naa APPROVED BY Z //_�ns Examiner Zoning Structural Review Clerk (Revised02/24/2014) ---"MON .4��° CERTIFICATE OF LIABILITY INSURANCE DATE /5/201/YYY1f) 5/5/2015 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY BATISTA INS INC. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 4159 E 4TH AVE CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE HIALEAH FL 33010 COVERAGE AFFORDED BY THE POLICIES BELOW. JOSE F.BATISTA(305)685-0524 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A UNDERWRITER OF LLOYDS OF LONDON MIAMI MECHANICAL CONTRACTORS INC INSURER B: norGUARD INSURANCE COMPANY 31470 5005 COLLINS AVE#1018 INSURER C: MIAMI BEACH,FL 33140 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRO DATE MM/D DATE MWD A ® GENERAL LIABILITY JUF2D-A 09/19/2014 09/19/2015 EACH OCCURENCE $1,000,000.00 COMMERICAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,000.00 ❑❑CLAIMS MADE ®OCCUR MED EXP(Any one person) $5,000.00 PERSONAL BADV INJURY $1,000,000.00 GENERAL AGGREGATE $2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ® POLICY❑PROJECT El LOC PRODUCTS-COMP/OP AGG $1,000,000.00 $ ❑ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ANY AUTO (Each Occurrence) $ ❑ALL OWNED AUTOS BODILY INJURY ❑SCHEDULED AUTOS (Per person) $ ❑HIRED AUTOS BODILY INJURY ❑ NON-OWNED AUTOS (Per accident) $ ❑ PROPERTY DAMAGEIn $ (Per accident) ❑ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ❑ANY AUTO OTHER THAN EA ACC $ ❑ AUTO ONLY: AGG $ ❑ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $t ❑OCCUR ❑CLAIMS MADE AGGREGATE $ ❑ DEDUCTIBLE $ ❑ RETENTION $ WORKERS COMPENSATION AND MIWC688521 03/20/2015 03/20/2016 ® WC STATU- ❑6TH- EMPLOYERS'LIABILITY TORY LIMITS ER _ ANY PROPRIETOR/PARTNER/EXECU- E.L.EACH ACCIDENT $100,000.00 TIVE OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $100,000.00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000.00 ❑ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CMC:12M000023 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 10050 N.E.2nd Avenue, EXPIRATION DATE THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MIAMI SHORES,FL 33138 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Tel:(305)795-2204 Fax:(305)756-8972 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESINTATIVES. AUTHORIZED REPRESENIATIVE ACORD 25(2001108) 0 ACORD CORPORATION 1988 Local Business Tax Receipt, Miami—Dade County,State of Florida -THIS IS NOT ABILL-D0 NOT PAY LBT 6960422 !_j BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MIAMI MECHANICAL RENEWAL SEPTEMBER 30,2015 CONTRACTORS INC 7236011 - 5005 COLLINS AVE#1018 Must be displayed C place of business MIAMI BCH,FL 33140 Pursuant to County Code Chapter SA`Art.9 fx 10 OWNER SEC.TYPE OF BUSINESS MIAMI MECHANICAL CONTRACTORS 196 SPEC MECHANICAL er TAX COLLNT ECTOR INC CONTRACTOR 49.50 10/02/2014 Worker(s) 1 12M000023 0221-15-000063 This Local Business Tax Receipt only coldirma payment of the Local Business Tax.The Receipt is not a license, permit,ora 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 ga-276. MIAMI-2 IAMI For more information.visit wwwmiamidade.eow/taxcollector �T Municipal Contractor's Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY M C CC NO: 12M000023 BUSINESS NAMEMOCATION RECEIPT NO. EXPIRES MIAMI COL COLLINS AVE#1018ANICAL RACTORS INC NEW BUSINESS SEPTEMBER 309 2015 MIAMI BCH,FL 33140 745882 Must be displayed at place of business Pursuant to County Code Chapter BA-Art.9&10 OWNER TYPE OF BUSINESS PAYMENT RECEIVED MIAMI MECHANICAL CONTRACTORS SPECIALTY MECHANICAL BY TAX COLLECTOR INC CONTRACTOR 175.00 10/02/2014 0221-15-000063 M&Z For more infonTotion,visit www.miamidadeaavAncollecter Miami Mechanical Contractors MIRMI MECHEM 1171 Bay Drive CONTRACTORS Miami Beach,FL 33141 AIR CONDITIONING/INSTALLATIONS Ph:786-402-4457 SPECIALIZING IN NEW CONSTRUCTION Fax:305-397-1728 RESIDENTIAL&COMMERCIAL CMC:12M000023 PROPOSAL PROPOSAL SUBMITTED TO TODAY'S DATE DATE OF PLANS/PAGE i'S GERALD SUPREME 5/7/2015 PHONENUMBER FAXNUMBER JOBNAME SUPREME RESIDENCE ADDRESS,CITY,STATE,ZIP JOB LOCATION 535 NW 112ST MIAMI SHORES,FL 33168 We propose hereby to furnish material and labor necessary for the completion of *ONE(1)SPLIT UNIT SYSTEM/RESIDENTIAL(BRAND"GOODMAN")2 TONS, 14 SEER.REFRIGERANT R-410. * (AHU)TONS COOLING:ARUF24D14AA AHRI CERTIFIED *CONDENSING UNIT:VSX140241AA *ELECTRIC HEATER:5 KW,V.208-1-80 *-Conditional Unit Replacement Warranty-10 Years(Registration Required) *-Limited Parts Warranty-10 Years *(1)T-FLOAT SAFETY SWITCH;(1)DIGITAL THERMOSTATS ;(1) A/H ALUMINUM/METAL STANDS '*(8)A/C SUPPLIES;(2)RETURNS *10 FT OF(1 1/2')FIBERGLASS DUCT PLENUM;INSULATED R-6 FLEX DUCTS; * 1)3/8" 1)3/4"COPPER REFRIGERANT LINES *- 1 YEAR OF LABOR WARRANTY,PER WORK DONE BY MIAMI MECHANICAL CONTRACTORS,INC. We propose hereby to furnish material and labor—complete in accordance with above specifications for the sum of: dollars ( $2,800.00 ) Payment as follows: 25%PRIOR TO START 30B.65%UPON COMPLETION OF ROUGH. 10%UPON COMPLETION OF WORK. All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according to specifications submitted, per standard practices. Any alteration or deviation from above specifications Involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance.If either party commences legal action to enforce its rights pursuant to this agreement,the prevailing party in said legal action shall be entitled to recover its reasonable attorney's fees and costs of litigation relating to said legal action,as determined by a court of competent jurisdiction. Authorized Note: this proposal may be withdrawn by us Signature JESSE A. GARCIA PRESIDENT if not accepted within 30 days. ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions Signature are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance