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MC-13-2557
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-217242 Permit Number: MC-11-13-2557 Scheduled Inspection Date: August 06, 2014 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: CHEE-AWAI, CAMILLE Work Classification: Addition/Alteration Job Address: 1370 NE 103 Street Miami Shores, FL Phone Number (305)710-3331 Parcel Number 1132050300080 Project: <NONE> Contractor: CANE AIR CONDITIONING AND INSTALLATION, INC. Phone: 305-266-7800 Building Department Comments DUCT WORK VENTILATION REPLACE 2 UNITS AND 5 Infractio Passed Comments TON AND A 3 TON INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-202949. need lockcap Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 05,2014 For Inspections please call: (305)762-4949 Page 25 of 37 r ° Miami Shores Village a ` Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 1 BUILDING Permit No. MC � — `oZSs7:� PERMIT APPLICATION Master Permit No.F�().3 .Q�3 a- Permit Type: MECHANICAL JOB ADDRESS: 1 -to L.)1F_ 1 O3 City: Miami Shores County: Miami Dade Zip: 3 3 / 3$ Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: �- OWNER:Name(Fee Simple Titleholder): C1=)"VLl I L L1 k)&I Phone#: 3011 — G®6`31-4 Address: 13 10Z City: vlill 414M -S/A-6ye'G: State: rei Zip: 93/ 3 'R Tenant/Lessee Name: ' -A- Phone#: Email: GOk��^ l-e. cam. 6)ao KA, • co w%- CONTRACTOR: Company Name: Ce vt.e a�Q.K 4 am�I—a W(A,-.NC-Phone#: Address: `t$ -O s 1.a) - ^—� City: I dLukA-, State: ZiQ Qualifier Name: C"' L4 ` 0 I•e.rL Phone#: S''3 State Certification or Registration#: 6:. G® Certificate of Competency#: Contact Phone#: Email Address: errt i c_n ✓1 �S q ✓� -�. ' c4us _ DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New �--. ernpair/Replace ❑Demolition Description of Work: ��.0 �o r V ( � aL eC. t��Tf 5 Submittal Fee$ '�7 Permit Fee$ A 3 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ �' Z 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS and 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 Signature .�-Y— Owner or Agent Contractor The f go ore me this The fo go SUMM W ore me this �►� .•. day o '� f Rt c-State of Flom day of i i° M00, u ON i Pubk b�late of Florida 'S Y res Feb 7,2017 *l MY Comm.Expires eb 7.2017 who is - o fro ced who is '" • o W> ® pro iced did take an oath. " National Not 'd take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print:S 4 R l-f�— My Commission Expires: � t� v/ My Commission Expires: APPROVED BY 51a's Exa • er Zoning Structural Review Clerk Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09) p ♦yH�R�s h Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel. (305) 795.2204 Fax. (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. 1 Job Address(where the work is being done): L3 1p k)F_-, (o ✓��4° 4��'I �1A� r��c —� 3 13 , City: Miami Shores Village County: Miami Dade Zip Code: 3 . ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS �+-ri 00, ARI(AHRI)DATA SHEET REQUIRED Change Disconnecting means:YES ❑ NO❑ ARHI Sheet Attached:YES❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL# COND.UNIT MODEL# KW HEAT NOM TONS AHU CU PKG 1 M.C.A AHU CU PKG AHU CU PKG 2 M.O.P AHU CU PKG `AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature Date: (Qualifier's signature only) • a 6 1110111 AC# 6147099 �..' STATS OF FLORIDA DEPARTblEi� .OF BUSINESS CQNSTRUCTION IND URyRLICENIINGLBOARDLATION MZ R 05 31/2012 117058891 SEQ#L12053101435 i The CLASS B AIR CONDITRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 GUILLEN, OMAR P CANE AIR CONDITIONING & INSTALLATION 10700 SW 141 AVE INC MIAMI FL 33186-31.80 I RICK SCOTT GQVERNOR I� REN LAWSON j DISPLAY'AS REQUIRED BY CAW SECRETARY I � I _ I rz r- r- t0 ontsaa r Local Business Tax Receipt co Miami—Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY [ LBT_j 4305256 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES CANE AIR CONDITIONING&INSTALLATION INC RENEWAL SEPTEMBER 30, 2014 9870 SW 45 ST 4493870 Must be displayed at place of business MIAMI FL 33165 Pursuant to County Code Chapter 8A-Art. 8&10 SEC.TYPE OF BUSINESS OWNER 196 SPEC MECHANICAL CONTRACTOR SYTAXPAYMENT' RECE1ILLEC OR ED CANE A/C 81NSTALLATION INC CAC043927 BY 7AXCCStt.LECTOp Worker(s) 5 $75.00 08/09/2013 C FPPU05-1 3-003072 0 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Reeeiptis nototicense. permit,or a certification of the holders quallticetions,to do business.Holder must comply with any govern mental or to nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0,above must be displayed on all commercial vehicles-Miami-Dodo Coda Sac R-276, C For inure information,visit ytyyryv.miamldada Bovhaxcaliactor N U N C N U i I I i i i CERTIFICATE OF LIABILITY INSURANCE DA 11/07//1133"" PRODUCER Montovi Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 9301 SW 56 Street,Suite E ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami,FL 33165 HOLDER.THIS CERT151CATE DOES NOT AMEND,EXTEND OR TER THE COVERAGE AFFOR ED BY THE POLICIES BELQW, Phone (305)279.5592 Fax (305)279.5506 INSURERS AFFORDING COVERAGE NAIC# INSURED CANE AIR CONDITIONING INSTALLATION INSURER A: FEDERATED NATIONAL INSURANCE - 9870 SW 45 Street INSURER a: AM FRUST NORTH AMERICA MIAMI, FL 33165 INSURER C: 305 INSURER D: INSURER E: COVERAGES TTHEOLICIES OF INSURANCE LISTED HAVE BEENISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING EQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH ES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRi-TR A[fh'L POLICY EFFFCTNE POLICY EXPIRATION irw iN as TYPE OF INSURANCE POLICY NUMBER DATE MM/DD OAT$ tAMIlr) LIMITS GENERAL LIABILITY Q COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 11000,000DAMAGE TO RENT GL-0000014803-00 12/22/2012 12/22/2013 PREMISES(Ea occurrence) 100,000 A ❑ ❑❑ CLAIMS MADE (] OCCUR MED EXP(Any one person) 5,000 ❑ PERSONAL$ADV INJURY 1,000,000 ❑ GENERALAGGREIaATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PROOUCTS•COMP/OP AGG 2,000,000 ❑ POLICY ❑PROJECT ❑ LOC rAUTOMOBILE LIABILITY U ANY AUTO COMBINED SINGLE LIMIT r❑-I ALL OWNED AUTOS (Ea accident L_I B [� SCHEDULED AUTOS BODILY INJURY ❑ HIRED AUTOS (Per Denson) ❑ NON OWNED AUTOS BODILY INJURY ❑ (Per accident) PROPERTY DAMAGE GARAGELIABILITY (Per accident ❑ © ANY AUTO AUTO ONLY•EA ACCIDENT ❑ OTHER THAN EA ACC AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKER$COMPENSATION AND [�/ wC SSTATO• ❑ OTH- EMPLOYER$'LIABILITY YIN MIGS8313 11/07/2013 11/07/2014 TORYLIMIT6 F B ANY PROPRIETOR/ OFFICER/MEMBER EXCLUDEDNER?EXECUTIVE n00,000 E.L.f•L-EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 100,000 Ifyes,describe under - SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 50,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS AIR CONDITIONING SERVICE, REPAIR AND INSTALLATION CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEI.LED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPARTMENT THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NE 2 AVENUE OF ANY KIND UPON THE INSURER,ITS A REPRESENTAr11rE.S. MIAMI SHORES, FLORIDA 33138 AUTHORIZED REPRESENTATIVE ACORD 25(2009/41)OF 9 2 od ACORD CORP All rights reserved. The ACORD name and logo are re r marks of ACORD TAT:aced ZL689SLS02:ol 90SSISL2S02 :woad BS:ZT 2T02-2T-f10N