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MC-14-2236 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-221457 Permit Number: MC-10-14-2236 Scheduled Inspection Date: May 20,2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: NARDECCHIA,VALERIA Work Classification: Addition/Alteration Job Address: 1226 NE 93 Street Miami Shores, FL 33138- Phone Number (305)494-6888 Parcel Number 1132050270170 Project: <NONE> Contractor: HAVANA AIR CONDITIONING, INC Phone: (305)558-9136 Building Department Comments RELOCATE SUPPLY OUTLET AND VENTILATION 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. May 19,2015 For Inspections please call: (305)762-4949 Page 2 of 40 Miami Shores Village ! - : - < j -a Building Department OCT 10 ZU14 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BST, Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 200 BUILDING Master Permit No. ^ PERMIT APPLICATION Sub Permit NotC 14 - 136 (BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County Miami Dade Zio: Folio/Parcel#: _ &+�Z��= ®z'I- Q/;W Is the Building Historically Designated:Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: 41i� t4sp0&—<=it iA OWNER:Name(Fee Simple Titleholder): ' � _.°gyp !*�tAA2=q I Phone#:— A Address: L2l& ZV46 191�; City: A:.Awi � State: ���l�G! zip: ��� Tenant/Lessee Name: / Phone#: Email: /S,1 CONTRACTOR:Company Name: HA1/,4-►JA- A-t,P✓ Phone#: A 2 - -1/34 Address: a2gSr- City: State: Zip: 33V®.7- Qualifier Name: Os f✓!1 G-d,6 /-,;-a Xe-e-d Phone#: -3.f�F'3 State Certification or Registration#: G®.S(` j�fP / Certificate of Competency#: DESIGNER:Architect/Engineer:�� ��e :�u9 rdkZ fy� phone#: �/�01- r7� Address: ,.��,t! ��` l�Et�. s`yQ� Ci Zip: Value of Work for this Permit:$ _� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace la p _ ❑ Demolition Description of Work:_ �`" Q C-A7•-- s:;;&/tf "77.0/'^ Vdw7/LfJTc Specify color pf color thru tile: j- Submittal Fee$ Permit Fee$ �� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ D�BPpR$ - Notary$ Technology Fee$ Training/Education Fee$ d'1 Double Fee$ Structural Reviews$ Bond$ yy TOTAL FEE NOW DUE$ i (Revised02/24/2014) Bonding Company's Name(if applicable) MIA Bonding Company's Address XL4 City State AMA 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 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 OW or AGENT CONTRACTOR The forgoing)nstrent as acknowledged befor a this The foregoing instrument was acknowledged before me this h day g 20 by /d day of DG� 020 by i(tea who is personally known to who is personally known to me-or who has p duced as me or who has produce z&�3 72� as identification and w o did take a th. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: nt• oMAT %a Notary u is a o Seal: 13.2016 Seal: y Joanna M Feliciano a+ My Commission FF 082753 � Expires 01/12/2018 ************************************************************************************************************ APPROVED BY l T 6 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 't State of Florida General Contractor License CGC-002477 e:�;4L�sC ? JOSE F.PRIETO JR. MAO? Phone(305)829-1243 . Fax(305)829-0445 7270 N.Oakmont Drive Cell(305)495-2353 Miami,Florida 33015 Email PrietoDevelopment@Yahoo.com r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ' = � CONSTRUCTION INDUSTRY LICENSING BOARD a :' CAC0513638 � ^` The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 BORRELL, OSVALDO :. HAVANAAIR CONDITIONING INC 887 W 34TH STREET HIALEAH FL 33012 ISSUED: 09/03/2014 DISPLAY AS REQUIRED BY LAW, SEQ# L14 A Ro®® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM)DOMM) 10/01/2014 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.It SUBROGATION IS WANED,subject to the terns 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). PRODUCER ��; Saral Medina Emmanuel Insurance&Associates,Inc. PHONE (305)693-0003W5)691-4381 No: 2370E STH AVE _ADDRESS. saral@emmanualinsurance.cmm INSURERS AFFORDING COVERAGE NAIL 0 HIA-EAH FL 33013-4236 INsURER A: Preferred Contractors insurance Co. 12497 INSURED INsuRER a; RstalIFirts Insurance Co. 10700 HAVANA AIR CONDITIONING INC INSURER C: OSVALDO SORRELL INSURER D: 887 W 34TH ST wsuRERE: HIALEAH FL 330125159 INSURMF: 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. INURPOLICYEFF LTR TYPE OF INSURANCE PJJUL POLICY NUBIBEIt MID MMM] LIMITS GENERAL LIASILnY EACH OCCURRENCE S 1.000.000.00 COMMERCIAL GENERAL LIABILITY50,000.000 CLAIMS-MADE ® ME OCCUR PREMISES a doaarmme S A Y PC4405017-01 09/23/2014 09!232015 n ON are ) S 5.000.00 PERSONAL 8 ADV INJURY S 1.000.000.00 GENERAL AGGREGATE s 2.000,000.00 KGEWLAGGREGATELIMITAPPUESPEW PRODUCTS-COMPIOPAGG S 2,000,000.00 POLICY LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT. s ANY AUTO BODILY INJURY(Per fin) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per sodden!) S HIRED AUTOS ANUTO OS ED � e� $ S UMBRELLA LIAR IOCCUR EACH OCCURRENCE S EXCESS LIAa 1 AGGREGATE $ DE) I I RETENTIONS S WORIUM COMPENSATION A y.A AND EMPLOYERS'LIABILITY YIN 1� 1 ANY PROPRIETOR/RARTNERfiD(ECUTIVE E.L.EACH ACCIDENT $ 1,0w,000.00 B OFFICERIMEMSEREXCLUDED? r NIA 0520-45661-0 09/102014 09/102015 Iy8a,pandatwy desrrlbeln E.L DISEASE-EA EMPLOYEES 1.000,000.00 undar DESCRIPTION OF OPERATIONS belay EL DISEASE-POLICY LIMIT s 1.000,000.00 DESCRIPTION OF OPERATIONS I LOCAVONSIV@F66L�4(Attach ACORD 101,AddWwgd F mmft Sehedale,I more ePame 1a requI" Mechanical Contractor. 11II Any Changes or alterations Done to this document after being issued Shall Constitute it null and void. CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138-2304 AUTHOR®REPRESENTATIVE ACORD 25(2010105) The ACORD r►mne and logo are ®9988.2010 ACORD CORPORATION.All rights reserved. og registered marks of ACORD Local Business Tax Receipt Miami—Dade County,State of Florida -THIS 15 NOT A BULL-00 NOT PAY LBT 2878123 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES HAVANA AIR CONDITIONING RENEWAL SEPTEMBER 30, 2015 INC 3011129 Must be d'mpiayed at plaee of business 887 W 34 ST Pursuant to County Code HIAI.EAH,FL 33012 Chapter 0A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RE=CEIVED HAVANA AIR CONDITIONING INC 196 SPEC MECHANICAL BY TAX COLLECTOR CONTRACTOR 45.00 09/19/2014 Worker(s) 1 CAC055M 0228-14009012 This local RI Tex Receipt ooly cmd ngs paymem ofthe lord BusiawisTax.Tde Receipt is=to 0aeme. pmt,are ocIffoodas Idthe holdWs quatIlloadursto do bosloess.Holder mast comply vaitb car gavONONAIIII Grovagovansmarnalrgawmybmad requiremnowlildepplvtothe boshtess. The RECEff 1110.abm must be disphlyed on OR commercifel veltioles-Miea11-08do Colo SO Ba-D& For aere vishyrvAmbobw