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