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MC-15-1561 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-237524 Permit Number: MC-6-15-1561 Scheduled Inspection Date: November 09, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: KESSLER, NOAH &AUBREY Work Classification: Addition/Alteration Job Address: 1002 NE 105 Street Miami Shores, FL 33138- Phone Number (917)579-8541 Parcel Number 1122320280010 Project: <NONE> Contractor: ATLANTIK MECHANICAL INC Phone: (305)705-7189 Building Department Comments SUPPLY RETURNS GRILLES AND EXHAUST FAN Infractio Passed Comments ADDITION INSPECTOR COMMENTS False Inspector Comments Passed ®' Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 06, 2015 For Inspections please call: (305)762-4949 Page 5 of 42 It - I y,c�ttf$ Miami Shores Village h \ 10050 N.E.2nd Avenue NE 0,01� "' "'"" Miami Shores,FL 33138-0000 E Phone: (305)795-2204 Expiration: 12/27/2015 Project Address Parcel Number Applicant 1002 NE 105 Street 1122320280010 NOAH&AUBREY KESSLER Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell NOAH &AUBREY KESSLER 1002 NE 105 Street (917)579-8541 MIAMI SHORES FL 33138- 1002 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,400.00 ATLANTIK MECHANICAL INC (305)705-7189 (305)219-3276 _, .,.. . ._.__ _. ... _. Total Sq Feet: 00 Tons: Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved:: In Review Review Mechanical Date Denied: Type of Work:SUPPLY RETURNS GRILLES AND E) Review Mechanical Scanning:3 Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# MC-6-15-56086 DBPR Fee $2.25 06/24/2015 Check#:3272 $50.00 $ 116.70 DCA Fee $2.25 Education Surcharge $0.40 06/30/2015 Credit Card $ 116.70 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 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 certifyttat alt"t�ie' information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zon :Futh"' ize the above-named contractor to do the work stated. June 30, 2015 onzed Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 30,2015 1 Miami Shores Village N '4 Building Department �Y: JU22015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. RC-f-16'-Y.30 PERMIT APPLICATION Sub Permit No./ ,� . , *•` � 'V' A ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING PJMECHANICAL ❑PUBLIC WORKS CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1002 NE 105th Street City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-2232-028-0010 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Aubrey& Noah Kessler Phone#:(917) 579-8541 Address: 1002 NE 105th Street Miami Shores FL 33138 City State Zip: Tenant/Lessee Name: NONE Phone#: N/A Email: Aubrey.Kessler@gmail.com q (� CONTRACTOR:Companv Name: AV\a ll k 9�t,Q/1 1 C.(�Q _f�10. Phone#: jo5_ Z La— '3z-7� Address: k_44 ZZ� V LL) "_ 4Q WC1 City: VL"& State: Zip: Qualifier Name: V ``J �r� l`i Phone#- may` 7 l Q—�Z.� �z State Certification or Registration#: f^ '�- i Zit�[��. Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �, Yo o,o o Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: k&- 5'.1, Pin..; Specify color of color thru tile: Submittal Fee �� CCF$ CO/CC$ $ � °� _.�L Permit Fee$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 G ._9 u Bonding Company's Name(if applicable) None NIA 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. 1 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 em Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 14 day of 04e~r cl,, 20 16 by Z�2 day of -aavv e 20 S by who is personally known to !1'1� y who is personally known to me or who has produced t F4 L t as 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: r^ Print: Print: wt•2�—�n-� 7!��'�7—r�►}�p-�- :�1 e�' 1P,fiY PU9 i, �� Seal: ?2`. i`c= Notary Public-State of Florida Seal: _ _ Ex fres Nov 15.2015 ;�' COMMISSION # FF191694 MY Commission#EE 146568 �� EXPIRES:January 21,2019 oF �.�` www.AARoNNOTARY.COM 7APPROVED BY s Examiner Zoning Structural Review Clerk (Revised02/24/2014) ATLA TIK MECHANICAL, Inc. Estimate CMC1249997 17720 NW 73rd.Ave.Suite 209 Date: 3/31/2015 Hialeah,FL 33015 Estimate#: 15054 Name/Address: Project Name: Attn.:Eric Hochman 1002 NE 105th St. Acclivity Construction,LLC Miami Shores,FL 33138 2000 Ponce De Leon Blvd. Suite 60 Coral Gables,FL 33134 Description Qty Rate TOTAL: I.A/C ductwork changes.Including; 1 1,400.00 1,400.00 1.New exhaust fans&connectors(2). 2.New supply grilles 6x6&8x8 w/flex duct. 3.New return(3)w/common 16"x16"in hallway. 4.Labor&materials. 5.Permit&inspections. 6.Existing 1/-J '(4710 main ductwork to remain. 7- 1/- pd4710 w/ EXCLUSIONS: 1.Roof/wall penetration and sealing. 2.Any other A/C work. NOTE: 1.Down payment required w/confirmation. 30 a/e Jfwd- TOTAL $1,400.00 ACCEPTANCE OF PROPOSAL ESTIMATE VALID FOR 30 DAYS. RETURN SIGNED&DATED Phone#: 305-219-3276 Fax#: 305-517-3494 We accept Credit Cards atlantik@atiantikmechanical.com Fees may apply. www.atlantikmechanical.com ♦SNOREs G� Bull Miami shores Village Building Department �L�RI�p 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. _,t�COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: A l\a/)4�1< I. BUSINESS ADDRESS: 9740 AM) q Sr 4412, Z 1 CITY 41 ol. t�l STATE ZIP 33� BUSINESS PHONE: -7104 FAX NUMBER(305 ) G 0 CELL PHONE(?V5 ) 21q-3-47,46 QUALIFIER'S NAME: �)&o (` .4 QUALIFIER'S LIC NUMBER: 0_0 @--121A '�94f:3 RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CMC1249997 ' r The MECHANICAL CONTRACTOR " Named below IS CERTIFIED � s. Under the provisions ofChapter 489 FS.. Expiration date: AUG 31 2016 R. a ORTEGA, RODOLFO ATLANTIK MECHANICAL INC 17720 NW 73RD.AVE. IN APT 209 HIALEAH FL 33015 ISSUED: 08/03/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408030003836 0038 Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOTA BILL' - DO NOT PAY 6498786 EXPIRES BUSINESS NAME1!-OCdL11ON RECEIPT Ne_AL R��w ATLANTIK MECHANICAL INC RENEWS SEPTEMBER 30, 2015 17720 N1111 F3 AVE 209 Must be displayed at place of business MIAMI)FL 33015 Pursuant to County Code Chapter 8A-Art.9&14 SEC. fypE OF BUSINESS AYMENT RECEIVED OWN 2R 196 GENERAL MECHANICAL CONTFIACTQIhy TAX COLLECTOR ATLANTIK MECHANICAL INC CMC1249991 $75.00 08/19/2014 Worker(s) 1 FppUO6-14-015494 This Local BusinessTax Receipt only confirms payuaent of the Local Business Tax.The Receipt is Hot a license, permit,or a certification of the holder'squalifications to do business.Holder must capply with'80Y 9ove �1 or nongovernmental regulatory laws andrequiremems which apply to the business The RECEIPT NO.above must be displayed on all conmmmiai vehicles-Miami-Dade Code Sec Sa-276. For more imfornt116011.visit .�.. -9�:a' ^ovhruceaNector i CO-RDL CERTIFICATE OF LIABILITY INSURANCE DATE jSAMIDO/YYVY) (}b12?t_01, PRODUCER FTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MET ASSURANCE UNDERWRITERS,INC, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 40111 WEST FLAGl,ER STREET,#x302 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR MIAMI,FI-ORIDA 3313 . ALTER TETE COVERAGE AFFORDED BY THE (POLICIES BELOW. -. INSURERS AFFORDING COVERAGE INNA[C# SLIRE.C7 4 INSURERA: SCOTI'SISAI._EIIa;15111 ANc(':.E;(.'OTVIP.AI\3�' —.- ATLAIVT'II{Iti+EC HANIC'AL INC IlvsuRER B: GRANADA ADA INSURANCE C(3I42I'4iltiy 17720 I 14J 73 AVENt E,#?(K) FI"I13I.,Fi H: INSURER c: SC+C�T SDAI,E INSURANCE COMPANYkid. 3301.5 INSUPER0; ThCtfN0.0GY INSURANCE C OMPANY COVERAGES INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTW HSTANDING 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 DESCRIBEDHEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. (NSR AOD' ._ .— TYPE OF INSUELA A POLiCYNUMSER POLICYE F£CTIVE POLICt'J XPIRATION GEP1ERALLIABILITY EACH OCC URRENCE $ 1.000,00 COMMERCIAL GE NERAL LIABILITY DAMAGE TC?RENTEID UMITS P EriAJS S"Ea oecu ence' 1 p{1, CLAIMS MADE Lj OCCU€�, MED E�CP(Any one person) $ 5,010 A-. Cl'S21072861 124/17/2014 !112/17/2015 J"ERS NAL s AD' W JURY $ 10)0,000 RALAGGREGATE $ 2,000,00(() CsEN'LAcGREGnxI_Lcs�ITAI�RLIESI=ER: IS�ODucrs-cos�ProRAc� I$ 2,€)(i{),(}(1(7 POLICY PRO- LOCA .- AUTOMOBILE LIABILITY ANYAUTO COMr3INED SINGLE LIMIT � $ 1 4Ea a a nq ,(10 0,001 ALL OWNED AU10S '- OODILYINJURN . SCHEDULEDAhJTC s (i1 i1111�tJ{ (1S£i I 11tZE,62t)1 111126/2015 Iger person} HIRED AUT BODILY INJURY - NON-O4VNERALITLSS (PofacodeM) $ : PROPERTY DAMAGE � (f'eraccliien:) C3AE?AGELIA$ILITY f AUTflOi�€LY•EAACCIpENT .$ A iY A JTO JJ{{ _EA ACC 'S OTHER _ AUTOO€ctLY; AGG $ EXCESJx MSPELLALIABILITY EACHCCGURRENCE $ $,()f)O,U i) ✓ OCCUR CLAIMS MADE C. AGUHECaAFE $ 5,0(g),000�1 XE3S005E121.'; 04109/201-512/1712015 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION WCSTATU- 4TH- EMPLOYERS'LIABILITY I nIT� ISS ANY PROPRIET RPARlNERIEJEI T)v y�tC {j� ( 10/t5/2014 E.L.EACH ACCIDENT $ I fJ00,000 E"t.FFICERIMEMSER EXCLUDED? )Eyes.descrba under C.L.DISEASE-EA EMPLOYEE $' 1,(1{)QO(K) SPECIALPRI7VI IONSJIeIcx El,DISEASE-POLICY LIMIT $ 1,00{),000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS AWED BY ENDORSEMENT I SPECIAL PROVISIONS AIR CONDITION4NG INSTALLATIONIREPAIRS, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION '.I°i'Ziami Shores Village Bldg.Dept., DATE THEREOP,THE ISSUING INSURER WILL ENDEAVOR TO.MAIL DAYS,WRITTEN 10050 NE 2nd Avc;. �,q NOTICE TO THE CERTIFICATE HOLDER NAF D TO THE LEFT,BUT FAILURE TO DO SO SHALL IYA�d.I 1 Shores,1={L 33138 IMPOSE NO OBLIGATION OR LIA 1FANY Ols6 UPON THE INSURER,ITS AGENTS ORREPRESENTATIVES. AUTHORIZED REPRESENTATIVE/ �aT ACORD 25(2001!08) CORD CORPORATION 1988