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MC-05-67 Miami Shores Village NOV 0 Building Department x 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No f2 2W4 — IUl'-1 FBC 20 Permit Type: MECHANICAL OWNER:Name(Fee Simple Titleholder): AL Phonek 3as"�-1©. 1 `t a U Address: b City: AA�AA State: Zip: 3 Tenant/Lessee Name: Phonek Email: JOB ADDRESS: 301 �j 1A, City: Miami Shores County: Miami Dade Zip: 3 Folio/Parcel#: Is the Building Historically Designated: Yes NO � Flood Zone: CONTRACTOR:Company Name: U �l'e_r`.�Pi I '�t L CO 1� Phonek Address: —7 2 -2, 16 r City: M114 Ni State: FLo 2!n,4 Zip: -V 7 / 6 6 Qualifier Name: T/4 GA .v � © Phonek State Certification or Registration#: A C.� , 7 Certificate of Competency#: Contact Phonek ©� �2 2 L"C> Email Address: V�VI (JCP- S41-AG ai�' S c+s I* N':�T- DESIGNER:Architect/Engineer: Phonek Value of Work for this Permit:$ SS are/Linear Footage of Work: Type of Work: ❑Address ❑Alteration (81Vew ❑Repair/Re lace ODemolition Description of Work: 1 -Q — 4-r /1 f, T 1 Submittal Fee$ Permit Fee$ l CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ 1 R TOTAL FEE NOW DUE$ JI S- `-)3 ` VVV t 7 Bonding Company's Name(if applicable) G'1 Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) _t, 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 pennit with an estimated value exceeding $250� the applicant must promise in goodfaith that a co o t once o commencement alai construction lien law brochure will be*livered to the person P g .f py f f whose property is subject to a chni it. lso, a certified copy of the recorded notice qf commencement mustibe posted at the job site for the first inspection w i ccur se en (7) days after the building pennit is iss . In the absence of/, such posted notice, the inspection will not b prov and r inspection fee will be charged. t r Signature Signa u e Owner or Agent Contractor 3 instrument was acknowledgedbefore m this 1 The foregoing instrument was acknowledged before me this The foregoing �� re day of ()� 20 L,by ' r1`� $lM t?M day of b� ,20�by �4 `' who is personally known to me or who has prod,� who is personally known to me or who has produced As identification ai�c�` liy�did take an fah. as identification and who did take . '� •. 101-4 NOTARY PUBLIC: o_m o �, . NOTARY PUBLIC: �.N ,a0 ?tp Yee Sign: 0`. �,� v 5 _ Sign: I Whip ,c/3 Print: /��/.O'9 � Qr��`\` Print: r-A '4 0e o',MFV . � s � My Commission Expires: ''�ptti ��`''�\\� My Commission Expires: APPROVED BY &ans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) s f - STATE OF-FLORIDA DEPART OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 a TNORTHSSEEEMONROE STREET TALLAHASSEE MATOS, JAVIER W UNIVERSAL AIR CONDITIONING CORP 7228 NW 56TH ST MIAMI FL 33166 STATE C)F F�Ib{i ' ��r' Congratulations! With this license you become one of the nearly one million D.#3PAR� OF BUS Floridians licensed by the Department of Business and Professional Regulations ROiSS`I � . Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. ,# � 01M. t�ACO 577 63 Every day we work to improve the way we do business in order to serve you betters �� f For information about our services,please log onto www.myfioridaiicense.com. CERTTFIr _ a0 There you can find more information about our divisions and the regulations that �- impact you,subscribe to department newsletters and team more about the IIRIVERSA� Department's initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly.We Constantly strive to serve you better so that you can serve your customers. sa c�azYFxr� unaa� z # - rtk-you for doing business in Florida,and congratulations on your-new licenser � $• DETACH HERE Kip, � s � -STA7 1E f t ls^w-ter j R si ,Oil'' -r7 Cf7NS' RUC # FD'tETR _ s 413 .081 98 C:ArH'057763 'I' -OJ - T �2Vu- tL ' ZJ r�i 2. h^34 x4rw`G _ `. -C'J[ IIS }p"s` .y� E+p kFA =7 -#7 r-; ,r 'rte s. � a l'� 3 - jT � '` .y �' 7�` ✓�' _CT . O� 1316 6 �e z f ° Q- ?4 -wJOi 1 ,�wa � Z r yam. j Ml r AAtA E- 10E BUSINESS TAX EIECEIPT 2013 FIRST-CLASS foR ��E�trii Y ,� ATEDRtbA- U.S.POSTAGE :11stGL ST EKPIRESEPT 30,2p13 PAID MIA1Ni,>:L 33130,{ VAUSt ATHf1:lACE p�BWSIPIESS. MIAMI,FL i PERMIT NO.231 THIS IS NOT A BILL-DO NOT PAs' 399569-4 RENEWAL BUSINESS NAME IF LOCATION 1. RECEIPT NO. 417005-6 UNIVERSAL AIRCONDITIONING CORP STATE* CAC057763 7228 NW 56 ST 33166 UNIN DADE COUNTY OWNER UNIVERSAL AIR CONDITIONING CORP Sec:Type of Business WORKER/S 196 SPEC MECHANICAL CONTRACTOR 1 THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT IT DOES NOT PERMIT THE HOLDER TO VIOLATE MY EXISTING REGULATORY OR <ZONING LAWS OF THE 00 NOT FORWARD COUNTY OR CITIES. NOR DOES IT EXEMPT THE. PERMIT OR LICENSE�T°""ANY OTHERUNIVERSAL AIR CONDITIONING CORP PERMIT :JAVIER MATOS PRES REQUIRED BYLAW.THIS IS. `..., THE AHO CERTIFICATION Rs�OUALIFF"- 7228 NW 56 ST noxs. MIAMI FL 33166 PAYMENT RECEIVED MtAM1-RADE COUNTY TAX COLLECTORS 10/01/2012 09.010234001 000082.50 ill Il llFFIlIslip itI!illrr NIIlt p)IlRl{lljj ffijy) it11111111 Impt lllf1ltImwtil! I SEE OTHER SIDE i f ,�+e�, zr�► CERTIFICATE OF LIABILITY INSURANCE DATE r 100!31/31/22012012 Y) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Westward Insurance Services 305 418-8411 AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE 2500 NW 79th Avenue COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 283 Doral FL 33122 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ASCENDANT COMMERCIAL INS. UNIVERSAL AIR CONDITIONING INSURER B: ASCENDANT COMMERCIAL INS. 7228 NW 56 ST INSURER C: MIAMI FLA,33166 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. INSR ADUL INSR LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YY) DATE(MM/DD/YY) A GENERAL LIABILITY EACH OCCURENCE $1,000,000 ® ®COMMERICAL GENERAL LIABILITY GL-74999-0 10/24/2012 10/24/2013 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 ❑❑CLAIMS MADE ®OCCUR MED EXP(Any one person) $5000 ❑ PERSONAL&ADV INJURY $1,000,000 ❑ GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ® POLICY❑PROJECT r-1 LOC PRODUCTS-COMPIOP AGG $2,000,000 $ ❑ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ANY AUTO (Each Occurrence) $ ❑ALL OWNED AUTOS BODILY INJURY ❑SCHEDULED AUTOS (Per person) $ ❑HIRED AUTOS BODILY INJURY $ F] NON-OWNEDAUTOS (Per accident) ❑ PROPERTY DAMAGE $ ❑ (Per accident) ❑ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ❑ANY AUTO OTHER THAN EA ACC $ ❑ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ E] ❑OCCUR ❑CLAIMS MADE AGGREGATE $ ❑DEDUCTIBLE $ ❑ RETENTION $ $ WORKERS COMPENSATION AND10/24/2012 10/24/2013 ❑ WC STATU- ❑OTH- B X EMPLOYERS'LIABILITY \�7C-329943-0 TORY LIMITS ER ❑ ANY PROPRIETOR/PARTNER/EXECU- E.L.EACH ACCIDENT $100,000 TIVE OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $500,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $100,000 ❑ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS OPERATION INCLUDE AND ARE NOT LIMITED TO;AIR CONDITIOINING SERVICING AND INSTALLATION. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF MIAMI SHORE EXPIRATION DATE THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO BUILDING DEPARTMENT MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 10050 NORTH WEST 2 AV FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. MIAMI SHORE ,FLA, 33138 AUTHORIZED REPRESENTATIVE ACORD 26(2001/08) ©ACORD CORPORATION 1988