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MC-14-402 �. A01 2L- � -3- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231019 Permit Number: MC-3-14-402 Scheduled Inspection Date: March 30, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: MATEO, RAYMOND AND DAMARIS Work Classification: New A/C System Job Address:900 NE 100 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060340220 Project: <NONE> Contractor: AFFORDABLE AIR& HEAT&ELECTRIC CONTRACTOR Phone: 305-770-4167 Building Department Comments FURNISH AND INSTALL 3 TRANE SPLIT A/C SYSTEM Infractio Passed Comments AND 3,SUPPLY AND RETURN DUCT SYSTEM INSPECTOR COMMENTS False l � l Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-208248. MISSING KITCHEN R] HOOD JPP Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 27,2016 For Inspections please call: (305)762-4949 Page 11 of 17 Z � t Miami Shores VillageMAR a4 201 . Building Department B�� 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 BUILDING Permit No. i PERMIT APPLICATION Master Permit No. Permit Type: MECHANICAL ( n JOB ADDRESS: (X:) ME 1 City: Miami Shores -c—eq ^^C��ounntty�y: Miami Dade Zip: , Folio/Parcel#: "3ariD "W -oaaV Is the Building Historically Designated: Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): RC(f (i 1`\Q O-d Phone#: Address: t 0C) City: \ips`M State: Zip: ya Tenant/Lessee Name: 4lac Phone#: Email: CONTRACTOR:Company Name: N1k'�f�C��Gb\e \C A t-i .Q 'Phone#: / f��'��- Address: VF no �5y �� City: 1`V� p�rM i State: -Zip: Qualifier Name: �tsl \ 0 0 Phone#: State Certification or Registration#: �rL� 01-\�" \ Certificate of Co tency#: Contact Phone#:�3 dEmail Address: (10k (a� cJCv1PQSK-•CQ" DESIGNER:Architect/Engineer: N Phone#: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: L]Addres_s OAlteration ' ANew ❑Repair/Replace ❑ emolition Description of Work: A ✓4� el 01 yvppD ILI P, Fe Submittal Fee$ S;-d'06 _Permit Fee$ CF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ in Bonding Comp0ny's Name(if applicable) N Bonding-Company's Address City State Zip Mortgage Lender's Name(if applicable) PV 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such P§ ted otice, t e inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor _ The foregoing instrument was acknowledged before me this foregoing instrument was acknowledged before me this day of day of by , ec-n Qr�°— , who is y own to me r who has produced wh sonally kno t or who has produced i entification and who did take an oath. as identification and who di take an oath. OTARY LIC: NOTARY PUBLIC: Sign• Sigh Print: Ch P t: o MYCOMM # My Commission E aMR0,AU%12,2017 My Commissi : ERM:AUG 19,2011'' 4�iet g19�►Ar r0 lstl�It�tI11C@ APPROVED BY Plans Examiner Zoning Structural Review Clerk Revised 3/12/2012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) trooa3a Local Business Taxt,-M1!cei t Miami—Dade County,State off' . p ,,orida THIS IS NOTA ILL DO NOTPALB 2102424, == T BUSINESS NAMEJI-OCATION ' iCEwr NO. ES 515 re X90$'�R&HEAT INC hmEWAL SEPTEM13ER 30, 2074 MIAMI FL 33179 2211126 Must be din Aiayed at place of business Pursuant to County Code Chapter SA-Art.9&10 OWNER SEC.TYPE OF BUSINESS AFFORDABLE AIR 8 HEAT INC 196 SPEC MECHANICAL CONTRACTOR PAYMENT r1ECE1VED Worker(s) i CAC00111 '• BY TAX COLLECTOR 875.00 07/22/2013 CREDITCARD-13-003681 Tills Local Business Tac Receipt ualy conlinc pew 011ie�1 Business Tas The Bpcsipt is not a license, ponsa or a can'rdi�tory law" equ"!�o which pplybusiaoss.Holder as'=Vs, comply en,governmental or acn8ovammenml apply to he h�iaess, The RECEIPTNO.etrore aagtbe dispiaTedon all columarcfal vedipiss-118011-110114 Code Secs-27& forma,hdormatiParistt ATAEOP-_FLORIDA D>rPAR1'MENT OF 'BUSINESS- A11TD F•ROFRLSSTON REGULATION +, ;. NSTRdTC2IONIISTRY 'TaTGEN$ 3QG 80ARD LICENSE NRR. y SEQ#L120e L�. • \' L. � A1C._ .-•l�+•`�. ,T `'On Ql 0061j0:6I'll,- C. iTataed kae w AIR ONDI,' IONII . ITS CE Under thisrovls3ons of ChaptAAO F�cpiration date: AUG 31 2 014 `. . 'sem 515AFF0RDAELE: AIR & ` !•� TNC MSII,MT 190TH ST 1 °•earl 3{'et,it1tS„�' •. :. FL 331, tt RICK SCOTT QOvERNOR KEN LAWSON _� flySECRETARY 1 . OP ID:AP CERTIFICATE OF LIABILITY INSURANCE °��``031033/2014120 4 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 certificato holder Is an ADDITIONAL INSURED,the pollcy()es)must be endorsed. if SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder M lieu of such endorsemen s. PRODUCER 02,17 HallandaerInsuraannceeGroup ch PHONE PO Box 250 E Hallandale,FL 33008-0260 a� Vita Kagan Gopnm 104,,AFFOA31 MSU AFFORDING COVERAGE NAIL 6 INSURED Affordable Air$Heat,Inc. INSURERA: IDSCO Insurance Co. 516 NE 190 Street INSURER B:Philadelphia Ins Company Miami,FL 33179 INSURERC: INSURER D• INSURER E INSURER F: 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. INSR ADM WEIR POLICY LTR TYPE OF INSURANCE POUCYNUMSER ETF LIMITS GENERALLIABILI Y EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL uAwuTY P105501 B-02 03/17/2014 0311712015 PREppSES'� $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any are mean) $ 6,0 PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE S 2,000,00 GENS-AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOP AGO $ 2,000,00 X POLICYgeLOC $ AUTOMOMEUABILIY COMBINED SINGLE LIMIT $ 1,000,00 B X ANYAUro PHPK897567 07/20/2013 07/20/2014 BODILY INJURY(Perpmsan) $ ALL OVINED AUTOS BODILY INJURY(Per acddenl) $ SCHEDULEDAUTOS PROPGE ERTY HIREDAUTOS X NDN4WNEDAUTOS $ $ UMBRELLA UABHCLAIMSMADE OCCUR EACH OCCURRENCE $ EXCESSLJAB AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC ATM OThL AND EMPLOYED'LIABILITYER ANY PROPRIETOP PARTNEReXEcinvE YIN EL EACH ACCIDENT $ OpFlCERRAENIRER EXCLUDED? NIA (Mm tdm III NH) E.L.DISEASE-EA Ey!jL E $ RTION OF OPERATIONS ketwar E.L.DISEASE•POLICY OMIT I S WSCWUC N OF OPER MM I LCCA71ONS I VEHICLES(Attmh ACORD 161,Addilonnt Renu tm SdmdWe,Hmm°sp EB mgtdioM Air Conditioning Contractor; Service, Installation S Repair CERTIFICATE HOLDER CANCELLATION Miami Shores Village MIAMSHI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN 10060 N.E.2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIM REPRESENTATM - C�?1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD a + ACO® DATE(MMlDtlIYYYYI `„�. CERTIFICATE OF LIABILITY INSURANCE DATE 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. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate dam not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01tcT Felice Vinarub, AAI Corporate Insurance Advisors PHONE (954)3I5-5000 jAM FAX No:(934)315-5080 100 NE 3rd Avenue Xffg'6,FVI-arub@c:Lafl.net Suite 1000 INSU AFFORDING COVERAGE NAICS Ft. Lauderdale FL 33301 INSURERA Associated Industries Ins Co 23140 INSURED INSURERO: Affordable Air 6 Heat, Inc. INSURER C: 515 NE 190TH ST INSURER D: MIAMI INSURER E: FL 33179 1 INSURERF: COVERAGES CERTIFICATE NUMBER.CL1361211517 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. LTR TYPE OF INSURANCE INSR VWMVD POLICY NUMBER EFF PO DlYI Lam GENERAL LIABILITY EACH OCCURRENCE $ N/ COMMERCIAL GENERAL LIABILITY EMMISES a accivivrtcal S N/ CLAMS MADE E]OCCUR MED EXP are person) S N/ PERSONAL BADVINJURY S N/ GENERAL AGGREGATE S N/ GEWL AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGG $ N/ POLICY LOC S N/ AUTOMOBILELIABILITY comsIRED a seddern N ANY AUTO BODILY INJURY 0Wpmw) $ N ALLOVVNEDSCHEDULED BODILYIWURYFeracddeM $ N AUTOS S N A A OMIMDHIRED AUTOS AUTOS PROP DAMA E S UMBRELLA VAB SUR EACH OCCURRENCE $ N/A EXCESS LIAR CLAMS-MADE AGGREGATE $ N/ D I i RETE I I $ A INORIERSCOmPEN8AMON ANC1024644 /8/2013 /6/2014 RNMW OTH- M, AND EMPLOVEW W1BILM APROPRIETORIPARTNERfi!tECU IVs YIN Et .EACH ACCIDENT $ 500000 OFFICERIMEMSER EXCLUDED? NIA (Maeelaat Mm In NH) E.L.DISEASE-EA EMPLOYE $ 500000 yyDF& OF OPERATIONS W. E.L.DISEASE-POLICY LMT $ 500000 DESCRIPTION OF OPERATIONS!LOCATIONS!VBIICLES(Attach ACORD 101,AddlBsnal Remake Seheduls,I more apace Is requ)retl) Proof of insurance only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELWERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2 Ave AUTHORID REPRESENTATIVE Miami Shores, FL 33138 Schwartz ****/NORFZ .•�l dLJ- . uhr ACORD 25(2090/06} ©1988-2010 ACORD CORPORATION.Ali rights reserved. INS0261"l wnl Thu ArtnPn narnu ane(lnnn aro ranietarm(marke ri Ar`nAr1