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DEMO-15-968 Inspection Worksheet Miami Shores Village 1 10050 N.E. 2nd Avenue Miami Shores, FIL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233176 Permit Number: DEMO-4-15-968 Scheduled Inspection Date: June 08,2015 Permit Type: Demolition Inspector: Perez,JanPierre Inspection Type: Final Owner: UKAZIM, UCHENNA Work Classification: Mechanical Job Address:960 NE 97 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060143160 Project: <NONE> Contractor: ALL AIR SOLUTIONS INC Building Department Comments REMOVE 1 EXISITNG AIR HANDLER UNIT FOR FUTURE Infractio Passed Comments RENOVATION INSPECTOR COMMENTS False 1 Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 08,2015 For Inspections please call: (305)762-4949 Page 9 of 25 Perrrt��q 4,77,— Miami Miami Shores Village t l � itlon 77 10050 N.E.2nd Avenue NE 4 ••• Miami Shores,FL 33138-0000 Fer1 �f5te&s. 1PiiVE� R � Phone: (305)795-2204 R , Ex /02/2015 iration: 11 P Project Address Parcel Number Applicant 960 NE 97 Street 1132060143160 UCHENNA UKAZIM Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell UCHENNA UKAZIM 960 NE 97 Street MIAMI SHORES FL 33138- 960 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 300.00 ALL AIR SOLUTIONS INC Total Sq Feet: 00 Type of Demo:Mechanical Available Inspections: Additional Info:REMOVE 1 EXISITNG AIR HANDLER UNIT Inspection Type: Classification:Residential Final Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# DEMO-4-1545304 DBPR Fee $2.00 04/23/2015 Credit Card $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 05/06/2015 Check*1791 $64.60 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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 certify that all the foregoing informati i accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-no cont for to do the work stated. May 06, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 06,2015 1 Miami Shores Village REcFTvRD Building Department APR 28 2015 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 B Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.L I'l Z PERMIT APPLICATION Sub Permit No& ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING %MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP '/ CONTRACTOR DRAWINGS JOB ADDRESS: 00 0 �`' 92 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 32 O 6— 0 \'�— 3( 6 0 Is the Building Historically Designated:Yes NO L--- Occupancy Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): *%j V ie'ft-.611 W) Phone#: '56 1 —9 0 1 — 3kV-)- , Address: (00 iae- n�4- S7 S '- City: �`� Ar/� 1 S VP Wl State: � Zip: S313'e' , Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: All "` 14 �� Phone#: Address: /�P/ r-l- City: "(/'94//v "77jo)-7/ d1mr-l-1 State: /'¢ Zip::�, 3.) te 0� Qualifier Name: �;G�2 iso �ilri �� R , Phone#a6,/2®B-�OZ- State Certification or Registration#: c��/�ic�l�� ..jt,d . g Certificate of Competency#: DESIGNER:Architect/Engineer: Td-k o oles 141 Phone#: .! 1 a_ •r ��yd�r^j�' Address: `�, O oCA L-AA^13 10 J City: < itj 1 Yuck State: FiL Zi P:,3 3 i cC) oc) Value of Work for this Permit:$ 00 Square/Linear Footage of Work: 0'LF- Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace [j-Demolition Description of Work: MMoVG Q) Specify color of color thru tile: oO Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) r 1 Bonding Company's Name(if applicable) 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. 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 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 n appro d and a reinspection fee will be charged. I — Signatur Signature OWNER or AGENT CONTRACTOR The foregoing instrument /nwas acknowledged before me this The foregoing instrument was acknowledged before me this Mr day of �U1L1 120 , by mac! day of ae\ ,20 IS ,by 0WOM A who is personally known to 4o �cc�C'�et'�^who i <no to me or who has produced Uhl Ucf ny as me or who has produced as identification and who did take an oath. identification and who did take an oath. 4 NOTAR POLIC NOTARY PUBLIC: C_ Sign: Sim--►,�Q��„ Print: S Print• �1r�C+_e� otarq Public- tate of Florida Seal: y Comm.Expires Jul 27,2018Seal:Commission # FF 145261 REBECAM.PASTRW MY COMMISSION d EES72624 P� EXPIRES:Febmmy 07,2017 w 11 TIPJI� APPROVED BY � s Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) DATE(MMMD/Y " ACOR" CERTIFICATE OF LIABILITY INSURANCE It.„/ 1 4/21/2015 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 does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Alexander Dopazo Dopazo & Associates Inc PHONE (305)470-8500 F Ne:(866)647-9673 8725 NW 18th Terr Ste 300 E-MAIL-ADDREs:alex@dopazo.com INSURERS AFFORDING COVERAGE NAIC# Miami FL 33172 INSURERA Wesco Insurance Company 25011 INSURED INSURER B:Pro ressive Express Ins CO 10193 All Air Solutions Inc INSURERCMount Vernon Fire Insurance Co 26522 1101 NE 191 Street #408 INSURERDBusiness First Insurance Co. 11697 INSURER E: Miami FL 33179 1 INSURER F: COVERAGES CERTIFICATE NUMBER CL1533109569 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS POUCY NUMBER M D D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE ToD A CLAIMS-MADE Fx_]OCCUR PREMISES EaEoccu encs $ 100,000 WPP1144762-01 3/27/2015 3/27/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECTPRO F-]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident B R ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS02132056-1 3/27/2014 3/27/2015 BODILYINJURY(Peraccident) $ AUTOS NO OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident PIP-Basic $ 10,000 UMBRELLA UAB OCCUR EACH OCCURRENCE $ 5,000,000 C X EXCESS UAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION �XL1565466 3/27/2015 3/27/2016 $ WORKERS COMPENSATION g AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? Y� N/A D (Mandatory In NH) 0521-04444 9/23/2014 9/23/2015 E.L.DISEASE-EA EMPLOYE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Ia required) Air conditioning sales, intallation and repair. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10052 NE 2 Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE M Dopazo CPIA/CRISTI ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSD25 Nolan)