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MC-15-1398 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-236373 Permit Number: MC-6-15-1398 Scheduled Inspection Date: October 14,2015 Permit Type: Mechanical- Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: PING,ALEJANDRO Work Classification: A/C Replacement Job Address:9105 NE 5 Avenue Miami Shores, FL 33138- Phone Number (305)302-5770 Parcel Number 1132060141210 Project: <NONE> Contractor: MAGIC COOL AIR CONDITIONING Phone: 305-556-9620 Building Department Comments AC AND DUCT WORK 3 TONS AND 3 EXHAUST FANS Infractio Passed Comments INSPECTOR COMMENTS False V Inspector Comments Passed im Failed Correction Needed ❑ Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid October 13,2015 For Inspections please call:(305)762-4949 Page 6 of 69 1 i • _� \v� � S L,� � �� 353iy\j � Miami Shores Village hu � 10050 N.E.2nd Avenue NE ,' r Miami Shores,FL 33138-0000 ti Phone: (305)795-2204 ��a Expiration: 12/0912015 RIO1911 Project Address Parcel Number Applicant 9105 NE 5 Avenue 1132060141210 ALEJANDRO PINO Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone cell ALEJANDRO PINO 9105 NE 5 Avenue (305)302-5770 MIAMI SHORES FL 33138- 9105 NE 5 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $8,800.00 MAGIC COOL AIR CONDITIONING 305-556-9620 Total Sq Feet: 0 Tons: Available Inspections: Additional Info:AC AND DUCT WORK 3 TONS AND 3 EXHAU Inspection Type:- Classification: ype:Class cation:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40 Invoice# MC-6-15-55903 DBPR Fee $4.82 06/12/2015 Check#:15420 $290.64 $50.00 DCA Fee $4.82 Education Surcharge $1.80 06/09/2015 Check#:15410 $50.00 $0.00 Permit Fee $308.00 Scanning Fee $9.00 Technology Fee $7.20 Total: $340.64 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 information is accurst an that all wol will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the abo a-named contracto to do he wo June 12,2016 Authorized Signature:Owner / Applicant Date Building Department Copy June 12,2015 1 Miami Shores Village _?: Building Department JUN 0 9 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. �;z C- I -1Z:; PERMIT APPLICATION Sub Permit No.n C-I S - 13018 BUILDING ❑ ELECTRIC ROOFING REVISION ❑ EXTENSION RENEWAL ❑PLUMBING [3MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10 S A)� "5� Ad e- City Miami Shores County Miami Dade ZID: X31 3 p Folio/Parcel#: . c, Is the Building Historically Designated:Yes NO �_ Occupancy Type:,�f llzgad: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): .-�� n eQer o Phone#: Address: Q I D e_ City: /'T o G,rf% 0 State: Zip: 3 1 3 o Tenant/Lessee Name: Phone#: Email: Q 1 CONTRACTOR:Company Name: WA(-1 G �®ol-A;� (194,b eT/o'sw a160 �Phone#:� O f2t � ''`;X40 Address: q V.) 8.0 City: jG- I¢e, (cl'h-a e--e State. �f' Zip: Qualifier Name: £ �� ® ���1'e Q- Phone#: (,;:Ik State Certification or Registration#: C4'C- D 5-Y6 45 Certificate of Competency#: J DESIGNER:Architect/Engineer: �y� e t.-> "� —I d L Phone#: �7 .;> 35 Address- /-)Q-5'7 S"3 a-O`/ -rx4 --e-q- City: State: �--Zip: -2625/77 Value of Work for this Permit:$ ?,8 o O .O o Square/Unear Footage of Work: -- Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: #4/C- n t>J C'5 O o z y— -7 -5 4&J 3 £yc I.— ^C Specify color of color thru tile.- Submittal ile:Submittal Fee$150--CS- Permit Fee$ 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) 130 ing 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 not be approved and a reinspection fee will be charged. 0r Signature ignatur Signa (;L) OWNER or AGENT ONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 t S ,by 0 day of Vy A V ,20 / ,by a ri?O ,who is personally known to S D+` whoo�is,�ersonally known to Me or who has produced as me o �o has prodte ® �� � s�'`� �l as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: it o.�' Sign: Sign Print- Print: CARLOSJ• ES s: COM SEW#EE 10478 Seal: + MW SM=0 PM Seal: ,,, EXPIRES:Match 18,2018 , � Baked Thtu Notary P+A4ta Undaa�ra MY COMM1SS10N 0 88840M ' ;=04V E MIRSS:Naradw 16,2016 APPROVED BY ans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ' o Miami Shores Village Building Department M 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications.Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address(where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG.UNIT MODEL# COND.UNIT MODEL# ISL.. Oa ;;rEC= KW HEAT 7. 6 NOM TONS 25 AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER � D D YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES X NO YES NO NEW VCONCRETE SLAB YES X NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES K NO 1. Minimum Circuit Ampacity(Wire Size): -50 2. Maximum Overcurrent Protection(Fuse/Breaker Size): h� 3. Voltage of Circuit(208/240/480): °9 4. Size Disconnecting Means: Contractor's Company Name: dq e,Con( ie- ani,,4S0Ce-: r-e- Phone:6s'SZ' State Certificate orRegistratio IN, Certificate of Competency No. Signatur Date: ers si (Revised02/24/2014) Magic Cool Air Conditioning and Service Inc. 9821 N.W.80th Ave.Bay SL Hialeah Gardens,FL 33016 PROJECT DATE ESrypMA7E NO. 5/15/2015 JP08/2267 NAME/ADDRESS $MPTo GP BUILDER MR:ALEJANDRO PINO 4985 Davis Rd 9105 NE 5th AVE Coral Gables,FL 33143 MIAMI SHORES,FL 33138 DESCRIPTION QTY COST TOTAL A/C#1(Existent relocated) 8,800.00 81800.007 Include:11/2 fiberglass and round ducts,thermostat,labor and materials. (as plans) A/C#2 New A/C system of 3 tons RHEEM 18.00 SEER Mod:RASL3624C/RAHP36 Include:Refrigerant lines,drain lines,dryer vents,7 outlets,11/2 fiberglass and round ducts,heater,thermostat,4 exhaust fans,labor and materials(as plans) NOTE:1-Electrical by other. 2-Independent test and balance by other. PAYMENTS AS FOLLOWS: 1- 15%Commencement 2-40%Rough In progress 3- 40%A/C in place 4- 5%Final Sales Tax 0.00% 0.00 Thank you for your review and approval. TOTAL s8100•W Magiccool Other None Magiccool Other None Plans Roof Cubs Permits Pitch Pans Equipment Sleepers Crane&car Piping Refrig Duct&Grills Piping fond Electric Power Air Bal.by Electric Con Cutting Foundation Patching Terms and Conditions of this Contract:all parts,materials,equipments and other property sold or supplied here under shall remain Personal property,and title shall remain vested in Magic Cool,until the purchase price has been paid in full,pursuant to terms above set forth,or within(10)DAYS of rendering an Invoice. In the event customer fails to make his payment by the due date,MAGIC COOL may,at Its option declare the entire purchase price due and payable, and can remove all parts,materials,equipment and property supplied. Customer will hold Magic Cool harmless for any damages resulting from such action. MAGIC COOL is not resoonsibie for carts.materials.or ecuioment not furnished by them.and all guarantees are limited to the manufacturer's warranties. Any labor or materials required in addition to the above proposal,due to reasonable changes in job conditions or for replacement of worn or defective parts that were not noticed at the initial inspection,shall be invoiced separately and in addition to the above amounts. in the event customer defaults,he shall pay interest on the unpaid balance at the rate of 10%per annum from date of default,and all reasonable attorney's fees incurred in the event an attorney Is retained to enforce collection. This instrument constitutes the entire agreement between both parties and Is NOT effective until acceptance by Magic Cool. MAGIC COOL shag not be liable for anv failure or delays in cerformance occasioned by strikes.accidents or delays caused by conditions bevond their control MAGIC COOL CUSTOMER SIGNATURE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION s CONSTRUCTION INDUSTRY LICENSING BOARD FCFAC058693 The CLASS AAIR CONDITIONING CONTRACTOR Named below IS CERTIFIED DV Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 PORTELLA, REINALDO C � ~~ MAGIC COOLA/C&SERV1et INC 9821 NW 80TH AVENUE BAY 6�L HIALEAH GARDENS FL 33016 • D ISSUED: 08/10/2014 DISPLAY AS REQUIRED BY LAW SECI# L1408100000558 001376 I Local Business Tax Receipt Miami—Dade County, State of Florida THIS IS NOTA BILL - 00 NOT PAY i -1529750 RT i BUSINESS NAMFJLOCATION RECEIPT No. EXPIRES MAGIC COOL AIR CONDITIONING&SERVICE INC RENEWAL SEPTEMBER 30, 207 5 9821 NW 80 AVE 5L 7529750 HIALEAH GARDENS FL 33016 Must be displayed at piece of business Pursuant to County Code i Chapter BA-ArL 9&10 OWNER SEC.TYPE of BUSINESS MAGIC COOL AIR COND&SERVICE INC 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEVED Worker(s) 10 CAC058693 BY TAX COLLECTOR $45.00 07/18/2014 CHECK21-14-025890 This Local Business TwReceipt only coa ms payawd of the Local Business rax.The aaceipt is not a ficanse, pemdL or a carIfficaoa of the holder's qualifications to do business.Holdernaest comply with a or easgovern—n l regulatory hm and Mquiremauta which apply to the m aess m 9overnmeMai The RECEIPT Na above naW be displayed an all corm_parcial vehicles-Miami-Dade Code Sac ea-M For mare Informatics,visit I i CERTIFICATE OF LIABILITY INSURANCE DATE(M 06/011//1155 PRODUCER Southern Star Insurance Agency.Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 8338 SW 8th Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami,1=L 33144 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)262-2740 Fax (305)262-2647 INSURERS AFFORDING COVERAGE NAIC# INSURED MAGIC COOL AIR CONDITIONING&SERVICE, INC INSURER A. ASCENDANT COMMERCIAL INS. 9821 NW 80 Ave BAY 5L INSURER B Hialeah Gardens, FL 33016- INSURER C: INSURER 0: INSURER E: COVERAGES INSURER F. THE POLICIES OF INSURANCE LISTED 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 l LTR INSRD R SRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTDATE(MMIDDIVY) DATE(MWOONY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000.00 V COMMERCIAL GENERAL LIABILITY GL-36416-4 12/09/14 12/09/15 PREM SES Ea occurence) 100,000.00 CLAIMS MADE d OCCUR MED EXP(Any one person) 5,000.00 PERSONAL&ADV INJURY 1,000,000.00 GENERAL AGGREGATE 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPfOP AGG 1,000,000.00 V POLICY PROJECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS (Ea accident) SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per person) NON OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESSRIMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TORY TA- OERH- ANY PROPRIETOR r PARTNER J EXECUTIVE E.L EACH ACCIDENT OFFICER!MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE SPECIAL PROVISIONS below OTHER EA DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS t LOCATIONS!VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS AIR CONDITIONING SERVICE AND REPAIR. LICENSE NUMBER:CAC058693 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPARTMENT THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NE 2ND AVE OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. MIAMI SHORES,FL.33138 AUTHORIZED REPRESENTAT ROBERTO OJEDA ACORD 25(2001108)QF 0 ACORD CORPORATION 1988 MAGIC-6 OP ID:MY DATE(MACORO- CERTIFICATE OF LIABILITY INSURANCE 06101/2015I� 06/01/2015 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: R the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. ff 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 endorseme s. PRODUCER COANZCT Kenia Santana BROWN&BROWN OF FLORIDA INC PHONE 305.364-7800 FAx No):305-714-4401 14900 NW 79th Court Suite#200 Miami Lakes, FL 33016-5869 A L House Accounts INSU AFFORDING COVERAGE NAIL tt INSURER A:FCCI Insurance Company 10178 INSURED Magic Cool Air Conditioning$ INSURER B: Services,Inc. 9821 N.W.80th Avenue,#5L I"� C' Hialeah Gardens,FL 33016 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. I"LSR TYPEOF INSURANCE. ADDL POUCYNUMBER POLICY EFF POLICYEXP LIMITS COMMERCIAL.GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE r-1 OCCUR PREMISES occurrence $ MED EXP(Any are person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY 1 JEC El LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBIaINNEDD SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per $ AUTOS AUTOS (P ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION s NTH- $ WORKERSCOMPENSATION X ATUTE AND EMPLOYERS'LIABILITY A ANY PROPRIETORIPARrNEWEXECUTIVE Y/" 001WC14A55201 03/31/2015 03/31/2016 E.L.EACH ACCIDENT $ 500, OFFICERIMEM13ER EXCLUDED? EIN/A (Mandatory in NM E.L.DISEASE-EA EMPLOYE $ 500, If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMrr I$ 500, DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) License No.CAC058693 CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 Northeast 2nd Avenue AUTHORIZEDREPRESENTATIVE Miami Shores,FL 33138 Brown and Brown of Florida,Inc. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD