MC-14-1975 (2) � C Oil
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-219329 Permit Number: MC-9-14-1975
Scheduled Inspection Date: February 01,2016 Permit Type: Mechanical - Residential
Inspector: Perez,JanPlerre
Inspection Type: Final
Owner. TURK,JAMES AND JANINE Work Classification: New A/C System
Job Address:1275 NE 94 Street
Miami Shores,FL 33138-2946 Phone Number
Parcel Number 1132050100090
Project: <NONE>
Contractor: DYNAMIC AIRFLOW CORP
Building Department Comments
INSTALL NEW AIR CONDITIONING. Infractio Passed Comments
INSPECTOR COMMENTS False
Z
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
January 29,2016 For Inspections please call: (305)762-4949 Page 2 of 36
Irk Miami Shores Village
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Building Department
SEP 1 014
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 �Y: `
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC,,20LO
BUILDING Master Permit No. C 1"f- q s
PERMIT APPLICATION Sub Permit No. Mo
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING )� MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /1-15 NC, 914 S�'�`QR-�
City: Miami Shores County: cLL Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: ConstructionType: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 7 5)r Phone#:
Address: 9 1 l
City: V State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: e#:
Address: /3 1-7 sw ' 52
City: -State: F1 Zip: 33
Qualifier Name: / d ®� Phone#:
�+a4
State Certification or Registration M 6� 16 I� �� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$_V21 , Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration YkNew ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ �_) y� Permit Fee$ i CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ Q
TOTAL FEE NOW DUE$ �
(Revised02/24/2014)
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: 1 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 inspection fee will be charged.
m
Signature Signature
O NER AGENT WM-60 R
The foregoing in ument was acknowledged before me this The foregoing instrument was acknowledged before me this
..�' day of .1 tTRn.s>±n ,20 byday of 20. d • 'by
who is personally known to ais personally known to
me or who has produced as me or who has produced �- ��� s
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: �Nb �s+.T: r' NOTARY PUBLIC:
`. %X P�So�asYp�btwll°
ro
Sign Sh Sig
Print P !7 rint aubi /
Joanna Feliciano
Seal: Seal: My Commission FF 092753
aspimm 01H913010
Zlans*
APPROVED BY xaminer Zoning
Structural Review Clerk
(Revised02/24/2014)
J
.... ��, Miami shoresVillage
Building Department
R 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. §440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for an construction nstruction xo'ect
. . . Y project
prior to obtaining a building permit. Pursuant to the Florida Division of Workers Compensation pe on Em to er Facts Brochure:
P Y ore:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate
officers or members of a limited liability company (LLC) in the construction industry may
elect to be exempt if:
1. The officer owns at least 10 percent of the stock of the corporation,or in the case
of an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation
m the records of the Florida
Department of State Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members
are allowed to be exempt. Construction exemptions are valid for a period of two years or until
a voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers'compensation exemption.In these circumstances,Miami Shores Village
does not require verification of workers'compensation insurance coverage from the contractor's company. Therefore.y2u may be
personally liable for the worker compensation iWuries of any person allowed to work under this permit Please check with your
insurance carrier since most property insurance policies DO NOT cover this type of liability.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Owner Contractor
Print Name: A T /%,,4)<- Print Name:
Signature: a�
Signature:
,nzdz
State of Florida) State of Florida) 3
County of Miami-Dade) County of Miami-Dade) •
Sworn to and scnbed be a� stn Sworn to and subscribed before me this N
day ofMrnlssloN> 012ss'
useza,2ola day of �=,201 - m T
EXPIRES.- �blicUnd�vi a �� N 9,
By ...•d�;`• �dn' BY
(SEAL) (SEAL)
Type of Identification produced T entification roduced
ti
DYNAMIC AIRFLOW CORP.
13727 SW 152 ST.#213
Miami,Florida 33177
FL.LIC.#CAC1817782
Jim Turk
1275 NE 94 St.
Miami,Florida 33138
PROPOSAL
We hereby submit specifications and estimate for:
Air Conditioning and ductwork per plan Dated: 09/04/2014
• 34 drops
• 301 Lnft of duct board,main duct runs and returns.
• 3-duct extractors
• 3-turning vanes
• 9 jumper transfer
• 6 bathroom exhaust fans
• 1 dryer duct
• 1 kitchen duct,2 story
• 2 air handler stands
• 2 secondary drain pans with water switch.
• 2 line sets,underground installation
• 2 thermostats
• Labor
• Equipment LENNOX 16 SEER: 5 ton and 3 ton. Specs to be provided.
• Excluded BBQ duct and kitchen hood.
• Price for above work$21,500.00
NOTE:We do not repair wall,ceiling or painted surfaces.We will take the utmost care for your
property.Dynamic Airflow Corp.or its employees will not be responsible for the repairs for the
building.If unseen work is required it will be executed upon written proposal.
Payment Options:50%Initial 50%Installed Note:Permit not included
All material is guaranteed to be as specified All work to be completed in a workman like manner according to
standard practices.Any alteration or deviation from the above specifications involving extra cost,will be executed
only upon written orders,and will become an extra charge over the above estimate.
This proposal subject to acceptance within 10 days and is void at the option of the undersigned.
AuTxoRIzED SIGNATURE Arash Khaymedooz,electronic sipature.09/04/2014
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are hereby accepted. a�
You are authorized to do work as specified.Payment will be made upon completion of work or e a
specified.Failure to make payment will result in Legal action and it is uudWtoal-�at sonable attoru w v y
fees will be applied to balance owed. 00. NMIo
ACCE Dl
DATE / SIGNATURE 'A .
PRINT:
Our installations follow industry standards: Vlease protect yourself against
unlicensed contractors. Visit www.myflorida.com and use Licensee Database
Search.
Thank you for allowing my company to service your investment.Amsh Khaymedooz