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MC-14-1837 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218346 Permit Number: MC-8-14-1837 Scheduled Inspection Date:April 27,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: New A/C System Job Address:1032 NE 98 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132050180320 Project: <NONE> Contractor: SOUTHEAST AIR CONDITIONING INC Phone: (305)769-9959 Building Department Comments INSTALL NEW 2 TON SYSTEM WITH DUCT WORK. Infractio Passed Comments REMOVE EXISTING DUCT WORK FOR 1ST FLOOR AND INSPECTOR COMMENTS False INSTALL NEW DUCT WORK, SERVICE EXISTING 1ST FLOORS UNIT.TRANE 5 TON, INSTALL NEW HOUD AND EXHAUST DUCT WORK. ` Inspector Comments Passed Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 26,2016 For Inspections please call: (305)762.4949 Page 1 of 49 Miami Shores Village {; y 10050 N.E.2nd Avenue NE £ Z y Miami Shores,FL 33138-0000 # € � Phone: (305)795-2204 � `�.� 3 Expiration: 10/13/2015 Project Address Parcel Number Applicant 1032 NE 98 Street 1132050180320 1032 NE 88TH HOLDINGS LLC Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell 1032 NE 88TH HOLDINGS LLC 800 CORPORATE Drive FT.LAUDERDALE FL 33334- 800 CORPORATE Drive FT.LAUDERDALE FL 33334- Contractor(s) Phone Cell Phone Valuation: $ 10,000.00 SOUTHEAST AIR CONDITIONING INC (305)769-9959 (305)481-9631 - Total Sq Feet: 0 Tons:2 Available Inspections: Additional Info:INSTALL NEW 2 TON SYSTEM WITH DUCT Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Underground Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $6.00 Invoice# MC-8-14-52718 DBPR Fee $5.25 08/22/2014 Credit Card $50.00 $335.50 DCA Fee $5.25 Education Surcharge $2.00 04/16/2015 Check#:2625 $335.50 $0.00 Permit Fee $350.00 Scanning Fee $9.00 Technology Fee $8.00 Total: $385.50 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 accurate and that all work will be done in compliance with all applicable laws regulating construction and ing. Fu rmore,I authorize the above-named contractor to do the work stated. April 16,2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 16,2015 1 L Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY. INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2090 �[ BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. KA ❑BUILDING ❑ELECTRIC ROOFING [] REVISION EXTENSION []RENEWAL ❑PLUMBING [MECHANICAL [PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 103-2- N t 9,9184 511'bele i City Miami Shores County Miami Dade Zip• '. Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: ,i Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): i�3 NZ`1S e,{ f4pn6it4 L.LC.. Phone#: Address: �•- t...c1 t .., City: ["'T'. -t,s d-P d2 cl 4W. _ State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: f&j2 U, S il- Phone#: Address: �- City: 1 , State: Pt 4 Zip: ®� � �1 / e:�, L— M S7/Ll / "1 Plf he#:ff �— / h tate Certifiwt or Registration#: �. C ® ® , Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit: 0120 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Re pair/Replace ❑ Demolition 0g�r)ption of Work: *S�Yf� wzu, Ago.) mi.iF'Q , fi �ovr.✓�'t f Or ts�'G `b-1/ �Le k- Specify color of color thru tile: 15) Submittal Fee$ Permit Fee$ Q1,q9 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee S Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (RevMM2/24/2024) 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$2500,the applicant must promise In good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first Inspection which occurs seven (7) days after the building permit Is Issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatu 1"pSignature A"'- i�i0�ERorAG�N7� � p►yrR CONT CTOR Theforegoinginstrument was acknowledged before me this The foregoing instrument was acknowledged before me this or !"l day of Tu#J — .20 Iq by /9' day of &4U97—_____,20 Iq by M if 1.AAk 1 A 6,14 9...`4 who is personally known to �L���T�vlfdis personally known to me or who has produced as me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 1�7 Sign: L Print: Print !T S� Seal: N0WyPulft-8hftd*eMrl/orlt Seal: ,� ivt p�,�'ti-t / R A.SMITH ,do` ; Notary Public-Stds of FlorNa No 01TAS1 "Av Comm. .:My Comm.E>PIM SOP 18,2017 Expires '. �F CommiSOW N FF 088621 sssssssssssssss*ssass*sstsssssssssssss* s�* ssss*ssssss*s*s*s**sr*ssssssssr*s*s s �„ 1111111 WOW APPROVED BY �® \ Plans Examiner Zoning Structural Review Clerk (ReviseOZ/24/2014) RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY ' ANT OP ,I PR�t ,IGML tESTATE OFFLORIDA Gl�L�kTl4N , .. 4DV lot Q _ . Tftt WAR I: S. ter_ { rs- - IN .�, ® .✓' e,,.r""' ... `� Aty Y � ,,n. - �'. _ e f .� 't, `� �y��t�`��Q e E ¢ �' 1._1/ sf 1, iSSUM: 05/1812014 DISPLAY AS REQUIRED BY LAW SEQ# L140518=1171 0®1902 f ou" ff � A'Blt� N6, 1'AY 8611th►1M1 fl4 4� w + }�y As �i!XX 1X40!V�o: G a f D1lust be di adet pi�er� g' Nq � a 68 f �[ 4gg f SBC. B"NE AM � 965 '� Y T LLE barker{�, 10 4 C01 5.00 /15 . 14-0 54 �m Say z`h � � � z, .r, �.< • Th Of Tax.T lade to do budow$T: tlm s i8ceti w6icH lytatlre �9 A see r . co CERTIFICATE OF LIABILITY INSURANCE1812112014nA.Monawl"rm THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFER 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 INSUREP4S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlfical a holder Is an ADDITIONAL INSURED,the pollcy(les)must be endomed. If SUBROGATION IS WAIVED,subject to the terns 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 GOWAUT NAME Gateway Insurance m95413,55m5500Fax 2430 W.Oakland Park Blvd. Fort Lauderdale FL 33311 INSU AFFORDING COVERAGE NAIC 0 INSURERA.'FCCI Insurance Company &W-2 ISL RED SOUA102 INSURERBiBridgefield CasuaU Ins Cc 10335 Southeast Air Conditioning Inc INSURERC: Attn: Ms.Nancy Smith INBURERD: 13840 N.W.6th Court Miami FL 33168 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER:1111691647 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. Irn ADM SUBR TYPE OF INSURANCE POLICY NUMBER POLICY EFF Lam A GENERAL LIABILITY Y Y GL00037749 0/112013 0/1/2014 EACH OCCURRENCE $1000,000 X COMMERCIAL GENERAL LABILITY PREMISESmai oe 5100000 CLAIMS-MADE a OCCUR MED EXP(Any one pommt) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000 000 GEMLAGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGG $Z000,000 X POLICY PFtO LOC $ AUTOMOBILE LIABILITY eastNGLE LIMIT ANY AUTO BODILY INJURY(Per pm m) $ ALL OWNED AUTOS UTO Ul ED BODILY INJURY(Per ) $ HIRED AUTOSNNOjTp LAMED PROPERTY DAMAGE $ $ UMBRELLA LRB OCCUR EACH OCCURRENCE $ EXCESS LWB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ B AND O LIABILITY Y 19&33714 /1/2014 /1/1015 A YIN ANY PROPRIETORIPARTNERIMCUTIVE EL EACH ACCIDENT $500 000 OFFICERIMEMBEROCCLUDED? El N/A Hy l0 N EL DISEASE-EA EMPLOYEE $500,000 desolbe under DESdRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500 000 DEBCW"MOF OPERATIONS/LOCATIONS/VBBCLM(A7fsch ACORD 101.Addlftmml RMMU Sdwdufe B nme spree M M**eM License#CAC015457 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE ACCORDANCE WITH THE POLICY PROVISION& BUILDING DEPARTMENT 10050 N.E.2 AVENUE AUTINNUM REPRENWATNVE MIAMI SHORES FL 33138 �90 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(20108) The ACORD name and logo are registered marks of ACORD A�� CE CATE OF LIA II-ITIr INSURANCE1118/2015 THIS CERTIFICATE IS ISSUED AS OF INFORMATION ONLY A C NR O RIGHTS UPON THE CERTIFICATE HOLDER.THIS ERTIFICATE DOES NOT AFFI OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES FLOW. THIS CERTIFICATE OF 1 E DOES NOT CONSTITUTE A CO CT BETWEEN THE ISSUING INSURER(S) AUTHORIZED REPRESENTATIVE OR PRODUCER, CERTIFICATE HOLDER IMPORTANT. If the certificate holde s INSURED,the Poilcy(�es)m be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the poi n policies may require an A statenent on this certificate does not confer rights to the Certificate holder in Neu of such Is. PRODUCER VwCT Gateway Insurance TIME 2430 W.Oakland Park Blvd. 28,52 Fort Lauderdale FL 33311 INSU AFIMMG COVERAGE MAIC s HMM RIMA onroe Guara*Ins Cc 32508 INSURED 02 RMURER s 'n d Casuab Ins Co 10335 Southeast Air Conditioning Inc HMMERC: Attn: Ms.Nancy Smithonto D: 13840 N.W.6 Court Miami FL 33168 E: INSURER F: COVERAGES C 1 TE NUMBER.977027712 REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICI URANCE LISTED BELOW HAVE�ENI UED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY E ENT,TERM OR CONDITION O�^1" CO CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MA THE INSURANCE AFFORDS[}Bl(THE UCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SU S.LIMITS SHOWN MAY HAVE B RED ED BY PAID CLAIMS. L TYPE OF USURANC.E NU R EFF POLICY UNITS A GENERAL LUIMLRY L000377410 0/1 4 0/1/2015 EACH OCCURRENCE $100000 X COMMERCIAL GENERAL LIABILITY Ml' o $100000 CLAIMS MADE OCCUR MED EXP Any are person) $51001D PERSONAL&ADV INJURY $10001030 GENERAL AGGREGATE $240OOMQ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPMP AGG $20000 E POLICY FI JECT PRO- LOC j $ AUTOMOBILE I"ITY (Eaao*MM ANY AUTO BODILY W"Y(Pr persm) $ ALL GANED LAUTOS AUTOSU� BODILY INJURY(Pr accident) $ HIRED AUTOS AUTOSS PROPERTY DM%M $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS UABCLAI AGGREGATE $ DED I I RETENTION $ BWOMUMCOMPBMTM 1=13714 /120 5 112018 X 1A� ATU- O AND EMPLOYERS'LUUNUTY 1,� S, ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $500000 OFRCER/MEMBER EXCLUDED? Ky8s,Pundawy InIQ EL DISEASE-EA EMPLOYEE $50DDDD DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $5400W i DEscRw ioN OF OPERATx m J LoCATION8/ ACORD 101.Additional Rem Schedule,Water i space Is rem License#CAC015457 I CERTIFICATE HOLDER C ANCELLATION SHWILIDA JNY OF THE ABOVE DESCRIBED POLIOS BE CANCELLED BEFORE THE ExP RATION DATE THEREOF, NOTcE WILL BE oammm IN MIAMI SHORES VILLAG AccORDA NcE WrrH THE POLICY PRovwtoNs. BUILDING DEPARTME 10050 N.E.2 AVENUE AUTHORMED I EPIUMNEATIVE MIAMI SHORES FL 331 ©1888-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) It 4 ACORD name and logo area regi, marks of ACORD