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MC-16-1303 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-260965 Permit Number: MC-5-16-1303 Scheduled Inspection Date:June 15,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: KREUTER,ANDREA&UWE Work Classification: Addition/Alteration Job Address:1111 NE 91 Terrace Miami Shores, FL 33138- Phone Number Parcel Number 1132050010120 Project <NONE> Contractor. AIR X MD INC Phone: (305)620-8883 Building Department Comments CHANGE OUT PRESENT DUCTWORK FOR A/C UNIT Infractio Passed Comments EXISINT. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-258810. Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 14,2016 For Inspections please call: (305)762-4949 Page 36 of 39 Miami Shores Village 10050 N.E.2nd Avenue NE "" Miami Shores,FL 33138-0000y Phone: (305)795-2204 � �� ' ��a �� E r y 3 . �p � Expiration: 111 2016 Project Address Parcel Number Applicant 1111 NE 91 Terrace 1132050010120 ANDREA&UWE KREUTER Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ANDREA&UWE KREUTER 1111 NE 91 Terrace MIAMI SHORES FL 33138- 5161 COLLINS Avenue MIAMI BEACH FL 33139- Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 AIR X MD INC (305)620-8883 (786)285-9856 Total Sq Feet: p Tons: Available Inspections: Additional Info:CHANGE OUT PRESENT DUCTWORK FOR A/C Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Review Mechanical Date Denied: Type of Work: Underground Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.60 Invoice# MC-5-16-59766 DBPR Fee $2.00 05/13/2016 Credit Card $50.00 $67.80 DCA Fee $2.00 Education Surcharge $0.60 05/19/2016 Credit Card $67.80 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $117.80 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 zoning. Futhermore,i aythoriz�ee aboed contractor to do the work stated. t [[vim L1__J\ May 19,2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 19,2016 1 Miami Shores Village cam ` M Y 13 2016 Building Department � .. 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: -! Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 �u J BUILDING Master Permit No. MU� _1303 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP p q I .--�-- CONTRACTOR DRAWINGS JOB ADDRESS: 1 l I / 1 7'�&tz_R Ce City: Miami Shores County: Miami Dade Zip: 3 Fouo/Parcelm 11 -32 0 -- 0 0 1 t 2-0 Is the Building Historically Designated:Yes NO Occupancy Type-Af,1 4d: Construction Type: Flood Zone: BF�E: FFE: OWNER:Name(Fee Simple Titleholder): Ow e )�i`e u4tp, PhoneX300 71P 6- 32- Address: / . 32Address:: / // 91 `70&o6?Q Q City: ^,A-M State: PZ Zip: 3 Tenant/Lessee Name: Phone#: Email: d�lSi"�L� 0-C 'COn 5e4 IQL/meq . C0/7-7 CONTRACTOR:Company Name: �/2 ,Z2Ne Phone(30S?20'(ya� Address: �Z ? /O A/Gl) 157Gnow c.2 City: /� ��i 6,e-�� `� State• � L Zip: Qualifier Name: �,- C 6'i9 z5e. -0, 0 L1W A F!!9! PhoneA(-),g 0 ZiO State Certification or Registration#:(? e 1S h0Q Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: ity: 'AJ12 Q �Edi'i~A�i Sta �� <<. Zip: 3&7a�Q �etch- � Value of Work for this Permit:$ ® � Squar a Type of Work: ❑ Addition ❑ Alteration ❑ New molition Description of Work: CM-4A)66- car vaeswigekm/_ iauFY w`ti Specify col a.,�li 111110,4 11suW to bs rr90W� N • 3 (� ® $ Submittal Fee$ �� b x ,q•�'aa+ C S � ,„, Scanning Fee$ Radon Fee$ DBPR$ >1�b�taryF Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 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: 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 no a[pprovead and a reinspection fee will be charged. 4L4'0.-Q .0 �Signat re Signature �• OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this / day of 020 14 ,by _ L day of 20 14 by who is personally known to ,who is personally known to AW me or who has pro me or who has produced as U` identification an 1 .Ilsea identification and who did take an oath. • fllp Conan.(Esq#W 24. NOTARY PUBLIC: � _ NOTARY PUBLIC: Sign: Sign: r Print: Print: .11114- 4Z Seal: y� Seal: ILAB 1UIyASONO SILM -oft ofkl*y Fb •Oft of FIS � V&24 2C/t ► .Fad M 24.111? •IEINYN MU"� Am APPROVED BY lans Examiner Zoning Structural Review Clerk (Revised02/24/2014) d` sun Miami shores Village ' R Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. OPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. L' COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI BADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder. MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. ####/#/#/#/####/##■ ss#■ ■ #///#■#//#///###/#/##/#///##/#//#/// BUSINESS NAME: j M Qom. BUSINESS ADDRESS:. r,/® OV 15 CITY&�i4wo STATE r L ZIP 3 3 P--S't BUSINESS PHONE: �J �a.9 � V-3 FAX NUMBER( ��I CELL PHONE 74 )?Ss, R 0 QUALIFIER'S NAME: In fc- -1+ ,D" Sr�, QUALIFIER'S LIC NUMBER: C 1�Q . 1 -1 A 1) S g i a � s Local Businew Tac Recent Miami-Dade County. Stat® of F THIS IS NOTA BILL - W NOT PAY 7180265 on ►*5 ww" SEP I IMM 3�0, 2016 29 X MD 7 Mobs et aIm01 btreh M 2910 MV 157 15717R �mom to C � 11r1t GARDE F1.33054 SSA-Arta&10 SBC.TYPS Op Duane" �� PAYMENT RBCRfliBD MR x n 196 SPEC MECHA .QAC•AOR BY TAX CO LLBOM INC CAC1818038 $45.00 09/23/2015 Wolker(s) 2 CREDRCARD-15--048737 Tkir�Bn�seseTtni �� s taQd e��eTax.Tire h�1 B Iiaeose, it , m� a1t� t91� Noldottt�t1 � � y ��tlrefre�, Tire IICEPT N0.gbresat rre ad ao atei -A Oo4e 8wo Be-,418 Form .r KEN IAWSON,SECRETARY RICK SCOTT,GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS X"nTnuhTtW INDUSTRYLI�L`EESSIIO ��ULATION CAC181i8 . The CLASS 8 IS CEROT FIEOONING CONTRACTnR Nam below Under the prolA of ChapWr 486 FS. EXpirdon date: AUG 31,2 18 DUPILAP, i ►EL HOUNDRMt' AIR INC sep 2910 NVU 187 TERRACEMIAAiII ��.en• +�naMU � DISPLAY AS REQUIRED BY LAW _ SEQ# 1-141214 �® CERTIFICATE OF LIABILITY INSURANCE ° �`' '°°"""Y' 4 l2 16 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: N the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. N SUBROGATION 13 WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this cwditate does not confer rights to the certificate holder M Neu of such endorsemen As. PRODUCER Construction Pros Insurances LLC PHONE FAX PO BOX 186 San Antonio FL 33576 INS AFFORDING COVERAGE NAIC# INSURER A-WeSCO Insurance Company 25011 INSURED AIRXMDI-01 INSURER 8: Air X Md Inc INSURER C: 2910 NW 157 Terrace INSURER D: Miami Gardens FL 33054 998lIRER E DI8URER F COVERAGES CERTIFICATE NUMBER-183483264 REVISION NUMBER: THIS 1S 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 ADDIJBUIM TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP Lam GENERAL LIABWTY WPP1432758-00 1/12/2016 1/12/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea oraarmt $100,000 CLAIMS-MADE rI OCCUR MED EXP Wry one $5,000 PERSONAL 8 ADV INJURY $1,000.000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 X POUCy 7 JECTPRO LOC $ LIMIT AUTOMOBILE LIABILITY Ea accident) ANY AUTO BODILY INJURY(Per parson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION VIC S?ATi] OTH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORMARTNER EXECUTIVE❑ N 1 A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOY $ If yyeess describe under DESCRIP r1ON OF OPERATIONS bar EL.DISEASE-Policy Ltmrr I$ DE8CRWTION OF OPERATIM I LOCATIM I VEHWA ES(A#wh ACORD 001.Adder Remake Schedule,it mare space lsmm*e* Florida Certified Air Conditioning Contractor per License Number CAC1818038 Please review named insureds policies referenced in this document for complete list of all applicable coverages,limits,endorsements, exclusions,deductibles,and their respective terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AUTHORIZED REPRESENTATIVE ®1988 2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD DATTe� CERTIFICATE OF LIABILITY INSURANCE 4/25/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THUS CER14FICATE 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 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 In Ueu of such endor7ieme77t(s. PRODUCER Ur.CT Nazimo Dopazo CPIA Dopazo a Associates Inc PHONE (305)470-8500 AlFN (as6)ga7-9x73 8725 NK 18th Tarr Ste 300L .maz@dopazo.com AFFORDING COVERAGE NAIL 6 Miami FL 33172 INSURERAAssociated Industries Ins CO Inc 23140 INSURED INSURER B' Air X ND Inc mac. 2910 NW 157 Terrace INsURERD: INSURER E Miami Gardens FL 33054 INSUpERF: COVERAGES CERTIFICATE NUM13ER-.CL1642213258 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. R POLICY EFF POLICY TYPE OF INSURANCE POU Y NUMBER LTLIMIT'S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ CLAIMS-MADE F—I OCCUR PREMISES Me R cru nwm $ AHED EXP one Person) $ PERSONAL&ADV INJURY $ GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑,�T F-1 Loc PRODUCTS-COMPIOP AGG $ OTHER $ AUTOMOBILE LIABILITYaccideit BNED SINGLE LIMIT(Eg $ ANY AUTO BODILY INJURY(Per perm) $ ALL OWNEDSCHEDULED BODILY INJURY(Persa7dmd) $ AUTOS AUTOS HIRED AUTOS NO PROPERTY DAMAGE(per 000MOrm $ UMBRELLA LIARHCLAWIS-MADE OCCUR EACH OCCURRENCE $ EXCESS LIAR AGGREGATE $ RETENTION $ WORKERS COMPENS/ITION g R AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTVVEN/A E.L.EACH ACCIDENT $ 100,000 A cNiFICERJMEMBER EXCLUDED? AWC1062325 4/21/2016 4/21/2017 (Mr M NH) EL DISEASE-EA EMPLOYEE $ 100,000 DESCRt OF OPERATIONS bebv E L DISEASE-POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 907,Addf Rem ftM&le,may be aNaeFied N more spacer is required) HVAC contractor. CERTIFICATE HOLDER CANCELLATION (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2 Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATM Maximo Dopazo CPIA/AD 01588 2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD IM8025 PX imi% ti Report Commentary Angel Calle WDO Inspector(Termite):JE168310 PILLAR POST Florida Licensed Mold Assessor-MRSA250 Florida Licensed Home Inspector H1445 Date: 10-Feb-2016 1111 NE 91 Terrace, Miami Shores, Florida 33138 This summary is not the entire report. The complete report may include additional information of concern to the client. It is recommended that the client read the entire report:. 4.0 AtticUcrvJ�'2K � GKs•S TiNC.� 4.1 AC Ductworro_ `V ' c 1Lrn = X 9-"Osm V7 i N[/Vc,ern. �7 •(`�' �3 C4)—/ �i V!N Old Metal ducts being used(Steel wrapped with insulation which has a life expectancy of 40 years). Ducts are worn/dented and have been patched/repaired in various areas. Not energy efficient and have condensation problems.Budget to replace. -- COST ESTIMATE:+/-s3,800 4 � 4 ... 4-4 F1, • • fees 6686•• IYfr.�- ,ti *ear 6 7 •• -�. `key ,. ••• ;d.u.'_,. ±� a ..,a„' •i• t Page 10 of 20 23865-7059