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MC-15-1388 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-236319 Permit Number: MC-6-15-1388 Scheduled Inspection Date: March 07,2016 Permit Type: Mechanical- Residential Inspector: Perez,JanPlerre Inspection Type: Final Owner: GREENBERG, DAVID Work Classification: A/C Replacement Job Address:534 NE 95 Street Miami Shores, FL Phone Number (786)333-8567 Parcel Number 1132060140820 Project <NONE> Contractor. FLOW-TECH AIR CONDITIONING CORP Building Department Comments INSTALL HVAC SYSTEM AND DUCTWORK Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed 19 Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-Inspection fee is paid March 04,2016 For Inspections please call: (305)762-4949 Page 3 of 41 .�l✓i�� f 3 ft fi 4y Miami Shores Village f'WM TypB;` 10050 N.E.2nd Avenue NE Work ClSs; iCBif(tti Miami Shores,FL 33138-0000 rm , Phone: (305)795-2204 f x 3 x ienr3is /#�?!PtV i"fl �s take 7f'i512�l5 . Expiration: 01111/2016 Project Address Parcel Number Applicant 534 NE 95 Street 1132060140820 1031 FUNDING&REVERSE COR Miami Shores, FL Block: Lot: Owner information Address Phone Cell 1031 FUNDING&REVERSE CORP. 681 ENCINITAS Boulevard (786)333-8567 ENCINITAS CA 92024- 681 ENCINITAS Boulevard ENCINITAS CA 92024- Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 FLOW-TECH AIR CONDITIONING COF Total Sq Feet: 1600 Tons: Available Inspections: Additional Info:INSTALL HVAC SYSTEM AND DUCTWORK Inspection Type: Classification:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# MC-6-15.55888 DBPR Fee $2.63 07/15/2015 Check#:192 $191.26 $0.00 DCA Fee $2.63 Education Surcharge $1.00 Permit Fee $175.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $191.26 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 AFFI i certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable taws regulating construction d z Ig. F r re,I a�above-named contractor to do the work stated. July 15,2015 ortk9jdI&aturek9vner / Applicant / Contractor / Agent Date B ilding Department Copy July 15,2015 1 Miami Shores Village JUN88 15 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER:(305)762-4949 mFBC 20 ao BUILDING Master Permit No. 1`--q 5--G 1 PERMIT APPLICATION Sub Permit No. 01 C-I S--1 BUILDING ❑ELECTRIC M ROOFING M REVISION M EXTENSION RENEWAL ❑PLUMBING MECHANICAL QPUBLIC WORKS M CHANGE OF ❑CANCELLATION ❑t7 SHOP , p CONTRACTOR DRAWINGS VW JOB ADDRESS: 5-3 /V 6 / .S7�' City: 1 Miami Shores County:ty_ Miami Dade Zip: 3318 Folio/Parcel#; I 1 -6'2-t)(6 - D 14- O 9-2- d Is the Building Historically Designated:Yes NO x^ Occupancy Type: <:-E—Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder) �3 l �Lt N��N G 1�15� a Phone#: Address:rJ 3SsY�IJ l b�- �IUG t N�4S2a3 City:CM-L.S'Rs M> State: G- Al Zip: 2 oc g Tenant/Lessee Name: P 36��q b Email: LAct l?=V A a fPK(QRL. •�-01� CONTRACTOR:Company Name:14i.®ld -T"A's Chap. Phone#: Z64-60G Address• 10'Z?) 1'b 1 ER. city: I Alm 1 tate: F L. Zip: L 4A4 Qualifier Name: MA Rw hone#: State Certification or Registration#: CA1✓O ZAb'1 1 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ dab Square/Linear Footage of Work: l G OO Type of Work: ❑ Addition ❑ Alteration X New ❑ Repair/Replace ❑ Demolition Description of Work:j S 5 -1'x- -Dk�w be-k- Specify color of color thm We: 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$ ( �I • 2 (Revfsed02/24/2014) 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 flrst inspection which occurs seven (7) days after the building permit is issued. 1 e absence of such posted notice, the inspection willnot b approved and a reinspection fee will be charged. Signature Signature OWNER AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _ day of .20 .by tv� day of IJ�N�s 20 1� ,by IRV AK 31-2,14S, who is personallyknown to nally 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: Sig Sign. k a_ !�-- Print: Print: °pt►�:w MYRM MARTM IN 081ISSION#FF 018= Seal: Seal: * W COMMISSION#FF 011133Q � EXPIRES:Sit& t 15,2017 EXPIRES:September 15,2017 1"'0"F+.00 kt9d7htnBudgRNoWySery % ° oFcro��O Baha ft NoWySwim r 1 APPROVED BY ` ans Examiner Zoning Structural Review Clerk (Rev1sed02/24/2014) �,..� FLOWT-1 OP ro•A CERTIFICATE OF LIABILITY INSURANCEof THIS CERTIFICATE M 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 LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cefflicabe holder is an ADDITIONAL INURED,the policy(les)must be endorsed. N SUBROGATION IS WANED,subject to the terms and condlOons of the pofdcy,certain policies may require an endIweemeOL A statement on this certificate does not confer rights to the certificate holder in leu of such s Alfredo Andrial BROWN&BROWN OF FLORIDA INC 305384-7800 301E-714.4401 14400 NW 78th Court SulleM M FL 830164088Mm AFFORDING NSE "Wo ummmA:*Am*ndent Commerchd Ins Inc* 13083 INSURED Flow-Tech Air Conditioning ue ee:*National Tnrst Insurance Co. 20141 Cam. a8W 13th Terrace u c:*Phlledel la IndemnityIns Cc 18088 Miami,FL 33144 a D: DOOM E: IAF: COVERAGES CERTIFICATE 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 QED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. TYPE OF INSIIRANCE POLI CV NUMIBER Lam B X C011MERCIAL GENERAL LIABILITY EACH OCCURRENCE i 1,0� CLAIMS-MADE 0 OCCIM GLM09224 10106iZ014 10/0612816 i 10D MED EXP Qft one poem i PERSONAL$ADV nNJURY i 1,000. GEN'L AGGREGATE I=APPLIES PER GENERAL AGGREGATE $ POLICY EIM 0 LOC PRODUCTS-COMPW AGG i 2,o OTHER Em Ben. $ 1,000, AUTOMOKELIAIIII.ITY LOMBINEDSINGLELIMIT i 1,000, C X ANYAUTO PHPKI240492 10/0812014 10=/Y0'I5 BODILY INJURY(Per Perna) i � AUTOSBODILY MVJURY(Per void i X HIREDAUTOS X AUT PRO DA i i UIbBItE<LA UAB �( EACH OCCURRENCE i ROM UAB CLA�AtADE AGGREGATE $ Dl� RETENTOM i rMO tNf11PE1BAfl0N XIMI NH AMIMPLOWIRS' a MIA A ANY LxxUaEI»r YIN 064211=5 061 1016 EJ=EACHACCIDENT i 1,000 EXf 'FN EJ_D -EAEMIPL i 1A00: 0F OPERATIONS 1�1"' EJ.: ASb-'POLICYLWpT i 1, rM OP OPEnAT !LOCAnDUS I VEIOd.ES IACORD 107.AdeDbnd RemuUs .aaY rsa aaaOied a nae sp—Is r0led Mechanical Contactor CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE Miami Shores Village EXPIRATION DATE PO PROVISIONS. NOTICE WILL BE W9.1VERED IN BWlding Deparbuent 10050 Nordmmiet 2nd Avenue AUTHORIM REPRESMAIM Miami Shores,FL 33138 Brown and Broom of Floft,Inc. ®1808-2014 ACORD CORPORATION. Ali rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i—^1 FLOWT-1 OP ID:LD 14 E'® CERTIFICATE OF LIABILITY INSURANCE DATE(NIIUDD/YYY1rJ 10/02/2014 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 policy(les) must be endorsed. If SUBROGATION IS WANED, subject to the tenrm 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 s. PRODUCER Phone:305-3647800 BROWN&BROWN OF FLORIDA INC Fax:305-714-4401 PHONEFax 14800 NW I th Court Sultetf200 Miami Lakes,FL 330164M Carlos L Lacasa,Sr INSU S AFFORDING COVERAGE MAIC A INSURERA:*Ascendant Commercial Inslnc* 13683 INSURED Flow-Tech Air Conditioning INSURER B:*National Trust Insurance Co. 20141 MCorp. SW 13th Terrace TNsumpic:*Philadel hila IndemnityIns Co 18058 Miami,FL 33144 INSURER 0; INSURER E: WWM 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. INSR im TYPE OF tiiSURAr�EADDL Y POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0 B X COMMERCIAL GENERAL LIABILITY GL00108224 10x0 M14 10x /2015 PREMISES Eaoowrrencs $ 100,004 CLAIMS-MADE XX OCCUR MED EXP(Any are perew) $ 5, BM ADDL INSURED PERSONAL S ADV INJURY $ 1100010 BLKT WAIVER GENERAL AGGREGATE $ 2,000,0 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,M,O POLICY X JECTPRO- LOC Emp Ben. $ 1,000,0 AUTOMOBILE LIABILITY COMBINED SINGLE cadent MIT 1,000,0 C X ANY AUTO PHPKI240492 10108x2014 10x06x2015 BODILY INJURY(Per person) $ AAUTO NED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS ED O DAMAGE $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCEN UAB CLAIMS-MADE AGGREGATE $ DED RETENTION S $ WORKER8C ENSAT�N X ,WC3TATU OT AND EMPLOYERS'LIABILITY A ANY C2P'JM EI'FR A CTLU RIDECUTNE � YIN VNC65626 06/28/2074 ON28@015 E.L.EACH ACCIDENT $ 11000100 D((XUDED? N/A (MarKlatmy In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe uru DESCRIPTION OF O below E.L.DISEASE-POLICY UMIT $ 11000100 DE8CRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Mario Perez-Velasco License # CACO24371 CERTIFICATE HOLDER CAN TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXP RATM DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue Miami Shores Village,FL 33138 AUTHORIZEDREPRESENTATIVE m 1888-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIONI INDUSTRY LICENSING BOARD CACO24371 The CLASS B AIR CONDITIONING CONTRACTOR--,,- Named ONTRACT ,,Named below IS CERTIFIED Under the pwislons of Chapter 489 FS. Expiration loth: AUG 31,2016 = PEREZ-VELASCO,MARL FLOWNTECH AIR-CONEY 7023 SW 13 -' `° MIAMI R ISSUED: OSAMM14 DISPLAY AS REQUIRED BY LAW SEo 0 L1406090000687 oo,o� UP 14, Xr y dZ • �'�rwe' �33 7'� t r: ,9s s A � AIR CE3N CORP TAX �. 10 SkA/SRA F-'�j��W V. oA h 1 r f uk V 14s LaoN BWWd16uTaL rm Isom ��