The URL can be used to link to this page

MC-16-677 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: IN -254735 PermitNumber: MC-3-16-677 Scheduled Inspectio Date:August 22,2016 Permit Type: Mechanical - Residential Inspector: Perez,Ja Pierre Inspection Type: Final Owner: KLEIN, SON Work Classification: Addition/Alteration Job Address:9310 BISCAYNE Boulevard Miami Shores, FL 33138- Phone Number (786)344-2378 Parcel Number 1132060141610 Project: <NONE> Contractor: HERZTECH CORP. Phone: (786)348-8023 Building Department Comments Infractio Passed Comments RELOCATE DRYER VENT INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid August 19,2016 For Inspections please call: (305)7624949 Page 7 of 42 H r 'v �C- - ffi ' fid: g Miami Shores Village Fs ?i + ? €MSCwlatesideritial 10050 N.E.2nd Avenue n Nw, INorftla�ssrfc Add I�h Miami Shores,FL 33138-0000 PermitStalw:AP PIR ''tee Phone: (305)795-2204 lu ` .4141 �16 Expiration: 10/0112016 Project Address Parcel Number Applicant 9310 BISCAYNE Boulevard 1132060141610 Miami Shores, FL 33138- Block: Lot: KLEIN&SALOME INVESTMENT Owner Information Address Phone Cell KLEIN&SALOME INVESTMENTS LLC 9310 BISCAYNE Boulevard (786)344-2378 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 700.00 HERZTECH CORP. (786)348 8023 ... _._. __.. _ Total Sq Feet: 0 Tons: Available Inspections: Additional Info:RELOCATE DRYER VENT Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Review Mechanical Date Denied: Type of Work: Underground Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# MC-3-16-59019 $2.25 04/04/2016 Credit Card $264.10 $50.00 DCA Fee $2.25 Education Surcharge $0.20 03/15/2016 Credit Card $50.00 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Work without Permit Fee $150.00 Total: $314.10 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:JZrtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo g. Futhermorauthorize the above-named contractor to do the work stated. April 04, 2016 Authoriz gnatur Owner / Applicant / Contractor / Agent Date Building Department Copy April 04,2016 1 Miami Shores Village Building Departmentg Ma 1 � 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-49491 FBC 20 04 BUILDING Master Permit No.V-►► tic; PERMIT APPLICATION Sub Permit No.\A BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION E]RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: '9310 o ISG Y�U L NVJ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: I l-32 Ute' 0 1 LA" 1(01 0 Is the Building Historically Designated:Yes NO c Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �( (� S AL01M (b U 01M IUT� LLC Phonem 10.S 5:1 2-4(1c) Address: _s s® NL I City: NM.-Th M ik l KA t-1 State: F LL&1M Zip: 33/W Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: _/'��G CD r Phone#: ;�% 3evV_ WZ Address: 12-7,5D S w y0 5-1-- City: /m1&I l State: °(., Zip: Qualifier Name: T? /O 1iit ,*QA)}>,P2_ Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ _ V� , Square/Linear Footage of Work: ':�T Type of Work: 2 Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 6 C IC 9 NCE _ I 1� , 0Jj fA C t^-T I ION OF I f7qTH6E('1 1�4 us—( N Specify color of color thru We.- Submittal ilerSubmittal Fee$ Permit Fee$ e t CCF$ ® _CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ ^'f� Notary$_5:� U'N Technology Fee$ ® Training/Education Fee$ - Double Fee$ I E10, Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 19 (Revised02/24/2014) i . 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. /n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature 0 NER or AGENT TRACTOR The foregoing instrument was acknowledged before me this The foregoing instrume was acknowledged before me this S _ day of � .20 t G by � /day of 20 (, a by 4A J N 3J !a,15 �f°� ,who is personally known to Ll /�J9,c�S?.2�who is personally known to me or who has producedt � t�= (' me or who has produced DaLex-s ►CeAX+_ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTAR PUBLIC: Sign: Sign Print: Pri v`-C1 Seal: Seal: rc�Y°M Notary+Pub i@ 81d1g d'f Fioni)a ry TANIA URIA S1lggndie A.Ivs,��F� .: +� MY COMMISSION#EE 885415 o-d og APF0g /0312 1 x �i9 �xm *+es�xt *+z�x s�x�x* m�Winkg9ier;l"* "�, ' 8oreied Thru ivm�y Pu�io Undsnercttsre APPROVED BY Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) t -STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION _ 5 CONSTRUCTIOONIR�E S�TRENSING BOARD (850)487 139 19401VORTH M E32399-0783 TgC LAHASSEE FL HERNANDQ ROBERTO HERZTECH CORP 12250 SW 40THFSTREET 1 5 MIAMI . ------ a one of the nearly _ Congratu►ationst VUtttt this license You bet�m nt of Business STATE OF.FLORIDA, one m►'�'lon Floridians Gr�nsed by D wed businesses range �F BUSINESS AND Professional Reguia6an Our p� Ue restaurants, DEPARTA�IEI ""{ GIILATION from architect to yacht brotcers,from boxers to bard •PROFESrSIO L and they keep Florida's economy strong' CAC'I81fi646 '0713012014 Every day we Work way we do business in order to log OritO ar serve you b8W n ADO our find morept intonation CEftn1716 AiF��NP Gem vwvw-mYfl°ridalicense'can. There You can tiERNAti1DE about our divisions and the regulations that impact You,subscribe - HERZT t �fi . aboutthe DepartrnenYs CHC �- to department nwstettere addteam mare 4 initiatives• is-License-Effidently,Regulate Fairly. Our nit on at the Departrve y so that you can serve Your " We Stlldeta serve better' - .I$ CERTIFIED under the pro�isivns of ch-489 8 I hank You for doing business in Florida, Aus;11.2+e c customers- mngrat<,tiations on your new license!and DETACH HERE-----..-, —- KEN IAWSON,SECRETARI RICK SCOTT,GOVERNOR - - STATE OF F�.ORiDA T10�1 SsA � PlEGULATIOd Iu TFsUSiNE 3EPARTw IOINDUSTYAINGBOkRD coNSTRUC JI: The I.ASS.AAIRCONDI. ONONTRACTOL� Idatnisd below-IS SEF-FIE'D an r{i ;prnvisiora 0f ChapteF 489 FS - y - •Explration-date HGrRR c y rIAl1A� W .,.....,, S L14U730O01408 - ...+��.uo Rvr EQ# 002548 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY 6719513 BUSINESS NAME/LOCATION RECEIPT NO. T] EXPIRES HERZTECH CORP RENEWAL `7 12250 BIRD,RD 6992789 SEPTEMBER 30, 2016 MIAMI FL 33175 Must be displayed at place of business Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS HERZfECH CORP 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED Worker(s) 2 CAC1816646 BY TAX COLLECTOR $75.00 08/31/2015 CREDITCARD-15-043183 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holders qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 8a-276. For more information,visit www.miamidade gov/taxcollector ACCERTIFICATE OF LIABILITY INSURANCE DAT3/10/2016 Y) 03/10/2016 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION OPTION INSURANCE SOLUTIONS,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 14750 SW 26 ST SUITE 105 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR MIAMI,FL 33185 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: FEDERATED NATIONAL INSURANCE HERZTECH CORP INSURER B: 12250 SW 40 ST INSURER C: MIAMI,FL 33175 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS ADD' POLICY EFFECTIVE POLICY EXPIRATION LTR INS TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD LIMITS GENERAL LIABILITY GL-0000029311-00 07/09/2015 07/09/2016 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO REN= X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $ 1,000,000.00 CLAIMS MADE r--1 OCCUR MED EXP(Any one person) $ 5,000.00 PERSONAL&ADV INJURY $ 1,00Q,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,000.00 POLICY JET I 17 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE(ABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 7 OCCUR FICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ TAT - WORKERS COMPENSATION AND TORY IMITTH- S OER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS AIR CONDITIONING LIC-CAC1816646 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MIAMI SHORES VILLAGE BLDG DEPT DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN 10050 NE 2ND AVE MIAMI SHORES,FL 33138 NOTICE TO CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NOTION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPR Nr \ AUTHOR ED R TI ACORD 25(2001108) ©ACORD CORPORATION 1988 PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE IMPORTANT STATEOFFLORIDA Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation DEPARTMENT OF FINANCIAL SERVICES who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or DIVISION OF WORKERS'COMPENSATION � F compensation under this chapter. CONSTRUCTION INDUSTRY EXEMPTION O CERMCATE OF ELECTION TO BE EXEMPT FROM FLORIDA L Pursuant to Chapter 440.05(12),F.S.,Certificates of election to WORKERS'rAMPMATM www D be exempt..apply only within the scope of the business or trade ACTIVE DATE: MUMS EXPIRATM DATE: 5/2521n 7 listed on the notice of election to be exempt. PERsM HEfit MOM ROBERTO H Pursuant to Chapter 440.05(13),F.S.,Notices of election to be FEN: 2rMIN4 E exempt and certificates of election to be exempt shall be BUSINESS NAME AND ADDRESS. R subject to revocation R,at any time after the Mg of the notice HERZTECH CORP E or the issuance of the certificate,the person named on the notice or cartificate no longer meets the requirements of this section for Issuance of a certificate.The department strati revoke 12250 SIN 40 ST MIAMI FL 33175 a certificate at any time for failure of the person named on the MIAMI FL 33175 certificate to meet the regrtiremods of this section. SCOPES OF BUSINESS OR TRA HEATING,VENTILATION, AIR-COND �w DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 HERZTECH CORPORATION ROBERTO HERNADEZ 305-205-4135 Date: State of r1orkig County of AAML�),4N� Before me this day personally appeared toLezln Mzwmaho, being sworn, deposes and says: That he or she wipe the only person orkin ontte projeat: � �C 33t3� Sworn to ( fFir ed) nd subscribed before me this��day of. 20�, by Personally Know Or Produce Identification 1z Type of Identification Produce��Li4(,Pa--72-z)-29-.342-0 TANIA WDA W COMMISSION+1 EE UM16 El(Thru TJn No March 19,2017 Nofory Pubtic Urn Print, Type or stamp Name of Notary ♦5�r'°''ES yi Miami shores Village logo Building Department res n, 10050 N.E.2nd Avenue � LpR1pA 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 any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: 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 in 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. �0U Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of Ill ,20_x. By( If��® �� who is personally known to me or has produced -f�— �� as identification. Notary: SEAL: F.4O Notary�uwis Mata cattftSindia AtvaroaMy Oorn +isafen Fr 16750�° Explr�a Op/��I �1b ERZTECH CORPORATION t�OBERTO HERNMNDF 05-205-41 ------------------------------------------------------------------------------------------------------------ AGREEMENT OF SERVICES Date: March, 23, 2016 Attn: Klein & Salome Investments LLC Tel: 305-972-7139 Email: thiagomiami@hotmail.com Re: For the following services at: 9310 Biscayne Blvd. Miami Shores, FL. 33138 Installation of 3 bathroom exhaust fans *TOTAL FOR PARTS & LABOR: $ • 50.00 Terms of Payment: 50% deposit due at commencement of job ($ 225.00) 50% balance due when work is completed ($ 225.00) Robe ernandez K ' & Salome Investments, LLC Herzt h Corp. Thiago Salome Date Date: