MC-15-2817 Permit NO. MCA 14
Miami Shores Village P1 T a "h
3� 10050 N.E.2nd Avenue NEper
'� s�rlcar-Residential
n
#r brkCla itiCatfon:A/C Replacement
Miami Shores,FL 33138-0000
Peirt Status:APPROVED
Phone: (305)795 2204 „
r � if /20th _ Expiration: 7!2016
Project Address Parcel Number Applicant
10208 NE 4 Avenue 1132060135101
CORY GITTNER
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
CORY GITTNER 10208 NE 4 Avenue (305)757-4900
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 6,000.00
WEATHERSHIELD AC (954)985-9900
......... ... ...___ Total Sq Feet: 0 .
Tons:3 Available Inspections:
Additional Info:REMOVE OLD AIR CONDITIONING UNIT AN 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 $3.60
Invoice# MC-11-15-57670
DBPR Fee $3.15 11/09/2015 Check#:1928 $228.90 $0.00
DCA Fee $3.15
Education Surcharge $1.20
Permit Fee $210.00
Scanning Fee $3.00
Technology Fee $4.80
Total: $228.90
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,PLitat
G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFF, T I certiall he oregoing i ormation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo ,Futh ,I ut ove-named contractor to do the work stated.
"1, November 09, 2015
Authorized Signa ure:Owner / Applicant / Contractor / Agent Date
Building Department Copy
November 09,2015 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 t Q 1 C
Inspection Number: INSP-261031 Permit Number: MC-11-15-2817
Scheduled Inspection Date: August 03,2016 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre Inspection Type: Final
Owner: GITTNER,CORY Work Classification: A/C Replacement
Job Address:10208 NE 4 Avenue
Miami Shores, FL Phone Number (305)757-4900
Parcel Number 1132060135101
Project: <NONE>
Contractor: WEATHERSHIELD AC Phone: (954)985-9900
Building Department Comments
REMOVE OLD AIR CONDITIONING UNIT AND INSTALL Infractio Passed Comments
NEW AIR CONDITIONING UNIT. INSPECTOR COMMENTS False
Inspector Comments
Passed p` CREATED AS REINSPECTION FOR INSP-247302. WILLIAM
786-399-8855
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 02,2016 For Inspections please call: (305)762-4949 Page 6 of 29
Miami Shores Village NOV 01, 2015
Building Department
10050 N.E.2nd Avenue,Miami Shores,F orida 33138
Tel:(305)795-2204 Fax:(305)75,--8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 1
FBC 201 �
BUILDING Master Permit No. Z 15 -,-2_24
PERMIT APPLICATION sub Permit No. ME 15- �;�
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION ❑ SHO.
� y�
CONTRACTOR DRA KINGS
JOB ADDRESS: t o goc6 1 E Ll+k BV
P
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: I I "--? (7 -�� �1�Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: /� Flood Zone: BFE: FFL:
OWNER:Name(Fee Simple Titleholder) 0 A-1. (0 e'ry _phone#:
Address::: 5 1 "Y6 1,&2, -' ,�
City: , � State:
Tenant/Lessee Name: Phone#:
Email: d� � l°i 911- 41H✓t w ,&91t
CONTRACTOR:Company Name: q �Q� %f�t( ,�11 �l I �l ' Phone#:
Address:
City: State: I Zip:
Qualifier Name: Q-�f_ Phone#:9S_(22,5
State Certification or Registration#: "►ll .I F I `i 6nq�Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City:_ State: Zip:—
Value of Work for this Permit:$ 6�, MO C-0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New [ 'Repair eplac ❑ Demoli 'on
Description of Work: c)I 61 tT 0 c , Tl
Specify color of color thru tile:
Submittal Fee$ A 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$ �
(Revised02/24/2014)
y
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 suc, posted notice, the
inspection will nonbeprovead d a reinspection fee will be charged.
Signature Signature_
WNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged ;iefore me this
day of 20 1� by 4 3 day of d 0 by
who is personally known to J►'Y C 1 who' pers anally known o
me or who has produced C as me or who)as produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: ASign:—OA '—
Print: y Print: ,
Seal: CHRISTINA ALTMAN Seal: .•` � ��'h.
CHRISTINA AUMAN
.•`. °ye'•, `at' Notary Public-State of Florida
Notary Public-State of Florida My Comm.Expires Dec 13,2018
?• My Comm.Expires Dec 13,2018 Commission#FF 189874
Commission#FF 169874 �''�h �� ��•`
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APPROVED BY / ' / ins Examiner Zoning
Structural Review Clerk
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
w� 1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
ALVAREZ, JHON E
WEATHERSHIELD AIR CONDITIONING INC
406 N,W 68TH AVE APT 520
FORT LAUDERDALE FL 33317
Congratulations! With this license-you—become one of the nearly ;,:: - �.,;_. K �>;,.ot::.,;.;,,:•,•,•,:....,:;�:
one million Floridians licensed by the 0sipartrnent of.Business and
Professional Regulation. Our professionals and businesses range ; STATE�'OF FLORIDA "
from architects to yacht brokers,from boxers to barbeque restaurants, i%• DEPAIZTMI`NT.O,F BUSINESS AND
and they keep Florida's economy strong. PROF'1 'S••� f(.;&F.3RE.GULATION '
Eve da we work to Improve the waywe do business in order to % ="' . N`' r"v,
serve you better. For information abot our services, please log onto CA:C181469.5.,;: ;...; . Mxt�Dti/19120'14
www.myfloridalicense.com. There you can find more information
CEi2TIFIE!]AIR;" i'( fJN1h
about our divisions and the regulations that impact you,subscribe _ ALVAREZ' JHO
to department newsletters and learn more about the Department's ' • A •: '_
initiatives. ; 'Vif.Ei4°i HIRSHi c'' ' NG�;iG lNC'
..
• Our xs. �••:'�s�' .• .. •• •
mission at the DepaMtment is:License Efficiently,Regulate Fairly.
We constarity strive to setveyou better so that you can serve your :• .' :,.: :': `',:<<%°'';'• .y ' ':" :...."
customers. Thankou for doing business in Florida,
and congraturations on your news l!censel 1 . lriair.thy•a�ovts•ans,or.'cn;.a'd;�• ;s_ '.:
a.• / plretton ante•:dvG
DETACH HERE
' BROWARD COUNTY WCAL BUSINESS`TAX RECEIPT
115 S. Andrews Ave., Run. A-100, Ft. Lauderdale, Fl- 33301-1895—954-531-4000
VALID OCTOBER 1,2015 THROUGH SEPTEMBER 3o,2016
DBA; .,:NIN,,7 Receipt#:!63-1.557 TIN / IRCONDITION CONT1* 'TR
Business Name;iai:;:i':'.... ;�i:':f::?.,;:° ,,.ii ;?<' :. Business Type:(AIRCONDT_TION CON TRIACTOR)
Owner Name:•�"I?:; .. n::,;,;_.,:`:' Business Opened'11/21/2005
Business Location: 1, State/Co
linty/Ceft/Reg:CA; ].814 695
Exemption Code:
Business Phone:
Rooms seats Employees Machines Professionals'
s
For vonding Business only "
Ilamber of Machines:
Vending Type:
Tax Amount ; TransFer Fee NSF Fee Penalty
-,—•----••--•f_......_....._.:.:. ... _._.......... _ .... ..� _—_-- I Prior Years Collection Cost Total Paid
_..._.+.......................__ "_:'...1.... _.._._ :'.=". ...._.._ Rr..(�0` 0.00 19.70
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Browerd County and is
non-regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATE=D and zoning requirements..This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address
'OP r: ; P.I.'.i ct 'C
-4 (i ;•:4$ lit+ e?1 i'. Receipt #04B-14-00010869
Paid 07/23/2015 29.70
i
2015 - 2016
140.
Name of Business Busir;tess�Tax.•'Receip't:•. • • ` Ftoceipt No,
WEA THERSHIELD AIR Oct: 1 `.2015"hi 8;1: o;?oys 16-lawso
is HerebyEn >3 T,DINIV••OF. ....f3R4KE.PARK
r Flit The Business $15f1 S'YV.* Avgnire. . Aciau"''Mo.
Profession or Occupation Of
Pembroke Park PTvrida a.3023 .13305.0.
A10SERV.IC,E.&WaTAUATIONs
(•IVO OUT DOOR S710RAGE/RPR) Fee$ 79.75
Local Lcication: , Del:Penalty
3121 SW 21 STREET Sri . 1/2-year
Name 4f.BWnesi*6illtig Address:
Date Paid 0
WEATHERSHIELD AIP N�T��:. In the ev®mt#lis busineft for which tAis'rei:eipt was issued
CONDt7fONl(VG 1NG changss.n ttil ,said.re'�ipt•fgybo tf'ari6feired wltiiin 3a1'dgys of'suetr
4OB.NtN tSdf A4lL�,#�20 ehange+or.will becdnte null:and Vltiid;:Alt IPergonei lex due Ott eatd
PLANTA TlON FL 33317' i9u9lness tttttitgi be'pu3fd befCte•sticl�'trtgaIr will be gr
This Receipt Must Be Posted In Q gonspier:ous Place Tis :ni3g®r
CERTIFICATE OF LIABILITY FDA-M(M""DD/�
�r Y INSURANCE 11/3/2015
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: If the certificate holder Is an ADDITIONAL INSURED,the POIICY(ies)must be eltdorsed. It SUBROGATION IS WAIVED,subject to
the terms and condition 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 endorsemen s).
PRODUCER COCT
Leighton Campbell
1st Allegiant Insurance, LLC PHONE (954)378-3235 (954)3233477
2419 Hollywood Blvd. �DRESS:leighton@lIstallegiant.Com
ate• I• IN 8 AFFORDING COVERAGE NAIL 9
Hollywood FL 33020 INSURERAOhi.o Security Insurance Co 24082
INSUq);D
[NSURER0:XoPmMdy Harbor insurance Companv 13012
Weathershioid Air Conditioning Ina 94%)FIER C:
3121 SW 216t St #673
INSURER D•
INSURER B;
Pembroke Park TL 33009 REFI P
COVERAGES CERTIFICAITI=NUMBEA:1 Basic certi:Cicatd 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. NOTuwTHSTANDING 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.
Min [Aff" 5M
LTR TYPE OF INSURANCE POLICY NUMBER P EFF POLICY
"IIMiDD LIMITS
% COMIAERCUIL GENERAL LFAB1Lrry
A
CLAIMS-MADE Q OCCUR EACH OCCURRENCE $ 1,000,000
WISES(Ea cis e $ 300,000
SS31656870673 Ii/4/,2015 11/¢/2016 MED EXP one person) S 25,000
GEN'L AGGREGATE LIMIT APPLIES pPERSONAL&ADV INJURY $ 1,000,000PER- GENERAL AGGREGATE $ $.000,000
% POLICY F]JLO'f LOC
OTHEIL PRODUCTS,COMP/OPAGG $ 2,000,000
Emplayee $
AUTOMOBILE LIABILITYBenemCOMBINED SINGLE LIMIT
ANY AUrO s 800"M $ 30,006
A ALL OWNEDBODILY INJURY(Pef person) $
83
AUTOS SCHEDULED 81656870673
NOON-O�VUNED 9/1!2015 9/1/2016 BODILY INJURY(Peracclaent) $
HIRAUTOS AUTOS PROP
E
ED $
-MoL
UArtBRELLA LIAgOGCURPIP`Baa. $ 10,000
�
EXCESS LIAR EACH OCCURRENOE $
CLAIMS•MgDE
AGGREGATE $
DED RETENTION ,
WORRIERS COMPENSATION $
AND rimpLOYERS'LIABILITY Y/N PfVE AI EF.'
OFFICENMANYP 16ERREE EXCLUDED?�� N/A E.L.EACH ACCIDENT $ 500 000
B (Alertdat°ry In wvdw.NH) 1IIII L0o4a222015 11/6/2'019 11/4/2016 t L.01SEA6E-EA EMPJ OYE S 500 000
DESGRttl PPTI N O OPERATIONS bLkw
EL DISEASE-POLICY LINT $ 500 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VERIOLES%Conn io1,Acid tf9rW R=m*6 Sq;eed11*" ,y be ettsenefl 1 mora yppp r nd)
CAC18'14696• .
CERTIFICATE HOLDER
(305)756-8972 CANCELLATION
10Shores Village SHOTHE ULD ANY OF THE EXF9RATION DATE VTHE OFF, NOTIPOLICIES WILL CBE DELIVERED RN'
10050050 WE 2 Ave ACCORDANCE WITH THE POLICY PROVISIONS,
Miami Shores , FL 33138
AUTNORRED REPRESENTATIVE
Leighton Campbell/LC
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and 1090 are registered marks of ACORD
INS025 r�Q�en9)