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MC-16-1948 �ci � Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-263148 Permit Number: MC-7-16-1948 Scheduled Inspection Date: November 07,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: MARKUS, DAVID Work Classification: Addition/Alteration Job Address:1190 NE 92 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132050270460 Project: <NONE> Contractor: DEDICATED COOLING LLC Phone: (786)326-0911 Building Department Comments REMODEL BATHROOM - 110 CFM EXHAUST FAN. Infractio Passed Comments INSPECTOR COMMENTS False 11 v� Inspector Comments Passed In Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 04,2016 For Inspections please call: (305)762-4949 Page 7 of 36 IWE I + �hlt �`' :�•' Miami Shores Village Pt?ltXriy�eMc'Ct1a*, a) 'Resldeet 10050 N.E.2nd Avenue NEtion.Ac )tic lAlltet�t Miami Shores,FL 33138-0000 PBtmif Status:APPRt��O Phone: (305)795-2204 a`'t RivA Expiration: 112 2017 issue gate. `1 6i1i0�6.. ` p- Project Address Parcel Number Applicant 1190 NE 92 Street 1132050270460 DAVID MARKUS Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell DAVID MARKUS 1190 NE 92 Street MIAMI SHORES FL 33138-2935 Contractor(s) Phone Cell Phone Valuation: $ 600.00 DEDICATED COOLING LLC (786)326-0911 Total Sq Feet: 115 Tons: Available Inspections: Additional Info:REMODEL BATHROOM-110 CFM EXHAUST 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 Invoice# MC-7-16-60577 DBPR Fee $2.25 07/13/2016 Credit Card $50.00 $109.10 DCA Fee $2.25 Education Surcharge $0.20 07/26/2016 Check#:4006 $ 109.10 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.60 Total: $159.10 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 AF rtify tha all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construct n and nin herrn e,I authorize the above-named contractor to do the work stated. , July 26,2016 Au orized Signature: ner / pplicant / Contractor / Agent Date Building Department Copy July 26,2016 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 J L 1 3 2016 � Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 �Y: FBC 0 I V BUILDING Master Permit No. I)CI r,,— PERMIT APPLICATION Sub Permit No.ZI((_�" L GQ BUILDING ❑ ELECTRIC ROOFING ❑ REVISION EXTENSION ❑RENEWAL ❑PLUMBING /MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP f /� �/l// CONTRACTOR DRAWINGS JOB ADDRESS: / 7 0 C 0/� � _S City: Miami Shores County: Miami Dade Zip: 331 3 9 / Folio/Parcel#: //- 52 0-5--0 A 7 0 y 6 d Is the Building Historically Designated:Yes NO r� Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: �n 3o5-- 1i 6 _6.5'42 OWNER:Name(Fee Simple Titleholder): �fl it/� / /i`��'� Phone#:7��7 — ! ;z /V Address: 4aQ E t S7- �a City: l 5 s State: f�L Zip: Tenant/Lessee Name: y Phone#: Email: CONTRACTOR:Company Name: CWU k)&— Phone#: M 3L(b—y sj�I Address: gam(CP NUJ �"1 O,Vf, / City: State: Fy__ Zip: Qualifier Name: Zu )5 PcC��iZ pp�� Phone#: State Certification or Registration#: 1 gi ' oo Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work:lr> Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Rep�lacce, n ❑ De olition Description of Work: �'( f�D _C F*k 1[Ty'Pne7 I Specify color of color thru tile: Submittal Fee$ !:; Permit Fee$ , D L`vc� CCF$ 6) CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$� u`"Il° Q (Revised02/24/2014) r .r a 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 oc rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved a reinspection fee will be charged. Signature Sig�tLre / `--- OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before/me this day of i-v—q 120 /6 by day of 20 by 1�who is personally known to U 5 '4ip-ALZ who is pefw�known me or who haspro� V 9-r c, �N;c.,2 Sv,_ 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: Sign: Print: a,►-�r`12- �� Print: Seal: ; JOANNE L Seal: , ' icy,, JOANNE L DEAN r. MY COMMISSION#EE 845044 ?x: a? MY COMMISSION 4 EE 845W IRES:November 4,2016 Bonded Thru Notley Public ...... iBonded TfiN PubNo l;odww fats APPROVED BY `'�\' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �. � DEDIC-1 OP ID:CC DATE(MMM PMm CERTIFICATE OF LIABILITY INSURANCE 06124/2016 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 osiffleate holder is an ADDITIONAL INSURED,the polloy(les)must be endorsed. H 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 lieu of such endorsement(s). PROMWER coj r Chi Clawson Clawson 8 Com;:n InCL L PHONE 954-388-6930 No;954.389-0452 2731 Executive rk brave,#B+_ 1 Weston,FL M31= ,� Chi clawsclninsumace.com Clawson&Company Inc INSU AfFOROINO COVERAGE NAIO 0 DIRER A:American Empire Ins.Co. INSURM Dedicated Cooling Inca..:3 INSURER 8: Luis Perex z� 8964 NW 174th Lane'" :" IN$URERC Hialeah,FL 33018 UMRER 0: INSURER E, INSURER - INSURER 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 NTH 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. LTR TYPE'OF INSURE POLICY NUMBER POL EFF PO6 E7,P UMITS A X conm/ERcmL caEN»AL uAwuTY EACH OCCURRENCE $ 11000,000 OLAIMB•MADE M OOCUR X ISCGO187314 02/0=16 02/0812017 PREMISES t'E_..=cs1 $ 100,000 MED EXP mica n $ 14000 PERSONAL&ADV INIURY $ 11000,000 OEM AGDREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ,EGT Lac PRODUCTS-COUIPiOP AGO $ 11000,000 OT $ AUTOMOBILE LIABILITY IPI IIT $ a dent) ANY AUTO BODILY INJURY(Par parson) $ ALL OWNED SCHEDULED BODILY INJURY(Per+ancldent) $ AMOS N�OWNED $ HIRED AUTOS n AUTOS M anddeal LIAROCCUR EACH OCCURRENCE $ EXCESS Me HCLAIMS-MADE AGG 0ATE $ DED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS'LRABII#1 Y YIN A R ANY PROPRIETOMPARTINEROMCUTIVEEl.EACH T $ OFFICERfMEMBEREXCLUDED? �' IA (Mandatory In NH) E:L.DISEASE-EA EMPLOYE $ II Wme c us - DESCRIPTION OF OP TIONS hdow E.L.DISEASE-POLICY LIMrr $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Add anal Remek SehedWa,may 6e If man RMCS Is shad) Air Conditioning Systems or Equipment-dealers or diedbutors A �c Installation seduce or repair. LICt€CACiSM17 CERTIFICATE HOLDER CANCELLATION VILLMIA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shoran THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 10050 NE and ave-:I_ Miami Shoves,FL 33138 AUTI[ORAED ttEPRE9ENTATN'E iT 0 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD DEDICOO.01 LOPEZMI CERTIFICATE OF LIABILITY INSURANCE ��12 2016 YI 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 SY 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. 0 the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsemeLTt A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. CONTACT PRODUCER License#L012420 NAE: Milton LO CompuPay Insurance Services,Inc. 1401 Forum Way 561 471-3331380307 =C So: 305 IB75-8141 Suite 500 dl-W I Inefltmall.com West Palm Beach,FL 33401 INSUNRR AFFORDING COVERAGE NAIC a INSURER A:RettiiFfmi:Insurance Comeny 10700 INSURED INSURER 6, Dedicated Cooling LLC WC INSURER c: 75.51 NW 174 Terrace INSURER D: Hialeah,FL 33015 INSURER E INSURER 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 CONTRACTOR 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. LTRINSRADDL SOUR TYPE OF INSURANCE POLICY NAIMBER LINM COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F=1 OCCUR PREM ES Ea $ MED EXP IAny am arson $ PERSONAL&ADV INJURY $ GEN'.ACI REGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ POLICY®�T LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE UABAM COMBINED IMI SINGLE LT ANY AUTO BODILY INJURY(Par pa um) $ A AUTOS 1aEO OS LED BODILYIN.JURY(FWidem) $ OWNED HIRED AUTO$ AUTOS acddaar7 $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAS CLAJMS-MADE AGGREGATE $ DED I I RNTION 6 $ WORKERS COMPENSATION SPER OTH TATUTE E AND EMPLOYERS'LIABILITY YIN A ANY PROPRIETORMARTNERIEXECUTIVE y- ,NIA 20-63'129 0112116 0112112017 E L,EACH T $ 10%000 OFFICERRAEMSER EXCLUDED? (ya�ndiftr1'In NH) E L.DISEA -EA EMPLOYE $ 100.,000 wbar DESCRI OF 9EEBangn Ww E L.DISEASE-POLICY LIMIT $ 50%000 DESCRIPTIaN OP OPERAIM-S d LOCATIONS I VP.HICLES IACORO 401,Addftnal Schedule,M"be aftschad If mare WOOD Is reaufedl Lltaense D CAC1a17917 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 N.E.2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 REPRESENTATIVE I _A44-104062-- i 0 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 23(21114f01) The ACORD name and logo are registered marks of ACORD