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MC-16-2815 ff Miami Shores Village e ? ria a 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 � Phone: (305)795-2204 R ' ,issutpOft 11A1 Expiration: 04/19/2017 Project Address Parcel Number Applicant 9488 NE 2 Avenue 1132060132780-88 Miami Shores, FL 33138- Block: Lot: MSVC LLC Owner Information Address Phone Cell MSVC LLC 2310 HOLLYWOOD Boulevard ()__ HOLLYWOOD FL 33020- Contractor(s) Phone Cell Phone Valuation: $ 23,000-.00------ RESULTS AIR CONDITIONING CO 305-886-2534 __.. _ _. _.:._. _ ....._ ....,_... Total Sq Feet: 0 Tons:6-4 Available Inspections: Additional Info:INSTALL 1-6 TON NO HEAT 1-4 TON W Inspection Type: Classification:Commercial Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work:INSTALL 1-6 TON NO HEAT 1-4 TON Scanning:1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $13.80 DBPR Fee InvOICe# MC-10-16-61682 $10.35 10/18/2016 Check#:28789 $50.00 $700.50 DCA Fee $10.35 Education Surcharge $4,80 10/21/2016 Check#:28807 $700.50 $0.00 Permit Fee $690.00 Scanning Fee $3.00 Technology Fee $18.40 Total: $750.50 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,statementsor SP cifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, agent, servants, or employes I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,RO G and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accuratet all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor t e York stated. October 21, 2016 Authorized Signature:Owner / Applicant / Contractor ! e t Date Building Department Copy October 21,2016 1 (:& cu6 _Zl�q Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-269108 Permit Number: MC-10-16-2815 Inspection Date: October 24, 2016 Permit Type: Mechanical- Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: LLC, MSVC Work Classification: Addition/Alteration Job Address:9488 NE 2 Avenue Miami Shores, FL 33138- Phone Number Project: <NONE> 0-- Parcel Number 1132060132780-88 Contractor: RESULTS AIR CONDITIONING CO Phone: 305-886-2534 Building Department Comments INSTALL 1-6 TON NO HEAT 1-4 TON WITH 5 KW Infractio Passed Comments RELOCATE RETURN DUCT INSPECTOR COMMENTS False Inspector Comments Passed 1K Failed El Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 October 24,2016 Page 1 of 1 Miami Shores Village o�� b Building Department T 1 016 /^� 1 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 \` V Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 BUILDING Master Permit NO.W 09 - 16- 2- 1 (o7 PERMIT APPLICATION Sub Permit No. M (- Io-luo ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [�MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP l PCONTRACTOR DRAWINGS JOB ADDRESS: 00 {� City: Miami Shores County: Miami Dade Zip: 33 O Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: I Flood Zone: BFE: FFE: OWNER:Name(Fee dL Simple Titleholder): (�{� �tc Phone#: Address: - 4 J 2 f 1 Cis (J)aj-i City: Clad" C4 C. State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 9'C'5L) I �J tc Phone#: ���' Z•(,-3� Address: / V5'I A/ "-; 7d u~� a City: State: 1 Zip:^'S ® �-C Y Qualifier Name: ef® Phone#: State Certification or Registration#:CA V O 05 —1 k. '3 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: 2p(3 ��M�JW� City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 12$Repair/Replace ❑ Demolition Description of WorkM- AS; n2a he-O ' Specify color of color thru tile: Submittal Fee$ Permit Fee$ 0UL"CCF$ 13 • 50 CO/CC$ Scanning Fee$ Radon Fee$ /0. 311V5 DBPR$ /o• S 'a'Notary$ Technology Fee$ 13 • // O Training/Education Fee$ `f •&n Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ "ice../ • 50 (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 not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by /-3 day of �U6e� ,20 ®� by who is personally known to 0sL ide Z- ,who is personally kno 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: Sign: Sign: ;::R.► ELIZABETH RODRIGUEZ Print: Print: MY COMMISSION#GG004316 0 Seal: Seal: 407)3880183 FWWaNaWySer41ce.cem K *I APPROVED BY P xaminer Zoning Structural Review Clerk (Revised02/24/2014) t , V C.1132 Miami Shores Village Building Department .... u...M 10050 N.E.2nd Avenue Miami Shores, Florida 33138 L �oy� Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheetsarenot acceptable. Job Address(where the work is being done): 14 9 �J E, oq 4e_— City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER If--i K/,< AHU or PKG. UNIT MODEL# G D r7 Z s g -1 v,— CON D. COND.UNIT MODEL# KW HEAT NOM TONS AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS Y 0 YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker SizGe}: 5d f�^ 3. Voltage of Circuit(208/240/480): (vim D ® I�� 4. Size Disconnecting Means: /S0 4-� Contractor's Company Name: ( �Su /,A //t, Phone: 3® State Certificate or Registr tion No. 6* C®517(' 5_3 Certificate of Competency No. Signature AV Date: J(dual er's signature) (Revised02/24/2014) St;ORiE;s y Miami Shores Village Building Department .... loll" 10050 10050 N.E.2nd Avenue Miami Shores, Florida 33138 4_W4_ � Tel: (305)795.2204 WR Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on sinfgle sheets are not acceptable. Job Address(where the work is being done): q / ke V36 c� A-w— City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER C_ AHU or PKG. UNIT MODEL# COND.UNIT MODEL# 30 o KW HEAT GvJ c� NOM TONS AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT E NO YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES N YES NO NEW RETURN PLENUM BOX YES O 1. Minimum Circuit Ampacity(Wire Size): if Co P * F 2. Maximum Overcurrent Protection (Fuse/Breaker Size): �� P 3. Voltage of Circuit(208/240/480): 2, ® O r 4. Size Disconnecting Means: S CD ) Contractor's Company Name: �'c- S U / Phone: r State Certificate or RegNo. G�'C S 7 S 3 Certificate of Competency No. istratio Signature Date: Q ifiees signature) (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 4.87-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 CORBERA, JOSE ALEX RESULTS AIR CONDITIONING COMPANY 7451 NW 72ND AVENUE MIAMI FL 33166 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range '► STATE OF FLORIDA from architects to yacht brokers,from boxers to berbeque DEPARTME T OF-BU (NESS AND restaurants,and they keep Florida's economy strong. PROFESSI#3�. EG LATION Every day we work to improve the waywe do business in order CAC057653 SIJ D7/07/2016 to serve you better. For Information about our services, please log onto www.myfloridalicense.com. There you can find more CERTIFIED AIR �3 information about our divisions and the regulations that impact CORBERA,J you,subscribe to department newsletters and learn more about '. ^ RESULTS AIR CLSAiD PANY the Departments initiatives. .� Our mission at the Department is:License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! � ale:�31,zoic t1607070000rS DETACH HERE RICK SCOTT GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD Qe CAC067653 The CLASS B AIR CONDITIONING CONTRACTOR w Named below IS CERTIFIED u Undee the provisions of-Chapter 489 FS. Expiration date: AUG 31,2018 _ 1600 CORBERA,JOSE ALEX -RESULTS AIR CONDIT MPANY 11240 SW 29's ISSUED: 07/07/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1607070000557 �.•�.1 RESUL-1 OP ID:MIAC CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYYY)02/16/2016 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 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 endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NNE cT Jorge Pena,PIAM CPIA Alisafe Insurance Group dbaPHONE 305-262-5244 aC No:786-388-7244 ASI Florida ac N Ext: 7171 Coral Way#209 toREss:jorge@asiflorida.net Miami,FL 33155 Jorge Pena,PIAM CPIA INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Western World Insurance Compan 13196 INSURED Results Air Conditioning Comp INSURERB:Brid efield Employers Insuranc 10701 7451 Nw 72 Ave Miami,FL 33166 INSURER c INSURER D: 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 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. ILTR TYPE OF INSURANCE POLICY NUMBER MMOJDD EFF MMlDD EXP LIMITs A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE 7 OCCUR NPP8288064 0112612016 01/26/2017 PREMISES Ea occurrence $ 100,00 X Deductible$500 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEMLAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 POLICY X JEC T LOC PRODUCTS-COMPIOPAGG $ 2,000,00 OTHER: $ BI AUTOMOBILE LIABILITY O ld n SINGLE LIMIT $ Ea acdet ANY AUTO BODILY INJURY(Per person) $ ALS ED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED Peraccident) UMBRELLA $ HIRED AUTOS AUTOS UMBRELLALWB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE X ER B ANY PROPRIETORIPARTNERIEXECUTIVE Y/N 063045672-0 01/26/2016 01/26/2017 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N❑N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes describe under DfiZRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT I$ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) AIR CONDITIONING INSTATLATION, SERVICE & REPAIR LICENSE # CAC057653 CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue NE Miami Shores,,FL 33313-8220 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 000120 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT ABill-DO NOT PAY �_LBT 323923 !_j BLM94EM RMIVI .00ATION RECEIPT NO. EXPIRES RESULTS AIR CONDMONING CO RENEWAL SEPTEMBER 30, 2017 7461 NW 72 AVE 323923 Must be displayed at place of business MEDLEY FL 33166 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECENED RESULTS AIR CONDITIONING CO 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR Y JOSE A CORBERA,QUALIFIER CAC067653 Worker(s) 10 $45.00 08/17/2016 CHECK21-16-113850 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 holder's qualifications,to do business.Holder must comply with any governmental or mmiloveromental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sac 6a-276. For more information,visit bonne=IamidadMovkexcotlector i