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MC-09-1902Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -1-(53 Inspection Number: I NSP- 129451 Permit Number: MC -11 -09 -1902 Scheduled Inspection Date: April 09, 2012 Inspector: Perez, JanPierre Owner: POLANCO, DEYSI Job Address: 1183 NE 91 Terrace Miami Shores, FL 33138- Project: <NONE> Contractor: AIR MIKE A/C INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New A/C System Phone Number Parcel Number 1132050010200 Phone: (305)970 -5897 Building Department Comments AC NEW HOUSE zkiz_ Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 09, 2012 For Inspections please call: (305)762 -4949 Page 1 of 24 • B aq�INc Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Horida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONENUMBER: (305) 762.4949 PE ' ► 4PLICATION FB 20 CD7) ` Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): b e 1 `I n C(O Address: h% 37 . - t%ilS°e t Sir p City: Skin tl I sE C State: f / TRECEIVED MAR 222012 Permit No. VY1C--0C1 ®6 j CZ- Master P e r m i t No. WC- 1 ' O ° \ - - ‘ 5 ) \ Phone#: 7 o / 11 Zip: 203 aa- Tenant/Lessee Name: Phone #: Email: IcSeisirn 90\Q 1Q n c °e CL lj • cL J JOB ADDRESS: Ci3.3t 1 3E City: Miami Shores County: Miami Dade zip: -33 (3? Folio/Parcel#: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: /41600 City: "1..-0614... Qualifier Name: State Certification or Registration #: CA i f .J 947 49 Contact Phone #: *78 r' 57-90/5 Email Address: dottliGi ® .4• 2 .€47:74-1. it/X-r4 DESIGNER: Architect/Engineer: Phone #: NO Flood Zone: State: Phone #: 3a5 ,970-5-13-3 Zip: —37 / ?J Phone #: 705- ”61-1-97,3 Certificate of Competency #: Value of Work for this Permit: Type of Work: ❑Address Description of Work: /" Gm $ 7,250 Square/Linear Footage of Work: ❑Alteration New Ctv AC' , \tig- ❑Repair/Replace ❑Demolition . "S /4 . T1 Q.9J * **. six***** s*********a cs***************** F************* ******* ** *$$$ ** ****** ** ** *s **** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ CCF $ CO /CC $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 FI.RCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 promise in good faith that a copy of the notice of commencement and construction lien law bro whose property is subject to attachment. Also, a certified copy of the recorded notice of comme for the first inspection which occurs seven (7) days after the building permit is issued. In inspection will not he approved and a reinspection fee will be charged. Signature 9r24 g $2500, the applicant must 11 be delivered to the person must be posted at the job site ce of such posted notice, the Owner or Agent S% Contractor The foregoing instrument was acknowledge before me this / The foregoing instrume t was acknowledged before me this /'sue day of/ rCk , 20 / 2; by J e_y� 1 0 ( aarc b , day of M civ-c Ft , ' O L, by Z.-®p-e' °L r who has produced FO is personally known to me or who has produced As identification and who did take an oat 'C' , 215 5't 6.3 36$ tells identification and who did take an oath. NOTARY PUBLIC: Sign Print: �L My Commission Expires: ELZIRIS GOMEZ MY ommIssrox r. DD85'166, EXPIRES: January 25, 2013 4 Assoc. Co. NOTARY PUBLIC: Sign: Print: ELL S My Commission Expires: 'f1• i,•■ CO 146301014 e N 0 DD8 3 4166 23.2013 ear Assam co. ***************************************************** ** ** *** * *,x***+x****+x+x**+ *** **** *+six**** * * **********+x*** ** APPROVED BY i 7 2-6 t 'Plan Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 T Permit N. Req 09 1531 Owner's Name (Fee Simple Title Holder): Dey Si ?ot &rvc• Owner's Address: 63? svuseT .9—ntAP City: goiter: se State : .FG Phone #: (78C) Zip Code: 3332a, Job Address (Of where work is being done): U 83 NF °! 7G161f- City: Miami Shores State: Florida Zip Code: Contractor's Company Name: %`1.1 r Al iu Phone #: (300'-O%.3 Address: /80o ive j v7 resit. City: All A-MI State: FL Zip Code: 33/ 79 Qualifier's Name : Mao' L v ptz Lic. Number: C..A C. 1 613 86 7 Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: I hereby certify that the work has been abandoned and/or the contra unable or unwilling to complete the contract. I hold the Building Miami Shores harmless for all legal involvemen . Signature rr, oudher or Agent The foregoing instrument was aknowledged .afore me this dayofH ,.cL ,2012,by i 1 w a Who is personally known to me or who has produced • as indentification. Signature o architect is ffici 1 and the APP6on ror Architect The foregoing instrument aaknowledged before me this T __ day of ' a 20I2by Ncee Love--1 who is personally known o me or who has produced as indentification. CUk OSSIJi. a L:t':t• ^.1 • ExpiRES. r.,,. ry s5.20 a. ARY • Deysi M. Po lanco 1183 NE 91st Terrace Miami Shores, FL 33138 March 12, 2012 Grana Electric and Air Conditioning, Inc. Jorge F. Granadillo 144 SW Dalton Cir Port St. Lucie, FL 34953 Re: 1183 N.E. 91st Terrace, Miami Shores, FL 33138 Permit #MC09 -1902 Dear Mr. Granadillo: I am contacting you regarding the above reference home for which you have permit #MC09 -1902 with the village of Miami Shores. Saad Homes the general contractor for the project was given notice of termination on June 2, 2011 and soon thereafter terminated from the job. Please consider this your notice of termination from the mechanical job /contract with permit #MC09 -1902. This notice is your seven (7) day notice of termination for the following reason: The General Contractor with whom you had a contract, Saad Homes, Inc. of 18601 Wentworth Drive, Miami, FL 33015 is no longer the contractor for the 1183 NE 91st Terrace, Miami Shores, FL 33138. Sincerely, fr-y' 4.e........4.4) Deysi Polanco Owner • Sender. Please print your name, address, and ZIPA4 In this box • peysr Pccrcit, I1V3 nJ€ 9(PVT-cry- /it m i SMO(S, FC. 33/38 SENDER: COMPLETE THIS SECTION ■ Complete items 1, 2, and 3. Also complete item 4:1f. Restricted Delivery is desired. • Print your name and address on the reverse so that we can return the card to you. IN Attach this card to the back of the maliplece, or on the front If space permits. ' 1. Article Addressed t araoa E/ r /,c .)6i / 14 0 et 9f. (,Luce F(�, 3(1,41 1 COMPLETE THIS SECTION ON DELIVERY A. Signature X B . Rev d by (Printed raceme) • C. Date s{f Delivery D. Is delivery Wises different Item 17 0 Yes If YES, enema delivery address mow: No 1-4 el- g's41-e-astf,esee 3. S8. Service Type oMall oMall 0 Registered CI Return Receipt for 13 band Mali 0 C.O.D. 4. Restricted Dew fkke Feel 0 Yee 2. /Wide Number alwisfer trora settee Me° PS F01411 3811, February 2004 Danmark) Rehm Receipt 7011 1570 0002 0352 6741 102500244540 UNITED SrATEs POSTAL SERVICE First-Claw Moll && Peesq. Paid USPS Permit No. 0-10 h1111 tt►41111111WI 11116.J19f It9111011,4I LLJ111Ji3,t1HI ° STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 LOPEZ MIGUEL AIR MIRE A /C, INC. 14050 NW 22ND AVENUE OPA -LOCRA FL 33054" 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflortdalicense.com. There you can find more information about our divisions and the regulations that impact you, subscvibe to department newsletters and leam more about the Department's 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, and congratulations on your new license! BATCH NUMBER A f 4545'1 ,NMAL ±t' HO o" °ate lam:: 41 SEE OTHER SIDE_ DO NOT FORWARD AIR MIKE AC INC MIKE LOPEZ 1800 NE 197 TERR MIAMI FL 33179 i, Jhnllnt t11611, lnu11iin11 ,ai111nd1hA,i?$il From:Gruber & Associates Ins. 305 246 7090 04/04/2012 11:36 #000 P.001 /001 2.M"` "W" CERTIFICATE OF LIABILITY INSURANCE DATE(MM►DD/YYYY) 04/04/12 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 POUCIES 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 pollcy(les) must he endomed.'Tf 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 holler In lieu of such endorsement(e). PRODUCER Gruber & Associates 1135 N. Krome Ave. Homestead, FL 33030 Phone (305)2485453 Fax (305)246 -7090 JOHN BARNES • . (305)248 -5453 Fr, (305 246 -7090 ,. RCS: bamesjs®bellsouth.net INSURERS) AFFORDING COVERAGE NAC 0 INSURER A: ASCENDANT COMMERCIAL INSURANCE INSURER B : ASCENDANT COMMERCIAL INSURANCE GENERAL LIABIJTY 0i COMMERCULL GENERAL LIABILTY ❑ CLAIMS-MADE OCCUR INSURED MIKE LOPEZ DBA AIR MIKE NC, INC. 1800 NE 197 TERR. MIAMI, FL 33179 (305) 370 -5833 COVERAQER r•C07•,C,AATC u....w�.._ INSURER C : GL 37925 INSURER D : 03/23/2013 s'S E : 1,000 000.00 eQ8lIRERF: 100,000.00 THIS INDICATED. CERTIFICATE EXCLUSIONS racy WI' V,\ ,r V aaOCru IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTIMTHSTANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. waRn TYPE OF INSURANCE ADD 1• t,- ; ∎ . n � PO NUMBER , Foxy MUD. AAA LI>ap78 A GENERAL LIABIJTY 0i COMMERCULL GENERAL LIABILTY ❑ CLAIMS-MADE OCCUR GL 37925 �_!a 1� _'i4a'w 03/23/2012 03/23/2013 EACH OCCURRENCE 1,000 000.00 ! . TO RENTED 100,000.00 MED P one one $ 5,000.00 PERSONAL &AOVINJURY $ 1,000,000.00 0 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLES PP POLICY I 4' NI LOC PRODUCTS - COMP/OP AGG $ 1.000,000.00 $ AUTOMOBILE LIABB.TY • ANY AUTO SCHEDULED 0 Wawa) ❑ r ...1; INED SINGLE LIMIT BODILY INJURY (Per person) $ BODILYINJURY(Pereo�eer:t $ OPE •AMAGE $ $ El UMBRELLA LIAS r OCCUR • EXCESS LIAR ■ CLAIMS -MADE NIA 111 • WC- 60380.3 03/25/2012 03/25/2013 EACH OCCURRENCE $ AGGREGATE $ El DED ❑ RETENTION$ ■ 1 -i ATU- • � B WORKERS COMPENSATION /A��yPROPRIETORtPAAfITIERIEXECUT1yEIN OFFICEWMEMBERExcLUDern (Mandatory In NH) ■ EL EACH ACCIDENT $ 100,000.00 EL DISEASE - FAt]d1P1.0 �: $ 100,000.00 u:._ desaRhawdaz • RLPTION OF OPERATIONS .:. ow EL DISEASE - POLICY (MIT $ 500,000.00 a` DESCRIPTION OF OPERATIONS / LOCATIONS I VENICLES AIR CONDITIONING INSTALLATION & REPAIR. CERTIFICATE HOLDER (Attach ACORD 101. Additional Remarks Schedule, If more apace Is requited) $500 DEDUCTIBLE PER CLAIM. - -_ - -_- - _ —_ -- MIAMI SHORES VILLAGE 10050 NE 2 AVE. MIAMI SHORES, FL 33138 I (305) 756 -8972 FAX ACORD 26 (2010106) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUT HORMED REPRESENTATIVE ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From:Gruber & Associates Ins. 305 246 7090 03/01/2012 13:07 #617 P.001/001 " `�`` CERTIFICATE OF LIABILITY INSURANCE °" 03/01/12 pirafforryr o3ro1/1a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES 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 N an ADEM ZONAL INSURED, the policypes) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may moults an endorsement A statement on this certiflcats does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Gruber & Associates • 1135 N. Krome Ave. Homestead, FL 33030 Phone (305)248 -5453 Fax (305)246.7090 _NBdIE JOHN BARNES . (305)248 -5453 1 c No . (305)246 -7090 ADDRESS; bamesja(gbeU> auth.net INSURERS) AFFORDING COVERAGE NAM: 0 INSURER A: ASCENDANT COMMERCIAL INSURANCE INSURED MIKE LOPEZ DBA AIR MIKE A/C, INC. 1800 NE 197 TERR. MIAMI, FL 33179 (305) 370 -5833 COVERAGES CERTI INSURER s: ASCENDANT COMMERCIAL INSURANCE INSURER C: d INSURER D s INSURER E : INSURER P' 4 A FICATE 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, g�EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURANCE ADD18UBit .... INSR VW[t� POLICY NUMBER B GENERAL LIABILITY • COMMERCIAL GENERAL LIABILITY ❑ ❑ CL IS -MADE ® OCCUR 0 GENT. AGGREGATE L�I p WTAP IP R: LILIES PE POLICY El JE 0 LOC AUTO/40E1LE LIABILITY ® ANY pAtrrro �I ❑ AUTOS L-1 AUTOS OTIRED AUTOS p Nc GL- 34398 -2 ,paraw, 03/23/2011 (� 03/232012 PERSONAL &ADV INJURY $ 1,000,000.00 OMITS EACH OCCURRENCE AMAGE TO RENTED PR ,B (Ea a ias ) a 10 000. D00 MED EXP (Anyone person) $ 5,000.00 $ 1,000,000.00 GENERAL AGGREGATE s 2,000,000.00 PRODUCTS - COMPtOPAGG 4 1.000,000.00 ❑ UMBRELLA LIAR OCCUR ❑ EXCESS LIAR 0 CLAIMS -MADE ❑ DED 0 RETENTION$ C�OMB141 SINGLE LEST $ $ BODILY INJURY (Per pesamt) $ BODILY INJURY (Per accident 6 OP g I AMAGE $ �LOYERS COMPENSATION ANY PROPRIErORIP Y/N OFFICa jMEMBER EXCLl1bED7 I N U A 1►y�, (Mandatory hi imam NH) DESCRIPTION OF OPERATIONS below 3 EACH OCCURRENCE s AGGREGATE $ WC- 80380 -2 0324/2011 03/24/2012 ❑ °RI" S ❑ E°R " E.L EACH ACCIDENT $ 100,000.00 E.L DISEASE - EA EMPLOYE a 100,000.00 DESCRIPTION OF OPERATIONS /LOCATE U VEHICLES (Attach ACORD 101, Additional Remari® Schedule. If more space is requ:ed) AIR CONDITIONING INSTALLATION & REPAIR. $500 DEDUCTIBLE PER CLAIM. CERTIFICATE HOLDER E.L DISEASE - POLICY LIMIT $ 500,000.00 CANCELLATION MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2 AVE. MIAMI SHORES, FL 33138 I FAX: (305) 756.8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) QF ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING ��!" Permit No. r PERMIT AP'LICATIO Master Permit Nok ' 15'b FBC 20 Permit Type: MECHANICAL ..Owner's Name (Fee Simple Titleholder) SrO 19�6/fa ("del, Phone# �D�O���`�'"�1 t Owner's Address 1.M0 on N iQ '1 1 Cfi + City alrn ry State 40 A Zip 8'3 'l —1(6, Tenant/Lessee Name Email Address (where the work is being done) Phone # City Miami Shores Village County Miami -Dade Zip 3) 8 FOLIO / PARCEL # ` 1 - 00 I - Od oo Is Building Historically Designated YES NO Flood Zone tractor's Company f Name li ra k-eG1 C. JU 'Phone # 905 - &2_Ct - -C? Co ctor's Address 1414 n 0 e r ., (:).' S , (e b4C153 City �j . L State Zip FAet 5- ® 'e e° G7 r',!' C( : lLQ Phone # State Certificate or Registration No. C./et C l g 1655- —7 Certificate of Competency No. Contact Phone E -mail Qualifier Nam Architect/Engineer's Name (if applicable) C 'to `o. Phone # E) a'$- 50 (00 Value of Work For this Permit $ ✓ 2. 0 0. 0 0 T ype of Work: ❑Addition ❑Alteration o(Tescribe Work: KO (u 1DUS..Q S are / Linear Footage Of Work: vy New ❑ Repair/Replace ❑ Demolition Submittal Fe * ** *** * * * * * * * * * * * * ** * ** * * * * * ** * *Fees ** ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** Permit Fee $ Notary $ Training/Education Fee $ 04C Scanning $ ) Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 4)' } CCF $ Q " CO /CC $ Technology Fee $ 3 '2J Bond $ See Reverse side -->f 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 -sectitelfor ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must promise in good faith that a copy of the notice whose property is subject to attachment. Also, for the first i ecti n which s rs seven commencement and construction lien law brochure will be delivered to the person certified copy of the recorded notice of commencement must be posted at the job site days after th uilding permit is issued. In the absence of such posted notice, the ection fee wil a charged. er or Agent r /ontractor The foregoing instrum y't was acknowledged before me this 13 The foregoing instrument was acknowledged before me this t+ day of t/ , 200C1, by , day of f V OU , 2009 , by who is personally known to or who has produced who is personally known to me or who has produced as identification and who did take an oath. As identification and who did take an oath. NOTARY PUB 404 Sign: is Print: Mie- °'"Y My Commission Expires: l' A$AN * MY WMh9 SSION #DD81662 EXPIRES: June 20,2013 BOndedThtuBudietNo117 SeMces *vk9c3c*nk*4edtdeo ***k9t******** APPROVED BY Sign: Print: b C ( e.rl 15) _$Y PV MyCommiss* °� •``.fir ASIAN * � r ; * Y OIMuf$SIOM #DD891162 ��.. -.`P� i 'e EXPIRES :June20,2013 % 'ome Wed1luuIMO Nittry Sofas 1 k* ************************** ****************** ************* a Examiner Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Clerk checked STATE•OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL, REGULATION MITRUCTION O ESSTRERTGuSIAe BOARD (850j 487 -1395 T16LL1 ; BE PL 32399 -0783 G RANADILL©, JQRGE F G ti ELECTRIC A RRIR C� _ TION /NG INC PORT SAINT LUCIE FL 34953 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 businasSee recge from architects to yacht breakers, from boxers to berbeque restaurants, and they keep Florida's economy strong, Every day we work to improve the way we do business in order to serve you bar.. Far information about our services, please log onto www.myflorldalicense.com. orldalicense.com. n3 u con find more y@ Information about our divisions and the regulations that Impact you subscribe to depar'benent 118Wfdaktell and team Departments Initiatives. more about the Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you hatter so that can serve your customers. Thank you for doing business in Florida, and congratulations on your new licensel DETACH HERE 5;4.3,4.4, :?'' • 4; i� , ,,1i,8 ; 4 � f'i.•,i�i '11kr•md6•. T¢}{ �dpr Qm IR. AIN 31, .2Q3.Q 46110 01,4 • td :'West :to n Ifl f e �>r 6 ALS( SPX Mae Patilficgo. OFFILIM STATE OF FLORA DEPARTMENT P OF FINA AL SERVICES * *crRrWrcn���rtoH�� ���TION CONSTRUCTION INDUSTRY EXEMPTION APT FROM FLORIDA WORKERS' SA'[!AN LAW This certifies that the individual listed tielaw has elected to be exeryu# from Florida Workers' Compensation law' 02111312009 EXPIRATION DATE 02116/2011 JORGE 02 -16 -2009 EFFECTIVE DATE PERSON ORANADILLO 010830009 BUSMEN; NAME GRAM 1: & �� ADDRESS: 144 " DA UM mama I �i01�t#IGi Inc PRAT SAW LUE FL 34893 SCOPES OF BUSINESS OR TRADE f 1- CERTIFIED AC cR 2- REGISTERED ELECTRICM. CONTRACT 116,11111:4111: Parma Ito f ma Qtr Md . dfii]at F.S„ m Meer of koalas at e� o ear�e►atisa who elects � the hostooss tor We hated so a main ell g e�� sOh ch mom to 44 � �� a be exempt al e�octiaa Nds to �Y___ U, et r 44e 05fi3),l F. g3y� t - aPDFF Daly �ieere rke MEI knee sons oesetl ea e c f la n ai t sec, for ►mew of a *o Wag esttt�e� or knee= of slro earHfieate the p ®d wcBliceseo of iliMC -252 CE�fliFjEAU [!F ELECTION TO 9E EXEMPT REVISED 119 -e8 �apem� d7Bfl remote a cortFtteetA at .µp Utz gm Wore of mite pau�a ��1LNU'S7' {8501 413 -16'99 CITY OF PORT ST. LUCIE LOCAL BUSINESS TAX RECEIPT Thy receipt does not warrant that tho receipt hoidorTERM: October 1, 2000 to Se tber 20 2010 pint to perform in the business, but that the holder has paid the requires! tax. !Valid only when all state and local wul, trade licenses /+Qmpetency cards are valid for the current fiscal year as required by law. TUIS RECEIPT IAMpuipppIrlenlinetROWAILItCE OP MINUS VALID AT THIS RUSINen 1pI DOES mor THE AIJTHOR,TY 7'O OPEN THIS HOLDER Business WITHoLIT MEETING ALL sari '' Talc 123343 / 10»1047487 Address: 144 SW DALTON 1UIREMENTS Pty: clesSi cation: CONT CONTRACTOR Di o►ultt: 121.E Wetted to: GRANA ELECTRIC & AIR CONDITIONING INC 0.00 144 SW DALTON CIRCLE PORT ST LUCIE FL 34053 THIS IS A RECEIPT FOR TAX PAID AND IS NOT REGULATORY IN NATURE fees: 243,10. , 7 U < ESS AX LUCIE HOR1 1 T This receipt does not warrant that the receipt holder le competent to perform In the business, but that the holder has paid the and provided the necessary documentation (if required ) for this business. Valid only when all state and !owl required s / co peter cent are valid for the curront fiscal year as required by law, regulated trade Ifcenegg / competency THIS RECEIPT MIST BE EXHIBITEMIMEagfeav obr 30, 2010 on: - 01'0RPCTOR Issued to: TIONSIARECEmSEUMBDILININKIRNIX NOT REGULATORY IN NATURE 144 SW DAMN CIRCLE PORT $T LUCIE FL 34 LOCAL MINOS TAX RECEIPT CITY OF Riga Wag Fees: 243.18 I at Faarr n Mt "`/tfei +t,tA „n....,,.► , �.,, .,, 2d WeL : to z 0z • t nr . •or�i XeJ : wow bd WeLti:TO LOOS OE 'Inr DD NOT FFOMMARD SRAM ELECTRIC S AIR CONDITIONING JORGE L CRCL PORT SAINT LUCIE FL 34953 LfiIldnf hJttllthus Hhld*IJHhllt /ftfilr /lJ,d ? II : 'ON AU 11/13/2009 16:31 7727859986 .-�- N. E.:'NON&ASSQOI '+�!';1' CE�t ' 'E OF LIABILITY INSURANCE PA E 03/04 GRAM SWOT= fc & AIR COMMON 0, INC, 144 SW DAI.,TON CIR. PORT ST LUCIE, FL 34953 OM MUM THE POLIgelp ilistenteg mow mum mamma t OR CM OP Am, qR ap t ►QB. Awmwit SHOWN *MR MAU �t"..t;9 8YWAro OINK commas !!M1 P,Llrr�r,N_ ' eia:nSE'.Sr!I !'d' 03!97/2940 [:11111'° same AZO lit s'omet1R NionaNIN F44X#:772 -944 78 Td Wee2.2I L02 ' t nt : 'ON Xdd : WONd Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 1183 91 Terrace Miami Shores, FL 33138- Owner Information Address 1132050010200 Block: Lot: ANTHONY FERNANDEZ Phone CeII ANTHONY FERNANDEZ 1183 91 Terrace MIAMI SHORES FL 33138- Contractor(s) Grana Electric & A/C Phone CeII Phone Tons: Additional Info: NEW HOUSE Classification: Residential Approved: In Review Comments: Date Denied: Date Approved: : In Review Type of Work: Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Scanning Fee Technology Fee Total: Amount $2.40 $0.80 $405.00 $3.00 $3.00 $3.20 $417.40 Invoice # Total Amt Paid Amt Due MC -11 -09 -36438 $ 417.40 $ 417.40 $ 0.00 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Underground Rough Final Rough Duct 1 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. 1 understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. November 25, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 25, 2009 1