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MC-19-926Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit No.: MC-04-19-026 Permit Type: Mechanical - Residential fLai work classification. Addition/Alteration Permit status: Approved issue Date: /02/2 19 Expiration: 10/23/2019 Location Address Parcel Number 270 GRAND CONC, Miami Shores, FL 33138 1132060136210 Contacts ERHAN KOSTEPEN Owner FREEZE AIR CORP Contractor 78 NE 47 ST, MIAMI, FL 33137 REINERO ROSALES Other: 7863190562 ERHANKOSTEPEN@GMAIL.COM Business: 7864123308 Inspection Requests: Description: NEW ADDITION AND REMODELING TO REPLACE Valuation: $ 4,000.00 305 i62 4949 PERMIT#MC-16-2158 Total Sq Feet: 2,600.00 Amt Paid Payments Date Paid Fees Amount 100% Permit Renewal Fee $107.50 Total Fees $157.50 Application Fee - Other $50.00 Credit Card 05/02/2019 $157.50 Total: $157.50 Amount Due: $0.00 Building Department Copy 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: 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. / Applicant / Contractor / Agent Date May 02, 2019 Page 2 of 2 Permit Type: Mechanical - Residential Application Date: 08/24/2015 Owner: ERHAN KOSTEPEN Work Class: Addition/Alteration Issue Date: 08/26/2015 Parcel 1132060136210 Status: Expired Expiration Date: 06/05/2016 Address: 270 GRAND CONCOURSE Miami Shores, FL IVR Number: 622311 Subdivision: 113206013 Scheduled Actual Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection Complete Date Start Date Required? 10/28/2015 10/28/2015 Rough INSP-246649 Passed Jan Pierre Perez No Complete Reinspection of INSP-131606 Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS Yes April 26, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ PLUMBING JOB ADDRESS: ❑ ELECTR ECHANICAL 76 �_ Miami Shores Village o Building Department ��- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 �j'F�BC 201j � Master Permit No.:� C_N— i '�-✓2 3 Sub Permit No. I nC CH- c — TI ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS l.:e Inln1�C� 2 � �p Countv: Miami Dade Zio"J : c� 3 O Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load OWNER: Name (Fee Simple Titl Address: Q Crtr City: Q Construction Type: Flood Zone: BFE: FFE: er): �%'hA4 N3 �Pii'l Phone#: /O l9 3jq (D5;.2 State: Tenant/Lessee Name: P Email: CONTRACTOR: Company Name: 46ee--L•P f "r, coY1 Phone#: ?0�37La��/ Address: .�/ (�� N f/2lfe°S &'l-i--t City:�i--N.tii¢State: f .C.• Zip:_7i-39 Qualifier Name: pe,';g, �f Phone#: State Certification or Registration #: z Z Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Type of Work: ❑ Add'ti n Alt ration Description of Work: 7b ieu� S? Square/Linear Footage of Work: ❑ New ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF•$ �• � • • � ',PO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) Double Fee $ Bond $ TOTAL FEE NOW DUE $ I S_� '4:_� <4 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 OWNER or AGENT The foregoing instrument was acknowledged before me this - J:a— day of zt�&1 L_ , 20 ( I by W.Nw who is personally known to me or who has produced/ yy � ` `� identification and who did take an oath. NOTARY( PUBLIC: Print: Seal: SINDIA ALVAREZ MY COMMISSION # GG 238273 ��EXPIIR�EES: September 3, 2022 #,t APPROVED BY Signature CONTRACTOR The foregoing instrument was acknowledged before me this aday of 4,01-I 20 � by who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: as Print: AJ &2 P U n e 2— Seal: var Pir,, Notary Public State of Florida ?4 Nancy Nunez N � My Commission GG 766008 Hof cu Expires 03128/2022 ############### # # # ##### Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) ACOR 7 0 `� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 04/23/2019 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(ies) must have ADDITIONAL INSURED provisions or 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 endorsemen s . PRODUCER CONTACT NAME: Nadia Nicolas PNONE : (305) 267-4541 A/C No): G-MAR INSURANCE EDORE : QUOTES@GMARINSURANCE.COM 9851 NW 58th ST #108 INSURERS AFFORDING COVERAGE NAIC # INSURER A: GRANADA INSURANCE DORAL FL 33178 INSURED INSURER B : ASCENDANT COMMERCIAL INSURANCE INSURER C : FREEZE AIR CORP INSURER D : 5103 North Travelers Palm Lane INSURER E : INSURER F Tamarac 33319 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY Err LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE J OCCUR N N 0185FL00062766 09/15/2018 09/15/2019 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUTIVE YIN OFFICERIMEMBEREXCLUDED? N (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATIONS below NIA N AWC1094800 11/01/2018 11/01/2019 PER OTH- STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) AC Equipment Installation - Contractor License #CAC057312 .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS, 10050 NW 2nd Avenue AUTHORIZED REPRESENTATIVE A /� Miami Shores FL 33138 1 NADIA NICOLAS @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 41-441-R55 PALM L" Jw- low' d4-qLSTATE OF FLORIDA DEPARTMENT b,' Iz r OF BUSINESS AND PROFESSIONAL REGULATION CAC0517312 ' ISSUED: 05/3112018 CLASS 8 AIR CONDITIONING CONTRACTOR ROSALES, REINEIRO FREEZE AIR CORP UCENSED UNDER CHAPTER 489, FLORIDA STATUTES EXPIRATION DATL: AUGUST 31,2020 W74, Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A 1341,1. - DO NOT PAY 3852770 •U1111iR;1111B NAIVIVLOCATIOfy FREEZE A!R CORP Twit W 35 TH AVE 192 #4ft&W ft 33018 '7� _ se RECEWT 140 EXPIRES RENEWAL SEPTEMBER 30, 2019 4022661 lu uC tm dispiayali az 111lme o' busengas Pursuant lo County Cwe Cliamor &A - A" 9 & 10 &NC_ TYPE OF BUSIr4rSe 196 SPEC MFC*IA1lIGAL CONTRACTOFI PAYMENT RECEIVED CAC057311 By TAX CO«eCTDn S4 5.00 0613 V 2018 tj FPPU03-18-020822 selivatia Iasi Receipt only confirms payment of the local Business Tax The Rscolpl is not a liceeata. ABal�off* bolder a qualihceUons to do business Holder must comply with tiny gnv*r mwnlal haute and requirements which apply to the business y iwYi atfatiba display" on ell commrrciai nehICfes - Mranh-D"I Cede Sec U-276. hrown information, visit wwwffilear la19!