MC-10-1933B 64, DING
PERMIT APPLICATION
FBC 20
Permit Type: MECHANICAL
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
SEP 2 7.. ��51
By: -- ®F.
Permit No. I
Master Permit No. C G - - ) 0 - 14 2C,
OWNER: Name (Fee Simple Titleholder): L 16 rk 5l.,, �. 7i-or c1,4? 6--S. Phone #: 3-04=853 — 9 4-13'
Address: (o ct (o 0 2 %2j S-}-.
City: 1J o a. #14 si.■ 4 -,.:. State: FL Zip: 3 3 I $
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: q0(0 I - 5 t-s C.7 , TLV A
City: Miami Shores County: Miami Dade
Zip: 3'3 t 3
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: Ai if 2 't' n 4 / -' Phone #: 3 61- - •g'- 2-'
Address: 26 / 2 L41 7 3 57
City: a A-C..4 I-4.
fate: t `G�° gip. •3 °I C.
Qualifier Name: Y-0-4-4, t'' Z Phone #: 3 mr ° art 8'(° a t 9f
State Certification or Registration #: e a ° az...c. 3 o Certificate of Competency #: ®c )f)L 3 n i
Contact PhonetC) S65- - 21 9& Email Address: NA/WO AO-. 6 s • 1 Q -
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ a7O0 s 00 Square/Linear Footage of Work:
Type of Work: ❑Address $1teration ONew ORepair/Replace ODemolition
Descriptio,pf Work: = ..1-�c■■®PC• 1_% .> tLo - 601- (a) S74-A-1 a ATrt 000 't \.
Lo RA•> re G4 Q/2 1€46, Cit >7.a/s ,
d G S:e a q Be✓R 6 A-- TH.
c.) a a-4
' r*' x' x' x*' x*' x*' x*' x• x' x 'x *a'****'r'x'x'x**'ra'** **'x' *** Fees' x**** +x+x**a'**'x*s'+x*'x'x **** * �vcw** hl *'CSZ�4 o1L-
Submittal Fee $ Permit Fee $ 1 O( t2 CCF $ CO /CC $
Scanning Fee $ 3- 00 Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ 1 l � 00
Bonding Company's Name (if applicable) /(Pc
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) t R •
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.FCTRICAL 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 pennit 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. Al a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection w id occurs : 'en (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be ap �ov'> any 'a reinspection fee will be charged.
Signature
The foregoing in
day of 501•O(
er or Agent
was acknowledged before me this 211-11 The for
12_, by lbrary)."--2-110-- , da o
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commissio Expires:
ent was acknowledged beforry this
20 Lasby ct
* * * * * * * * * * * * * * * * * * * **
APPROVED BY
Pik_ Notary Public State of Florida
Jacqueline Ortiz
s My Commission EE 189537
e Expires 04/15/2016
*
‹11,
own to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Prim • II �lrr,�u6 �yr�� a I �. .L..4
E IRE.S: June 16, 20
My¢�si tlolnySety
+ N**** ****** **** *+ k+ k**** ************************ **+k****
"Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
4
Permit N.
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 ARCHITECT
Owner's Name (Fee Simple Title Holder): 61/0/1-‘ c Phone #: 34r-133 -
Owner's Address: C q, r�r% izs Sk
City: Mon., -i-- State : - Zip Code: 16
Job Address (Of where work is being done):
City: Miami Shores
061- 13
State: Florida
Contractor's Company Name: ' 4 1'G a / �-
Address: 24 7— w 7 s- r
3Lvm
Zip Code: 3 3- (3 .
Phone #: 9 - 9 jT -. -f pr
City: /te c �A. State: Zip Code: ' 3 ( t
Qualifier's Name :
Architect/ Engineer of Record Name: 1 n,-,.,,
Lic. Number: e e¢ 3 a
kar-o- -1�7ch Phone #: 9 -4-3 2 - 0 .
Address:
City: State: Zip Code:
Describe Work: r,,- 1n.;.o z, mil(.® - �J C� 6"-) ATittly0 ®11)
I hereby certify that t
work has been abandoned and/or the contractorlarchitect is
unable or u will 'g to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involve nt.
Signature
The foroing ins
this Otlay of
Who is
or Agent
t was aknowledged before me
�i - 2012,by \ GM- z%�G
x.0 ./1 o me or who has produced
as indentification.
1L
Notary P
Sign:
Seal:
li
ry Public State of Florida
ko Jacqueline Ortiz
B My Commission EE 189537
or Expires 04/15/2018
Signature
ctor or Architect
The foregoing instrument was aknowledged before me
this 75" day of 5 i , 201 .y
to me or who has produced
as indentification.
No
Sign:
Seal:
Public:
po;:."4, VILMA E. FEINANDEZ
• t • * MY COMMISSION #EE196114
EXPIRES:June 16, 2016
Boded sew
u-1
m
r-
ru
U.S. Postal Service,.
CERTIFIED MAILTM RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
For delivery Information visit our website at www.usps.como
IE
MOM
Postage
Certified Fee $2.95
al
al Retum Receipt Fee
ci (Endorsement Required)
al Restricted Delivery Fee ct.)/
(Endorsement Required)
rq 0.y-/ el
I=3 Total Postage Fees
•i• C cn
SentTo ru
ri .•
1:3
N 4-,
0 xi 0)
, .
PS Form 3800, August 2006
See Reverse or Instructions
SHORE SQUARE PROPERTIES, LLC
696 N.E. 125th Street
Miami, Florida 33161
September 19, 2012
Quality Cooling System
12194 SW 131 Ave.
Miami, FL 33186
Master Permit # MC -11 -10 -1933
We wish to cancel this permit for the work has not been done. We have leased the space
to a new tenant who is going to submit new drawings. Also we have a new contractor
and they will be obtaining their own permits so we wish to close these permits since no
work has been • mpleted.
Since ;
4,'
r
Yo
Pres
Shore
uare Properties, LLC
Miami Shores Village
Building D epartment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. J 10 — I�l
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: MECHANICAL
R303RVIS
it)l 0 7. 4V)
Owner's Name (Fee Simple Titleholder) �, t U . _ ��` �c
L-LC Phone # —1�i
Owner's Address 4--, SD ?x- RG,\ 5lAk-L (A01
City'\ \ONn State Zip E l4L4v
Tenant/Lessee Name NrAC c (% \- Phone #
Email l ,El.teYl}V._,S al C -c %►3rou,F% C6n-,
Job Address (where the work is being done)
q06 'E5
scizto -660.
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL # l` — 6a0(.9 -O \ 1- ooT) 1
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name am Lily Coo Li ar c j )15 1 Phone # 30 S -15S " 914 3G%
Contractor's Address 14 (p 9 SW 1 O L rw S -F , UN I r sa 2-6G
City MI SI N11 r State Lo )1.1 DA Zip 33 1 (p
Qualifier Name 1Z V 15I2- W( ,�7 IV..1 S Phone # 30S -cii 0- 1 Q3 S
State Certificate or Registration No. C A C 01_111 13 Certificate of Competency No.
Contact Phone 3o x" "70 -• 1 q.3S
E -mail QCStgC e..,otcoM
Architect/Engineer's Name (if applicable) --3Cc, Q RattY-Y105 Phone P 4 - Q6 Sclo
Value of Work For this Permit $ 21 SDO Square / Lin e(E. etage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New [ Repair /Replace
Describe Work: a i0 'Zee' ,r 11,K. (o,.) .
❑ De olition
* * * *: * *** * * * * * * * * * * * * * * * * * * * * * ** * ** *** ** * * * * * * ** * ** * * * * ** * * * * * * * * * * **
Submittal Fee $ Permit Fee $ ` • ±�� 4 CCF $ CO /CC $
Notary $ Training /Education Fee $
Scanning $
Double Fee $
Structural Review. $
Radon $
DPBR $
Violation date:
Technology Fee $
Bond $
Total Fee Now Due $
See \Re`v' rse1 `side —>
V V�
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 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 $2500, the applicant must
promise in good fait that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is s . 'ect t attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspe . is w 6 h occurs seven (7) days after the building permit is issued. In absence of ch posted notice, the
inspection will not e app ed and a r inspection fee will be charged.
or Agent
The foregoing instrum t was acknowledged before me this 3
day of AU Jr,20 ,by IOhnCxh Worest Zo ,
who is personally known to me or who has produced
As identification and w take an oath.
NOTARY PUBLIC:
Signature
Contractor
The for ot : instrument was acknowledged before me this
l� tv,by ,20j iC�-- id. Pi 17 2.2),
who is persona ly known to me or who has produced E_,
as i ., ntification and w : did take an oath.
day of
NOTARY
IC:
Sign.
Print:
My Commission Expires: qaPA t4
Sign:
Print:
My ommission Expires:
rot1�,n. ry ANA M. RODR$GIIE$
MY COMMISSION # 00 777751
EXPIRES: Ap il1, 2012
Banded "Mu Budget Notary Metes
****** * * * * * * * * * * * * * * * * * * * * * * *** * * * * ** * * * * * * * **
APPROVED BY
* * * * * * * * * * * * * * * * * * **
* * * * * * * * * * * * * * * * * * * * **
t7 l L'�lans
(Revised 07 /10 /07)(Revised 06/10/2009)
ner
Engineer
Zoning
Clerk checked
PROPOSAL
QUALITY COOLING SYSTEMS, INC.
A/C SALES - SERVICE- INSTALLATION
STATE LICENSED & INSURED CAC # 042713
13220 SW 132°d AVE, UNIT # 5
MIAMI, FL. 33186
PHONE: (786) 293 -1045 FAX: (786) 293 -1046
gcsac@aol.com
PROPOSAL SUBMITTED TO
PHONE AND FAX
DATE
INTEGRAL SOLUTIONS GROUP
ATTN: VICTOR
I STREET
1680 NE 168 STREET
786 - 402 -1140
email: vdepradine@yahoo.com
JOB NAME
11/03/2010
9061B SHORE SQUARE
I CITY,STATE AND ZIP CODE
JOB LOCATION
MIAMI, FL. 33162 9061B BISCAYNE BLVD., MIAMI SHORES, FL.
I WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR
TO RELOCATE (1) ONE EXISTING RHEEM AIR HANDLER WITH FACTORY HEATERS.
TO SUPPLY AND INSTALL (1) ONE NEW 4" SUPPLY FLEXDUCT WITH 10X10 DIFFUSER.
TO SUPPLY AND INSTALL (1) ONE NEW TOILET EXHAUST FAN DUCTED TO EXTERIOR.
JOB INCLUDES:
• NEW DUCT PLENUM IN FIBERGLASS FROM EXISTING TRUCKLINE.
• RELOCATION AND RECONNECTION OF EXISTING CONDENSATE AND REFRIGERANT LINES.
• DRAIN FLOAT SWITCHES, AIR HANDLER STAND.
• (1) ONE TOILET EXHAUST FAN, DUCTED TO EXTERIOR.
• PERMIT FEES, ALL LABOR AND SALES TAX.
• PURGE AND VACUUM, AND RE -START EXISTING EQUIPMENT.
JOB EXCLUDES OR NOT APPLICABLE TO:
• ANY NEW OR RE- LOCATION OF ELECTRICAL, ELEC. WHIPS, BREAKERS, LOW VOLTAGE ETC.
• DUCTWORK OTHER THAN THE REPLACEMENT OF EXISTING PLENUM TO NEW LOCATION
• DIGITAL THERMOSTAT OR OTHER CONTROLS, FIRE CONTROLS, SMOKE DETECTORS ETC.
• ANY CONCRETE, ROOF OR OTHER BUILDING PENETRATIONS, PATCHING OR SEALING.
• ADDITIONAL AIR DISTRIBUTION GRILLES AND REGISTERS.
• FIRE AND SMOKE DAMPERS, CEILING ACCESS PANELS OF ANY SIZE.
• INDEPENDENT TEST AND BALANCE SYSTEM REPORT.
WE PROPOSED HEREBY TO FURNISH MATERIAL AND LABOR- COMPLE 1'E IN ACCORDANCE WITH ABOVE
SPECIFICATIONS, FOR THE SUM OF: ABOVE
TWO THOUSAND FIVE HUNDRED DOLLARS AND 00 /100 CENTS
$2,500.00
PAYMENTS TO BE MADE AS FOLLOWS: 50% PRIOR TO START AND BALANCE AT COMPLETION
ACCEPTANCE OF PROPOSAL
DATE