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MC-14-273Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-207153 Permit Number: MC -2-14-273 Scheduled Inspection Date: July 14, 2014 Permit Type: Mechanical - Commercial Inspector: Perez, JanPierre Owner: , TROPICAL CHEVROLET Job Address: 8880 BISCAYNE Boulevard Miami Shores, FL Project: <NONE> Inspection Type. Final Work Classification: Addition/Alteration Phone Number (305)754-7551 Parcel Number 1132060200880 Contractor: BLUEWATER COOLING INC Phone: (954)431-1775 Comments REPLACE ALL SUPPLY DIFFUSERS NEW SPLIT SYSTEM WITH ASSOCIATED DUCT WORK AND GRILLES AS PER PLANS 2- 1/2 TON INSPECTOR COMMENTS False July 11, 2014 For Inspections please call: (305)762-4949 Page 3 of 26 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 11, 2014 For Inspections please call: (305)762-4949 Page 3 of 26 Miami Shares 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 APPLICATION Permit Type: MECHANICAL JOB ADDRESS: a O P -)l FBC 20 Permit No. MC. Master remit NoCC 1 '5 6 V,?AU City: Miami Shores County: Miami Dade zip: Folio/Parcel#• Is the Building Historically Desigaated Yes NO A<, Flood Zone: :('t2Qf'ic.Jai, 4:41°I/KOL t OWNI: (dee Sebe Address M City: 05'52S"3b2. k - - --- -- --s - Sstate: _T_ -L zip: 4_—_-)0, 133 l 3 g Tenauft,essee Name: C ? C Ly L STT Phone#: Email: CONTRACTOR: Company Name• i- r iJuA EioLlt 1.L 1 de, Phone#: "1 ✓ " -C 1 Address: ia� S u, • .� V IL�- ., City: "'-� 1 9-AYI.1 A q- State; �__ L_ zip: J r Qualifier Name• PI°► U � A - Phoned#• State Certification or Registratton#: C ACJ 51 Certificate of Competency #: e A C- 0 -'3 Contact Phone#• q - q- jr` 4 " 114kl Email Address: t DESIGNER: Architect/Engineer-_ Phone#: - Value of Work for this Permit: $ 31 Squarel Aear Footage of Work: Type of Work: OAddress �teration ONew ORepairlReplace ODemolition Mme``-� ALL, 5v VOLLA 'el net, Submittal Fee S. .:QL)..�_ Permit Fee $�_ L V VCCF $ CO/CC $ Scanning Fee S Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ _ Technology Fee $ Double Fee S Structural Review $ _ TOTAL FEE NOW DUE $ 1 ` 2 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 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 Owner or Agent / CpnWtor The foregoing instrument was acknowledged before me. this 5 day of 6jgfim.20 L�, by. I 410L^ , who is persondy to me who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: A YANmS ALEMANN Print: +Notar Publi4ps: My Comm. Expires Apr 13, 2015 My CCommission# EE 84053 T'he foregoing instrument was acknowledged before me this day of tb r_ . 20 1q, by 9U- u 1.(� wh ersonally known to ;who has produced ' as identification and who did take an oath. NOTARY PUBLIC: Sign: IJYI!' V ` —ERM—t —LCA —It =1' 1 r--) 1� Notary PuMie • 00 of F11001ft it My Commission Expires: �'r�;Na �„ Commissim N FF 0021 G /1511, APPROVED BY �P Examiner Zoning Structural Review Clerk Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009XRevised 3/15/09) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ■■r■■r■■■r■■■■■■■■rrr■■■■■■■rrr■rr■■■■■•■r■■■r■■■■■■•■■■■■■■r■■rrrrr■■rrr■r■r■■■■�■■■■■■r. COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: "� Ly -,I- y-> c) l e. L ? k. G ( tel. C BUSINESS ADORESS:1 "CV S' W • 991&t,-'& CITY )� l IeA m Ae- STATE C 1. ZIP CODE 35 0� BUSINESS PHONE: (T94 14 3 r1 T; FAX NUMBER (_^) CELL PHONE A 19 q9- a-� QUALIFIER'S NAME: r i' L, L A , sto 1 QUALIFIER'S LIC NUMBER: L A C D S% 6'�;L-)" E-MAIL ADDRESS OF APPLICABLE): CreaW an M90 BY MLDV / RV MAN VWV 179/05/2813 03:15 4b44J1bbtil t5LULWAILK MLLkM1(.A_ t At* 191/121 3R01AtARD COUNTY LOCAL BUSINESS TAX RECEIPT 116 S. Andrews Ave., Rm. A-100. Ft. Lauderdale, FL 33301-18968 931-4000 314000 VALID OCTOBER 1, 2013 THROUGH Ftmlpt#'fLEAjU %IRCONDrT%OW COI SLUZWATM COOLING INC 131111gnW TYPe: (AIR CONDITIONING CWM 3019hem Name: SWIness Opened:12/20/2006 Owner N8rne: PAUL A sMiJ'ti CAC057527 *n;1900 SW98 AVE StatetCoueY r9: MIRAMAR E°n Code: S Phone. 954-4 954-01 7S. ; Rooms sum _ 3 • For gUlinaes Ohiy • _ Numtewf of" V + - fl1or _ . cdmc n Cast Tafal Paid 'zrA t TraestWpow N6 Fr .. _ 27.00 IS':bd 0.00 0.ou 2?.fl0 0.00 10.00 _ THIS RECEIPT MUST 8E POSTE© CONSPICUOUSLY IN YOUR PLACE OF BUSINESS Murwp an ail County THIS BECO11AE3 A TAX RECEIPT TMs tax is levied for the privies of doing business within Snyward County and is non -regulatory in nstuye. You must meet ty d/or tY �t slit zhis Susinesa Tsar Raced must be transferred when oning requkament& T WHEN VALIDATED the bus'mess is soid. business name hGo changed or you have MOmd business locstion. This 1 �ipt does not indlc�e that the business �9 or that it is in compliance wfth State or loci Wm and mguldons aim�. pravl.szaa�s of �Ch� h- rat-oa claire w_l = 31, �- - _ a SlIXTH. AMU. a `(��1r� � 3. Y�t#i �R RZ, 33025 CERTIFICATE OF LIABILITY INSURANCE DATE (MWDONYYY) 02107/14 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 cortfficate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the twm 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 endorsernai*4 PRODUCER Depace Insurance & Financial Svcs. 9690 W. Sample Rd., Ste. 201 Coral Springs, FL 33065 Phone (954)752-0837 Fax (954)75240989 WCT PHONE 54)752-0837FAX ( , (954)752-0989 ADDRESS9 idepaceodepaceinsumnee.com INSURER So AFFORDING COVERAGE MAIC # INSURER A - WESCO INSURANCE COMPANY INSURED Blue Water Cooling, Inc.DBA Blue Water Mechanical 1900 SW 98 Avenue Miramar, FL 33025- (954) - wwRER B: MOUNT VERNON FIRE INS CO INSURERC: INSURER D' INSURER E: 06101/2014 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, INSR LTR TYPE OF INSURANCE DL SU13R POLICY NUMBER POLICY EFF IMMIDDIYYYY) fPOLICY EXP LIMITS • GENERAL LL480JW COMMERCIAL GENERAL LIABILITY n n CLAIMSMADE W OCCUR ❑ WPPII01996-00 0610112013 06101/2014 EACH OCCURRENCE $ 1,000,000.00 GE TO RENTED PRDAMAEMIalM (E@ om-ence) $ 100,000.00 MED EXP (Any one person) $ 5.000-00 PERSONAL & ADV INJURY $ 1,000,000-00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEWL AGGREGATE LIMIT APPLIES PER PRO - n Foucy El jua El Loc PRoDucts - compiop AGG $ 2,000,000-00 $ • AUTOMOBILE LIABILITY ❑ANYAUTO ALL OWNED w SCHEDULED Ej AUTOS AUTOS HIRED AUTOS w AUTOS NON -OWNED W131>1101996-00 06/01/2013 06/01/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000.000.00 BODILY INJURY (Per person) $ BODILY INJURY (Per accidenq $ PROPERTY DAMAGE $ Imecd ) $ B UMBRELLA LIAR OCCUR n MM UAS D CLAIMS -MADE XL 2551341A 06101(2013 0610I/2014 EACH OCCURRENCE s 2,000,000.00 $ El DED D RETENTION$ -AGGREGATE $ WORKERS COMPENSA71ON AND EMPLOYERS' LIABILITY YIN ANY PRDPRIETORPARTNERIEXECUTIVE OFFICER#AEMBER EXCLUDED? ❑ (Mandatory In NH) ' UrKler 9M. VINN OF OPERATIONS lneFow NIA p WC A% L1 TH_ UEOR EL. EACH ACCIDENT E.L. DISEASE - EA EMPLCYEI:. $ E.L. DISEASE - POLICY LIMIT $ DESCRIFrnom OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 1101, Additional Remarks Schedule, N more space is required] Heating and air conditioning installation, repair and service. At this location: 1 complete a/c system. Replace existing diffusers. CERTIFICATE HOLDER CANCELLATION if 1988-2010 ACORDJtORPoRA-nON. All rights reserved. ACORD 25 (2018105) OF The ACORD name andlogo are registered marks of ACORD I SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE Miami,Shores Village Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 l;ta if 1988-2010 ACORDJtORPoRA-nON. All rights reserved. ACORD 25 (2018105) OF The ACORD name andlogo are registered marks of ACORD `�� "® CERTIFICATE OF LIABILITY INSURANCE 2/3;20"'""'4 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 be endorsed. ff 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 Mack, Mack & Waltz Insurance Group, Inc. 1211 S Military Trail Suite 100 Deerfield Beach FL 33442 CONTACT Vanessa Souvenir NAME: LaiPHONE (954) 640-6225 Fax (954)640-6226 Ig aAwgm.vsouvenir@mackinsurance.com INSURERS) AFFORDING COVERAGE NAK:B INSURERA:Summit Consulting COMPany INSURED Bluewater Cooling, Inc., dba Bluewater Mechanical 1900 SW 98th Avenue Miramar FL 33025 elsu R e INSURERC: INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBERCL13101429202 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 NU EFF Y EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FlOCCUR EACH OCCURRENCE $ DAMAGE TO RENTEO $ MED EXP Arty one person $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEt rL AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS COM81NED SINGLE LIMIT E BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMA $ E UMBRELLA B EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I RETE TION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE YIN OFFICERIMEMBER EXCLUDED? F -]NIA (101814 ory In NH) Ifs desaibe under DESCRIPTION OF OPERATIONS below 830-43282 0/10/2013 0/10/2014 WA TU OTH -- F -L EACH ACCIDENT $ 1000,000 — -� E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, U more apace is requhed) (305)756-8972 City of Miami Shores Village Building Department 10050 N8 2nd Avenue Miami Shores, FL 33138 25 (201 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 INS0251gmrmi n1 Tho Ar`nPn n2m& 2nd Inn^ 2r'Y mnia"rnd marker of Ar`Mn 1111111 1 CORPORATION. All rights reserved. py SUBCONTRACT AGREEMENT DOW maty January 20, 2014 Conpad Coffm*ment#.1 20-001 Vendor# BkrWEEN GS Coming LLC 4675 Anglers Avenue Fort LAtKkwdaK Fl. 33312 a Limited l iabaitY Company, hendnafter c "CONTRACTOR" or "GSD" AND 1900 S.W. 98 til kmw,Fl.33025 hereinafter calf "SUBCONTRACTOR" who agrees to famish all materials and to Z mplebe all of the work described in Paragraph "SCOPE OF WORIC hereof for the construction of and work lode on: PROJECT: 133220 Tropical -Chevrolet t Shores 6880 dyne Boulevard Uland Shotes, FL 33130 in strict with the applic" terms and provisions of contract beton: OVWIER: lel Archftw is 600 W bxWley Pleas, Sine 200 farad, FL 32751 and CONTRACTOR, including in their entirety all general, supplementary, and special conditions, pb, drawings, specifications, modifications, supplemerdA addendum and alternates accepted. Prepared by ARCHITECT: M W6xlerley Phu^ Suite 220 NWIlland, R. 32751