MC-15-2423 CL 1:5- 2-4 24 2
Inspection Worksheet
Miami Shores Village
. .• ' 10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)798-2204 Fax:(308)756-8972
inspection Number. INSP-244072 Permit Number. MC-9-15-2423
Scheduled inspection Date: March 14,2016 Permit Type: Mechanical-Commercial
Inspector- Perez,JanPierre Inspection Type: Final
Owner: ,SHORES SQUARE INVESTMENTS Work Classification: Addi#ion/Aitemlon
Job Address:9017 Biscayne Boulevard
Miami Shores,FL 33138-0000 Phone Number
Parcel Number 1132060110070-17
Project <NONE>
Contractor: KINGDOM AIR CONDITIONG INC Phone.(305)886-0423
Building Department Comments
ALL MECHANICAL FOR INTERIOR RENOVATIONS. INSPECTOR COMMENTS False
3
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
No MdMwW Iris can be scheduled urs
fee Ispaid
March 14,2016 For inspections please calk(307624949 Page 11 of 40
Minimi Shores Viii
10050 N.E.2nd Avenue
Miami Shores,FL 33138-0000
Phone: ( 795-2204
Expiration:0710=016
Project Address Parcel Nun*w Applicant
9017 Blscayne Boulevard 1132060110070-17
SHORES SQUARE INVESTMENT
Mlaml Shores, FL 33138-0000 Block: Lot:
omm hdorrrrdlorr Address Phone Cell
SHORES 8SQUARE INVESTMENTS 3= BIRD Road
MIAMI FL 33146-
Contractor(s) Phone Cell Phone Valuation: $8,000.00
KINGDOM AIR CONDITIONG INC (30986-0423 Total Sq Feet: 0
Tons: Available Inspections•
Additional Info:ALL MECHANICAL FOR INTERIOR RENOVAT Inspection Type.
Classification:Commercial Ventilation
roved:In Review Final
Comments: Date Approved::in Review Rough
Date Denied: Type of Work: Rough Dud
Scanning:1 Review Mechanical
!Duct hector Test
Fees Due Amount Pad►Date Pay Type Amt Paid Amt Due
CCF $4•80 Invoice# MC4-15.57187
DBPR Fee $4.20 09/23/2015 Credit Card $50.00 $834.20
DCA Fee $4.20
Education Surcharge $1.64 01/112016 Chedc#:1581 $53420 $0.00
Penyd Fee $280.00
Scanner Fee $3.00
TeMnolow Fee $6.40
Work wMout Pemit Fee $280.00
Totak $584.20
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 kr strict conformity with the plans,drawings statements or specifications submitted to the proper authors of Miami Shores Village. In
accepting this permit i assume responsibility for all work dome by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL.,PLUMBING,MECHANICAL,WINNOWS,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 appiic"laws reguleft
construction and zoning. Futtenmore,I authorize the above-named contractor to do the work stated.
January 11,2016
AMhorked sige>ahare: / Applicant / Contractor / Agent Dat
Building Department Copy
January 11,2016 1
�..• Miami Shores Village
• • - FfffCF__T� .
Building Department
SEP 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION UNE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No.QOJ 5-
PERMIT APPLICATION Sub Permit Not&
❑BUILDING (]ELECTRIC ❑ ROOFING REVISION M EXTENSION ❑RENEWAL
❑PLUMBING [MECHANICAL CJPUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION [:] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: &I-) - 1 g Qismu A 4 ,awd s
City Miami Shores County: Miami Dade Zia:
Folio/Parcel#: is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 9WG Se cr4me
Address:. 12.'T ST'
City: 14• M-9-Li '1l State:_EL Zip:" �0
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Ki w qc -on Ar&OL C Og k� Nei+ 4 Phone#:
Address: Y 0 6 S'/ ^t w /3a s #Y
City: //.1,f//a.4 State: Zip: 3.7o/P
Qualifier Name:TO Phone#•
State Certification or Registration#: A C J t! G& (P / ____.Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Unear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Desciptionofwork: Aj/ f?C eoe #7
Specify color of color thm We: ((��
Submittal Fee$ Permit Fee$ $ v_ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ . ' Notary$
Technology Fee$ 6 `40 Th 'Education Fee$ ( . 00 Double Fee$
`ructural Reviews$ Bond$
TOTAL FEE NOW DUE$ 93t4. 20
- _d02/24/2014)
t ,
r � �
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$250, 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 cerdfled 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 rein fee will be charged.
Signature Signature
OWN ENT CON R
The foregoing instrument owiedged before me this The foregoing instrument was acknowledged before me this
22 _day of .20 )X by day of oZ� 20.1 J ,by
/ .who is personallyown tob who rsonaily kno 0
me or who has produced as me or who has rod as
p P
Identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLIC:
Sign: Sign•
Print- Print•
Seal:
Seal: k.. ::• '.., sete of F}arkfa
Sgon#E FF 915708
sssssssssssssssssssssssssss :ssss ssss•:•:: ss ssss ssss:::::: s ssss
nn-
APPROVED
BY P n1 miner c s
IIIIIN�•.• JG�.
5A► .. so 7.ills!E
NOW
AM
Structural Review
(Rwbed02/24/2014)
♦ w
JW A7Ni M
t F FNV4CiM.O STATE A
I ARUIW OF SIAL SEMMES
OF.VVORKRRS'COLY43MIM
tS MPICATE OF IEI1.11IC7IM1 TO ME WIRMPTIFROINWORIaNtV CO TM lAMif
COI88TRtkT 1t RgWSTRY EXEWTM
Thk CWVNN Vid the metal lftd MW has eWcIed to to woompt f m FWds WMIWW CwWwwalm law.
12/12=4 ERgTION DATE: 12111/2016
PWAM SARDUY ROBERT J
Peft 6507MS41
BUSBUISS NAM AND
KIS AR CONDITIONING INC
10651 NW 132 ST
HIALEAH GARDENS FL 33018
SCOPES OF MILISINESS Oft TRADE*
CERTIFIED AC HEATING,VENT LATION,
CONTRACTOR AIR-GOND
Pins to Choomr4M.OW4 F.S.,an allicerofa cupowabn who ebuft miamptlealksm Us chmplerby4ft a cedocaloofa andw th semen
may not miner beaeRe orcmapensailm asdwPare Chaplor4o GRI j,F.S.,CoMates of m b be auoarr pL-apply only
s deo seop of ortade don of a b bo Panmd b 44&0603I FS.,Nefto dales b be
examptandculikdossfalmdoulbbeemempt sba�be sabb # anyt dare eBay bs naflce or#te ba
limpersesr an fw oodoe ar H I ao bar spa dyer of sadim Ab a of a cis.The sbd nvobe a
DFS-F24)WC-252 CEm l CATE OF ELECTKM TO BE EXEMPT REMED 07-12 QUESTMW{
i
i
I
I
i
Page 1 of 1
..R- � r�
9 a NOW � x �
ig
s r rF xr a
mall,
1
%�, s .�
t
w
A� EE �6 A W '. ✓n15��
... K ♦j �„�,�,� �"ia rt. saz +�'W
CZ
rWw
z
. E
�ii�,.�irrr+N"S_,rM�'�:�� �..-.•-M4++ '' 1(91�dYe4iiAlY R'��i_�1Nptip�(,i"��
„
m� �
'6
- s
t t ••..- i . i 1 t/ . 11
;.: «a' -.. - :•.. iii � < �- •: -•-'.; :•. t. . •.. -�- � .<.• -it1 •. - • •--
Of
PRODLXMR
M&M Famity bmuence.UCL
:.i S.W.ft SL SM
MWd,FL 33184
U
Phone M 554-5282
552-WO r
� ��� « ♦.« E■!111 /.1.11'1 �
c='. .or•i - ■::i•:•.-'� «•�,:.•�.i:h`.oi�i bt:1 r1:1 11
1
1
Miami Shores Village
....
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tei: (305)795.2204
Fax: (305)756.8972
Notice to Owner-Workers' Com nation Insurance Exem tion
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction.-industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or &U-time
employees,including the owner,must obtain workers'compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if
1. The officer owns at least 10 percent of the stock of the corporation,or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership,
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State,Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTE
Signature:
OV
State of Florida
County of Miami-Dade
The foregoing was acknowledge before rro this day of L---- ,20_1 Cr.
,ro
By N✓)dV �Y)� `Z who is personally known to me or has produced
as identification.
Notary•
SEAL• SANDY ROMERO
•Nth PvWic-state of FbWMW
•
CIMMOSSWOFF915708
• ep .
6et11e0 NNNaryAMa.
� M%tT* 40r]E> 40) A/1
AIR C0wpI 'TIONING
10651 NW 132 ST Bay 4 Hialeah Gardens FL 33018
PE.305.553.9946/FAX 305.480.5665
Email 10&@ J&
January 8,2016
This letter is to certify that I am an independent contractor with no employees.I do not sub contract
work out nor hire any employees.
Sincerely,
Robert J Sarduy
Uc#CAC181661
CERTIFIED AIR CONDITIONING CONTRACTOR
10651 NW 132na St#4
Hialeah Gardens,FI 33018