MC-16-2204Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number
Expiration: 02/12/2017
Applicant
1561 NE 103 Street
Miami Shores, FL 33138-
1132050310220
Block: Lot:
M2J4 HOLDINGS LLC
Owner Information
Address
Phone
CeII
M2J4 HOLDINGS LLC
1561 NE 103 Street
MIAMI SHORES FL 33138-
(786)290-8051
660 NW 125 Street
NORTH MIAMI FL 33168-
Contractor(s) Phone
MARVIN'S AIR CONDITIONING CORP (305)541-8408
CeII Phone
Valuation:
Total Sq Feet:
$ 3,970.00
0
Tons: 4
Additional Info:
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Scanning: 1
Date Approved:: In Review
Type of Work:
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$2.08
$2.08
$0.80
$138.60
$3.00
$3.20
$152.16
Pay Date Pay Type Amt Paid Amt Due
Invoice # MC -8-16-60886
08/16/2016 Credit Card $ 152.16 $ 0.00
Available Inspections:
Inspection Type:
Final
Rough Duct
Review Mechanical
Underground
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 t egoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Fgthermore uthorize the above-named contractor to do the work stated.
August 16, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
August 16, 2016 1
BUILDING
PERMIT APPLICATION
E] BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION
❑PLUMBING E JCHANICAL ❑PUBLIC WORKS El CHANGE OF CANCELLATION
CONTRACTOR
Miami Shores Village
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
RECEIVED
AUG 0 2 MG
BY'
,34-11
FBC 2011
Master Permit No. 42 -CA b _ 1 2-4D3
Sub Permit No. MC -A(0 ' 92,04
❑ RENEWAL
❑ SHOP
DRAWINGS
JOB ADDRESS: 1561 NE 103rd Street
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:1132050310220
Occupancy Type: Load:
Is the Building Historically Designated: Yes NO X
Construction Type: Flood Zone: V BFE: FFE:
OWNER: Name (Fee Simple Titleholder): M2J4 Holdings, LLC / (Mark LLerena) Phone#: 305-643-1136
Address:660 N.W. 125th. Street
City: North MiamiState: Florida Zip: 33168
Tenant/Lessee Name: N/A
Email: MarkL@cspaintwc.com
Phone#: 786-290-8051
CONTRACTOR: Company Name: M.CV J%n S CoyAJl%�ibfi\ COW(. Phone#: ajDS—S-/ / —14d8
Address: ! 7' ( s ) l ( I c ((Ace
City: 61 44/ i State: FL Zip: ,33/35
Qualifier Name: ----S( a'IE v-) ,� e (DCcc c,
Phone#: -7D0 s c"/ 9 -(g3
State Certification or Registration #: CA C t 6 (6 %,l l Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Square/Linear Footage of Work:
q
Value of Work for this Permit: $ 3, 19'0 sa
Type of Work: El Addition E Alteration El
Description of Work: t jc k wo g K_ • ..{>K\ --)c _Yc ,
New 0 Repair/Replace
anlJl ank r? �� ' Aa 1"/ (c Per ()Sc,ns
❑ Demolition
Specify color of color thru tile:
Submittal Fee $
43r.
Permit Fee $
Radon Fee $
\ 3 �V� CCF $ a. CO/CC $
Scanning Fee $ - 00 • c)9 DBPR $ a • 03 Notary $
Technology Fee $ Training/Education Fee $ 0 • e0
Structural Reviews $
1Pcsitiectrill117 AnmAI
95
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 15Z , (c
/"
Bonding Company's Name (if applicable) n/a
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) n\a
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 $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 p"reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument
''was acknowledged before me this
04 day of l/ \Z./7y , 20 /4' , by
, 142is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: iF
Print:
Seal:
;., DAMAYI
•
,., = MY COMMISSION # FF 214016
' EXPIRES: April 1, 2015
Rto Bonded Thai Notary Public Underwriters
n
The foregoing instrument was acknowledged before me this
• T1 day of _ft,1/y , 20 16 , by
�DA cgl1 D O , who is5:•ersonally know o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Eticltq F7ete-t
Seal:
ER CKA A. FLUES
* `c_ * MY COMMISSION i FF 088456
EXPIRES: May 31, 2018
' Ft.00. BondedTtwBudget Notary Services
*************************************..:******************************************************************
APPROVED BY
ro,...r.,,.1no Mn Hns Al
tans Examiner
Structural Review
Zoning
Clerk
, Aug 01, 16 10:44a Marvin's A/C Corp.
3055411856
p.3
otiCIPI CERTIFICATE OF LIABILITY INSURANCE
.�s
DAIEOSu00Yri17
7/13/2015
TRS CEIIDR:ATVS-ISSUES AS A MATTER OP DIFORMATIONONLY n1@ CONFERS NO DEWS UPON WE CERTfftCAIENOUDER.
DES
BY INE POLICES
NSURERRS). ALTT10RDED
POLICY AJMER
CER1WICATSBOFS NOT APfERNATNELY OR NEOATTIELYAMEIO. EXTEND DR ALTER TME GOYERAGEAFFOROED
MOPS DES CElimi7GTE OF WSORANCE con NOT CWISTRME A CONTRACT BETWEEN 1145 ISSUN6
REPRESENTATIV®R PRODUCER -ANO TME C9l1WCATSMO&Dl7t
IMPORTER; RMs aAi5aWbsWrls an ACISMONALI.LEIRECISM pafry(faf}lust be atlm1ed. R SUBROOATIONIS WAVED.sabjsass
Estopmssadcmdtdansalths polayperiabrppedsaraympism srMsssmssd.Aatsbmsmmn 1Nss0dOeIIsdoefnot malsrrsbns wow
cortlNwtpttoldwh lieu of 400 mss).
PROS• t1�1
BEACON INSURANCE GROUP INC
8567 Coral Way #301
Miami, FL 33155
CONTACT
Mab
r* (305)266-9706
1=pt (305)468-6503
PLERESE angel@insnrez.co
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s 1,000,000
MCA
MUMMA: GRANADA INSURANCE CO.
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1761 SW 11TH TER
MIAMI, FL 33135
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DES BTO CmIIFY THAT TME POLICES OF INSURANCE USED BEIONHAVEREENESUE0 1011tE NEARED WED ANNEFOR 11E PO1LY PERIM
r4ICATED. NOIVCRSTANOMi 514 EtEOIROANT, TERM OR CONOMON OF AMY CONTRACT OR ODER DOCUMENT LEEN RESPECT 70 WHICH TMIS
CERTIFICATE MAY BE ISSOES OR MAY PERTAIN. DE INSURECE AFFORDED BY DE POLICIES DE9QES) WREN B SLBEGI 70 ALL TIE TEARS,
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40CRIPOON OPOPH+ATIO SOLOCA5 OSSiVE1505 (ACORER1.Adlesd RstadsbA A L tem5AbAdIEms opus sn*Apq
AIR CONDITIONING CONTRATPOR
CAC1816314
CERTIFICATE HOLDER
CANCELLATION
MIAMI SHORES BUILDING DEPARTMENT
10050 NE 2ND AVE
MIAMI SHORES VILLAGE, FL 33136
040U.D ANY OF DE ABDYEDESCRIBED POLICES Be CANC'1LED SEITCRE
DE OPS/NMION OATS 114EREOi. NOTICE MALL SE MAMIED M
ACCONOANCEYRLNTFEFOLa.Y PRCNISMIS
ACOR025(2013(54)
MINOR® RIPRFSH'ITATIYE
01268.2013 ACORD CORPORATION. All Fights merged.
The ACORD name and logo we regIstered narks of ACORD
.Aug 0`1,1610:44a Marvin's A/C Corp.
JEFF AIWATER
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
" CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation taw.
EFFECTIVE DATE: 9/8/2015 EXPIRATION DATE 9/7/2017
PERSON: DELGADO JONATHAN
FEIN: 651217717
BUSINESS NAME AND ADDRESS:
MARVIN'S AIR CONDITIONING CORP
3055411856
1761 SW 11TH TERRACE
MIAMI FL 33135
SCOPES OF BUSINESS OR TRADE:
HEATING, VENTILATION,
AIR-COND
Pursuant to Chapter 440.05(14), F.S.. an officer of a corporation who dads exemption hem this chapbtr by filing a certificate of election unties -Es section
may not recover benekts or compensation tinder this chapter. Pursuant to Chapter 440.135(12). F.S., Certfc tes of election to be exempt...
within the scope of the trustless or trade fisted on The notice of dedion to be exempt Pursuant to Cbe et otapply only
be
exempt and certificates of election to bePine of
notice
F.S., a issuacesnce
ce of the
er ak
the person named on the notice a certificate exempt std be subject to revocation if, a1 any time after the tOhtg of the notica cribs isauantx of the rxrti8cafe,
longer meets he requirements of this section for issuance of a certificate. The department shell revoke a
DFS-F2-OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13
p.4
QUESTIONS? (850)413-1649
, Aug 01, 16 10:44a Marvin's NC Corp.
JEFF ATWATER
CHEF FINANCIAL OFFICER
3055411856 p.5
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DNISION OF WORKERS' COMPENSATION
• * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW* *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 9/8/2015 EXPIRATION DATE: 9/7/2017
PERSON: DELGADO MARVIN
FEIN: 651217717
BUSINESS NAME AND ADDRESS:
MARVIN'S AIR CONDITIONING CORP
1761 SW 11TH TERRACE
MIAMI
FL 33135
SCOPES OF BUSINESS OR TRADE:
HEATING, VENTILATION,
AIR-COND
Pursuant to Chapter 440.05(14), F.S.. en otfioer of a corporation who elects exemption from this chapter by Hing a certificate defection under this section
may not recover benefits or compensation under this chapter. Ptasuar4 to Cheater 4 0.05(12), F.S., Catificatee of election to X oleffla , apply wdY
within the scope of the business collude rated on the notice of election to be exempt Pursuant to Chapter 440.05(13), F.S, Nollces of election to be
exempt and certificates of election to be exempt shall be subtext to revocation if. at any time after the filing of the notice or the issuance of the oertifcate,
the person named on the notice or ate no longer meets the requirements of this section for issuance of a certificate. The department shed revoke a
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
Marvin's Air Conditioning Corp
License CAC1816314
1761 SW 11 Terrace -Miami, Fl. 33135
Off Ph: (305)541-8408- Fax: (305)541-1856- Cell: (786)487-0801
PROPOSAL
July 15, 2016
To: Mark Llerena
Address of Work:
1561 NE 103th St
Miami Shores, FL 33138
Scope of Work:
1. Supply and installation of new mixed duct work system (rigid and fiberglass R-6)
2. Supply and installation of new air supply exits (8 regular and 4 diffusers)
3. Supply and installation of ventilation system (4" and 6" bathrooms, dryer, and kitchen
exhaust)
4. Supply and installation of A/C split system according to plans
Warranty: 10 years on compressor and parts; 12 months of labor (this job only)
Value of this job: $ 3,960.00
Payments:
Payment in advance . $ 2,376.00
After duct inspection $792.00
After final inspection $792.00
Notes:
• The client is responsible for permit fees
• We are not responsible for the following:
o Carpentry
o Residential Plumbing
o Roofing
o Electricity
Marvin Delgado
Marvin's A/C Corp
•Aug.01.16 10:43a Marvin's A/C Corp.
RICK SCOTT: GOVERNOR
CICEhSE;NtJ.R1BE
The CLASS B AIR CONDITIONING CONTRACTOR
Named below IS CERTIFIED
.tinder the provisions of Chapter 4130 FS.
Expiration date: AUG 31, 2016
3055411856 p.1
KEb.1 tAWSON, 'HstT
STATE OF FLORIDA
DEPARTMENTINDUST LICENSINBOARD
REGULATIONESSIONAL
DELGADO, JONATHAN R
MARVIN'S MR CONDITIONING COR
1761 SW 11TH TERRACE
MIAMI R.33135
ISSUED: 06!0112014
DISPLAY AS REQUIRED BY LAW
4
Local Business Tax Receipt
Miami—Dade County, State of Florida
-Tis IS NOTA 81U. - DO NOT PAY
6482681
BUSINESS NAME/LOCATION
MARVLNS MR CONDmONING CORP
1761SW111BR
MIAMI R. 33135
OWNER
MAIMS AIR CONDITIONING CORP
Worker(s) 1
RECEIPT NO.
RENEWAL
6752431
SEGO L1406010002146
LBT
EXPI RES
SEPTEMBER 30, 2016
Must be displayed at place of business
Pursuant to County Cade
Chapter SA -Art 9 & l0
SEC. TYPE OF BUSINESS
196 SPEC MECHANICALCONTRACTOR
CAC1816314
PAYMENT RECEMIlia
BY TAX COLLECTOR
$45.00 07103/2015
CREDITCARD-15-032574
Tble
Reconfines ceipt
Local
Tent.aS
po sd. eta ce eadon oftheholder'saaatcations.to do business. Business
with any eoaerame tel
or eangosalmaeetel regulatory kw end regairemenowbicb apply to the business.
The RECEIPT NIL above mist be displayed on all emmnaa Tal vehicles- Miami -Dads Cada Swage -212
For awe intimation, visitw+vwzdemidade.govltaxeogactoi' ..