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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 ausuosoN AMMON ammo= s 1,000,000 MCA MUMMA: GRANADA INSURANCE CO. $ MAALSIALCIE X OCCUR mum MARVINS AIR CONDITIONING CORP 1761 SW 11TH TER MIAMI, FL 33135 aaMtxb: LISUR IC I s 50.000 A ,twEIaID• =SUR S: 0185FL00051143 07/22/16 IED EXPrAm a.p.vn s 5/000 s 1,000,000 COVERAGES • CERTIFICATE NUMBER: 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, ECRLSIONSANDCONaT10NS13F SJOIPDUOESL/.dfS910NNMAYINVEESENRaL WPM) GAM. .�s TYPE OPSmJAm01 — m — ., POLICY AJMER alreDOTTmPOL ACOYM vrm UtsiS X CowelltaAl.oEtlBtAt usI>alrr MN B s 1,000,000 - $ MAALSIALCIE X OCCUR PRBARES CEA mum.) s 50.000 A 0185FL00051143 07/22/16 IED EXPrAm a.p.vn s 5/000 s 1,000,000 07/22/17 PEPSORAL&AOVtKAss . _ OEMA CREGAIS LAST APPLES PER OENOW AOSPESAVA , 2,000,000 IR ARUMACTp lac PRODUCTS .00I6tDPAOG _ s 1, 000 , 000 OR,PA $ AUT05OSLEIABLILY ANYAUTO IAL CPAPED AMR HIRED AUI'os COMMSn4aELOLIT RA SWOPS) f BOILLYINARYtP,rpems.) $ , — SMELLED AUTOS NOt404.e3) AUTOS B0aLY1nutreir aorid■N f PROPERTY twwP fPwAW,O s I - W aRFLl1, LAS � amR e - FACM ORIO53 f/e EXCESS UM AOGREG R - 3 IND 1 , asmsmt+ s S cows/swm r /R Moo MFA YTATLF6 -1 1MODDLOYDISUAB EL EAOIAOC>OBIT Ar ACU RILISO ,rtu—w svmrs„ &MIM)/ pumo my„ MIT AIS, oleo., wr oESCAP00/ OPOPEAATODIS EL Dame EA owtoTec t EI. DISEASE -POLICY )SUR f 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' ..