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MC-16-3190 Permit NO. MC-11-16-3190 r `SCONES V� Miami Shores Village Permit Type:Mechanical-Commercial it.. n-+ 10050 N.E.2nd Avenue NE Work Classification:Addition/Alteration Miami Shores,FL 33138-0000 Per 1"t fes"' Permit Status:APPROVED Phone: (305)795-2204 <ORtS)A Issue oate: 1=21112016 Expiration: 05/30/2017 Project Address Parcel Number Applicant 9501 NE 2 Avenue 1132060133920 Miami Shores, FL 33138- Block: Lot: DVS LLC Owner Information Address Phone Cell DVS LLC 9400 NE 2 Avenue (305)756-3711 MIAMI FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 MILLION AIR CONDITIONING CORP (305)328-9347 Total Sq Feet: 0 Tons: Available Inspections: Additional Info:NEW 5 TON SPLIT. 10KW HEATHER NEW Inspection Type: Classification:Residential Ventilation Approved:In Review Final Comments: Date Approved::In Review Rough Date Denied: Type of Work:NEW 5 TON SPLIT. 10KW HEATHER Rough Duct Scanning: 1 Duct Detector Test Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# MC-11-16-62147 $3.67 11/22/2016 Credit Card $50.00 $206.94 DCA Fee $3.67 Education Surcharge $0.20 12/01/2016 Credit Card $206.94 $0.00 Permit Fee $245.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $256.94 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 the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. December 01, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy December 01,2016 1 Miami Shores Village RECEIVED NO 2 2016 Building Department 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 BY. au,+~ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. CC- l k6,-- PERMIT ,-PERMIT APPLICATION Sub Permit No. fAC 1t— % [—]BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBINGMECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION F-1SHOP CONTRACTOR ^1 DRAWINGS q4 �q—[ ctQ Or ,- JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: PP Construction Type: Flood Zone: BFE: (// FFE: OWNER:Name(Fee Simple Titleholder): 1 v J : Phone#�>(C9 �3' 5 q Address: 20 t Lc� �— I 2 City: �y 6 1�'L-i�\IA.SI/e.�� State: Zip: �J 13�� . Tenant/Lessee Name: M 101141 ►.{ Phone#: Email: CONTRACTOR:Company Name: y Address: /36Z S%a;�- oo City: v�FZ State: Zip: Qualifier Name: �U /f.� ^� Phone#: / State Certification or Registration#: G ` W-7 Certificate of Competency#: / DESIGNER:Architect/Engineer: - --•_r_ Phone#: Address: f'�// Ci State: Zip: Value of Work for th Permit:$ 771 bt?o r 6D Squar near Footage of Work: Type of Work: ❑ Ad i on---El Alteration....©-New rT ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color"thruvtile:.. '`► ``' ' "�` Submittal Fee$ l Permit Fee$* w + V CCF$ s '`CO/CC$ Scanning Fee$- `" Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ Cl(A TOTAL FEE NOW DUE$ Z® (Revised02/24/2014) 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$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 e-a pr. einspection fee will be charged. �, - ignature Signature 0 R or AG CO ACTOR -The foregoing instru``m//ent was acknowledged before me this The foregoing instrument was acknowledged before me this —y day o/f�/� ✓P vIt be r 20 / (a by day of �J!62& { V— 2016 by who is personally known to MWI V U I M0r'r-7–/p_,who is personally known to me or who has produced as me or who has produced h ri(,t'rl 6�&h g as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: Seal: �" ELIZABETH ELORRIAQA ;;jC1` ELIZABETH ELORRIAGA r :.; '�' M1'COMMISSION 0 FF9535M MY COMMISSION R FF953S36 EXPIRES"nmj 25 EXPIRES,ma y 25. ********** #fb�i 1F#f*****F s******* *** ** ********************** ,str****swWA�iAS�e***? ** ******** � � oar APPROVED BY 1� %V ;V tans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ♦SORes GI ... Ji .,... Miami hores Village L� -0y� Building Department �LORiDA' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D.��COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: BUSINESS ADDRESS: 13 2t6Z d & EafV CITY �o� STATE ZIP--33 Z� BUSINESS PHONE: (� ) �y FAX NUMBER CELL PHONE (3'9s ) (Od �3 QUALIFIER'S NAME: 12- -/ QUALIFIER'S LIC NUMBER: DATE(MWDDIYYYY) ACOREP CERTIFICATE OF LIABILITY INSURANCE kk_, 11/15/2016 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. If 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 CONTACT NAME: Carmen Perez L.P.Insurance Associates,Inc. ac°No EtI: (305)888-5747 WC No: (305)888-8926 801 W.48th Street Suite B E-MAIL-ADDRESS: Lssette insure.com I iC P INSURER(S)AFFORDING COVERAGE NAIC# Hialeah FL 33012 INSURERA: WESTERN WORLD INS.CO. INSURED INSURERB: PROGRESSIVE MILLION AIR CONDITIONING CORP INSURERC: COMMERCE&INDUSTRY INS CO. 13762 STATE RD 84 INSURER D: 245 INSURER E: DAVIE FL 33325 IINSURERF: 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 ADDLSUBR TYPE OF INSURANCE POLICY NUMBER MM/D Y EFF MM/POLICY EXP LTR DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEff__ CLAIMS-MADE FlOCCUR PREMISES Ea occurrence $ 100.000 MED EXP(Any one Person) $ 5,000 A NPP8321787 08/26/2016 08/26/2017 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 100,000 Ea acadent ANYAUTO BODILY INJURY(Per person) $ B ALL OWNEDX SCHEDULED 01983291-3 01/05/2016 01/05/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peracddent $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIM DE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? ❑N NIA WC033-57-1234 04/13/2016 04/13/2017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEP$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I more space Is required) Combined Heating&Air Conditioning systems installation,servicing or repair. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVE AUTHORIZED REPRESENTATIVE Miami Shores Village FL 33138 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA 1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ,�,..��,�� 1940 NORTH MONROE STREET (850) 487-1395 TALLAHASSEE FL 32399-0783 MORALES, MANUELA MILLION AIR CONDITIONING CORP 13762 STATE ROAD 84#245 DAVIE FL 33325 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque :; DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. v--� PROFESSIONAL REGULATION Every day we work to improve the way we do business in order CAC1814827 ISSUED: 06/01/2016 to serve you better. For information about our services,please log onto www myfloridalicense.com. There you can find more CERTIFIED AIR COf b CONTR information about our divisions and the regulations that impact MORALES,MANUEI.A•- _ you,subscribe to department newsletters and learn more about MILLION AIR CONDITIOIVINGACORP the Department's initiatives. _ Our mission at the Department is:License Efficiently,Regulate r Fairly.We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new license! Expiration date:AUG 31,2018 L1606010001498 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD I V4CAC 1814827 - The CLASS AAIR CONDITIONING CONTRACTOR" Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 MORALES, MANUELA MILLION AIR CONDITIONING'CORP 13762 STATE ROAD 84#245 — - DAVIE `FL 33325 ISSUED: 06/01/2016 _DISPLAY-AS REQUIRED BY-LAW ' SEQ# L1606010001498 rj BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S.Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA:MILLION AIR CONDITIONING CORP Receipt#:HEATING%AIRCONDITION CONTRACTR Business Name: Business Type:(AIR CONDITIONING CONTRACTOR) Owner Name:MANUEL A MORALES Business Opened:Il/09/2006 Business Location:13762 STATE RD 84 State/County/Cert/Reg:CAC1814827 DAVIE Exemption Code: Business Phone:954-474-5923 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: MANUEL A MORALES Receipt #ICP-15-00018270 13762 STATE RD 84 245 Paid 08/09/2016 27.00 DAVIE, FL 33325 08/08/2016 Effective Date 2016 - 2017 A11e 1VWr A r1A-