The URL can be used to link to this page

MC-17-933fittc. 4133 cis-v(ictn Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 897 NE 91 Terrace Miami Shores, FL 33138- Owner Information Permit ItiC . Permit Type. Mechanical - Residential rk Ctass&rceion: A/C Replacement Permit Status: APPROVED Parcel Number 2017 Expiration: 1 /1 /2017 Applicant LTIMOTHY JAMES MARSH JAMES Address 1132060050300 Block: Lot: 3250 NE 1 Avenue MIAMI FL 33137- 3250 NE 1 Avenue MIAMI FL 33137- Contractor(s) COOL FREEZE AC CORP Phone (305)591-9794 Cell Phone Phone TIMOTHY JAMES MARSH JAME: Valuation: Total Sq Feet: Tons: Additional Info: REPLACE OLD AIR CONDITIONING UNIT Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved:: In Review Type of Work: REPALCE OLD AIR CONDITIONING L Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.60 $2.89 $2.89 $1.20 $192.50 $3.00 $4.80 $210.88 Pay Date Pay Type Invoice # MC -4-17-63576 04/17/2017 Check #: 248 04/05/2017 Check #: 258 Amt Paid Amt Due $ 160.88 $ 50.00 $ 50.00 $ 0.00 Cell $ 5,500.00 0 Available Inspections: Inspection Type: Final Review Mechanical Review Building 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 AFFIL .at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction- iiiFuthermore, thorize the above-named contractor to do the work stated. d Signature: er / Applicant / Contractor / Agent April 17, 2017 Building Department Copy Date April 17, 2017 1 qa'pql/ 7g6) g( ) 441 OV,6, 6-11 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION 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 APR 0 5 2017 FBC201/ RCi---41 Master Permit No. Sub Permit No. M C - (133 ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR n JOB ADDRESS: p ci. i s _{ T City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Flood Zone: BFE: zip: 3 3 13g Load: Construction Type: OWNER: Name (Fee Simple Titleholder): (j Ira .4 Address: 79 7 ( '7e r City: �)A i'4 1 oryA State: / NO FFE: Phone#: 3O •774 Tenant/Lessee Name: Phone#: Email: zip: 3 3 8, CONTRACTOR: Company Name: 6) I IC- 45' -42--2-57.— A Address: 1S414 '3 t dc�AP*.- 3"15' i City: /. r State: c,�et'61j5'2_�2 Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ 6,. CD Type of Work: ❑ Addition ❑ Alteration Maga l� Phone#: ?Ig 6 3 t-1 ca -i 39* 7E% - (363- t31O7 Zip: ? t L Phone#: 141-1- u3 Certificate of Competency #: Phone#: City: State: Zip: / et 03 ❑ Demolition Square/Linear Footage of Work: // I ❑'1New I ElRepair/Replace Description of Work: �pfc422e Qtc/ Air �m-Irk0�!n - C3v ( . A`4 Specify color of color thru tile: Submittal Fee $JQ }�(1 d Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) Notary $ Double Fee $ Bond $ / /� TOTAL FEE NOW DUE $ Y 60 • 83 7 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and a structiatili'n law hrorhu e_wiu by delivered-ta_tke-persoa whose property is subject,to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature NER or AGENT The foregoing instrument was acknowledged before me this day of ff,pii� ,20 /�- ,by mo -My -)77r fr./ , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as APPROVED BY CONTRACTOR The foregoing instrument was acknowledged before me this ,20/7 ,by o is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: iriV ,,r MAGALY FONSECA • pYx' EXPIRES: April 24, 2020 "% '• �"•' Bonded Thru Notary Public Underwriters Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. -�' 1 Owner's Name (Fee Simple Title Holder): /; 7? %Y15 A Phone #: Owner's Address: / / fci YLP_ tj Z.40e City: 'flh/4e)/ . e ic/7 v State : Job Address (Of where work is being done): gyp P6. 9i Zip Code: 3313 City: Miami Shores •)( State: Florida X Zip Code:63738 Contractor's Company Name: Noe )7 j,Y (�O !! ►ie9, Phone #: 3o$ 74 12 J4 r Address: 2 2 Z. 1 W 1G9 4 r/ City: ilia le 0) h State: C/ Zip Code:':930 14 Qualifier's Name : e4 Ore, Co Lic. Number. G%fC /i/1- /3i' Architect/ Engineer of Record Name: 5 . y S )4,1 44 4 / ieC I'/.Phone #: Address: 3434 A /11/4oi Ave 4 2 -- City: ill 7c,v✓i ; State: FI Zip Code: V 3 /Z'7-- 6. eY2'/ Wo if- Describe Worlc hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless of all legal involvement. Signature Signature Contractor or Architect The foregoing instru 'gent was .ged before me The foregoing instrument was aknowledged before me this,, day of 'H' O( 20/7,by this day of , 20 by Who is personally known to me or who has produced who is personally known to me or who has produced as indentification. as indentification. Notary Publ' Sign: Seal: • dai4eA};d 0. t3zallo :li . �'• Nutai v PUbI,C /.• �,� z State of Florida • 41 = C,munisswn * GO 001702 `• . �r my r.: ',n, EAptres Jun 13, 2020 Y1 .Al_ Wit ',, ,y g^ National Notary ASO. Notary Public: Sign: Seal: To: 2�Oen 1R,y (j79 ATTN: G/ dYb 2;.// " j RE: Permit #: Address: 897 NE 91 Terr. Miami Shores FL 33138. Please accept this letter as our formal notice to you that your services are hereby terminated from our project/permit for above/%referenced permit. I/We 'l�r h? M4 r5 !7 , as legal owner of subject property, am hereby terminating your service for the following reasons: 1 / I/We no longer authorize you the current permit holder to proceed with the work covered by this permit. And hereby inform you that 1/We intend to apply for a change of contractor, to take over the permit to construct or complete the construction covered under said permit. Owner(s) Signature Date Print�am�T Print Name Title (If corporation) Title (If corporation) BARBARA LOZANO Notary Public - State of Florida •e Commission # GG 001702 4= My Comm Expires Jun 13, 2020 X4,44 ie Bonded through National Notary Assn. SENDER: COMPLETE THIS SECTION • Complete Items'1, 2, and 3. • Print your name and address on the reverse so that we can return the card to you. • Attach this card to the balk of the mallplece, or on the front If space permits. 2221 as -� ys The., /,c h, (. 33®/,6 Ph0er iV c'; IIIIIIIIIIIIIIIIIIIIIII II1111IlIlil11111111111 9590 9402 2270 6225 8710 73 2F EL341976650US PS Form 3811, July 2015 PSN 7530-02-000-9053 COMPLETE THIS SECTION ON DELIVERY of Delivery 3. Service Type o Adult Signature 0 Adult Signature Restricted Delivery St Certified Mall® 13 Certified Mall Restricted Delivery 0 Collect on Delivery ❑ Coleot on Delivery Restricted Delivery ❑ Insured Mali 0 insured Mali Restricted Delivery (over MO 'JSP egistered art ❑ RReeffvel alstered Mall Restricted ed ercitandiae Receipt for ❑ Signature Confirmatlonn, 13 Signature Confirmation Restricted Delivery Domestic Return Receipt 11 1 1 USPS TRACKING # 1 1 9590 9402 2270 6225 8710 73 United States Postal Service First -Class Mall Postage & Fess Paid USPS Permit No. G-10 Sender. Please print your name, address, and ZIP+4® in this box* /65 /O Ski / a,f4i4e-. # 9/� h C. -i C)-iJ eve //al USPS.com® - USPS Tracking® Results Page 1 of 5 USPS Tracking® Results FAQs > (http://faq.usps.com/?articleld=220900) Track Another Package -I- Tracking Tracking Number: EL341976650US Scheduled Delivery Day: Monday, March 6, 2017, 3:00 pm ® Money Back Guarantee Product & Tracking Information Postal Product: Features: Priority Mail Express Insured 1 -Day TM PO to Addressee Return Receipt Up to $100 insurance included Restrictions Apply Q See tracking for related item: 9590940222706225871073 (/go/TrackConfirmAction? tLabels=9590940222706225871073) DATE & TIME Remove X In Transit ble Actions March 31, 2017, 9:30 am STATUS OF ITEM LOCATION Out for Delivery MIAMI, FL 33177 Your item is out for delivery on March 31, 2017 at 9:30 am in MIAMI, FL 33177. https://tools.usps.com/go/TrackConfirmAction?tReffullpage&tLc=3&text28777=&tLabe... 4/12/2017 USPS.com® - USPS Tracking® Results Page 2 of 5 I_qk\ DATE &TIME STATUS OF ITEM LOCA `Q� March 31, 2017, 9:20 am Sorting Complete MIAMI, FL 3 ; 77 APR 1 2017 March 30, 2017, 9:38 am Arrived at Post Office MIAMI, FL 3317 March 29, 2017, 2:46 pm Unclaimed/Max Hold Time HIALEAH, FL 33016 Expired March 23, 2017 March 6, 2017, 12:52 pm Redelivery Scheduled HIALEAH, FL 33016 Notice Left (No Authorized HIALEAH, FL 33016 Recipient Available) March 6, 2017, 10:07 am Out for Delivery HIALEAH, FL 33016 March 6, 2017, 9:57 am Sorting Complete HIALEAH, FL 33016 March 6, 2017, 9:57 am Arrived at Post Office HIALEAH, FL 33014 March 6, 2017, 7:32 am In Transit to Destination March 5, 2017, 12:32 am Departed USPS Facility MIAMI, FL 33152 March 4, 2017, 8:13 pm Arrived at USPS Facility MIAMI, FL 33152 March 4, 2017, 3:25 pm Departed Post Office MIAMI, FL 33177 March 4, 2017, 9:34 am Acceptance MIAMI, FL 33177 See Less /\ https://tools.usps.com/go/TrackConfirmAction?tRef fullpage&tLc=3&text28777=&tLabe... 4/12/2017 USPS.com® - USPS Tracking® Results Page 3 of 5 Available Actions Text Updates Email Updates u Proof of Delivery v See Less " Can't find what you're looking for? Go to our FAQs section to find answers to your tracking questions. FAQs (http://faq.usps.com/?articleld=220900) https://tools.usps.com/go/TrackConfirmAction?tRef fullpage&tLc=3&text28777=&tLabe... 4/12/2017 BUILDING PERMIT APPLICATION El BUILDING ❑ ELECTRIC 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 LY: `.IVT ID OCT 0 9 2015 BY: FBC 20 Master Permit No. R.(/ 57--/ ' 3z Sub Permit No. MC 7'1 ' / 3 ROOFING ❑ REVISION I I EXTENSION ❑RENEWAL PLUMBING I-44VIECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 4417 PL: qt P/242 CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: =31-� '7 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: 2i, b 13o X 39/ 30 `. City: GLA. _ A---(A-k. , State: ri l c____:,. cel. C-- Zip: 3 3 ( 3 "} Tenant/Lessee Name: Phone#: ?P6 C w 6 ( 6(ej Email: Viae Phone#: -?8b 5-6 6 ! S / CONTRACTOR: Company`Name: / fletAl /x' (.001/k& '(')')6 f t'�15 (ref Address: 222/ It( f (L�(' c/m/ / City if //JPfI/) State: �L Qualifier Name: GD)/ Ore 2(6'1 re2(61 State Certification or Registration #: Ca' %tirf'i 3f DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ S . co o Type of Work: ❑ Addition ❑ Alteration )(1 New Phone#: 30C 8 q 5 6 6 c1' Zip: 3J`'" 479 Phone#: Certificate of Competency #: Phone#: City: State: Zip: Square/Linear Footage of Work: Description of Work: ?epic' ie. C9;69 4 Repair/Replace 2- (--.97v31 h M4N( Ci/v(% / yoD Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ \rikL `7 0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 16 ' S (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 beeapprov-.. d a reinspection fee will be charged. Signature Signature 0 ' ER or AGENT CONTRACTOR The foregoing instrument wa acknowledged before me this The foregoing instrument was acknowledged before me this day of v C , 20 ) , by day of , 20 / $ by who is personally known me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: , 4IFI 'MARTINEZ :'"',;`':! SSIGV 4 FF228453 ':0:±v 07. 2019 **************************I, APPROVED BY (Revised02/24/2014) who is personally knowjto as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:---^.,-, Print: 1) A I O t --,k A f2 t Seal: -Plans Examiner Structural Review DANIEL MARTINEZ MY COMMISSION # FF228453 rxrr ;)f_ ',,;,a, •i,• '019 *s******,*AiKt*#,:.lS, *� **** ************** Zoning Clerk Local Business Tax Receipt Miami -Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 7012453 BUSINESS NAME/LOCATION PHOENIX COOLING SYSTEMS CORP 6540 W 12 AVE HIALEAH, FL 33012 RECEIPT NO. RENEWAL 7288103 EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PHOENIX COOLING SYSTEMS CORP 196 SPEC MECHANICAL CONTRACTOR 1 CAC1817135 Worker(s) PAYMENT RECEIVED BY TAX COLLECTOR 49.50 10/06/2015 0243-16-000096 This Local Business Tex Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles — Miami—Dade Code Sec Ba -278. MwrtFoAn;. For more information,visit www.miamidade.gov/taxcollactor MI Notice to Owner Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Workers' Compensation Insurance Exemption 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 full-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 1 ELO YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida Owner County of Miami -Dade The foregoing was acknowledge before me this day of ,20 `J By 404 f ,1/ e/A who is personally known to me or has produced Notary: SEAL: as identification. EWOT SOTO * MY COMMISSION # FF 922126 EXPIRES: September 27, 2019 °'+4,0, coo Bonded Thru Budget Wary Services PHOENIX COOLING SYSTEM CORP October 7, 2015 STATE OF FLORIDA COUNTY OF MIAMI DADE BEFORE ME THIS DAY PERSONALLY APPEARED EDY OROZCO WHO, BEING DULY SWORN DEPOSES AND SAYS THAT HE WILL BE ONLY PERSON WORKING ON THE PROJECT LOCATED AT: 897 NE 91 TERRACE MIAMI SHORES SWORN TOO AFFIRMED AND SUBSCRIBED BEFORE ME THIS DAY OF 20J( PERSONALLY KNOW PRODUCED ID MATO iii��/, N c , ;;:: \ON EXAM'`. Ja'° •2 i •off 4,.. oo*ki" os