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MC-18-805Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. MC-3-18-805 Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Dates 4/3/2018 Expiration: 09/30/2018 Parcel Number Applicant 141 NE 102 Street Miami Shores, FL 33138- 1132060131830 Block: Lot: MARGUERITE MERRILL Owner Information Address Phone Cell MARGUERITE MERRILL 141 NE 102 Street MIAMI FL 33138-2324 (786)4'23-5653 Contractor(s) MARVI BUILDERS LLC Valuation: Total Sq Feet: $ 300.00 0 Tons: Additional Info: RELOCATION OF AC VENT IN THE CEILIN Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: RELOCATION OF AC VENT IN THE C Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.00 $0.20 $150.00 $3.00 $0.80 $158.85 Pay Date Pay Type Invoice # MC-3-18-66954 04/03/2018 Credit Card 03/28/2018 Credit Card Amt Paid Amt Due $ 108.85 $ 50.00 $ 50.00 $ 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 conf with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assu re nsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRI , PL ING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS construction certify that all th herm Authorized' ignature:Owner / Applicant for ation is accurate and that all work e-named contractor to . o thew. k / Contractor / Agen ijVbe done in compliance with all applicable laws regulating April 03, 2018 Date Building Department Copy April 03, 2018 1 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 Master Permit No. REC MAR 2&2018 AAA FBC 2011''11' Rci .-3n Sub Permit No. '' lc ❑ EXTENSION RENEWAL ❑PLUMBING gj MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: 3 p Folio/Parcel#: Is the Building Historically Designated: Yes" NO Occupancy Type:01,0 .P/1 Load: OWNER: Name (Fee Simple Titleholder): Address: / `C I � E . lDZ Construction Type: Flood Zone: Cf11i�vzjitelri4r ?dm1e1(✓t'i( BFE: r FFE: Phone#: 7R 4 • q 23 -S6Ac3 City: a (4A,1 %Lb ►'ZS State: L Tenant/Lessee Name: Phone#: Email: r Zip: 33(3 O CONTRACTOR: Company Name: Ar,14' /D(- &$ 7 9(Z -c Phone#: 6 0 y %_�j -t Address: / 2 11►..) (Ai M (; , c ` �T / City: \cb tfekk ( \ /W1 State: (_ Zip:, :.3ai) 166 Qualifier Name: ILA LC,V.0 Ar k Phone#: 7A6. b k 4/3 3. State Certification or Registration #: ' c' c.. -1 tG cfertificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 3 O. Q- Square/Linear Footage of Work: Type of Work: ❑ Addition p Alteration El New ❑ Repair/Replace ❑Demolition Description of Work: dot= 4_0C 1 l Per— AA 6/144 4 4, -772.E_ ('(._1 /J !� . F ' Specify color of color thru tile: CCG� Submittal Fee $ `—^� i d. Permit Fee $ I^^ c/ t �� CCF $ Scanning Fee $ Radon Fee $ OS: • CC1) DBPR $ ' . -5 Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ • (Revised02/24/2014) CO/CC $ Notary $ TOTAL FEE NOW DUE $ Bonding Compny'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 i\ ed. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature PP 1L� 4,IJ ,tLbi:a • Signature \\ CONTRA TOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this „2 % day of �lLl ✓G(� 20 Si , by 0-1- day of c , 20 [ p , by , who is personally known to M.i sv 'P (7 *' (\ e—c ho is personally known to me or who has produced i' (etD - 7a - 6 as me or who has produced as identification and w ;.id take an oath. NOTARY PUBLIC: Sign: Print: Seal: OWNER or AGENT :.,'Kt : 'oar =. ; V ;• * My Comm. Expires Jul 7, 2018 '" • off: Commission # FF 139343 "•:;,oF ''' Bonded Through National Notary Assn. ***************"******************s******* APPROVED BY identification and who did take an oath. * A�53 91030 NOTARY PUBLI Sign: Print: Seal: ************************************************************** Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) '. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ARNEDO, MARCELO GABRIEL MARVI BUILDERS LLC 13150 NW MIAMI COURT MIAMI FL 33168 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www,myfloridalicense.com. 'There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT. GOVERNOR (850) 487-1395 STATE OF FLORIDA • 7 DEPARTMENTOF BUSINESS AND PROFESSIONAL:REGULATION r CAC1817894- -"' ISSUED,.05/05/2016 CERTIFIEDAIR,COND CONTR `". ARNEDO, MARCELO GABR IEL'— MARVI BUILDERS-.LLC;;:,- , IS -CERTIFIED hinder the provisions of Cti,489`FS. -;Expiration date AUG 31 2018 - L1605050000648 DETACH HERE KEN LAWSON. SECRETARY " .. STATE OF FLORIDA J DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER " CAC1817894 Named below*IS CERTIFIED' Under the provisions°of Chapter 489 FS:.r„y 444 .. ,Vkti - t-r_ , ARNEDO,.,MARCELO. GABRIEL' -` P.— ,„.,,,MARVI BUILDERS L-LC;: ,- H13150'NW MIAMI COURTS. `*0-. --MIAMI`- .. " ,FL-'33168' - yy.. - 0.-,.. 4: r .y..., -+ r •- .-S SEQ # L1605050000645 ISSUED: 05/05/2016 DISPLAY AS REQUIRED BY LAW 007918 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6644661,- BUSINESS NAME/LOCATION MARVI BUILDERS LLC 13150 NW MIAMI CT MIAMI FL 33168 OWNER MARVI BUILDERS LLC Worker(s) 1 RECEIPT NO. RENEWAL 6915343 EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A -.Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC1508585 PAYMENT RECEIVED BY TAX COLLECTOR S75.00 07/07/2017 CHECK21-17-052703 This.Local Business.Tax Receipt only confirms payment of the Local Busirless.Tax. The Receipt is not a license, permit, or a certification of the holder's 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 veh' For, more information, visit.wwvy.ntiatp lat}ri-Dadtrfrtcd Spcifti=276. awA0 I} ` gz 009983 LocalBusiness Tax Receipt Miami -Dade County, State of Florida -THIS.IS.NOT A BILL - DO NOT PAY 7173812 BUSINESS NAME/LOCATION MARVI BUILDERS LLC 13150 NW MIAMI CT MtAMI FL 33168- OWNER. MARVE BUILDERS LLC C/O MARCELO ARNEDO. MGR Worker(s) 1 RECEIPT NO. RENEWAL 7452973 EXPIRES SEPTEMBER 30,.2018 Must he displayed at place of business' Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPEC MECHANICAL CONTRACTOR CAC1817894 . ` PAYMENT RECEIVED BY TAX COLLECTOR 575.00 07/06/2017 CHECK2 1-1 7-052333 This local Business Tax Receipt only confirms payment of the local Business Tax. The'Receipt is not a license, permit, or a certification of the.holder's 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 8a-276. For more information, visit wwwwmip_rnidad._g,gov/taxcollector MARVBUI-02 STWIGGS ACORtY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03/27/2018 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 have ADDITIONAL INSURED provisions or 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 Collinsworth, Alter, Fowler & French, LLC 8000 Governors Square Blvd Suite 301 Miami Lakes, FL 33016 NQkiACT PHONE Ext): (305) 822-7800 FAX No):(305)362-2443 Mal Miss: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Company 39993 INSURED Marvi Builders LLC 13150 NW Miami Ct. Miami, FL 33168 INSURER B: Ohio Security Insurance Company 24082 INSURER C: INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE N • 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP IMM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 103GL001977200 09/01/2017 09/01/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO OWNED r— X SCHEDULED AUTOS w E AUUTOS ONLY BAS1858203802 09/01/2017 09/01/2018 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY accident�AMAGE $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE XS172544 09/01/2017 09/01/2018 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) License #CGC 1508585 and CAC 1817894 CERTIFICATE HOLDER Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORif CERTIFICATE OF' LIABI'LITY`INSURANCE L........*:*--02/013/2018 DATE(MM/DDNYYY) 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 have ADDITIONAL INSURED provisions or 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 A & A UNDERWRITERS INC 8778 SW 8TH ST MIAMI FL 33173 769DW CONTACT NAME: PHONE FAX r (A/C, No, Ext): i(A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE. NAIC S INSURER A: FLORIDA W.C. JUA 236220 INSURED MARVI BUILDERS LLC 13150 NW MIAMI CT MIAMI FL 33168 INSURER B: wsuRERC: - INSURERD: INSURER E' INSURER F: CERTIFICATE 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 LTR....— _ —. TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DDIYYYY) .$ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE D OCCUR MED EXP (Any one person). $ PERSONAL & ADV INJURY S GEN — L AGGREGATE LIMIT APPLIES PER: POLICY D PROJECT LOC GENERAL AGGREGATE $ PRODUCTS — COMP/OP AGG S AUTOMOBILE — —_ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY — _ — SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident} _. - S $ UMBRELLA LIAB EXCESS LIAB — OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEDI (RETENTION $ 5 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ,,,. Y/N (Mandatory In NH) C If yes, describe under DESCRIPTION OF OPERATIONS below NIA N (6FR 13UB-7D76989-5-17) 09-15-17 09-15-18 X PER STATUTE ,... OTH- ER_ E L. EACH ACCIDENT S 1,000,000 E LDISEASE — EA EMPLOYEE S 1,000.000 E.L. DISEASE —POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CGC 1.508585 CAC 1817894 , CANCELLATION" MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI. SHORES ACORD 25 (2016/03) FL 33138 SHOULD MAY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD