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MC-18-1259Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address it Permit NO. MC-5-18-1259 Permit Type: Mechanical - Commercial Work Classification: AdditionlAlteration Permit Status: APPROVED Date: 8/2612018 Expiration: 12/23/2018 Parcel Number Applicant 9501 NE 2 Avenue Miami Shores, FL 33138- 1132060133920 Block: Lot: DVS LLC Owner Information Address Phone Cell DVS LLC 201 NE 95 Street MIAMI FL 33138- (305)756-3711 201 NE 95 Street MIAMI FL 33138- Contractor(s) AIR RESCUE INC Phone CeII Phone (305)247-2878 Valuation: Total Sq Feet: $ 17,077.50 0 Tons: Additional Info: NEW 5 TON SYSTEM , NEW DUCT WORK Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved:: In Review Type of Work: NEW 5 TON SYSTEM , NEW DUCT W Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $10.80 $7.69 $5.13 $3.60 $512.33 $3.00 $14.40 $556.95 Pay Date Pay Type Invoice # MC-5-18-67507 06/26/2018 Credit Card 05/11/2018 Cash Amt Paid Amt Due $ 506.95 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Ventilation Final Rough Rough Duct Duct Detector Test Review Mechanical 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 zonin . Futher ,eeff;, 4.aj2t 6k(Q-c I A Authorized Sigwner / Applicant / Contractor / Agent re, I authorize the above -named contractor to do the work stated. June 26, 2018 Date Building Department Copy June 26, 2018 1 JOB ADDRESS: City: Folio/Parcel#: -6\\ A Building Department Miami Shores Village 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING 1E1 MECHANICAL ❑PUBLIC WORKS D/ FBC 20 Master Permit No77_— g—/ Sub Permit No. RC.lg - kas 1 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Shores County: Miami Dade Zip: ..33/39. I/3460/ 3q�o Occupancy Type: eos4 Load: Construction Type: OWNER: Name (Fee Simple Titleholder): Is the Building Historically Designated: Yes NO De___ Flood Zone: BFE: Address: gb/ ��I E 47, City: .Qd to — State: i-- FFE: Phone#: (3c2c) 7- 7l l Zip: '33/41e g Tenant/Lessee Name: Phone#: Email: r CONTRACTOR: Company Name: Address: Z '/d/ 5 ` 4 ®'t-e City: Qualifier Name: AI-440- T State Certification or Registration #: DESIGNER: Architect/Engineer: Address: ' Q® Value of Work for this Permit: $ State: PhoneJ(3dS) / ) Zip: Phone#:/ :QC) 3?/_4 =- s-' Certificate of Competency #: Phone#: (-40-4- • tS Type of Work: ❑ Addition ❑ Alteration ❑ Descripti)on%oof Work: ll/il Lc� J City: State: Zip: Square/Linear Footage of Work: New ❑ Repair/Replace 1 ❑ Demolition Specify color of color thru tile: Submittal Fee $ 1 a Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ TOTAL FEE NOW DUE $ Bond $ 642- ci '/33 S%•�� (Revised02/24/2014) 2_ . 33�- CO/CC $ Notary $ 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 n. approved and a reinsp .n fee will be charged. The foregoing instrument was acknowledged before me this day d (of , 20 %X , by /IC ii/1�, who is personally known to mere l me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature TRACTOR The foregoing instrument was acknowledged beforereme this ((��AA ,_�1 0' day of/� lyti , 20 18 , by M.940 'C81TS 1 ,c rt ti , who is personally known to me or wF1'o has produced identification who n oath. NOTARY PU // GZ- Sign: 2 -%o ff G -1 orl a lPrint: .SPr;Y P '•.i ° �• YANADYPR 0 ; "� ELITJIBETH ELORRIA Seal �� :.e M�iMMISSION4FF214031 •'c MY COMMISSION # FF953536 =;;F- -: EXPIRES: March 25, 2019 +•'' °F ;°"° Bonded 1hruNotary( Pubic Underwriters -r,, EXPIRES January 25.2020 lwtlaMwrySerwce car *****************************i******!******1s*********************************************************** Sign: Print: Seal: APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 Summary Report Property Information Folio: 11-3206-013-3920 Property Address: 9501 NE 2 AVE MIAMI SHORES, FL 33138-2704 Owner DVS LLC Mailing Address 201 NE 95 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 6400 COMMERCIAL - CENTRAL Primary Land Use 1229 MIXED USE - STORE/RESIDENTIAL : MIXED USE - COMMERCIAL Beds / Baths / Half 0/0 / 0 Floors 1 Living Units 0 Actual Area 25,475 Sq.Ft Living Area 25,475 Sq.Ft Adjusted Area 24,806 Sq.Ft Lot Size 40,200 Sq.Ft Year Built 1949 Assessment Information Year 2017 2016 2015 Land Value $959,400 $959,400 $798,600 Building Value $1,872,540 $2,080,600 $1,684,559 XF Value $0 $0 $0 Market Value $2,831,940 $3,040,000 $2,483,159 Assessed Value $2,754,599 $2,504,181 $2,131,801 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction $77,341 $535,819 $351,358 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 12 TO 17 INC BLK 29 LOT SIZE 40200 SQUARE FEET COC 22525-4024 07 2004 6 Generated On 5/11/2018 Taxable Value Information j 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $2,754,599 $2,504,181 $2,131,801 School Board Exemption Value $0 $0 $0 Taxable Value $2,831,940 $3,040,000 $2,483,159 City Exemption Value $0 $0 $0 Taxable Value $2,754,599 $2,504,181 $2,131,801 Regional Exemption Value $0 $0 $0 Taxable Value $2,754,599 $2,504,181 $2,131,801 Sales Information Previous Sale Price OR Book - Pa a 9 Qualification Description 12/23/2010 $1,600,000 27542-4900 Qual on DOS, multi -parcel sale 08/06/2010 $100 27394-3799 Corrective, tax or QCD; min consideration 07/01/2004 $3,900,000 22525-4024 Other disqualified 12/01/1971 $400,000 00000-00000 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: https://www.miamidade.gov/propertysearch/ 5/11/2018 2018 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT DOCUMENT# L10000129579 Entity Name: DVS, LLC,D Current Principal Place of Business: 201 N.E. 95TH STREET MIAMI SHORES, FL 33138 Current Mailing Address: 201 N.E. 95TH STREET MIAMI SHORES, FL 33138 US FEI Number: 80-0670481 Name and Address of Current Registered Agent: CACCAMISE, THERESA 201 N.E. 95TH STREET MIAMI SHORES, FL 33138 US FILED Mar 22, 2018 Secretary of State CC3484352049 Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: THERESCACCAMI 03/22/2018 Electronic Signature of Registered Agent Authorized Person(s) Detail : Title Name Address City -State -Zip: AUTHORIZED MEMBER, MANAGER CACCAMISE, THERESA 201 N.E. 95TH STREET MIAMI SHORES FL 33138 Title Name Address City -State -Zip: AUTHORIZED MEMBER, MANAGER CACCAMISE, RICHARD 201 N.E. 95TH STREET MIAMI SHORES FL 33138 Date I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 605, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: THERESA CACCAMISE MANAGER MEMBER 03/22/2018 Electronic Signature of Signing Authorized Person(s) Detail Date #tCiC p® CERTIFICATE OF THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY A EfELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CON REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLD IMPORTANT: If the certificate holder is an ADDITIONAL INSURED If SUBROGATION IS WAIVED, subject to the terms and conditions this certificate does not confer rights to the certificate holder in lie PRODUCER Madison Insurance Group 15190 SW 136th Street Suite 21 Miami, FL 33196 INSURED AIR RESCUE INC 23401 SW 154th Ave Homestead, FL 330322019 COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSN URED NAMEDSOVE FOR THNUMBER: E 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.INSDL LTRR ADSUBR INSD WV!) A TYPE OF INSURANCE COMMERCIAL GENERAL UABIUTY I CLAIMS -MADE vl OCCUR GENL AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: AUTOMOBILE UABIUTY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA UAB EXCESS UAB DED RETENTION $ OCCUR CLAMS -MADE WORKERS COM PENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOWPARTNER/EXECUTIVE OFFICER/MEMBER E)cLU7ED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A POLICY NUMBER 1000381429181 106-58806 LIABILITY INSURANCE MEND, STITUTE DATE(MM/DD/YYYY) 04/30/2018 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ER. , the of the u of such policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. policy, certain policies may require an endorsement. A statement on endorsement(s). CONTACT Marvin Rivas NAME: PHONE (305) 597-8771 IFAX (NC. No. Eat): (NC No): (305) 597-8773 NAIC # E-MAIL mrivas ADDRESS: @madisoninsgroup.COm INSURER(S) AFFORDING COVERAGE Starr Indemnity& I INSURER A: LiabilityCon'pany A0271 INSURER B : Florida Citrus, Business & Industries Fund A0201 INSURER C : INSURER D : INSURER E : INSURER F : POUCY EFF (MM/DD/YYYYI 04/03/2018 04/03/2018 POUCY EXP (MM/DD/YYYYI 04/03/2019 04/03/2019 UMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY $ 1,000,000 $ 50,000 5,000 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG COMBINED SINGLE LM(T (Ea accident) BODILY INJURY (Per person) 2,000,000 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE $ PER V I STATUTE I I ERµ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) HVAC sales, installation and repair contractor. CERTIFICATE HOLDER $ 1,000,000 Miami Shores Village 10050 NE 2 AVE NE Miami, FL 33138 ACORD 25 (2016/03) CANCELLATION 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 ce(- © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The CLASS AAIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 GARCIA, MARIO JESUS AIR RESCUE INC - 23401 SW 154 AVE HOMESTEAD .> .. FL033032 'U 7 s.,. ISSUED: 05/16/2016 NAy rrs •, N Y�• iy =W_t •' DISPLAY AS REQUIRED BY LAW SEQ # L1605180000696 001983 Local Business Tax Receipt Miami—Dadetounty, State of Florida —THIS IS NOT A BILL — DO NOT PAY 2543255 BUSINESS NAME/LOCATION AIR RESCUE INC 23401 SW 154 AVE MIAMI FL 33032 OWNER AIR RESCUE INC Worker(s) 2 RECEIPT NO. RENEWAL 2668672 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 SPEC MECHANICAL CONTRACTOR CAC050348 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 07/02/2017- CREDITCARD-17-041399 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 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 8a-276. For more information, visit yvww.miamidade.gov/taxcollector