MC-17-2914Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
mit
Parcel Number
Permit NO. MC-12-17-914
Permit Type: Mechanical - Residential
Work Classification: Addition/Alteration
Pam* Status: APPROVED
Expiration: 07/25/2018
Applicant
89 NE 109 Street
Miami Shores, FL 33161-7039
1121360040550
Block: Lot:
JAGRUTI & HEMENDRA PATEL
Owner Information
Address
Phone
Cell
JAGRUTI & HEMENDRA PATEL
89 NE 109 Street
MIAMI SHORES FL 33161-7039
89 NE 109 Street
MIAMI SHORES FL 33161-7039
Contractor(s)
ADVANCE AIR TECH CORP
Phone
(305)795-3414
CeII Phone
Valuation:
Total Sq Feet:
$ 900.00
0
Tons:
Additional Info: RELOCATE AHV AS PER PLANS
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
$0.60
$2.25
$2.00
$0.20
$150.00
$3.00
$0.80
$158.85
Pay Date Pay Type
Invoice # MC-12-17-65876
01/26/2018 Cash
12/12/2017 Cash
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 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
constructiorLa2 zoning. uthrmore, I authorize the above -named contractor to do the work stated.
Authorii_zed'Signature:Owner / Applicant / Contractor / Agent
J'
January 26, 2018
Date
Building Department Copy
January 26, 2018 1
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
PLUMBING MECHANICAL
JOB ADDRESS: e6C? / 6 Ea
Miami Shores Village RECEIVED
MAY 0 2 2018
FBC 20V—\
Master Permit No.'l /10 l4 -� /p
Sub Permit No. SAC.
�l��. Z� l
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
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
❑ PUBLIC WORKS
to
�A.
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load:
County: Miami Dade
Construction Type: Flood Zone:
BFE:
Zip: 3.3 fC
NO
FFE:
OWNER: Name (Fee Simple Titleholder) Q iti(,kt ) 44rIIQ /ZA, SW 7E (..PhonO30281' 6 9
Address:
II
City: ,4--/t i I77� State: dr Zip: 3 �i 1
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Oit9Z0 Phone#:
Address: CS—0 0 1 `Y1/24.0 29Y' -2 3
v i/cY'tc1�
City: /�(�! A (�h State:
Qualifier Name: A�� cQO • G-i(/CiPI
State Certification or Registration #: Cy4'Ci a'7/ 7 Certificate of Competency #:,
. r : f
DESIGNER: Arc2rchitect/Engineer_,�`, e ,J0 d°4ry�,
Address: ) 3 '- 1 6� wV S� 40 ✓ City:
Value of Work for this Permit: $ G ,, 0 CO.
Type of Work: ❑ Addition I Alteration
Deskription ojf Work:
f J
g--777‘4
Zip: 1%2J
Phone#: (30S)0216 ✓ 761
Zip:
Square/Linear Footage of Work:
Phone geo24J<'.4343
6aan�fg State: F .
New ❑ Repair/Replace
molitio
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
t'
City State Zip
Mortgage Lender's, Name (if applicable)
4 .
Mortgage Lender's Address
City State Zip
3 •
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 '4
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 a reinspection fee will be charged.
�`I I
Signature
OWNER or AGENT
The foregoing instrument/wads acknowledged before me this
day of y-�<<�l �-, 20 b� , by
PG- , who is personally known to
me or who has pr
roduced 1 I cep as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
f
P11Crd�U' Y o[JGndOY t2ij , who is personally known to
me or who has produced 1r,v ) r l iNr4Sktas
identificati
NOT RY P
Sign:
Print:
Seal:
h.
YANAIETO
YCOMMIS`1 FF214031
XPIRES: Mach 25, 2019
Bonded Thru Notary Public Underwriters
************************************************************************************************
APPROVED BY
Plans Examiner
**********
Zoning
Structural Review Clerk
(Revised02/24/2014)
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. katik2itl?
Owner's Name (Fee Simple Title Holder): Hemendra Patel & Jagruti Patel
Owner's Address: 89 NE 109 St
City: Miami Shores
Phone #: 305-281-6559
Job Address (Of where work is being done): 89 NE 109 St
City: Miami Shores
Contractor's Company Name: Advance Air Tech Corp.
Address: 7255 NW 68 St #15
State : FI
State: Florida
Zip Code: 33164
Zip Code: 3316i
Phone #: 786-554-7875
City: Miami
Qualifier's Name LABRADA, IZMERT
State: Ft
Architect/ Engineer of Record Name: Fermin A. Martinez P.E
Address: 8340 SW65 Ave
Zip Code: 33166
Lic. Number: CAC1819345
Phone #: 305-298-3216
City: Miami
Describe Work: Relocate existing air handler.
State: FI
Zip Code: 33143
1 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
4 �
Owner or Agent
The foregoing instrument was aknowledged before me
this day of Pfll ,20 eby («� At)
Who is personally known to me or vyho has produced
l CIZin
No -`ub c:
: o•;�P
Seal:
Si
as indentfcation.
;' MAHARAI K. GONZALEZ
MY COMMISSION # GG 044602
, o;= EXPIRES: November2, 2020
'•RRP §tV Bonded Thru Notary Public Underwriters
nu,l
Signature-ga,
Contractor or Architect
The foregoing instrument was aknowledged before me
this aO day of Apr'/ , 20/gby i.Q6rc
who is personally known to me or who has produced
.2 p ter& as indentification.
Notary
Sign:J
Seal: /r
Dawn Marie Leighton
NOTARY PUBLIC
Al STATE OF FLORIDA
,* Comm# GG110341
Expires 5/31/2021
4-
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
❑PLUMBING
JOB ADDRESS:
City:
MECHANICAL
89 NE 109 St
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
❑ ROOFING ❑.REVISION
❑PUBLIC WORKS
Sub Permit
RECEIVED
DEC 12 2017
BY:
FBC 20 (t--Cg-tl�
No. fie /6
No. l A `�� :Lc I VI
❑ EXTENSION ❑RENEWAL
CHANGE OF ❑ CANCELLATION Ea SHOP
CONTRACTOR DRAWINGS
Miami Shores
Folio/Parcel#: 11-2136-004-0550 Is the Building Historically Designated: Yes
Occupancy Type: Resident Load: Construction Type:
County: Miami Dade
Zip: 33161
NO
x
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): HEMENDRA PATEL & JAGRUTI PATEL phone#: 305-281-6559
Address: 89 NE 109 St
City: Miami Shores
State: Florida
Zip: 33161
Tenant/Lessee Name: N/A Phone#: 305-281-6559
Email: dpate029@gmail.com
CONTRACTOR: CompanyName:-f7U'C/s4,VCe 14 /Eti'`i wvt'r
Address: 7ZSC N14.2 ca,6 . S - i s
City: !">o c 4- .4-1 •r
Qualifier Name: �z•-c�K� '10
State Certification or Registration #: CAC (S l e 0 Z So
Phone#: 3 ° C 7 `r7 5 70`r
State• F C-
4 Phone#:
Certificate of Competency #:
DESIGNER: Architect/Engineer: ` Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ t97a Square/Linear Footage of Work: " -
t
Type of Work: ❑ Addition ❑ Alteration ❑ New
Zip: 33 (
❑ Repair/Replace n Demolition
Description of Work: , /Q/!,..,fie- �( p/a'iff.
U.'• I , ,-
-2_, -4Net"_fip
t
Specify color of color tliru file:
{P
Submittal Fee $ �A . �" � • • Permi $ 1 C0 `�t Fee $"
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ 'CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE$ �(09 '��
Company 'Ne(pN/A miflicable)
Bonding Company's"Address N/A
City _ ,b_ -i State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City C 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 a reinspection fee will be charged.
Signature ,
I H.
OWNER or AGENT
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument wasacknowledged before me this
/JC()l3ayof o(%eele<jj,7e7 ,20 / ,by of /l/z.:6 /leP,20 ,-,70/,Aby
/4171, frer_�r%/e,, who is personally known to yZ �F•TL4624-04¢ , who is personally known to
me or whd has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
P
Seal:
�/0�lC//
lDaWn mart elghwn- �Oj�
as
me or who has produced
idehtification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC
STATE OF FLORIDA
Commit GG110341
Expires 5i31/2021
***************►******************l*****************•***************************************** ***************
L �� Vi Vela s Examiner
as
APPROVED BY
' ‘.�' NOTARY PUBLIC
:,�: STATE OF FLORIDA
' ,J CommitGG110341
sMCE 141 Expires 5/31 /2021
Sign:
P
"Seal:
Zoning
(Revised02/24/2014)
Structural Review
Clerk
AeoRo CERTIFICATE OF LIABILITY INSURANCE
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.
DATE (MM/DO/YYYY)
12/07/2017
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
Florida Bankers Insurance
6874 SW 8 ST
Miami, FL 33144
Phone (305) 266-6493
Fax (305) 262-0679
CONTACT MARTA ALONSO
NAME:
PHONE
0 th (305)266-6493
MNL mikeeloridabankersinsurance.com
ADDftEss•
INSURER(S) AFFORDING COVERAGE
INSURER A : UNITED SPECIALTY INSURANCE COMPANY, IN
(BC, No N): (305)262.0679
NAIC it
INSURED
ADVANCE AIR TECH, CORP.
6010 SW 19th Street
MIAMI
FL 33155-
INSURER B :
INSURER C :
INSURER D :
INSURER E
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POUCIES 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 POUC ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IP
LTR
TYPE OF INSURANCE
ADDLSUBRW
POUCYNUMBER. '
(MMMD/D�YYYY) FF
POLICY
MNWYYYYV
UMITS,
A
WI COMMERCIAL GENERAL
N
Binder# 172193
12/20/2017
12/20/2018
EACH OCCURRENCE
S 1,000,000.00 ."
f�LIABILITY
❑ CLAIMSMADE OCCUR.
J
PPRREMISES (Ea occurrr
rence)
$ 300,000.00 ..
MED EXP (Any one person)
$ 5,000.00
Q
PERSONAL & ADV INJURY
$ 1,000,000.00
GEN'L AGGREGATE UMIT APPLIESEl 7PER:
❑ POLICY 1,7067 ! LOC
GENERAL AGGREGATE
s 2,000,000.00
PRODUCTS - COMP/OP AGG
S 2,000,000.00
• OTHER
$
$
AUTOMOBILE UABIUTY
❑ ANY AUTO
r ' ALL OWNED SCHEDULED
J LAUTOS LJ AUTOS
HIRED AUTOS r�----1� NON -OWNED
I —I AUTOS
❑
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident)
S
$
❑ UMBRELLA UAB ❑ OCCUR
EXCESS LIAB ❑ CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
f❑
IJ DED ❑ RETENTION $
"
WORKERS COMPENSATIONPER
AND EMPLOYERS' UABIUTY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIV�
N/A
TH-
• SIA"ATE"' �R
E.L.EACH ACCIDENT
$
OFFICERJMEMBER EXCLUDED?
-(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - EA EMPLOYE
$�..____.^___
$
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
License #CAC1818026
CERTIFICATE HOLDER
CANCELLATION
MIAMI SHORES VILLAGE
BUILDING DEPARMENT
10050NE2AVE
MIAMI SHORES, FL. 33138
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE. DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01) OF
®1988-2014`ACORD CORPORATION. All'rights reserved.
The'ACORD'name and logo are' registered' marks of ACORD