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MC-18-2442Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 11300 NE 2 AVE Landon Student, Miami Shores, FL 33138-0000 Contacts Permit NO.: MC-9-18-2442 Permit Type: Mechanical - Commercial Work Classification: Addition/Alteration Permit Status: Approved Issue Date:09/27/2018 I Expiration 03/18/2019 Parcel Number 1121360010160-26 BARRY UNIVERSITY 11300 NE 2 AVE, MIAMI SHORES, FL 331616628 Owner BTU SOLUTIONS CORP 135 WESTON RD 117, FORT LAUDERDALE, FL 33326 (954)548-8111 Contractor Description: HVAC WORK + GRILLS AS PER APPROVED PLANS ADDING 3 NEW GRILLS & RELOCATING 5 GRILLS Fees Amount CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee $1.20 $2.00 $2.00 $0.40 $100.00 $3.00 $1.60 Total: $110.20 BARRY UNIVERSITY. 11300 NE 2 AVE, MIAMI SHORES, FL 331616628 Applicant Valuation: Total Sq Feet: $ 1,800.00 3,556.00 Payments Total Fees Credit Card Credit Card Amt Paid $110.20 $50.00 $60.20 Amount Due: $0.00 Permit Received By Inspection Requests: 305-762-4949 Inspections: Inspection Type Mechanical Underground Mechanical Rough -In Ventilation Inspection Duct Detector Test Mechanical Final Review Mechanical Date Building Department Copy 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 AFFIDA IT: I certify that all e foregoing information is accurate and that all work will be done in compliance with all applicable laws regul onstruct on and .Ong. F ermore, I authorize the above named contractor to do the work stated. uthorized S'ture: 0 er / Applicant / Contractor / Agent Date September 27, 2018 Page 2 of 4 BUILDING PERMIT APPLICATION BUILDING PLUMBING JOB ADDRESS: City: Folio/Parcel#: Occupancy Type: Miami Shores Village REc 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 ❑ ELECTRIC ❑ ROOFING SEP BY: 018 A FBC 20 Master Permit No. C S--(/ S Sub Permit No. M V \ C 1P - 244 7� ❑ REVISION ❑ EXTENSION MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION CONTRACTOR `7,N9 A Miami Shores County: /2- 136d2O ad(O OWNER: Name (Fee Simple Titleholder): Address: City: 'Tenant/Lessee Name:- iami Dade Zip: Is the Building Historically Designated: Yes ❑ RENEWAL SHOP DRAWINGS NO Load: Construction Type: Flood Zone: BFE: FFE: Phone# 5l? 5 I\\ r°Vivlvexs /17 /Assi»L #(7 5 State: Zip: 33/ t 0 Email: Address: CONTRACTOR: Company Name. _ / / s 70 (A/ S 7 i if ` P✓ c� City: �/�+� t_ State: Qual Phone#: Y /s �7 w� Zip: /� 5 ifier Name: G� ' `10 -+" ���/ 'I • ��' Phone '-( Certificate of Competency #: �c7 .- 77 t / / Vc-5I``� Phone: q-Y) V7,31 3 State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Pc(7/7 v-1 Value of Work for this Permit: $ Type of Work: 4'- 1 Description of Work: A0a/A/ .( Addition 51 ?(-( City: fit\ ✓t/ /, V//) 0 Square/Linear Footage of Work: Alteration n New ❑ Repair/Replace State: npmolition vA c- 6e-r (.L S � ^�V (/t?(<9 VS �-► C.0 -s Specify color of color thru tile: sc( Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) IN/ Phone#: Permit Fee $ Radon Fee $ c CCF $ CO/CC $ DBPR $ y- G) Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ ' 2 4 4 c Bonding Company's Name (if applicable) Bonding Company's Address 7.; $ . 7 City • State , Zip Mortgage Lender's Name (if applicable) . 1 4 ,I, Mortgage Lender's -Address r. City State Zip 1 ApplicatiOn is hereby made to obtain a permit to'do the work and installations as indicated.1-1,cei-tify that no Work or installation has commenced prior to the issuance of a permit and that sall_work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I 'understand that a separate permit must b6' ;ecurled for ELECTRIC, PLUMBING', SIGNS; POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC , .1 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. ..4 "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 fstimated 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 commenceme t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit- I; issued. In the abs ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. OWNER or AGENT The forgoing instrument was acknowledged before me this. , iTIN day of AUglEr , 20 I X ,'by A A (. , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: "Of Nit Notary Pudic State of Fici1 rida .1; Jeffry J Yao Ai My Commission FF 168481 Wins 11/12/2018 * 114 * ******* It** *** 44 44* * APPROVED BY Signature CONT CTOR The foregZ5 instrument w acknowledged.before'rne this • 20 by '73 day of V Ufi:p.f? wf f‘i , vste-ts--rp-rstiriaily Icru?to Me or who has prbduced as identification and who did take an oath. NOTARY PUBLIC: - Sign: , .... 11CIRD‘ r 4.:*':Orldi'l Print: .., , ow . N Seal: -,, q 0-- - , . .... ,... .._ . :,-.-._ Commission #,,FF,88555..„ ** ********* * V" . -1:*:::*ES*::::17:*„..*c;2:-1::::1.` :I.B0144,11tiOigi14194.i40;arY.A7tRI ** v.... , - ., w.................--- • s xamin-er— Structural Review e• Zoning Clerk 44: (Revised02/24/2014) Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this 43 day of Snl 63G l� , 20 d By a,sAN M3hi LnAL-- Nota SEAL: I i«� VAfle r P •i c State of Florida Jeffry J Yao +� 4 � My Commission FF 168481 ou Expires 11/12/2018 who is personally known to me or has produced as identification. jBTU Solutions Corp 7520 NW 104th Ave STE 103, l04 Dora1 FL 33178 Ph. (`,-64) 548-8III CAC05701 I State of County of //�Q/'7 Before me this day personally appeared Z:v,d,e 04 © who, being dully sworn, deposes and says: That he or she will be the only person on the project located at: ILrL4 L--v€�S Contractor S //3/a ,e,t, 2',v./4,e �� �. 4/t,, Sworn to (or affirmed) and subscribed before me this `Z day of SG197743Crio(' By 50UVAYW O 5t4 0 Personally know XI OR produced ID Type of ID {{� Notary Public State of Florida Jeffry J Yao d My Commission FF 168481 Explres 11/12/2018