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MC-18-1579Permit NO. MC-f-18-1579 `SKUR ys L,� Miami Shores Village Permit Type: Mechanical - Residential 10050 N.E. 2nd Avenue NE ' Work Classification: Addition/Alteration " Miami Shores, FL 33138-0000 Pen ot Permit Status: APPROVED Phone: (305)795-2204 Issue ©ate: 6/18i2018 Expiration: 12/15/2018 Project Address Parcel Number Applicant 150 NE 94 Street 1132060132970 STEFANO CARNIATO Miami Shores, FL Block: Lot: Owner Information Address Phone Cell STEFANO CARNIATO 150 NE 94 Street (786)210-0789 MIAMI SHORES FL 33138- 150 NE 94 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone RELIABLE AIR CONDITIONING REFRI (786)247-6622 2 Additional Info: INSTALL A NEW 2 TON PACKAGE UNIT Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Fees Due Amount CCF $3.00 DBPR Fee $2.21 DCA Fee $2.00 Education Surcharge $1.00 Penalty Fee $100.00 Permit Fee $147.00 Scanning Fee $3.00 Technology Fee $4.00 Work without Permit Fee $147.00 Total: $409.21 Valuation: $ 4,200.00 Total Sq Feet: p Date Approved:: In Review Type of Work: INSTALL A NEW 2 TON PACKAGE U Pay Date Pay Type Amt Paid Amt Due Invoice # MC-6-18-67851 06/08/2018 Cash $ 50.00 $ 359.21 06/18/2018 Credit Card $ 359.21 $ 0.00 Avauaoie inspections. Inspection Type: Final Rough Duct nical 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 AFF certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an om ermore, I authorize the above -named contractor to do the work stated. June 18, 2018 Auth d ' na re: Owner / Applicant / Contractor / Agent Building Department Copy June 18, 2018 1 BUILDING PERMIT APPLICATION Miami Shores Village RECEIVED Building Department JUN082018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 Q�J INSPECTION LINE PHONE NUMBER: (305) 762-4949 (-0 6 FBC 20 I� Master Permit No. *�G� - - 2 Sub Permit No. ly1 — 79"(:�;j ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores , County: Miami Dade Zia: S61 6 %s Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: All OWNER: Name (Fee Si ple Titleholder :5 Xu I. n% 1,i 7 Phone#: 10 a -4017 Address:.. ��U��s 3ao3 City: <z;upoU q I �� L� State: i Zip: 2A 16.0 Tenant/Lessee Name: Phone#: Email: //%J ' ^ CONTRACTOR: Company Name: Rr'LU•d31A_(_r�cr 'L'?J _ 1 ,, =2f�Ns:4-xu. Phone#: 3 OQ 7, 3 Address: (� SCtJ 6r bd S/ City: W�.2 State: �� Zip: 3 313 c Qualifier Name: A-IA!W to QW Z VPhone#:.3 )? L' 2. State Certification or Registration #: CAc- lg A' (k L l a Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State Value of Work for this Permit: $ Z V-­- Square/Linear Footage of Work: Zip: Type of Work: ❑ Addition ❑ Alteration DQ New �s ce ❑ Demolition Description of Work: S'.,. Gl:;k: Specify color of eolors'thru°tile -7, Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ Pl I Oro - vz) (Revised02/24/2014) ii!Y • s �A, r{ei .�.:iAti.a ; M1r y� �; . DBPR $ " o` Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 399 • 21 f I Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 propert is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first in ection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will at bWpproved and areinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this Q day of -- JU 7..C- 20 i; by �(<:nZ/)'who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Zi::;7 Print: Seal: -40PA 1" d APPROVED BY CONSUE10 PEW „ Cormriselot��(3Lif5919p r EMM MaO 9. 2W Signature CONTRACTOR The foregoing instrument was acknowledged before me this �T day of /U /i � 20 % e by HEI7.��/ M d �O 2 who is ersonally Known to me or who has produced eVF. r S D 4 141 �oWf7 as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: e` EON �a�d► eona.etrue�apK�arr�•wwn *:**sssr**•�s*r*r****�:::*::s*****ssss*s*******s************ssssssssss** /rls Examiner Zoning Structural Review Clerk (Revised02/24/2014) Henry Munoz STATE CONTRACTOR CAC 1814210 24 Hours Emergency Service 305-325-9283 www.acreliable.com support@acreliable.com Air Conditioning 305-325-9283 10 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): 15O JU ti SSTjY'i' e City: Miami Shores Village County: Miami Dade Zip Code: 33 142 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO I ARHI Sheet Attached: YES NO & ' Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER p�a�r,,... AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER I It, LW YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YE NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND S YES NO NEW RETURN PLENUM BOX dYES 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size) 3. Voltage of Circuit (208/240/480): 10 4. Size Disconnecting Means: Contractor's Company Name: i State Certificate or RegistratioiyJ C� G 1 cL Z l c Signature signature) 0 Phone: Certificate of Competency No. Date: (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 Notice to Owner - 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, p rt-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will I the only erson allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' co p s i insurance coverage fr m the contractor's company for day labor, part-time employees or subcontractors. BY SIGNI L W YOU ACKNOW DGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of %) , 20. B �1r iV e) / %� who is personally known to me or has produced as identification. • . I . i 1111110/r SEAL: * �f3158199 Egku March 9, tort -ISM, , ao�w.efl a ara rwury awlw. RIM MI/�1B1L,E ., �F-� 1 �•�.�;`� fi��•. ���ca ESE iE-�. F- � 1 ►�•� � 305-325-9283 (CAC 'B 8q 429 0) Date: up State of. �1/0 i -Cl a.) County of.- / (Z' - J, Before me this day personally appeared Pwho, being duly sworn, deposes and says: 11 That he will be the only person working on the project located at ntractor Signature. Sworn to and subscribed before me this 15 day of 20 By IVEr�,eS/ v n a Personally know _....r < <