MC-19-582Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138 ftm jl
305-795-2204
Issue Date:
Location Address Parcel Number
87 NE 92ND ST, Miami Shores, FL 33138 1132060130290
Contacts
Permitno: MC -03-19-5582
Permit Type: Mechanical - Residential
Work Classificatfon., A/C Replacement
Permit Status: Approved
Expiration: 09/17/2019
PATRICK COWAN Owner ANACHRIS A/C & REFRIGERATION INC Contractor
SERGIO NUNEZ
Other: 7865473255 821 NE 109 ST, MIAMI, FL 33161
Business: 3058991187
Description: UNIT STOLEN REPLACING WITH NEW Valuation: $ 13,000.00
Inspection Requests:
r5-762 4949SUBMITTINGNEWPERMITAPPLICATIONFOREXISTING
WORK TO REPLACE EXPIRED PERMIT MC -5-18-1250) Total Sq Feet: 0.00
Fees Amount
Application Fee - Other 50.00
CCF 7.80
DBPR Fee 6.83
DCA Fee 4.55
Education Surcharge 2.60
Permit Fee 405.00
Scanning Fee 3.00
Technology Fee 11.38
Total: 491.16
Payments Date Paid Amt Paid
Total Fees 491.16
Check # 2250 03/15/2019 $50.00
Check # 2258 03/21/2019 $441.16
Amount Due: 0.00
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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulatinoonstruction and zonings uthermore, I authorize the above named contractor to do the work stated. / I
re: Owner /-"pplicant / Contractor / Agent
March 21, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department AR1520
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
Master Permit No. C- 3 —
1l
q S81
Sub Permit No
BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
PLUMBING ["MECHANICAL PUBLIC WORKS [:]CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: p - ,kJ 9- - S -
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes . NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
is, OWNER: Name (Fee Simple Titleholder): ,/f f r ' P'ione#:
Address:_ 97 A °g- // S-1 .
City: JiA li <S l` rr.5 , State: Zip: 33 13,,
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
hone#: 5 ! —//%
e: Zip: .7-3 /e ,
Z Phone#:S
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Add
Value of Work for this Permit: $
Type of Work: Addition
Description of Work: _
f
City:
Square/Linear Footage of Work:
Alteration New
Specify color of color thru tile:
Submittal Fee $
r
Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Revised02/24/2014)
State: Zip:
Repair/Replace
C
Demolition
Sb
CCF $ CO/CC $
Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ T I -I Gq
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
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 Signature
OWNER or AGENT OONRA
The foregoing instrument was acknowledged before me this The foregoing instrum litwas ackno le ge ore me this
day of VVI,04 20 Iq by Sr' day f 20Jby
VJ Dlv1 who is personally known to 7`er 1 O )N , O fl`Q who is prsonally known to
me or who has produced r 4V, I as me or o h duced iW- i CQAS`Q as
identification clod who did tak n o identificatio and o did takeAm-eath.
NOTARY PU
Sign:_
Print:
Seal:
MY COMMISSION # FF 214031
EXPIRES: March 25, 2019
APPROVED
Revised02/24/2014)
N
OiD a Print:
L Seal:
Plans Examiner
Structural Review
YaUiADY PRIETO
MY COMMISSION # FF 214031
EXPIRES: March 25, 2019
9wde4i P+r NMik Fi:AdA9llGtfl[i* ************
Zoning
Clerk
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): 27 hAL7nc;L
City: Miami Shores Village County: Miami Dade Zip Code: 3 3 I.Ss
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 ® ARHI Sheet Attached: YES NO Contract Attached: YES
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse/Breaker Size): -
3. Voltage of Circuit (20 240 80): L
4. Size Disconnecting Means:
Contractor's Company Name:
State Certificate or Registration N
Signature
Revised02/24/2014)
Phone: 5 D S - e9 `i
rtificate of Competency No.
Date: ,_3 —
UNIT BEING REPLACED DATA NEW UNIT
MANUFACTURER
AHU or PKG. UNIT MODEL #
COND. UNIT MODEL#
KW HEAT L .
NOM TONS jpti1 .
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
YES NO REPLACING DUCTS YES NO
YES NO REPLACING THERMOSTAT YES2 NO
YES NO NEW 4"CONCRETE SLAB YES NO
YES NO NEW ROOF STAND YES NO
YES NO NEW RETURN PLENUM BOX YES NO
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse/Breaker Size): -
3. Voltage of Circuit (20 240 80): L
4. Size Disconnecting Means:
Contractor's Company Name:
State Certificate or Registration N
Signature
Revised02/24/2014)
Phone: 5 D S - e9 `i
rtificate of Competency No.
Date: ,_3 —
ANACHRIS A/C & REFRIGERATION INC
Date:
State of Mori
County of
Before me this day personally appeared R WQ- who, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
Contra for ign 4i e
worn to (or affirmed) and subscribed before me this ' '`day of IM AV C . 20JI, by
Personally know
OR Produced Identification r •< <JA),'
Type ojlclen ificati¢n P
Print, Tyke or Stamp Naftwof Notary
Mw .. r,'-YMMY PRIETO
FF ZVIh®MMISSION
k IF1.S March 2U'rAe iteTs
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.
I. 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:
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this S qday of I' ' Y 20—ft—.
ByTGI\-f CY &VU C4 '1 who is personally known to me or has produced
r r 1C i1 i as identification.
rrrrf
Notary: YANADY PRIETO
h!1 'QMMISSION # FF 214431
b = UHRES: March 25,2D19
SEAL: 0 a.::g ;;, eRuuNsavrbrxtf deiwrs
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, FI 33138
Tel: (305) 795-2204 • Fax: (305) 756-8972
01/02/2019
To: Current Owner
87 NE 92 ST
Miami Shores , FL 33138
Permit: MC -5-18-1250
Address: 87 NE 92 ST Miami Shores, FL 33138
Dear Owner,
Our records indicate that the above referenced permit application has expired without obtaining the proper
permit approval. In order to serve you better, we need to keep our files up to date.
As per section 105.3.2 of the Florida Building Code, An application for a permit for any proposed work shall be
deemed to have been abandoned 180 days after the date of filling, unless such application has been pursued in
good faith or a permit has been issued. "
Please be advised that open permits will hinder your ability to refinance or sell this property.
Please contact the Building Department, within 15 days of receipt of this letter in order to take care of
this matter.
Sincerely,
Ismael Naranjo (CBO)
Building Director