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MC-19-2377
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 261 NE 95 ST 1132060133940 Contacts MTNEZ INVESTMENT GROUP II LLC Owner CORVO A/C CORP Contractor 4500 NW 37 AVE, MIAMI, FL 33142 LUIS CORVO Mobile: 7868284280 ------------- Inspection Request Description: NEW A/C SYSTEM, DUCT WORK , EXHAUST FANS I Valuation: $ 8,000.00 305462»4949 i Total Scl Feet: 3,200.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.60 Permit Fee (Manual) $240.00 Scanning Fee $3.00 Technology Fee (Manual) $6.00 Total: $309.40 Payments Date Paid Amt Paid Total Fees $309.40 Credit Card 10/08/2019 $50.00 Credit Card 10/15/2019 $259.40 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 regulating construction and oning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signattrri�Owner / Applicant / Contractor / Agent Date October 15, 2019 Page 2 of 2 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 FBC 20 (la+ BUILDING Master Permit No.�� PERMIT APPLICATION Sub Permit No. OC-10-10 - ? 3-+4 ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /� CONTRACTOR DRAWINGS JOB ADDRESS: Z61 Ivy' 1 I S 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: OWNER: Name (Fee Simple Titleholder): `'T11447 �-ChAU Mp ,N�� t1.1�1�Phone#: Address: Y sm Nr l 3 4ye City: M-) Am. State: zip: 3: W2 Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: C00y4 A Logo Phone#: Address: —49L4 i \m Z q W AV e City: H%xNedom State: r-L zip: 330� i Qualifier Name: L`3NS G%K3 _ Phone#: 3lb^ 824' U21(j, State Certification or Registration #: DESIGNER: Architect/Engineer Address: Value of. Work for this Per it: $ "Vu Type of Work: ❑ Addit n ❑ Alteration Description of Work: Q k. Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Certificate of Competency #: _ Phone#: 'City: Stat 5 are/Linear Footage of Work: ew ❑ .Repair/Replace Training/Education Fee $ CCF $ DBPR $ e: ZiP: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 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 property is sutrject 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 OWNER or AGENT The foregoing instrument was acknowledged before me this day ofyC+D Q r 20 �, by Q 1 who is personally known to o a me or whs produced as identification a NOTARYPUBLI ., �. YADIRAMARTINEZ MY COMMISSION # GG 180359 '•.°;,po ' EXPIRES: May 27, 2022 BondadThru Notary Pubiic uhdemtlters ^ , Sign. a Print: Seal: Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of 0C_+ Qf 20 ��, by kAA.;6 CdY V0 who is personally known to me or who has produced as identification and b an oaYPIRAMARTMIEZ MY COMMISSION # GG 180359 NOTARY PUBLIC: o�c EXPIRES: May 27,2022 F, °Q Bwdod 1Nv NotaryPubNc UndanKkers Sign: Mrs Print: /vn 1 ► 01 V)Qt Seal APPROVED BY �© Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Roy � Dewantis, Governor Halsey Beshears, Secretary Ronda (,J pr STATr7 nC V1 nDIMA UEZrPAM I I`ir-IN I %J� DVZMNr-SS PUNU I�IA.kj1=tSSIW►h1AL Kt%JU -kI 1U N CONSTRUCTION THE CLASS B AIR %'--.ONJITi( PROVISIONS N S I N G BC?A1111D EIN-.lS CEP i irlED UNDER THE i `A" STAT l)T [ S EXPIRATION DATE: AUGUST 31, 2020 Always verify ±icenses oniine at .N,,lyFios idaLicense.com Do no.- alter this document in any form This is your license. It is unlawful for anyone other than the licensee to use this document. Local Business Tax Receipt Miami —Dade County, State of Florida —THIS!S NOT A BILL — DO NOT PAY 7288184 BUSINESS NAME/LOCATION CORVO A/C CORP OPERATING IN DADE COUNTY OWNER CORVO A/C CORP C/O LUIS CORVO QUALIFiER Worker(s) 1 RECEIPT NO. RENEWAL 7576897 SEC. TYPE OF BUSINESS EXPIRES SEPTEMBER 30, 2020 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 196 SPEC MECHANICAL CONTRACTOR CAC1820110 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 08/21 /2919 0225-19-000166 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 ho;der's 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 Sa-276. �M�,�IA}MF- For more information, visit vvzp vi,ffii midade.aovltam Ilemi L71�IY I 4lCO/R0 CER'( 9t..AT : OF LIA'SILITYMSU. , C UATE(MM/DD/YYYY) y - -------------- -- -- --- — —.— — 8 / 2 0 / 2 019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIAATION ONLY AND CONrER S NO P;GHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIViELY AMEN, EXTi_I+ID OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NO"f CONS'RilJTE A CONTRACT 2ETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE: HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pofiey(ies) must ha.va ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may reqtiire an endorsement. A statement on this rertificate does not confer riahts to the certificate holder in lieu of such endorsernent(s). PRODUCER Westland South Insurance (..7N.,�Lt tJnr�;-----_____-_.__.----.__—__-- I " ' "SG5, ,93--f,F00 � Fax _�05 593-2533 )__—_-- 2608 NW 97th Avenue !J/' '' Fk`) °MA1 i"cmi.Lwe.st:i - - -- -----linrc�_( rolzthi:ns.carn Miami, Florida 33172 -• i IP1FIn; D( Af; t)P.DI,,.; ta COVEP.I.GE NAIC # r'': " :: F; A: - AC CORD --_— INSURED- CORVO i 1P751;..: y.t:13 : ___..---------------------- ----- ------------- 7451 W 29TH WAY r,(;•`k-tr; HIALEAH, FL 33018 COVERAGES CERTIFICATE NUMBER:_ —�— --_ REVISION NUMBER: THIS IS TO CERTIFY 'THAT THE POLICIES OF INSURANCE LISTED BEL.O'vV HAVE CEEN ;SSUED T1 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW!THSTANDING ANY REQUIREMENT, TFRM OR CON9rI-!CN OF AN%( COH7RAOT OR OTHER DOCUMFNT k,%ITH RESPECT -rO WHICH 'THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE iNSURANCE AFFORDED BY THE PC1_IC!ES DESG!?IEEU HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMPS .`•HOB'.'; MAY IIAVF PEEN REDUCED BY ."AIL" CLAIMS. NSR----------�C10L SIIBR ------ ?�iLIC\' El'�F T POLICY HXP,----- --- - LTA TYPE OF INSURANCE POLICY NUPARF:R —_--I L3AI_t.'iH�NYYY'� MAI/DI)/YYYV —_ -_ LIMITS -—_ —_^ COMMERCIAL_ GENERAL LIABILITY I EACH OCCURRENCE $ 1, 000, 000 — DAnTAGE T6RENTL� 19 8/2D/ 2017 i6/20/20: D I'fiEPAISES (Ea ocaurrnre I $ 100, 000 I� CLAIMS -MADE ®OCCUR O1t3.5CLOOi2�..59 i _- I I MED EXP ;Anyone Persor, I PERSONJAL Z ADV INJURY I $ 5, 000 $ 1 , 000, 000 4-i GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOC JECT OTHER: GENERAL AGGREGATE $ 2 r 000, 000 PRODUCTS - COMP/OPAGG $ 2, 000, 000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I ! I 1 ! I C D SIN L_ IM IT cci Eaa accident) $ BODILY INJURY (Per person) I $ BODILY INJURY (Per accident) _— $ ---- PROPER lY DAMAGE Per Acr0eirL — — — $ ---__._ $ UMBRELLA LIAB I I I EACH OCCURRENCE a -- II --a OCCUR I I ----------- EXCESS LIAB CLAIMS -MADE I i I AGGREGATE_ 9 _ DED RETENTION$_�_jtH —�$ WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY Y / N I I STnTUTE _L _ ` ER � ANY PROPRIETOR/PARTNER/EXECUTIVE (— j N / A E.L. LACH ACCIDENT — $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ It yyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 4/C REPAIR AND INSTALLATION CERTIFICATE HOLDER CANCELLATION CITY OF HIALEAH 501 PALM AVE SECOND FLOOR HIALEAH, FL 33010 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 ACORD 25 (2016/0,1) IGEORGE A DON - -� 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registeren marks of ACORD JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 10/8/2019 PERSON: LUIS A CORVO FEIN: 842372992 BUSINESS NAME AND ADDRESS: CORVO A/C CORP 7541 W 29TH WAY HIALEAH, FL 33018 SCOPE OF BUSINESS OR TRADE: Heating, Ventilation, Air - Conditioning and Refrigeration Systems Installation, Service and Repair, Shop, Yard & Drivers EXPIRATION DATE: 10/7/2021 EMAIL: ENMADEB01@HOTMAIL.COM IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01060783 QUESTIONS? (850) 413-1609 " CO RVO A/C 7541 W 29th Way Hialeah, FL 33018 Date: State ofLUi'ic County of l�llw I azz z Before me this day personally appeared Z—U15 6,010 who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: ;2&j AJE q5- 74 -</ 560'ee�;l Contract r ignature Sworn to (or affirmed) and subscribed before me this day of.20 1 1, by Lu! c-. &, &i& JOSE A. GONZALEZ Personally know MY COMMISSION # FF 975344 ;P EXPIRES: July 25, 2020 OR Produced Identification .0 e ;4• Bonded Thru Notary Public Underwriters Type of Identification Produced TL bL 'F-4;< <. A (! �' ," 6 a Print, Type, or Stamp of Notary 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: l . 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 A The foregoing was acknowledge before me this day ofociabef 20''f . By _CDJV0 who is personally known to me or has produced as identificatio�+++��+•�••�•. t�/11 YMMISS ON # G EZ Notary: _ _ � Q�_ .; .i MY COMMISSION # GG'g0359 EXPIRES: May 27, 2022 SEAL: %�o" ° Bonded Ttuu Notary Pubk- UldenMters