MC-19-3012Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
1191 NE 103RD ST, Miami Shores, FL 33138
Contacts
Permit NO.: MC-12-19-3012
Permit type: Mechanical -Residential
Work Classification.- Alteration
Permit Status: Applied
issue Date:12/27/2019 I Expiration: 06/24/2020
Parcel Number
1122320310050
COBIA LLC Owner ADVANCE AIR TECH CORP Contractor
8045 NW 155 ST, MIAMI LAKES, FL 33016 IZMERT LABRADA
Mobile: 7869994855
Business: 3057953414
Description: INSTALLATION OF 2 NEW EXHAUST FAN Valuation: $ 1,000.00 Inspection Requests:
305-62-4949
Total Sq Feet: 1,800.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total fees
$110.30
Credit Card
12/27/2019 $110.30
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: certi hat all t e_foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constructio d uthermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
December 27, 2019 Page 2 of 2
Notice to Owner — Workers' Com
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 tinder 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 (LI,C) 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: _
caner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this �— day of A00 , 20�
.. ► ► 1 _n
J!✓AL
who is personally known to me or has produced
fication.
ef�Notary PArre Stets of
CamillaArredondo
My Commission GG : s�
or Expires 09f28/2022
ADV CE AIR TECH
Air Conditioning Contractor
6010 SW 19th St Miami, FL 33155
Phone(305) 794 3414
Email:advanceairt@gmaii.com
Date:12/18/19
State of G vz- OP4
County DA.0a
Before me this day personally appeared �yts who,being duly sworn,
deposes and says:
That or she will be the only person working on theproject located at I I °► 1 0 C- 1 U 3 �Q ST
Sworn to (or affirmed) and subscribed before me this 1% day of D c c. .20 i-k;by
Personally know
Or produce Identification
Type of Identification
(-\ TP(-->-nI•k--C'
070
MARIANELA TEIXEIRA
08de(id
ry Public - State of Florida
,•,`` :mmisslon # FF 9 92
mm. 20
� •• through Nati arNotary Assn.
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
1 XTnRED
OEM 23 u;3
Fsc Zo»
BUILDING Master Permit No. LC-0S C? q(d::7
PERMIT APPLICATION Sub Permit No. _
Nc- �.- 3oI 2-
(BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ( (11 ( U 3 �4 `JT `
City: Miami Shores County: Miami Dade Zip: 3 3 (3 8
Folio/Parcel#: I ( - 2 ? 3 "Z -y 3 ( - G U Sy Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(FeeSimple Titleholder): �� T12( I A LA L Phone#:
l Address: 1 g 1 N l"� 1 Q3 C-t
City: � 1 r* 1 < � K 09 �4 State: i C� Zip: 3 3) 3�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Aivt4 L�' C E- 4 i rG Phone#: 3 C, '�- -7 Q 3 y T
Address:: a 0 ( U S� ccl S
City: M /r fi ,-4 1 _ State: ,, EC— Zip: 3 3
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
of Competency #:
-State: Zip:
f Value of Work for this Permit: /Square/Linear Footage of Work: i S -1 'S'q FT'
Type of Work: ❑ Addition Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: �^
Specify color of color thru tile:,
Submittal Fee $ Permit Fee $
CCF $ I CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ L 1V d
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
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.
Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
/day of JPf P.rrkj&- C 20 �J . by
L DP'GZ , who is personally known to
me or who has produced (S0jy4I1W lkilflai hj/ T as
identification apd who did take an oath.
NOTARY
Sign:
Print:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
(9, day of C- e- 20 1 by
z `� vt_l K who is ersonaliy kn to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: 106 Kr`:' ""h'1 p N LaP7EKEfRAI V Ci
Notary Public - State of Florida
Seal: Seal: `•' : Commission # FF 983292
�'40 Notary Public State of Florida ';?, Pam= My Comm. Expires Apr 18, 2020
Camilla Arredondo •;;aFf ``
+� My Commission GG 262408 ' Bonded through National Notary Assn.
�ia1,; Expires 09126/2022
#* # !T1a4
APPROVED BY vminer Zoning
Structural Review
(Revised02/24/2014)
Clerk
�1
momdx1e.G_OV7dM
_
Pursuant to amendments made to Florida Statute 119.071, effective July 1, 2019,
accounts exempt from public disclosure are not viewable or payable online.
2019 2nd Quarter Tax Bills are payable on September 1, 2019.
2019 Annual Tax Bills are scheduled to be mailed on October 31, 2019 and will be
payable on November 1, 2019.
If paying delinquent real estate taxes (2018 and prior) by mail, acceptable forms of
payment are: Cashier's Check, Certified Funds or Money Omer.
If paying delinquent real estate taxes (2018 and prior) in person, acceptable forms of
payment are: Cashier's Check, Certified Funds, Money Order, or Cash.
The information contained herein does not constitute a title search or property ownership.
Amount due May be subject to change without notice.
For instructions on obtaining Payoff/Release of Lis Pendens on Property Appraiser's
Office Ad Valorem Tax Litigation Cases, please " Click Here "
If you have a deed certified on your account, click the following link for sale information
hooeff ++iamidade realtdm com/nubiic%ases/list
2020 Details — Business Tax Account ADVANCE AIR TECH CORP J im—L
Business Tax Account #7181778 S Account dMWIS _ - Account mday'
2020 _ 2019
PWd Paid
Account number:
Business start date:
rr 2018
Paid
7181778
02/18✓2015
!017 2016
Paid Paid
Marling address:
L2015
Paid
ADVANCE AIR TECH CORP
C/O LABRADA IZMERT
6010 SW 19 ST
MIAMI, FL 33155
Phyakel business location UNIN DADE COUNTY
Owner(a) ADVANCE AIR TECH CORP