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MC-12-21-3321, 94 NW 95th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Y , / IN4 Issue Date: 12/29/2021 Location Address Parcel Number 94 NW 95TH ST, Miami Shores, FL 33150 1131010340090 Contacts Permit No-, M C-12-21-3321 ermit Type: ,Mechanical - Residential rkClassi}cat on: Addition/Alteration Permit Status: Approved Expiration: 06/29/2022 IMMOBILIEN LLC Owner MAGNUS R & S AIR CONDITIONING LLC Contractor GARCIA RICARDO FONG SR 7602 NW 2nd Court, Miami, FL 33150 7211 W 24 AVE 2221, HIALEAH GARDENS, FL 33016 Home: 9544106364 gnd2@msn.com magnusairconditioning@gmail.com Other:7202975338 _•�• N Inspection Requests: I Description: INSTALL NEW SPLIT SYSTEM A/C UNITS AND DUCT Valuation: $ 7,695.20 \ 305 762 4949 WORK Total Sq Feet: 224.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 DBPR Fee $4.04 DCA Fee $2.69 Education Surcharge $1.60 Permit Fee $219.33 Scanning Fee $3.00 Technology Fee $6.73 Total: $292.19 Payments Date Paid Amt Paid Total Fees $292.19 Credit Card 12/29/2021 $292.19 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 A I VIT: I ce at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating ns�nd �rrSg ,Futhermore, I authorize the above named contractor to do the work stated. ! Applicant / Contractor / Agent 29, Date Page 2 of 2 f Miami Shores Village BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC 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 / t7 FBC 20 .1� Master Permit No. RC-11-19-2844 Sub Permit No. (A C -.123 2- ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL III pEC 222021 IUI ❑PLUMBING Q MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 94 NW 95th St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3101-034-0090 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Nick Garcia - (mmobilien LLC Phone#:720-297-5338 Address:7602 NW 2nd Court City: Miami State: Florida Zip: 33150 Tenant/Lessee Name: Email: gnd2@msn.com CONTRACTOR: Company NaJne: Phone#: 720-297-5338 41 6) Phone#:4�25) Address: t / City: �� State: / Zip:`+ Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: _� City: State:: Zip: Value of Work for this Permit: $T�� `2;F Square/Linear Footage of Work: Type of Work: A Addition ❑ Alteration ❑ Neew ❑ Repair/Replace�� ❑ Demolition Q Description of Work: _S�f'sf�EL�/ Specify color of color thru the: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $_ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 29 2 ' (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 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 val a exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien la rochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co encem n must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the a sen e of such posted notice, the inspection will not be approved and a reinspection fee will be charged. i Signature Signature OWNER or AGENT C TRACTOR The foregoing instrume was acknowledged before me this The foregoing in4rume,,�sacknowledged ntwabefore me this day of 1 iT, " ! , 20 by day o20 -271 by Nick Garcia who is personally known to who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. p,ttVPa/c ;cRlJiZ NOTARY PUBLIC: * - ,; ,,575 NOTARY P LI . ,,i23 �iho�aryService3 Sign:�/y „ Sign: Print: Print: Ji I CPA Ilk' YO-V Seal: Seal: �►*. ��;,,. Y ILYN BRITO Notary Public - State of Florida Commission S GG 910115 My Comm. Exiires Sep R, 2023 Bonded through Nationa:.Notary Assn. APPROVED BY �_ �_.' Plans Examiner Zoning Structural Review Clerk (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 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):94 NW 95TH St City: Miami Shores Village County: Miami Dade zip Code: 33150 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 ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER rr � *, k' AHU or PKG. UNIT MODEL # & % COND. UNIT MODEL # G�iCJ KW HEAT NOM TONS y IDrc/ AHU CU PKG 1) M.C.A AHU W CU PKG AHU CU PKG 2) M.O.P AHU ' CUtQe PKG AHU CU PKG 3) VOLTS AHU,13OCU_,72CPKG PKG UNIT / / PKG UNIT EER/SEER 16 YES NO REPLACING DUCTS YES y NO YES NO REPLACING THERMOSTAT YES X NO YES NO NEW 4"CONCRETE SLAB YES y 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 (208/240/480): 4. Size Disconnecting M ans: _ Contractor's Company None: jjd vl-- PM% i A7 Phone: ' State Certificate or Re Signature Certificate of Competency Ncd Date: (Revised02/24/2014) Magnus R&S Air Conditioning LLC. Date: State of Florida County of Miami -Dade Before me this day personally appeared Ricardo Fong who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: ST. Miami Shores, FL 331SO re Sworn to (or affirmed) and subscribed before me this 22 day of December. 2021, by Ricardo Fong Personally know OR Produced identification Type of Identification Produced � sL. YYEEpNIIYN ANIITTOr Y ptC�3Fh�f,l� r�°�, Print, T m jai .; s or. I o. n . My Comm. Ec Bonded throu h N ores Sec +. 1023 S ationai!.otJrY Assn, its pIORIDA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 r 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, 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 �� day of 20�. By i �1���1 Q`� who is personally known to me or has produced Notary: V►*J Notary Public State of Florida Michelle D' Ambar Cruz Expires OW2312023 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C COPY OF LIABILITY INSURANCE* -, D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: BUSINESS ADDRESS: BUSINESS PHONE: ( ) CELL PHONE ( ) Kw FAX NUMBER ( ) QUALIFIER'S NAME: STATE ZIP QUALIFIER'S LIC NUMBER: