RC-11-19-2844, 94 NW 95th St (3)Miami Shores Village
RT1410EJVF1'13
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
Building Department All)R 2 6, 2023
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Bv:�
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2020
Master Permit No. 2 C ' lIl I - i c� - '2
Sub Permit No. CEY-Cc-I
❑ ROOFING X REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING �jMECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
TT�- AA CONTRACTOR DRAWINGS
JOB ADDRESS: y I v 11J Gi
City:
Miami Shores
County:
Miami Dade Zip:
3 -� r 5
Folio/Parcel#:
k \ �— 3 k U \ — � '-�
" v Q
9 Os the Building Historically Designated: Yes
`0
NO
Occupancy Type: Load: Construction Type: _ Flood Zone: BFE: FFE:
N-
OWNER: Name (Fee Simple Titleholder): L ,vimJ%s Phone#:
Address: / (� C. A' iJ " l"-� (_ •�.�
City: A1\- \ cxy-i State: Zip: —1S C�
Tenant/Lessee Name: Phone#:
Email: 4" V,I �' —1<:Z-1) rY- s I-,- - - z- ""
CONTRACTOR: Company Name: Q 6i'n AA; %E s i %/Z �(► a4l /%0,0/lf ne#: -3 Cl 3 j 3 (ice
Address: � ;2 // ty i-s( .2 41 A/ L% Jci 1��� 3 d % �y
Email
Qualifi
State Certification or Registration #: V-A (c'j K Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Permit Fee $
DCA Fee $
Technology Fee $ Training/Education Fee
Structural Reviews $
CCF $
DBPR $
CO/CC $
Notary $
Double Fee $
P&Z Review $ Bond $
TOTAL FEE NOW DUE $
(Revised04/05/2022)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
state Zip
Mortgoge Lender's Name {if applicable}
MortPee lender's Address
city State Ftp ., ,
Application is hereby rmatie to obtain a permit to do the work and ►instqd)ptions as indicted. 1 cenify that no work or instalUtion has
commenced prior to the issuance of a permit and that all wurk will be perforated to meet the standards of all iavr, regulating
construction in this jurbdicdon, i understand that a sepprate permit must be secured for ELECTRIC, PLUMBING, SaGNS, POOLS,
EURMACES, BOILERS, HEATERS, TANKS. AIR CONuiriONERS, ETC_
OWNER'S Af151DAVIT: t certify that all the foregoing information is wwrate and that all work will be done in compfance with all
applic2W laws reculatit:g construction and toning.
"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 AppGront: As a cor4ft.5 n to the issuance of a boding permit with an estimaird value exceedino $ 500, the opplicont must
promise in good Icith Mar a copy of tnc notice of commencement and construction Gen later brimhurr w9l be del irr+ed to the person
whose proper ry is subjva to attachment Also, o certi scd copy of the recorded notice of ' ' encemcat must be posted at the lab site
th for e first inspection which oceurs seven M days after stet bue?ding permit Is 4wed( 11 d.%/(e obAr" of sucsuchpostrd notice the
inspection stemt not be approved and a reinspec*a fcc vnTl be chonged: /
Signature
OWNER or AGCNT
The foregoing instrument was 3duwwIcdged before me this
day of l� 20 �� by
who is personally known to
me or who `+as produced ..A2as
identification and who did take an oath.
NOTARY PU%K!-
Print
Seal:
APPROVED BY
The foregoing instrument as a owledged before me this
ay of , 20� by
who is persona Ily known to
me or who has produced as
identification - d urho did take an oath.
NOTARY PU
Print:
Rta9lfF W Seal:
WCON&IISM#H1112=3
UP Z 20
Plans Examiner
�G Pzl Corrmt ior. s GG 9'0"5
r ti My Comm. Expires SeD a, Z023
Boceet through Nationai Notary Assr.
••�'I�ff1If1 •`f\\11ltti•s.1 a�1 �1 •�fA��H�♦�11
._. _ Zoning
Ukwtiun1CA1 A17W.?%
Struoural Revievi
Clerk
FQ.
0W
Ron DeSantis, Governor Melanie S. Griffin, Secretary Flotida
STATE OF FLORIDA dbpr
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION.,t ,
THE CLASS B AIR C0NDITI11:::::1,�N*
PROVISIO
e""• xP� �, y„t
d`.F :9 IX
g
LENSING BOARD
W IS CERTIFIED UNDER THE
< T
STATUTES
t
g
LICENSE- ., MAC9076
EXPIRATION DATE: AUGUST 31, 2024
Always verify licenses online at MyFloridaLicense.com
Do not 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 IS NOT A BILL - 00 NOT PAY
7228333
BUSINESS NAiME&OCATION
MAGNUS R & S AIR
CONDITIONING LLC
7211 W 24TH AVE APT 2221
HIALEAH, FL 33016-6530
OWNER
MAGNUS R & S AIR CONDITIONING
LLC
r/n RIr.ARnn Fomr, Mr;.^
Worker(s) 1
RECEIPT NO.
RENEWAL
7513281
EXPIRES
SEPTEMBER 30, 2023
Must be displayed at place of business
Pursuant to County Code
Chapter BA - Art. 9 & 10
SEC. TYPE OF BUSINESS
PAYMENT RECEIVED
196 SPEC MECHANICAL BY TAX COLLECTOR
CONTRACTOR 49.50 10/06/2022
CAC1819076 INT-23-003123
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 holders 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 6a-276.
MIAM for more information, visit www.miamidade.govAoxcoilector
JIMMY PATRONiS
CHIEF FINANCIAL 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: 10/18/2021
PERSON: RICARDO FONG SR
FEIN: 821600965
BUSINESS NAME AND ADDRESS:
MAGNUS R&S AIR CONDITIONING, LLC
7211 WEST 24 AVE #2221
HIALEAH, FL 33016
SCOPE OF BUSINESS OR TRADE:
Heating, Ventilation, Air -
Conditioning and
Refrigeration Systems
Installation, Service and
Repair, Shop, Yard & Drivers
EXPIRATION DATE: 10/18/2023
EMAIL: MAGNUSAIRCONDITIONING@GMAIL.COM
IMPORTANT: Pursuant to subsection 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 subsection 440.05(12), F.S., Certificates of election to be exempt issued
under subsection (3) shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business cr
trade listed on the notice of election to be exempt. Pursuant to subsection 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 E01430973 QUESTIONS? (850) 413-1609