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RC-11-19-2844, 94 NW 95th St (5)Miami Shores Village RIFICEAVE:1D Building Department APR 2 6 2023 10050 N-E.2ricf Avenue, MiamiShores. Honda 331.M Tel: 1,305) 795-2204 Fax; (305) 751-,-8g77 BY: U— LNSPECrM LINE PHONE NUMBER: )305) 762-4949 EBC 20Z1D - 74"% BUILDING Master Permit No. 0-IC — t k -1 R - 2 �- 4 `+ PERMIT APPLICATION Sub Permit No. 1" kX_ ❑BUILDING ❑ LLECrRIC ❑ ROOFING XRE'tiS10N L] EXTFNSION ❑RENEWAL- _ P�ev-mot-z- - l®zZ ' PJW'roti IN%'j MECHANICAL ❑ CHANGF UI- ❑ CANCLLLATION SKUP } CONTRACTOR DRAWINGS Ltrl' Miami Shorts _ County: Miami WOg. . rD=- 7. 7> C' roriio/ParcehV: 1 % — 1 1 3 `i — 0 Q 9 0 is the Stdiding t6mrkally Dersignar t , Yes NO — OccuDancy Type: _ - Load: Constructiun Type: . _ --- Flnod 2a^e: �+ R=E: FFr: _ 1w- f>Jrc.-j-d— OWNER: Name (Fre Simple Titiehot<9rr): �n►w/wr + f* L--L �_ _W�onen: City: �e' ` QL �ti� R _. Sit€e- — . 1 o r' -1 t7 runt/Lr %m Marne, Phunrli:� _ Email: r,, C--r .' S r` . C 0 M _ CONTRACTOR; Company Namr,- ��- $ G� � �!/2 (0 4)(4/%0#V n nr*; _ 23 0 V _3 Enrol: �j(�[✓ ! �G�l [/1fA7/Vt�iDot/dl j `w'—h4C2 �) • CiYfti Qu.-rlifier Name: . ..J �FQAJ V cST — Phnnc* State CertrfiCation or Registration 0: f0 & —Certificate of rompecency t: DESIGNER: A,-chi*PctrEng neer: Address: r . Ci7: _ —State: Zip: Value of Work for ties Permit: $ �J Square/Ur►ear Footsgc of Work: Type of work: = Addition ❑ Alteration ❑ rNew ❑ Reckair/ Replace ❑Demolition Description of Work: J L i.+1 (J •` C Specify color of color Lhru tile: Submittal Fcir $ Permit Fer' $ _.� CCF 5 _ CO/CC $ scanning Fee $ DCA Fee $ DE42R $ _ Rio:ary $ Technotogy Fee $ Training/ Education Fee $ _ Double Fee $ Szructurai Reviews $_ P&Z R�2view y _ Bend Gt�� _ TOTAL FEE NOW DUE $ I'—1 -cl i Rrw i; r: tei+t fp`ii 2 U 22I Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Morlpge Lendees Name {if applicaWr}�,_.._ Monvee lenders Address City State Zip - Application Is hereby rr.ade to obtain a permit to do the work and installations as indicted. I certify that no anrk or insta@ation has commenced prior to the issuance of a permit and that all work w71 be performed to meet the standards of all laws regulating construction In that jurisdiction. I understand that a separate: permit must be secured for ELECTRIC, PLUMBING, UGNS, POOLS, FURNACES. BOILERS, HEATERS, TANKS, AiR CONDITIONERS, ETC.... OWNER'S AFFIDAVIT. i crrtify that all the foregoing information is accurate and that all work will be draw in compFance with all applipble la%vs 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." liatke to Applicant: As a condio»n to the issvonce of a but76ing permit with an estirreatrd vduc rawer ding ,$2500, the applkant must promise in goon! Jcith that o copy of the notice of corrimcacement and construction lien law bnxhurr wirt be dekmrtrd to the person whose property is subject to attachment. Aiso, a ccnVkd copy of the recorded notice of encrmrrrt must be posted of the job sne for the first inspection which occurs scorn M dogs after the buiN inq permit Is tssutd�Me ob�gnc�r of such posted notice, the inspet bon w91 no. be appraiwd and a reinspey7ipn fee w771 be charged. / i Signature OWNER or AGENT The foregoing instrument wA% ad=wicdgrd before me this day of � ,�1 / ..___, 20 a " by who is personally known to me or who has p;aduced . �/ f= as identification and who did take an oath. NOTARY UPIX. Print_- AV Seal: E 762f il{777R APPROVED BY (%w6i.wf(AA'A17W2) The foregoing Instrument -dav of rfowtedged tvilbre me this _.. _.-_ . 20by who is personally known to me or who has produced . („/E�i�7�C as Identification and who did take an oath. NOTARY Print• o NI P y tjorlea +e" Con•mi ior. s GG 910"5 RWIFERRO o.n My Comm.. Expires Seo a. 2023 �ti /lam 80rece thra:gh Nationai rotary Assr. D�1RF Mid1 Z 2= ♦11/11111111111\11\"��\��\'�7\1'f�.ff\1=ItRR...�a�1��1111�11111�1 Plans Examiner StnaCtural Review __- Zoning Clerk V I a,L 6, R1bi ❑❑ Ron DeSantis, Governor Floi"ida pr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIO THE CLASS B AIR CONDITIC3 PROVISION r L 9d I 43 ti� k} t � � a Melanie S. Griffin, Secretary TENSING BOARD S CERTIFIED UNDER THE CATUTES 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 SILL - DO NOT PAY 7228333 BUSINESS NAME/LOCATION MAGNUS R & S AIR CONDITIONING LLC 7211 W 24TH AVE APT 2221 HIALEAH, FL 33016-6530 OWNER MAGNUS R & S AIR CONDITIONING LLC Worker(s) 1 RECEIPT NO. RENEWAL L rR7*i il 7513281 EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business 0 ` Pursuant to County Code Chapter 8A - Art. 9 & 10 a •� 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 Taut. 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 Be-276. MIAs For more information, visit www.rniamidade.aov/taxcollector 4a 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 or 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 ❑0 0 W Ron DeSantis, Governor Melanie S. Griffin, Secretary Florida STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION LICENSE NUMBER: CAC1819076 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 - DO NOT PAY 7228333 BUSINESS NAME/LOCATION MAGNUS R & S AIR CONDITIONING LLC 7211 W 24TH AVE APT 2221 HIALEAH, FL 33016-6530 OWNER MAGNUS R & S AIR CONDITIONING LLC r.1r1 AlrARfNI Fr1Nr; M(;R Worker(s) 1 RECEIPT NO. RENEWAL 7513281 LBT EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business Pursuant to County Code Chapter 8A - 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 most 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 Be-276. M® For more information, visit www.miamidade.govilexcollector 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 or 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 ACORN® `C CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F04/27/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: MARTA ALONSO PVH�" o . (305) 266-6493 FAX Noll: (305) 262-0679 6874 SW 8 St E-MAIL ADDRESS: marta@floridabankersinsurance.com 6874 SW 8 St INSURERS AFFORDING COVERAGE NAIC # INSURER A: UNITED STATES LIABILITY INSURANCE Miami, FL 33144 INSURED INSURER B INSURER C MAGNUS R 8 S AIR CONDITIONING LLC INSURER D 7667 TROPICANA ST INSURER E : MIRAMAR, FL 33023 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD OMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000.00 CLAIMS -MADE X OCCUR DA AGE To RENTED PREMISES E. occurrence) $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 500,000.00 A N N CL 1824238E 09/13/2022 09/13/2023 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000.00 X POLICY PRO LOC JECT PRODUCTS-COMP/OPAGG $ 1,000,000.00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OTH- STATUTE I—CER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, 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) LIC: CAC 1819076 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE BUILDING DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138� , C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD 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: 94 JVW 95tp �T. Miami Shores, FL 33150 Contractor " aturt Sworn to (or affirmed) and subscribed before me th�IR day of by Ricardo Fong Personally know OR Produced Identification Type of Identification Produced YENILYN SWO • Notary Pubiic • State 3, = orica �" Commission : GG 9' 0' ' S my Comm- ftnims c, 2023 Bonded through riatiora, %otar; Ass. t, Type or Stamp a- m e—of N o ary w'q" 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 Zlp 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 1LLd�y The foregoing Instrument was acknowledged before me this of �Q.( 200tC by personally kno a me or who has produced ------- " as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Comm' wan CONTRACTOR The foregoing instrument was acknowledged before me this 2 d day of OL'Mfcf. , 20 2-1 � by V'Ih ,-r-14, =1 (L= % --, who is personally known to me or who has produced Identification and who did take an oath. NOTARY PUBLIC: Print, as — r LQU&PS CAMM Seal: Seal: +" Comtnllon4d36611I3 #ys�p ExOM AUP013, 2023 CMf1� 8ortd1d1MiY1le1g1aM�ty"A�vkN � ###4########################t#########R#####M##4####�M##+I�i4#1###��W#�►#.##�kt�M##i+l�ti8'M###�M#+Y###�M6#rk#t+MtM�#1�M tl#�Y#F�k i APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)