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REV-04-23-971, 94 NW 95th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 94 NW 95TH ST, Miami Shores, FL 33150 1131010340090 Contacts IMMOBILIEN LLC Owner D-AIR CONDITIONING COMPANY Contractor GARCIA CARLOS CASTANO 7602 NW 2nd Court, Miami, FL 33150 1002 NW 99 CT, MIAMI, FL 33172 Home:9544106364 gnd2@msn.com Business:7867786380 carlosalbertocastano@icloud.com Other:7202975338 Inspection Requests: Description: KITCHEN REMODELING AND BATH REMODELING Valuation: $ 100.00 , Total Sq Feet: 280.00 11 1 111a.1-0 Fees Amount CCF (Manual) $0.60 DBPR Fee (Manual) $2.00 DCA Fee (Manual) $2.00 Education Surcharge (Manual) $0.03 Permit Fee (Manual) $100.00 Technology Fee (Manual) $10.00 Tota I : $114.63 Payments Date Paid Amt Paid Total Fees $114.63 Credit Card 04/18/2023 $114.63 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 c nstruction an oning. Futhermore, I authorize the above named contractor to do the work stated. 01--k Authorized Signature: Owner / Applicant / Contractor / Agent Date April 18, 2023 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING EBC 20 Master Permit No. R L " I \ —1 � — 2 ,� -+L� Sub Permit No. PL 10 "G 0 � 2-7 -L KREVISION ❑ EXTENSION ❑RENEWAL "PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP gy CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: � \ — '� \ C � U —0 f) 1 u Is the Building Historically Designated: Yes NO X_ Occupancy Type: Load: Construction Type: Flood Zone: _ / BFE: FFE: OWNER: Name (Fee Simple Titleholder): Jh,tY\ ':_1 \ \ -2-1-1 0- L ' Phone#: "1 ,:2 9 7 S 335, Address: AJ City: I'sA-, o, ✓v.'� Tenant/Lessee Name: Email: c\ � it', / State: 1 C: r�� Zip: Phone#: CONTRACTOR: Company Name: �� I +' �� ►.�# i -� �...4a °^ •A GjPhone#: f �� `-! 3 Z- Address: ` C c {ems to q `� CA i'1 ko wa i f1i --'� � � i 1 -L lam, Email: k ✓` cr c i YC ✓1 C `.• ►� Qualifier Name: cc1 '( c' _'� cl VA.L one#: -7 6 S State Certification or Registration #: C C: \/ 0 1 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ V O.0\'_� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: t1;: " \ c 2 �—� 6 Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ DCA Fee $ DBPR $ Notary $, Technology Fee $, Structural Reviews $ Training/Education Fee $ Double Fee $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ t (4 •�� (Revised04/05/2022) 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 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 t Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of � ,20 �3 by f , who is personally known to me or who has produced% c�%� �� as identification and who did take an oath. NOTARY PUBLIC: Sign: c Print: Seal:OR r;¢ *********** APPROVED BY (Revised04/05/2022) <l�/�'�-_I-e�Z-- The foregoing instrument was acknowledged before me this day of 11. , 20 �, by C. CAS-rwf,� D me or who has produced who is personally known to identification and who did take an oath NOTARY PUBLIC: Sign: Print: . A lt7 4Nr,j�,o G RUBY FERRO Seal: MY COMMISSION 8 HH 23 0 EXPIRES: March 2, 2= as DROgRc/ Gp�iR 13EYo 9 o I Dow NO i 'Py 41blic Undec� O Plans Examiner Zoning Structural Review Clerk Ron DeSantis, Governor Melanie S. Griffin, Secretary dbpr d STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 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. OAIRC-1 OP ID: AP ,a►c'c�►rzv CERTIFICATE OF LIABILITY INSURANCE DATE100fY 11/303012022 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies rnay 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: Ana Matra Tr'iguel'o South Florida Insurance Und. DiBIA Trimart LLC (Ai� 4 Exs)_306 599 8989 _(acyNQj 306�99-8788 --- MAIL 7950 NW 63rd Street Suite 213 E ERF Ana a_)southfialnSurance corn Doral, FL 33156 AnOREss: -- Ana Maria Trigueiro _ 6_.- 5t1R R SnAfF RD {a OV A ----._-- _------.----_—_._-----__.__-- _ .____ ___ INsur?ERA:Jantes Riverinsurattce Companyr INSURED D-Air Conditioning Company INSURERB:Progressive htsurance Compan 1002NW99Ct - ---- ---- Miami, FL 33172 INSURFRC:Aintrust North America Inc 01913 iNSURErtD.Evanston Insurance Co. 36378 - INSURER E : ('nVFPA(3PR CFRTIFICATF NIIMRFR-----�— —RF-VISION NIIMRER! THES IS 't0 C[RTI) Y 7IEAT THt=f�OLIC;IES :}f INSU}tANCE LISt LO i1E LOW HAVt_ HEL.N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMFNT, TERM OR COND11I014 OF ANY CONTRACT OR OTHER DC)CUMENT WITH RESPECT TO WHICH THIS CER'i FICArE MAY BE ISSUED OR MAY PERTAIN; 114L INSURANCE AFFORDED BY THL POLICILS DESCRiBL:D HL'REIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCA1 POLICIES. i_IMITS, SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS. INSR ----- — — Ao`ill- LTR TYPEOFINSURANCE POLICYNUMBER I MmIULYYYY� AAIDD�IYIYPY LIMITS A X COMMERCIAL GENERAL LIA13iLITY EACH OCCllRRENCE S 1,000,00 CLAIMS -MADE X ]OCCUR 00137935-0 12/0812022 12108t2023 0Afti(AG TO RENTED TD _.._ ! Pitf MI LS (t a occc enge) _ --- - S 100,00 X 2,500 Ded i MFO f XP (Anyone person) .._............... S 6,00 - ; PERSONAL & AUV INJURY S 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: � GLNt RAT AGGREGATE. S 2,000,0Q jj PRO- POLICY CX I ,}ECI I _I LOG I 1 PRODUCT COMP/OP ACG , _ _ _ .._ S - 2,000,00 OTHER: I i $ AUTOMOBILE uAs31uTY COMF1iNED SINGLE. LIMIT s 300,000 ANY AUTO 02621946-1 09122i2022 0912212023 HD ILl INJURY (Per person) S I ....- ALL OWNED T. SCHF01juO X -..._ _------------- t30` iLY INJURY tie. acc'dent) -------- S AUTOS AUTOS NON -OWNED PRLiPERTY T')AMAGE S HIRED AUTOS AUTO',, _- 'nr acrldant _ $ UMBRELLA LIAB _ OCCUR LACI, OCCURRENCE S EXCESS LIAB -...,,_ CLAIMS -MADE AGGRLOATL: S DED RETENTION WORKERS COMPENSATION X t STATUTE f TH C AND EMPLOYERS' LIABILITY N l ANY PROPRIETCTRiPARTNER!£XCCUTIVE AWC1187116 11t)J0612022 10f0612023 — ----- - f=.1. FACH ACCIDENT S 1,OQ0,00 i/ OFNCERIMEMDER EXCLUDF.09 1 NIA A _._ 1,000,00 (Mandatory In NH F'.i DBEASE - EA EMPLOYE S - — -- — — If yes, describe under DESCRIPTION OF OPERATICNS below I I .I DISFASE. - POI ICY LIRi1T $ 1,000,00 _1 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 10n, Addifionai Remarks Schedule, maybe aftachect If nwra space Is reglrlredj Plumbing and Air Conditioning Installation Service and repair f =MTICUTATC Uni M=0 r Ahfr"FI I ATIn AI VILLMAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF MIAMI SNORES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10060 NE 2 Ave Miami Shores, FL 33138 _ AUTHORIZED REPI.FSENTATIVE. O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD 1 f ' 7170298 BUSINESS NAME&OCATION D-AIR CONDITIONING COMPANY 1002 NW 99TH CT MIAMI, FL 33172-5742 OWNER D-AIR CONDITIONING COMPANY C/O CARLOS CASTANO QUALIFIER, n-AIRf'nNnlTlnnuN� C.C)KAPANV Worker(s) 1 RECEIPT NO. RENEWAL 7517488 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1430407 EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business Pursuant to County Code Chapter BA -- Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 08/02/2022 INT-22-380517 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 holder'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 6a-276. MIAMIt7WDE For more information, visit www.miamidade.gov/taxcollector