MC-16-297 Miami Shores Village 201
FEB 0 2
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 V4
FBC 20 ILA
BUILDING Master Permit No. rY1•Cl (0—Z,,I --v-
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION Ej RENEWAL
❑PLUMBING [MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
(�l • CONTRACTOR DRAWINGS
JOB ADDRESS: � to QKx- T
2y
City: Miami Shores County: Miami Dade Zip:
Folio/ParcelM Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FcFE:
OWNER:Name(Fee Simple Titleholder): 1"I Q Y n 8 t !o MVP 16f C_ Phone#: 305_— 4a WF (47(0 )
Address: OS-00 A.) E / 3S' 101i
City:V O rg Lj jar —State: 1' Zip: 3 3 t
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company�Name: l es ee RIC
C Phone#:s T�[
&I—d-1
Address: /6--&
6-- if CAS Cav r�
City:_/� n State: Y(., Zip:\3'3 01 o
Qualifier Name: o 1`n • /s. Phone#: (DT
State Certification or Registration#: 09 C f �r Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address:_ / 0o City: State: Zip:
Value of Work for this Permit: .. Square/Unear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace F-1Demolition
Description of Work: TO 17 i/�� C UvLil
i a
SpecifAy p � i� a
j otdcu lSH�E` i�yHRtl
Submittal v-I<SUJermi� $ +
Scanning Fee$ _j
Radon Fee$ c7`' �o DBPR$ '� Notary$
Technology Fee$ Training/Education Fee$ Q " Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ '
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City 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 certfled 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
— ";4
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_day of 5414 u tfr f ,20 lip ,by �day of 20��,by
Ito J&yfit M YAA,4 c ll ,who is personal) known to P is personally known to
_Mor who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Si Sign-
.-
Print. Print:
Seal: EBI OM Seal: ' ESIMEA 4M BARBA
ast is g'n4ft`wA to � � Nday P+bc•SNte of Flores
10m M ms- I 1AY Cyan.Exp Jon 93.2017
Vw"IV"AK93 ••,* 1 ,t•`` �''� ..�•' CommieeM#EE U0132
APPROVED BY bans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Prop e Search Application -Miami-Dade County Page 1 of 2
OFFICE OF THE PROPERTY APPRAISER
I
Summary Report
Generated On:1/8/2016
Property Information
Folio: 11-3206-044-0240
Property Address: 9120 NE 8 AVE UNIT: 2G
Miami Shores,FL 33138-3243
Owner MARTINos 6 6UP LLQ
1631 NE 114 ST#307
Mailing Address MIAMI,FL 33181 USA
Primary Zone
5000 HOTELS&MOTELS-
GENERAL'
0407 RESIDENTIAL-TOTAL
Primary Land Use VALUE:CONDOMINIUM-
RESIDENTIAL
Beds/Baths/Half 0/0/0
w
Floors 0
�v
Living Units 0
Actual Area Sq.Ft
Living Area 861 Sq.Ft Taxable Value Information
Adjusted Area 861 Sq.Ft 2015 2014 2013
Lot Size 0 Sq.Ft County
Year Built 1949 Exemption Value $0 $0 $37,577
Taxable Value $103,750 $98,810 $0
Assessment Information
School Board
Year 2015 2014 2013 Exemption Value $0 $0 $25,500
Land Value $0 $0 $0 Taxable Value 1 $103,750 $98,810 $12,077
Building Value $0 $0 $0 City
XF Value $0 $0 $0 Exemption Value $0 $0 $25,500
Market Value $103,750 $98,810 $70,580 Taxable Value $103,750 $98,810 $12,077
Assessed Value $103,750 $98,810 $37,577 Regional
Exemption Value $0 $0 $25,500
Benefits Information Taxable Value $103,750 $98,810 $12,077
Benefit Type 2015 2014. 2013
Save Our Homes Cap Assessment Reduction $33,003 Sales Information
Homestead Exemption $25,0001 Previous OR Book-
Price Qualification Description
Second Homestead Exemption $0 Sale Page
Senior Homestead I — 2914
Exemption $12,077 01/27/2014 $130,000 29009- Qua[by exam of deed
Widower lExemption $500 867
Note:Not all benefits are applicable to all Taxable Values(i.e.County, 04/26/2013 $69,000 3986 Qual by exam of deed
School Board,City,Regional). 3986
04/01/1993 $0 15900- Sates which are disqualified as a result
Short Legal Description 2045 of examination of the deed
SHORES PLAZA EAST CONDO 12/01/1989 $0 00000- Sales which are disqualified as a result
00000 of examination of the deed
UNIT 2G-1ST FLOOR
UNDIV.01907%INT IN COMMON
ELEMENTS
CLERKS FILE 7311213197
http://www.mianli&de.gov/propertysearch/ 1/8/2016
Detail by Entity Name Page 1 of 2
J
3
Detail Entity Name
Florida Limited Liability Company
MARTINO'S GROUP, LLC
Filing Information
Document Number L11000124583
FEI/EIN Number 30-0704057
Date Filed 11/01/2011
State FL
Status ACTIVE
Last Event LC AMENDMENT
Event Date Filed 06/30/2014
Event Effective Date NONE
Principal Address
2500 NE 135th St Apt 1109
North Miami, FL 33181
Changed: 04/25/2015
Mailing Address
2500 NE 135th St Apt 1109
North Miami, FL 33181
Changed: 04/25/2015
Registered Agent Name&Address
,MCCONNELL, ROBERT, CPA
7815 SW 97TH PL
MIAMI, FL 33173
Name Changed: 04/11/2014
Address Changed: 04/11/2014
Authorized Person(s) Detail
Name&Address
Title MGRM
Martino, Francesco A
2500 NE 135th St Apt 1109
North Miami, FL 33181
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/8/2016
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
TC=�8176MW
The CLASS AAIR CONDITIONING CONTRACTOR x
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2016
RODRIGUEZ,SEVERO RAFAEL-JR
RESCUE REFRIGERATI"AIR CONDITIONING CORP. ''i
1661 EAST 9 COURT
HIALEAH PL-331DID
ISSUED' 07115=14 DISPLAY AS REQUIRED BY LAW SEQ# L140715M787
omm
Local Business Tax Receipt - }
Miami-Dade County, State of FloridaLBT
THIS IS NOTA BILL — DO NOTPAY ,
7165501
BUSINESS;NAMRAI.00ATION RECEIPT NO. EXPIRES
RESCUE REFRIGERATION AND AIR CONDMONING GUMAL SEPTEMBER 30, 2016
1561 EAST 9 Cr 74438W Must be displayed at place of business
✓ HIALEAH R 3301Q Pursuant to County Code
Chapter 8A Art:S&10
d
OVMGR
SM TYPE OF BUSINEW
REVUE REFRIGIMARON AND AIR 196 SPEC MECHANICAL CONTRACTOR sr AX&
CONDMONING'CORP CAC1817698 $45.00 09/02/2015
Woffter(s) i CHECK21-15-119886
' T�isfoael.Bv�a�sTaa< �ao ��lecal8naiaeasTax.ilmRea�ptisaatalioeAee.
ata a ===Ono'�W" > ueas.
The WOMNO.awe numbs agwyl a$aI r -fMaw-909 Code sec 8a-278.
Tare►we l>fUaaaaarit
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Mia F Dade"' CO '' Sto
ge #
-TTS IS W t Al P14 NOT FW
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$ �..� .l, _ \ ,5.• ply S`t
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$£ PtAM QCATtOht ?_ S a Cels f, tO• F • IRs
}
RESCUI 121GTION ANQ IONING U
h TEiVIBE� 0, 1016
£ mo i u
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<S
A� CERTIFICATE OF LIABILITY INSURANCE DATE(/1=01'vY)
04/1812016
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 ttie certificate holler Is an ADDITIONAL INSURED,the pollcy(tes)must be endorsed. If SUBROGATION IS WA11/ED,sAect to
the terms and conditions of the policy,certain policies may require an endorsement.A statement on this ceettillcate does not confer rights to the
certfficate holder in Ila of such sndorsem"Sq
PRODUCER &NIZOT Lurgi Estrella
Accurate Na.Wt E (31)5)226-8727 FNok
(305)226-8767
8300 West Flagter Suite 114 lucfaa*eila@bdeouth.net
Miami,FL 33144 INsu AFFORDING COVERAGE NA1C#
Phone (305)226-8727 Fax (305)228-8787 IdSURERA: Covington Specialty Insurance Company
INSURED
INstiRER e:
Rescue Refrigeration&Air Conditioning Corp INSURER C:
1561 East 9th Court INSURER D:
INSURER Et
Hialeah FL 33010- 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,TERMOR 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 SEEN REDUCED BY PAID CLAIMS.
IN L TYPE OF INSURANCEADDLSUSR
PCJ EFF POLICY EICP
POLtCY'NUMBER W UROTB
Q COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1;000,000.00
❑ CL.AIM84AADE ® OCCUR PD
AMAGET $ 100,000.00
A ❑ VBA406469-00 .08/2472015 06/24/2016 MED EXP one pawn) $ 5,000.00
❑ PERSONAL&Aov INJURY s 1,000,000.00
GEML AGGREGhTE LlMrr APPLIES PER. GENERAL AGGREGATE S 2,000,000.00
POLICY ❑ ❑ LOC PRooucrs-coMProPAGG s 2,000,000.00
❑ OTHER $
AUTOMOBILE"LIABILITY IN SIdGLE LIMIT
❑ ANY AUTO BODILY INJURY(Per person) $
❑ ��ED ElAUTOS
SCHEDULED BODILY INJURY(Per accident S
El ❑ AUTO8 WNED P AMAGE
$
❑ $
❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE $
❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $
N $
WORKERS COMPENSATION ❑P
AND EMPLOYERS'LIABILITY YIN SW
-•
ANY PROPRIETOPJPARTNERIEXECUTIVED E.L.EACH ACCIDENT $
OFFICEWMEMBEREXCLUDED? NIA
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $
It yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L.IW $
DESCRIPTION OF OPERATIONS I LOCAM NSI VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if mare apace Is required)
License Number.CAC1917698
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED CANCEU ED BEFORE
Miami Shores Village Bldg Dept THE EXPIRATION DATE THEREOF, E RED IN
10050 NE 2nd Ave ACCORDANCE WITH THE POLICY S)
Miami Shores,FL 33138 AUTHOWW REPRESENTATIVE
305-756-8972 786-362-5004 Lucia Estrella ( wj
®1988-2014 A ORP RATION. AN.rights reserved.
ACORD 25(2014101)QF The ACORD name and logo are registered marks of ACORD
JEFF ATWATER
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
*'CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAID*'
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers!Compensation law.
EFFECTIVE DATE: 4/W2016 EXPIRATION DATE: 44"2018
PERSON: RODRIGUEZ SEVERO R
FEIN: 412630
BUSINESS NAME AND ADDRESS:
RESCUE REFRIGERATION AND AIR CONDITIONING CORP
1561 E 6 CT
HIALEAH FL 3$010
SCOPES OF BUSINESS OR TRADE:
HEATING,VENTILATION,
AIR-COND
PutsYaant�Chapter 44ftt15(14),F.s.,arr ofiic�atf a caparadott et#ro etxetttpdort�rom dad �by► � ��eti�on solder#xs sedfon
may not remverbenefits or compeaseffm tutuUus mer.Assuant to Ctwp e!440,05(12]FLS,.Cerfficales atStaten to be WOMPL.eppiyonly
w#tsin the scope of do business or haft Rated an um to ft of etecdon to be exempL PWWWd to Chapter 440.05(%F.S.,Notes of skaortio be
amnptmWcwbl&ftsafehxtantobeexwnpt std tm to #e3 aaty after lire f ig of ttsfl ru>#oa Ute isss u�ofIIte
tta person named on on nooks orcerOlkate no Iongermeells#a requirements #tis s for Wmanrxofa cerOzate.The department shd revokes
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED W13 QUESTIONS?(850)413-IW9
Gate
State of
County of
Before me this day personally appeared t.l2C) 't ,who,
being duly sworn,deposes and says:
That or she will be the only person working on the project located at
-,, A-o PJ
Sworn to(or affirmed)and subscribed before me this day of 2015 by
Personally know
OR Produced identification Z 3 �
Type of identification produced ��u4"t"')
w .
Print,Type,or Stamp of Notary
Pio•IM d i
• Ct #FF tit
My Co .Ex Apr 17'.M
J'C (4D-'4r-4
Miami Shores Village
�,► Building Department
gip► 10058 N.E.2nd Avenue
Miami Shores,Florida 33138
Tel: (305)795.2204
Fax:(305)756.8972
Notice tD owner- Wors' Compensation Insurance Exern tion
Florida Law requires workers' Compensation insurance coverage under C
allows corporate officers in the construction i Chapter`40 of the Florida Statutes. Fla. Stat § 440.05
obtaining a building permit, Pursuant to the o f Workers, this requirement for any construction project prim to
pensation Employer Facts Brochure:
An employer in the construction industry who employs one or more parttime or full-time
employees,including the Owner,must obtain workers,compensation coverage. Cerate offers
or members of a limited liability company (LLC) in the construction industry limy elect to be
exempt if
I. The officer owns at least 10 percent of the stock of the corporation,or in the case of
I LLC,a statement attesting to the minimum 10 percent ownership;
2. 'rhe officer is listed as an officer of the corporatist in the records of the Florida
Department of State,Division of Corpations;and
3 The corporatlon is registered and listed as acfive with the Florida
State,Division of Corporations. Department of
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
vohmtary revocation is filed or tate exemption is revoked by the Division.
Your COnh for Is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will use
day labor,part-time employees or subcontracxors for your prttject.The contractor has provided an affidavit suing that he or she will
be the only person allowed to work on your project.in time circums Misini Shores Village does not require vorificatIon of
workers'compensation icatrcance cover�e form 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; 1 "et
Owner
State of Florida
r
County of Mimi-Dade
The foregoing was Wmwledgo before me this t day of 5 XAra q ,20 NO
i
who is pun SMIly lntown to the or has pro&Xed
ification.No ISTWAASEL.
.
tttigiUfq
_ �o 't Notaty PUMk•State at
SE I By Co..Expires im.23,2011
C #EKE I1U
�' unto
Inspection Worksheet xv /
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-261017 Permit Number. MC-2-16-297
Scheduled Inspection Date:July 06,2016 Permit Type: Mechanical- Residential
Inspector: Perez,JanPierre Inspection Type: Final
Owner: , Work Classification: A/C Replacement
Job Address:9120 NE 8 Avenue 2G
Miami Shores, Fl- Phone Number
Parcel Number 1132060440240
Project: <NONE>
Contractor: RESCUE REFRIGERATION AND AIR CONDITIONING CORP Phone: (561)467-2176
Building Department Comments
REPLACE A 2 TON AC UNIT Infractio Passed Comments
INSPECTOR COMMENTS False
h
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-260996. CREATED AS
REINSPECTION FOR INSP-252129. missing lock caps
06/15/2016
Failed ❑ CANCELLED BY SHEILA
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
July 05,2016 For Inspections please call: (305)762.4949 Page 11 of 21
*At t
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 ,
Phone: (305)795-2204 �' x"' ', fir, • , ��_.. 3. . �'::
Expiration: 17/2016
}
Project Address Parcel Number Applicant
9120 NE 8 Avenue Number: 2G 1132060440240
Miami Shores, FL Block: Lot: MARTINOS GROUP LLC
Owner Information Address Phone Cell
MARTINOS GROUP LLC
FL
Contractor(s) Phone Cell Phone Valuation: $ 3,100.00
RESCUE REFRIGERATION AND AIR C (561)467-2176
Total Sq Feet: 0
Tons:2 Available Inspections:
Additional Info:REPLACE A 2 TON AC UNIT Inspection Type:
Classification:Residential Final
Approved:In Review Review Mechanical
Comments: Date Approved::In Review
Date Denied: Type of Work:
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40
Invoice# MC-2-16.58547
DBPR Fee $2.00 02/19/2016 Credit Card $77.90 $50.00
DCA Fee $2.00
Education Surcharge $0.80 02/022016 Credit Card $50.00 $0.00
Permit Fee $108.50
Scanning Fee $9.00
Technology Fee $3.20
Total: $127.90
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 foregoir .rafe� eirfs accuratq and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermor ove-name tr�c ol—r to do the work stated.
February 19,2016
Authorized Date
Building Dep ent Copy
February 19,2019 1