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MC-16-31740 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. MC -11-16-3174 Pennit Type: Mechanical - Residential Work Classification: AdditionlAlteration Permit Status: APPROVED Issue Date: 11/2912016 Expiration: 05/28/2017 Parcel Number Applicant 12 NE 96 Street Miami Shores, FL 33138 1132060130660 Block: Lot: GDS HOLDINGS GROUP LLC Owner Information Address Phone Cell GDS HOLDINGS GROUP LLC 151 N NOB HILL Road PLANTATION FL 33324- (754)244-4697 151 N NOB HILL Road PLANTATION FL 33324- Contractor(s) MANCO AIR INC. Phone 305/409-7719 Cell Phone Valuation: Total Sq Feet: $ 450.00 0 J Tons: 0 Additional Info: INSTALL DRYER VENT 4" GALVANIZED TO Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: INSTALL DRYER VENT 4" GALVANIZ Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $5.00 $150.00 $3.00 $0.80 $164.10 Pay Date Pay Type Invoice # MC -11-16-62129 11/21/2016 Check #:57 11/29/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 114.10 $ 114.10 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Review Mechanical Underground 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 construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. November 29, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 29, 2016 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-271455 �c Ro-z-18,(0 Permit Number: MC -11-16-3174 Scheduled Inspection Date: December 28, 2016 Inspector: Perez, JanPierre Owner: Job Address: 12 NE 96 Street Miami Shores, FL 33138 Project: <NONE> Contractor: MANCO AIR INC. Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (754)244-4697 Parcel Number 1132060130660 Phone: 305/409-7719 Building Department Comments INSTALL DRYER VENT 4" GALVANIZED TO OUTSIDE WALL CAP WITH DAMPER HAP NO SCREEN Infractio Passed Comments INSPECTOR COMMENTS False L* Llot Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 27, 2016 For Inspections please call: (305)762-4949 Page 6 of 32 BUILDING PERM IT APPLJCAIION Miami Shores Village Building Department 10050 N.E2nd Avenue, Miami Siores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 IN11ON UNE PHONE NUM BER (305) 762-4949 FBC 20 14 Master Permit No. P\C- 1 % - Z S(C, SAD Permit No. V1C. t (0 — 5 I-9"4 ❑ BUILDING ❑ RECTRIC ❑ ROOFING ❑ BENISON ❑ DCT NSON ❑ RENEWAL RF(~1-_- NOV 212016 ❑ PLUMBING [ M EHANICAL ❑ PUBLJC WORtS ❑ C1-IANGE OF ❑ CANCRI AT1ON ❑ S -IOP CONTRACTOR DRAWINGS DBADDRESS 1 0. /1{ E q6 S- atv: Miami Scores County: Miami Dade Zp: 33 l 3> Folio/ Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: RC -C Load: Construction Type: C 8S Rood Zone: BFE FFE OWNER: Name (Fee Smple Titleholder): a-Ir,S 1d C- n kit P Phone#: 7- (l ZQ - 9(.0 Address: Z10S 54,jC1 {Q 4/0 Oty: povt_e_S, sate: ( Zp: 53°) '5 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: /' l-'i(%C& 4/r Phone#: 3CS— q,C1` 77117 Address: 1 q 7 Ala) 1014, fit -PC Qty: Cx, ft1`-LhiNq�S //� gate: c J, Zp: 3.3 07/ Qualifier Name: ,icij ✓✓ L ��G,t/\I/V1) Phone#: nate Certification or Registration #: C £ -S t 5 Certificate of Qompetency #: DESIGNER Architect/Engineer: Fhone#: Address: Oty: Sate: Zp: Value of Work for this Permit: $ It LI S0 o c' Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ teration �/❑ New Li7�X1vFap/a�ir/Feplace ElDemolition Description of Work: # e -L [� f%GLJ 4" (c2%� f. 49e rke u) (( I.,,7 �� f7J( ...5.tile, Jv Deafy Color of Color thru tile: )"- vr S.ibmittal Fee $ Permit Fee $ L5D Z °V oxF$ • 00 OD/CC$ �anningFee $ . Radon Fee $ Z' DBPR$ 2 • z'S Notary $ Technology Fee$ ° ` 0 Training/Education Fee $ *ILO Double Fee$ 0,.-- a ructural Reviews$ Bond $ 11 TOTAL FEENOW DUE$ P I Lt ° (Fevi sed02/ 24/2014) Bon ing Cbmpan ' Name (if applicable) Bon ing Cbmpan ' A re Cty gate Zp Mor gage Len er' Name (if applicable) Mor gage Len er' A re aty Sate Op 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, 9GN$ POOLS RJRNACF9 BOILERS HEATERS TANKS AIR CONDITIONERS ETC.... O NER'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. " ARNING TO 0 NBR YOUR FAILURE TO RBCO D A NONCE OF OOM M ENGEM ENT M AY RESULT I N YOUR PAYI NG 'TWICE FOR I M PROVEM 9VTS TO YOUR PROPERTY. I F YOU INTEND TO OBTAI N R NANCI NG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE REORDI NG YOUR NO110EOF COM M ENCEM ENT." Notice to Applicant: Asa 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. Sgnature OWNER or AGENT The foregoing instrument was acknowledged before me this day of ki ,tlAeti , 20 1,t) , by kn'0• C)4 ca5 , who ispernaJIy known to me or who has produced as identification and who did take an oath. s aI: +61:: tt• BENJAMIN A ST HENSON * MY COMMISSION # FF 056206 EXPIRES: September 22, 2017 Oreo, we Bonded lAN Bud N Sgnature cD rfRACTOR The foregoing instrument was acknowledged before me this 2-1 dayof NOV , 20 ICJ . by (Piave(' mann©, who is personally known to me or who has produced Po-ridO brivC IS as identification and who did take an oath. NOTARY PUBLIC AO 9 Print: r IGJQ(Q( telok?2a1C--ZP mal: i •,��., MAHARAI K. GONZALEZ ,. = MY COMMISSION # GG 044802 w oQi 'k' EXPIRES: November 2. 2020 , i.Rle Bonded Thru Notary Public Underwriters ********************,tiro***#+*"*/ ,Pflt*****,twfrx**.***xxx**x*,t+w*- APPROVED BY (Fevised02/24/2014) IA- Pal \,1 - Examiner Sructural Fbview *"******************* Zoning Clerk Manco Air Incorporated CAC058505 197 NW 104 AVENUE CORAL SPRINGS, FLORIDA 33071 PHONE: 305.409.7719 FAX: 954.344.2695 Michael Manno Qualifier Date: 11— 29 -16 County of Dade Before me this day personally appeared: Michael Manno, who being duty sworn, �Ldeposes and /OZ Says: that he will be the only person working on the project located at l I/ E. / b" (Limited to Mechanical permit only) (fl C — Z —16 ^3 1 7/6 Sworn to ( or affirmed ), and subscribed before me this 2841' day of NOV'b , 2016, by M; c�a�el 5c,\nn Memo A/64646Z 4+-xwo i.\\0\1 Z9 , 2016 Personally know Or Produced Identification \,7/ Type of identification Produced brtV'ev L; Cver\S� t, Type or stamp YANADY PRIErO MY COMMISSION # FF 214031 EXPIRES: March 25, 2019 Bonded Thru Notary Public Underwriters Notice to Owner — Workers' Com Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation Insurance Exem • tion 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. State of Florida County of Miami -Dade The foregoing was acknowledge before me this By6Gi 0�aA y Notary: ilir�r �i���►�L.��� A STEPHENSON * MY C • , fSSION t FF 056205 S SEAL: ` \( EXPIRE : September 22, 2017 Bc ded111 gudget Notary Services _ day of 1451 , 20 ft 1 . who is personally known to me or has produced as identification.