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MC-17-1461Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 eg Inspection Number: INSP-283511 Permit Number: MC -6-17-1461 Scheduled Inspection Date: August 23, 2017 Inspector: Perez, JanPierre Owner: BECERRA, JACQUELINE Job Address:401 NE 94 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: VAN KIRK & SONS INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Pool Heater Phone Number Parcel Number 1132060140480 Phone: (954)755-4402 Building Department Comments NEW GAS HEATER (EXISTING POOL SPA PLUMBING) HOOK UP BY OTHERS. Infractio Passed Comments INSPECTOR COMMENTS False 3? Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 22, 2017 For Inspections please call: (305)762-4949 Page 12 of 36 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. MC -6-17-1461 Permit Type: Mechanical - Residential Work Classification: Pool Heater Permit Status: APPROVED Issue Date: 7/17/2017 Expiration: 01/13/2018 Parcel Number Applicant 401 NE 94 Street Miami Shores, FL 33138- 1132060140480 Block: Lot: JACQUELINE BECERRA Owner Information Address Phone CeII JACQUELINE BECERRA 401 NE 94 Street MIAMI SHORES FL 33138-2845 (786)201-4321 Contractor(s) VAN KIRK & SONS INC Phone CeII Phone (954)755-4402 (786)326-2747 Valuation: Total Sq Feet: $ 3,000.00 0 Tons: Additional Info: NEW GAS HEATER (EXISTING POOL SPA P Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.00 $2.00 $0.60 $105.00 $3.00 $2.40 $116.80 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -6-17-64169 07/17/2017 Check #: 41829 $ 66.80 $ 50.00 06/01/2017 Check #: 41709 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical 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 thrall work w' done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to do work stat Authorized Signature: Owner / Applicant / Contractor Building Department Copy July 17, 2017 Date July 17, 2017 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ PLUMBING ■❑ MECHANICAL JOB ADDRESS: 401 NE 94 ST 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 ❑ ROOFING ❑ PUBLIC WORKS 13Y: JU 01 .017 dt FBC 20 l Master Permit No?P\ - (-SC71 Sub Permit No.0 Cid (� I ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): JACQUELINE BECERRA Address:401 NE 94 ST Phone#: City: MIAMI SHORESState: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Van Kirk & Sons Inc. Address: 3144 SW 13th Drive Phone#: 954-755-4402 City: Deerfield Beach Qualifier Name: Robert P. Van Kirk Jr. State: Florida Zip: 33442 Phone#: 954-755-4402 State Certification or Registration #: CPC -045956 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City:State: Zip: Value of Work for this Permit: $) Type of Work: ❑ Addition ❑ Alteration Description of Work: a�- Square/Linear Footage of Work: N w ❑ Repair/Replace ❑ Demol*tiop 1ciS �i S Pb\. tL& L Specify color of color thru tile: Submittal Fee $ 50 (x) Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Structural Reviews $ CCF $ (Revised02/24/2014) CO/CC $ DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ • F90 (-\76 Bonding Company's Name (if applicable) N/A 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 certified copy of the recorded notice of commencement must be posted at the job site for the first ins ctro whi occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wi not be a•p ov d and a rei spection fee will be charged. ISignatu OWNER or AGENT The foregoing i strument was acknowledged before me this 3 day •f ,20 Signature The foregoing instrument was acknowledged before me this by 3 C day of Q l , 20 Jck C-14 e>efev ,whoispe me or who has produced identification and who did take an oath. NOTARY PUBLIC: vbho is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ty0'CA�` F�OFt\9 a G"n"ff'�� ***********************miss**`, ::**.6ss*****03 ******************************************** rss+�*********** Sign: Print: Seal: as rzabeth Sandoval Notary Public - State of Florida Commission #GG 30615 Expires 3/27/2020 APPROVED BY (Revised02/24/2014) ` Plan Examiner Zoning Structural Review Clerk