MC-10-12996
BUILDING
PERMIT APPLICATION
FBC 20
JOB ADDRESS: / /3 0 N' O•
Value of Work for this Permit: $ • O 0 '
Type of Work: C1 Address liKteration
Description of Work: 0) lS it
Miami Shores Village
Building Department
JUL SWERVED
1 5 2010
BY: V
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No.'s r C) I OH 2 9d1
Master Permit No. Cc ® °° cr 3
Permit Type: MECHANICAL r( v A�
OWNER: Name (Fee Simple Titleholder): r� /1 l ‘iti - S14ij
Address: /4.4 0 ® N. C. p?Aml AJQ _
City: /1 %LfM/ 5 4o(C.S State: rlort4.{ Zip: 3. ts 1
Tenant/Lessee Name: Phone#:
Email:
02
Square/Linear Footage of Work:
Phone#: 30s— — 9
Zip: 33 1 to
City: Miami Shores County: Miami Dade
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
T
CONTRACTOR: Company Name: A 41 M ir,1+ 1 CJ.l.. CNTn- }- '(b(LSPhone #:
Address: - 749S - N W 1 ST. 5Aj I
City: M l A M I State: F L. Zip:
Qualifier Name: a/®s`_. iao,Q/1./(.. d taL"Z.. Phone #: - 407 • - Si $4 fL
State Certification or Registration #: .A E... 0 43 633 ✓ ll Certificate of Competency #:
Contact Phone #: ®i) • W 4 • Di 4-ti Email Address: 6 eg4 A lf 14 44=1 4 6 14 1 C41,„• egY
DESIGNER: Architect/Engineer: A4 TCC.ItNICAL 1 =NC . Phone #: 13 -154- (
3o.- 2/07 — 31 IN
3312..c
New ORepair/Replace ODemolition
e. p4'44410A .
******** * * * * * ** * * * * * * * * * * * * * * * * * * * * * * ** eS ** *** *,�** **x�,vx�**** **** * * * **** �** **x�a ***
Submittal Fee $ Permit Fee $ 1 5 fe d a � + CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
1-2,0
•
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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
Owner or Agent
The foregoing instrument was acknowl
day of 7 —/ S , 20 /O, by
NOTARY PUBLIC:
Sign:
Print:
ged before me this
l�fa ✓k- -€S ,
who is personally known to or who has produced e -----
As identification and who did take an oath.
' �pS�gYpVe,, � Melanie James
.mac,+ COMMISSION #DD734951
ee EXPIRES: NOV. 18, 2011
APPROVED BY If)1 "P ans Examiner
My Commission Expires:
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Structural Review
Contractor
The foregoing instrument was acknowledged before me this /
`
day of 4 , 20 °, by F it) fret gocae kic),
who ispersanown to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
En 41' - Lir e l
My Commission Expires:
Clerk
Inspection Number: INSP - 150060
Scheduled Inspection Date: August 24, 2010
Inspector: Perez, JanPierre
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Wiegand & Annex A, 0 5
Miami Shores, FL 33138 -0000
Project: <NONE>
Contractor: A&M MECHANICAL CONTRACTOR INC
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 148663. missing rough duct jpp
INSTALLATION OF ONE RETURN AIR GRILL FOR OFFICE
PARTITION
August 23, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: MC -7 -10 -1299
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -09
Phone: (305)267 -3144
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