MC-10-373Project Address
Owner Information
Building Department Copy
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$4.80
$1.60
$276.50
$3.00
$6.40
$292.30
March 09, 2010
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Address
y h lical - R,de
Expiration: 09/05/2010
Parcel Number
10643 10 Place
Miami Shores, FL
1122320280550
Block: Lot:
DENNIS LEFEVER
Contractor(s)
C&R AIR CONDITIONING CO
Phone Cell Phone
305 - 685 -6394 (954)680 -4494
Phone
DENNIS LEFEVER
10643 NE 10 PL
MIAMI SHORES FL 33138 -2103
Valuation:
Total Sq Feet:
$ 7,900.00
Tons: 5
Additional Info: MECHANICAL
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Date Approved: : In Review
Type of Work:
Invoice # Invoice Total Amt Paid Amt Due
MC -3 -10 -37240
$292.30 $292.30 $0.00
Applicant
Cell
For Inspections please call:
(305)762 -4949
Available Inspections:
Inspection Type:
Final
2
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Mechanical
Owner's Name (Fee Simple Titleholder)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fax: (305) 756.8972
Owner's Address 106 43 /U E I (', P L
Cit 1► la Ili Ira) e,.1 State F') . Zip 2 V 38-
Tenant/Lessee Name Phone #
E - MAIL:
Job Address (where the work is being done) . / b 6 10 Me (b PL
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name CI C-I-P.A-str Lo v1 tf . Co . Phone # 30S 6 8's G 2 q C(
Contractor's Address &C 73 N W (( 7 S T G' • LI
City ln I Q Wi i State Fl. Zip 23o ir
Qualifier Name 6)6eet 6)6e1 TC � �� Phone #
State Certificate or Re No. CA C. 02,6 14 Certificate of Competency No. 0 LI g p Q �
® a °
E -MAIL: 01 Ind K (t e C9n'►(rGlv,i oC, C on-,
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Describe Work:
i1"
60
Type of Work: ❑Addition ['Alteration
['New
Permit No.
Master Permit No.
Phone# 7$6 - ,566° 01 IO
Phone #
Zip 03104'
Square / Linear Footage Of Work:
R epair /Replace ❑ Demolition
********** * * * * * * * * * * * * * * * * * * * *xxxxx * * *F * **x * * * * * * * * * * * * * * * * *wwwww * * * **
Submittal Fee .$ Permit Fee $ . §0 CCF $
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
CO /CC
Structural Review. $ Total Fee Now Due $
See Reverse side
IROZRVIE
MAR NCI9
c10-313
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.
Sign:
(Revised.02 /08/06)
Print:
My Commission Expires: : +`' Commission # DD524602
� Se 19* ' xxxxx
,Yg � ,Y xxx x'it�
xxxx x xxxxxxxx
• ., 4unded Tmy Fain -1 ,' "'-.Irx + 1919
Signature
Sign:
Print:
Signature &V v �-
Owner or Age °J Co tractor
The foregoing instrument was acknowledged before me this 9 The foregoing instrument was acknowledged before me this c l
day of Mardi , 20 1 0, by , day of 01 CI `L �. , 20 1 by
who i personally known o me or who has produced who i
As identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
to me or who has produced .
as identification and who did take an oath.
3 ((I r 2
,,.,
er JANET KRANZ
My Commission " "s:Commission DD 621880
„SiE :Fh°•`' Bonded Tlw Troy Fain magma 809-099701
.xx**Ok**********
APPLICATION APPROVED BY: 1 Plans Examiner
Engineer
Zoning
ITEM
UNIT
FEE
ITEM
UNIT
FEE
ITEM
UNIT
FEE
•
BATH TUB
SWITCH OUTLETS
SPACE HEATERS
DISHWASHER
LIGHT OUTLETS
CENTRAL HEATING 1.= (0
DISPOSAL
RECEPTAC(.ES
A/C (WIND)
FLOOR DRAIN
SERVICE TEMPORARY
NC (CENTRAL) (z. S
GREASE TRAP
SERVICE SIZE IN AMPS .
DUCT WORK + d
INTERCEPTOR
SERVICE REPAIR/METER CHANGE
n
REFRIGERATION
LAVATORY
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
LAUNDRY TRAY
RANGE TOP
UND RGROUND TANKS
CLOTHES WASHER
OVEN • •
ABOVE GROUND TANKS
SHOWER
WATER HEATER
U.F. PRESSURE VESSELS
SINK. POT /3 COMP.
MOTORS 0 -1 HP
STEAM BOILERS
SINK, RESIDENCE.
MOTORS OVER 1 -3 HP
HOT WATER BOILERS
SINK, SLOP.
MOTORS OVER 3 -5 HP
MECHANICAL VENTILATION
TEMPORARY WATER CLOSET
MOTORS OVER 5 -8 HP
TRANSPORTING ASSEMBLIES
URINAL
•
MOTORS OVER 8 -10 HP
ELEVATORS /ESCALATORS
WATER CLOSET
MOTORS OVER 10-25 HP
FIRE SPRINKLER SYSTEMS
INDIRECT WASTES
MOTORS OVER 25 -100 HP
COOLING TOWERS
WATER SUPPLY TO:
MOTORS OVER 100 HP
VIOLATION
A/C UNIT
'
A/C WINDOW
REINSPECTION
FIRE SPRINKLER
AIR CONDITIONERS
HEATER -NEW INST.
STRIP HEATER
,
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
GENERATORS TRANSFORMERS
SWIMMING POOL
GENERATORS TRANSFORMERS
WATER SERVICE
SPECIAL PURPOSE.
SEWER CONNECTIONS
OUTLETS COMMERCIAL
UTILITY -SEWER
SIGN TUBES •
UTILITY -WATER
SIGN TRANSFORMERS
SEPTIC TANK
SIGN TIME CLOCK
RELAY •
FIXTURES
FAINFIELD, 4" TILE /RES.
ANTENNA
PUMP & ABANDON SEPTIC TANK
TELEVISION OUTLETS
SOAKAGE PIT CU. FT.
VIOLATION
CATCH BASIN
REINSPECTION
DISCHARGE WELL
DOMESTIC WELL
'
AREA DRAIN
'
ROOF INLET
'
SOLAR WATER HEATER
FIRE STANDPIPE .' • .
POOL PIPING
.
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
a
GAS PIPING
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE
OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.
PLEASE CIRCLE 0 DISCIPLINE APPLIED FORS
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
PERMIT #
MECHANICAL
James Douglas Coiner jcolner @slk- 1aw.com
Stephen Douglas Jones sjones @ralaw.com, soharra@ralaw.com
John Winship Read jwread @vssp.com
Karen S Hockstad khockstad @slk- law.com, nrife @slk- law.com, sbranam @slk- law.com
Lisa A Wafer lwafer @ferronlaw.com, lferron @ferronlaw.com
Jessica G Fallon jfallon @ferronlaw.com, lferron @ferronlaw.com
Michael R Traven mtraven @ralaw.com, Eric.Branfinan@bingham.com, Jon.Frankel @bingham.com,
michael.romano @bingham.com, soharra @ralaw.com
Ky E Kirby ky.kirby @bingham.com, kelly.archung @bingham.com
Jonathan S Frankel jon.frankel @bingham.com
Eric J Branfman eric.branfinan @bingham.com
2:09 -cv- 00513 - GLF -MRA Notice has been delivered by other means to:
2:09 -cv- 00520 - GLF -MRA Notice has been electronically mailed to:
Rodney Alan Holaday raholaday @vssp.com, slmay @vssp.com
John L McManus mcmanusj @gtlaw.com, ftllitdock @gtlaw.com, yeargina @gtlaw.com
Kenneth A Horky horkyk @gtlaw.com
2:09 - cv - 00520 - GLF - MRA Notice has been delivered by other means to:
The following document(s) are associated with this transaction:
Document description:Main Document
Original filename:n/a
Electronic document Stamp:
[STAMP dcecfStamp_ID= 1040326259 [Date = 11/12/2009] [FileNumber= 2489071-
0][ 4c65197ec71c7557e199fe7fb01188ea82ad6b54697b9e5ea0 7bc42abf7f6c11ea
cbd5dl d2cf3f8ae7d78d6142ed588d0126e8bae92a7a81 a426b7fe68df2c51 ]]
11/17/2009
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