MC-09-2048 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 131462 Permit Number: MC -12 -09 -2048
Scheduled Inspection Date: May 13, 2010 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Inspection Type: Final
Owner: GAVIRIA, OMAR Work Classification: A/C Replacement
Job Address: 136 NE 91 Street
Miami Shores, FL
Phone Number (305)756 -7459
Parcel Number 113101019004
Project: <NONE>
Contractor: C&R AIR CONDITIONING CO Phone: 305 -685 -6394
Building Department Comments
EXACT REPLACEMENT OF 3 TON SPLIT SYSTEM
/0
Inspector Comments
Passed,
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 12, 2010 For Inspections please call: (305)762 -4949 Page 5 of 25
° tZ Miami Shores Village PBm ; Iechanlcal RiitfeRtt `
10050 N.E. 2nd Avenue WWot; d 0";�
Miami Shores, FL 3313 &0000
Phone: (305)795 -2204 b �!Sa 'f
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Expiration: 06119 /2010
Project Address Parcel Number Applicant
136 91 Street 1131010190040
Miami Shores, FL Block: Lot: OMAR GAVIRIA
Owner Information Address Phone Cell
OMAR GAVIRIA 136 NE 91 ST (305)756 -7459
MIAMI FL 33138 -2810
Contractor(s) Phone Cell Phone Valuation: $ 4,500.00
C &R AIR CONDITIONING CO 305 -685 -6394 (954)680 -4494
Total Sq Feet: 0
Tons: 3 For Inspections please call:
Additional Info: A/C REPLACEMENT SPLIT SYSTEM (305)762 -4949
Classification: Residential Available Inspections:
Approved: In Review
Inspection Type:
Comments: Date Approved:: In Review Final
Date Denied: Type of Work: MECHANICAL
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $3.00 MC -12 -09 -36635 $ 218.38 $ 218.38 $ 0.00
Education Surcharge $1.00
Permit Fee - Additions/Alterations $207.38
Scanning Fee $3.00
Technology Fee $4.00
Total: $218.38
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.
December 21, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 21, 2009 1
Miami Shores Village
Building Department DEC 14 2009
10050 N E.2nd Avenue, Miami Shores, Florida 33138
Te : (3 05) 795.2204 Fax: (3 05) 756.8972 BY. --
BUILDING Permit No. -- �("��
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PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type Mechanical
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Owner's Name (Fee Simple Titleholder) WIL Phone # c� Z i 9 4 6 6 T
Owner's Address _ 13 6 N E C l 1 41-
City ., iam 1 �► ®�C� State I Zip 131 e
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) . I T
City Miami Shores Viii a County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO I
Contractor's Company Name C+ Q t r vi C o. Phone # j0f 6 0
Contractor's Address (6 0 - 7 3 M E 3- r c, L
9
City i g MI Ste F . Zip 036 S_
Qualifier Name � � � . C k e , l Phone # s L19 4
State Certificate or Registration No. L• �} � , ® ' l� Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square /Linear Footage Of Work:
Type of Work: ❑Addition ❑Alterat on ❑New Repair /Replace ❑ Demolition
I I T
Describe Work:
i
k�� ' �x s ��x�� x� xnYYYeexdeatxxx & &Yiax4 &aexxeYie4txsese
Submittal Fee $ Permit Fee $ CCF $ COlCC
Notary $ Training /Education F $ 1 Technology Fee $ 4•
Scanning $ Radon $ DPBR�$ Zoning $
Bond $ Code Enforcement !$ Double Fee $
Structural Review. $ Total Fee Now Due $ ��, ' 3
See Reverse side
I '
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 fai that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is b� ct to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspe Pion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will no e .. proved and a reinspection fee will be charged
Signature Signature
Owner or Agent Co ractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of Bee. °t420 by day of ®eC@ Cd , 206A, by
who i ersona y known o me or who has produced who i ersonally known o me or who has produced
As identificati n ^ ^ as identification and who did take an oath.
NOTARY PUBLIC: ° Robert I Chryst NOTARY P "
. Commission # DD524S02 JANETMW
w L , Expires May 24, 2040 *' �Q . m DD R1 X
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Sign: Sign: °
Print: C r Print: dl ct V) d Kra Z
My Commission Expires: My Commission Expires:
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APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised- 02/08/06)
ADDENDUM TO BUILDING PERMIT APPLICATION
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 FOR: PERMIT #
PLUMBING ELECTRICAL MECHANICAL
ITEM UNIT FEE ITEM UNIT FEE ITEM
UNIT FEE
BATH TUB SWITCH OUTLETS SPACE HEATERS
DISHWASHER LIGHT OUTLETS CENTRAL HEATING rx
DISPOSAL RECEPTACLES �S -
FLOOR DRAIN A/C (WIND)
SERVICE TEMPORARY A/C (CENTRAL) :,'��,�
GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK
INTERCEPTOR �®
SERVICE REPAIR/METER CHANGE REFRIGERATION
LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING
LAUNDRY TRAY RANGE TOP UNDERGROUND 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
URINAL TRANSPORTING ASSEMBLIES
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 ITELEVISION 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)
GAS PIPING
United States Attorney's Office, Torre Chardon, 350 Chardon St., Suite 1201, San
Juan, PR 00918; Daniel I Vaccaro, Esq., Michael Best & Friedrich LLP, 100 E.
Wisconsin Avenue, Suite 3300, Milwaukee, WI 53202.
In Fort Lauderdale, Florida, this 9th day of October, 2008.
Respectfully submitted,
GREENBERG TRAURIG, P.A.
Attorneys for the Appellants
401 E. Las Olas Blvd., Suite 2000
Fort Lauderdale, FL 33301
Telephone: (954) 765 -0500
Facsimile: (954) 765 -1477
Ina M. rlingeri- mcenty
USCA Bar No. 32609
E -mail: berlingerii @gtlaw.com
Greenberg Traurig, P.A. Attorneys at Law 401 East Las Olas Boulevard Suite 20001 Fort Lauderdale, FL 33301 1 Tel 954.765.0500 1 Fax 954.765.1477 www.gtlaw.com