MC-10-888Inspection Number: INSP - 143868
Scheduled Inspection Date: August 19, 2010
Inspector: Perez, JanPierre
Owner: DOLL, JOHN
Job Address: 909 NE 99 Street
Project: <NONE>
Contractor: A -1 AIR & HEAT INC.
Building Department Comments
T-ic 0y
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 18, 2010
Miami Shores, FL 33138-
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
,x
Permit Number: MC -5 -10 -888
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1132060340230
Page 5 of 36
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: MECHANICAL
le Titleholder) 3 ! h 11
State 1-4.811 Zip
33/3,f
Owner's Name (Fee Sim
Owne 's Address
Tenant/Lessee Name
Email
Job Address (where the work is being done)
City Miami Shores Village County Miami-Dade
FOLIO / PARCEL # -3;19g- 0,3g 001-36)
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City - 001tilelet
Qualifier Name Miff
r rf f't e / /6f 2G
&a �sr ^I
Stat pin/' a lit Gl.
iL
Value of Work For this Permit $
Type of Work: ❑Addition I
Describe ork: 19Cf c-nc'
cL2 w.
Scanning $ 3' 00 Radon $
Double Fee $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
g09 rl E f9 shy
State Certificate or Registration No. V Certificate of Competency No.
Contact Phone E -mail eva AA- Com 54 hei
Architect/Engineer's Name (if applicable) Phone #
5 A, t
❑Alteration
Oita
Permit Fee $
EINew (.0044-e44,-1-
e ft& A2f2r
Submittal Fee $. cO
1 • 00
(-t
Notary $
Training/Education Fee $
Structural Review. $
Violation date:
Master Permit No.
Phone # 30 1' 3653—
Phone #
Phone #
Permit No. t. - S - 10 -8 81.
Zip 33/3a
Flood Zone
Zip 3303 6
Phone # 3C2r —,)-3 q 05
MAY 1 4, 2010 ,
Square / Linear Footage Of ork:
Repair .eplace ❑ Demolit on
�It rltl �t,/
SyS )
**F
tf t CCF $ 5 - (00 CO /CC $
Technology Fee $ 4
DPBR $ Bond I$
Total Fee Now Due $ c5
1 1)5
See Reverse side -*
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 whic occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
fr
inspection will not be a. t'ro and ' r ' nspection fee will be charged.
Signature
Owner or Agent C ntractor
The foregoing instrument was acknowledged before me this /r The foregoing instrument was , cknowledged before me this'
day of , 20G , by day of , 20 �� , by
who is erso known to me or who has produced
who is erso all known to me or who has produced
Y r Y ! 1
idGltiAcat on and who did take an oath.
,,,. STATE OFFLO
Sij (redo Marti]
F Cc r nissior.. DD57
Sign: a %,1u r 471 A. \err BQNDLyG 2411) . .
Print:
My Co ssion Expires:
NOTARY PUBL
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
lans Examiner Zoning
Engineer
as identification and who did take an oath.
NOTARY PUBLIC:
NO + YPUBLIC - STAT> OFFL( RIDA
e" " - Sigfredo Martinez
Clerk cjiecked