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MECHANICAL
g BUILDING PERMIT APPLICATIO SE4' y ?n FBC 2001 BY• 0110 $ Value of Work For this Permit Total Fee Now Due $ )1 ,1 ° `46 (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. Permit Type (circle): Building Electrical ^^,, Plumbing Mechanical Roofin Owner's Name (Fee Simple Titleholder) 4p�l, 4- diktel C�&ra /►'0' Phone # g L i 7 - � S', r ©1 7. �j #6 57J> Owner's Address 1081 S, b U C City De- heir ne...1 State T L. Zip 600 l Tenant/Lessee Name Phone # Job Address (where the work is being done) S N 1 9 g S City Miami Shores Village County Miamiade Zip Is Building Historically Designated YES NO S/ Contractor's Company ame G f R 6 << L0 C o. Phone # 30 f 6 0 J 6 / `1 Contracto 's Address . Q, b 0 X G o t Z3 0 0 City State ( Y . Zip 0 0 ( b & Qualifier Robe el T. C k t i S Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Type of Work: ❑Addition ❑ Alteration ❑New ( epair/Replace ❑ Demolition Describe Work: j, 1 I ,A "AL.,..J . I l� * * * * * * * * * * * * * * * * * * * * * * * * * * *F * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 4 t c CCF $ 3 CO /CC Notary $ Training/Education Fee $ (• 0° Technology Fee $ 4-0 3 Scanning $ ,s- ar� l Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 UVIPROVEMENTS 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 a d a reinspection fee will be charged. Signature Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 13 day of .Q 20 0 6 by , day of who s personally known t• e or who has produced who i ersonally known> me or who has produced Owner or Agent lutuo As identification and who did take an oath. UBLIC: My Commission Expires: Chc 12/15/03 , 20 0g., by as identification and who did take an oath. NOTARY PUBLI Sign: Pri nt Jc : kkeg +a fir= 7anei Kranz My Commission Fs3 p': „si* MY COMMISSION # 001 74033 EXPIRE t;.��_ v: December 24 2006 ************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * g* **ION 0fatU OVIA 1NS415 W** * * ** (Certificate of Competency Holder) State Certificate or Registration No. C A G o2 6. 41 q Certificate of Competency No. 0cp 0 0 p 0 2 • 3 ***************************************************** * * * * * * * * * * * * ** * * * * * * ** *************************** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) J /// 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 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) 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 FOR: PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL PERMIT # MECHANICAL From: To: FROM: MESSAGE: N /MBER OF PAGES INCLUDING COVER SHEET: • • C&R AIR CONDITIONING COMPANY PROPOSAL • • ESPECIALLY FOR: • The Andino Residence • 58 NW 96 r H Street • Miami Shores, Florida • 847 -946 -5737 • • SUBMITTED BY: • Robert I. Chryst • PO Box 681330 • Miami, Florida 33168 • • :305- 685 -6394 Dade • • 954- 680 -4494 Broward • C&R Air Conditioning C 2121 N.1y. 139 Stroet N10 P.O. BOX 681330 MIAMI, FLORIDA 33168 FAX TRANSMITTAL AT: P01 (305) 685.631 FAX: 305- 685 -639; DATE 6 4 1 From:' pu U C&R AIR CONDITIONING COMPANY POSE OF THIS_ PRQPOSAL We propose to furnish and install a C &R system for your home located at: 58 NW 98 STREET, MIAMI SHORES, FLORIDA 33161 The system is designed to provide cooling and warming conditioning for the following areas: EXISTING CONDITIONED AREA TS 11icLUDD EXISTING 3 TON GOODMAN UNIT TO REMAIN NEW 3 TON AIR HANDLER RUUD MODEL UHSA- HM38175A Ductwork installed by us will be designed, fabricated and Installed in accordance with standards of the American Society of Heating. Refrigerating and Air- ConditIoning Engineers within limits of existing installation conditions. WV MNG RECONNECT TO EXISTING; ANY UPGRADES REQUIRED BY CODE ARE NOT INCLUDED. p UMBING RECONNECT TO EXISTING; ANY UPGRADES REQUIRED BY CODE ARE NOT INCLUDED. SCEL,LANEOUS WILL HANG AIR HANDLER HORIZONTALLY AT SAME LOCATION IN GARAGE AND RECONNECT TO EXISTING DUCTS AND METAL CLAD AS PER CODE Nai of' 3 4 P02 From :` C&R AIR CONDITIONING COMPANY - P03 R PONSIBILITV Responsibilities below shall be assumed by either us or you, as indicated: R- Reconnect, E- Existing, N- None, Y- You. and U- Us, Delivery �_ 1 Phase electrical service from Uncrating, assembly. erection lam__, street to electrical panel �__ Ductwork g___ Wiring from panel to unit R Duct Insulation E Control system wiring $ Grilles E__ Cutting and patching holes for Plumbing R ducts, pipes, etc. M.___ Attic Insulation €. ____ Painting, redecorating Y____` GE ERAL A • alified air conditioning expert will start and test the system and explain its operation. Thi ! proposal is good for a two week period from date of proposal and at that time is subject to review. Till to the system shall remain In us until all sums due us have been fully paid. I n t e event the purchaser fails to comply with any of the requirements of this contract and such default res its In litigation, the Purchaser agrees to pay reasonable attorney's fees and all court costs and ex . nses incident to such litigation. Delinquent payments shall bear 1.5% per month Interest from due dat until paid. All ork Is to be performed during our regular work hours unless otherwise specified. Thi contract contains all agreements. Neither party shall be bound by any representation, warranties or agr .-ements, oral or written not herein contained. Thl proposal shall become a contract when accepted by you and approved In writing by our duly aut . razed corporate officer. 6 C &R AIR CONDITIONING COMPANY The Purchaser shall receive such warranties as are extended by the equipment and/or material manufacturers. In addition C & R shalt nrnvida Iahnr fn o..,,•a. e .... ......... Issue Date: 9/21/2006 Owner's Name: SUSANA ANDINO Permit Type: Mechanical - Residential Work Classification: New Job Address: 58 98 Street NW Miami Shores Village, FL Contractor(s) C &R AIR CONDITIONING CO Phone 305 - 685 -6394 Primary Contractor Yes Additional Information Tons: Classification: Residential Additional Info: 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. Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $3.00 $1.00 $164.33 $3.00 $4.13 $175.46 Invoice Number MC - 9 - 06 - 26217 Total: Amt Due $175.46 c Amt Paid Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/20/2007 Parcel #: Block: Section: Re • uired Ins ' ections Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Permit Status: APPROVED Permit Number: MC - - - 2376 Phone: Lot: PB: Total Square Feet: Total Valuation: 1131010330210 0 $ 4,695.00 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. LADDER IN GARAGE Passed Inspector Comments \,\, \ b\: (I° Oil Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -2721 fi Permit Number: MC -9 -06 -2376 Inspection Date: 11/20/2006 Inspector: Perez, JanPierre Owner: ANDINO, SUSANA Job Address: 58 98 Street NW Project: <NONE> Miami Shores Village, FL Contractor: C&R AIR CONDITIONING CO Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ao 29 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1131010330210 Lot: Phone: 305 - 685 -6394 Friday, November 17, 2006 Page 2 of 2 Date Thursday, September 21, 2006 09/21/2006 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: MC -9 -06 -2376 Invoice Number: MC -9 -06 -26217 Applicant: SUSANA ANDINO Company Name: 0 Owner Address: 58 NW 98 ST MIAMI SHORES, FL 33150 Job Address: 58 98 Street NW Miami Shores Village, FL Payment Type Check Number 7896 Amount $175.46 • Change $0.00 Total Payment: $175.46 Page 1 of 1