MC-10-671Inspection Number: INSP - 141103
Scheduled Inspection Date: June 22, 2010
Inspector: Perez, JanPierre
Owner: CHIONG, NENA
Job Address: 205 NE 101 Street
Project <NONE>
Miami Shores, FL 33138-
Contractor: BLUE BREEZE AIR CONDITIONING
Building Department Comments
June 21, 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
Phone Number
Permit Number: MC -4 -10 -671
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Parcel Number 1132060480030
Phone: 305 -865 -1220
L I l"L kl7
Passed
tykA.
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 8 of 26
205 NE 101 Street
Miami Shores, FL 33138-
1132060480030
Block: Lot:
NENA CHIONG
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Submittal Fee
Submittal Reversal Fee
Technology Fee
Total:
Amount
$3.00
$1.00
$173.36
$3.00
$50.00
($50.00)
$4.00
$184.36
Building Department Copy
Address
Contractor(s) Phone
BLUE BREEZE AIR CONDITIONING 305 - 865 -1220
Cell Phone
Authorized Signature: Owner / Applicant / Contractor / Agent
Phone
Tons: 2.5
Additional Info: REPLACEMENT AC
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Date Approved:: In Review
Type of Work: MECHANICAL
Pay Date Pay Type
Invoice # MC -4-10 -37640
06/02/2010 Check #: 11081
04/21/2010 Check #: 11076
Amt Paid Amt Due
$ 134.36 $ 50.00
$ 50.00 $ 0.00
June 02, 2010
Date
RO '
Expiration: 10 /25/2010
CeII
NENA CHIONG
205 NE 101 Street
MIAMI SHORES FL 33138 -2400
1
Valuation:
Total Sq Feet:
$ 4,953.00
0
1
Available Inspections:
Inspection Type:
Final
1
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.
June 02, 2010 1
Co 110 I2t8hho.
4
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
i zaircED
BY: ....
m c.• o -Co10
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: MECHANICAL
Owner's Name (Fee Simple Titleholder) «t\A C ( O"''\ Phone # C3q-)b
get ,
Owner's �
� r''s Address I �,, n
Cit V \ \WM1( `"-L, State Zip 3313
Tenant/Lessee Name n Phone #
Email V\�'� \'o(Mm . �
C�
Job Address (where the work is being done) 02 5- N 4 1 0 ( s 1—
City Miami Shores Village County Miami -Dade Zip 3) ( S.
FOLIO / PARCEL #
Is Building Historically Designated YES NO / Flood Zone ll., 0_
Contractor's Company Name )J 4- ipt Q Ze ill f C4361:1 il Phone # (3 0 ) to i'6"— -7.7 s
Contractor's Address l9 S-S- P to / i 7 s
City nt.. -- v State 1—L Zip 3 a I& 8
Qualifier Name Mcji ti. S —'b ( 01 Phone # - 1•7(9 - „n?-6 34, l'
State Certificate or Registration No. C A' e. "Is" 1 - 4: Certificate of Competency No.
Contact Phone 3os (975 — aaS> -- E -mail oie tov / c.i0 . CAS
Architect/Engineer's Name (if applicable)
Phone #
Value of Work For this Permit $ 1 - 1 ( I 5$ Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ['New Repair/Replace
Describe Work: : ,`- e 1 —
Submittal Fee $5/ • CJ
******* ******: r** * * * * * * * * ** ** * * * * * * * * * * * * * * ** * **
\\ 1 ) 1 .
Permit Fee $
CCF $ 3'W CO /CC $
❑ Demolition
Notary $ Training/Education Fee $ 1.00 Technology Fee $ 4.00
Scanning $ V '� Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ ) 34 '3(..p
See Reverse 41->
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must . e posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or : gent
NOTARY PUBLIC:
Sign: jlT ! s
Wr
Print:
P. E Van Den Bergh
My Co ids t'' Eiipi ffr.ommission DD778217
d Expires 04/13/2012
(Revised 07 /10 /07)(Revised 06/10/2009)
Signature
or
The foregoing instrument was acknowledged before me this 1 1 6 ‘ The foregoing instrument was acknowledged before me this t 1
day of &. cri L, 20 10, by , day of
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
,201,9, by
-z2 as identification and who did take an oath.
NOTARY PUBLIC:
II u
t$ u'xitary Public o, ; iorida
? ° " E Van Den Bexri,
9 Q My Commission DD778217
4'oF µ o Expires 04 /13/2012
APPROVED B �
2 17 V Y Plans Examiner Zoning
Engineer Clerk checked
MIAMI -DADE COUNTY
BUILDING DEPARTMENT
MECHANICAL FEE SHEET
*Attention applicant: you are responsible for filling out this application correctly. If you have any questions concerning what
category your work falls under, please see an inspector or processor for your trade. Refunds will not be given in case of error
on your part and you will be charged a double fee plus a $100.00 for doing work without a permit. Minimum fee for mechanical
permits if $51.50 unless otherwise noted.
Fee Code Description
123.01.69 10 /07 Pagel
Under penalties of perjury, I declare that to the best of knowledge , the facts stated in
I understand that perjury is a felony of the third degree.
Fee Calculations Units
Single Family Residence duplexes new construction South Florida Building Code (SFBC) Group I or Florida Building Code (FBC)
Group R -3
Includes Categories 03, 10, 41 (Must have building permit number)
Additionally, please note the fee will be calculated based on the square footage on the master permit)
M053 New Mechanical Construction 0.08¢ per Sq. Ft. # of Sq. Ft.
M054 Addition to Single Family Residence 0.08¢ per Sq. Ft. # of Sq. Ft.
and Duplex (Minimum Fee $68.70)
Category 03 Air Conditioning For new construction other than Group I (SFBC) or Group R -3 (FBC) and compatible change
out of existing equipment.
(New system with no building permit requires processing)
M001 Air Conditioner $ 17.18 per ton # of Tons
(Minimum Fee $68.70)
Category 09 Above & Below Ground Tanks/Pumps & Pollutant Storage System
(Must be processed if no building permit)
M010 Storage Tank Flam. Liquid $ 171.74 per Tank # of Tanks
Category 10 Heating For new construction other than Group I (SFBC) or Group R -3 (FBC) and exact change out of existing equipment.
(New system with no building permit requires processing)
M002 Furnaces & Heating Equipment $ 3.44 per KW # of KW
(Minimum Fee $51.53)
Category 11 Insulation (Commercial with no building permit requires processing)
M076 Insulation $ 12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
Category 15 Pneumatic Tube Conveyor System (Commercial with no building permit requires processing)
M077 Pneumatic Tube Conveyor System $ 12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
Category 16 Pressure Process Piping (Commercial with no building permit requires processing)
(Does not include Medical Gas)
M078 Pressure Process Piping $ 12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
# of Units Fee
Fee Code
Category 19
M001
Category 23
M079
Category 24
MO12
MO27
MO28
M035
M049
M050
M051
Category 25
M042
Category 38
M036
Category 39
M080
Category 40
MO11
Category 41
M081
Category 42
MO29
Category 43
M048
Category 45
M082
Category 46
M048
Category 48
M048
Category 50
M083
Category 52
M084
123.01- 6910/07 Page 2
Description Fee Calculations Units # of Units Fee
Refrigeration (Commercial with no building permit requires processing)
Refrigeration $ 17.18 per Ton # of Tons
(Minimum Fee $68.70)
Air Conditioning Duct Work (with no building permit requires processing)
Air Conditioning Duct Work $ 12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
Boiler (1 Boiler HP= 33,479 BTU /per hour) (Commercial with no building permit requires processing)
Estimated Value (Boiler Repair) $ 12.03 per $1,000 Value Est. Value
Steam Driver Prime Mover $ 68.70 per Mover
Steam Activated Machinery $ 68.70 per Machine
Shop Inspection of Boiler $ 85.87 per Boiler
Boiler less than 837 MBTU input $ 85.87 per Boiler
Boiler 837 MBTU to 6695 MBTU input $ 103.05 per Boiler
Boiler over 6695 MBTU $ 143.12 per Boiler
Conveyors (Requires Processing)
Conveyors $114.49 per Drive # of Drives
Commercial Hoods (Commercial with no building permit requires processing)
Commercial Hoods $143.12 per Hood # of Hoods
Cooling Towers (Commercial with no building permit requires processing)
Cooling Towers $12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
Internal Combustion (Commercial with no building permit requires processing)
Internal Combustion Engines $85.87 per Engine # of Engines
Mechanical Ventilation (Commercial with no building permit requires processing)
Mechanical Ventilation $12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
U.F. Pressure Vessel (Commercial with no building permit requires processing)
Unfired Vessels $85.87 per Vessel # of Vessels
Fire Chemical (Must be processed)
Fire Chemical $120.22 per System # of Systems
Ductless Ventilation (Commercial with no building permit requires processing)
Ductless Ventilation $12.03 per $1,000 Value Est. Value
(Minimum Fee $68.70)
Spray Booths (Must be processed if no building permit)
Spray Booth $120.22 per Booth # of Booths
Smoke Control $120.22 per System # of Systems
Raise Existing Roof Mounted Equipment
Raise Existing Roof Mounted $12.03 per $1,000 Value Est. Value
Equipment (Minimum Fee $68.70)
Residential Elevator (Private/Individual)
Residential Elevator $51.50
per elevator
Smoke Control (Must be processed if no building permit)
# of Mover
# of Machines
# of Boilers
# of Boilers
# of Boilers
# of Boilers
# of Elevators
Proposal Agreement
Customer Name
Address
City
Home Phone% l
❑ Optimum Comfort
System
❑ Heat Pump
❑ Optimum Heating System
❑ 10 Year Full Guarantee
❑ 20 Year Heat Exchanger
Guarantee
❑ Optimum Cooling System
❑ 10 Year Full Guarantee
❑ System To Include
❑ Advanced Craftsman
Installation
❑ Stringent Code
Compliance
❑ All Required Permits
❑ Exclusive Talking
Thermostat® Performance
Control Center
❑ Variable Capacity
Comfort Control
❑ Optimum Humidification
Control
❑ OxyQuantum® LED
❑ MicroGuardian® Air
Scrubber
❑ ToraVacTM Source
Removal
❑ One Year Comfort CIubTM
Membership
❑
We hereby propose to furnish complete as specified above, for the investment of only $
Payment terms will be:
Acceptance:
C - s c\A vre
CUSTOMER
BLUE
BREEZE
ON
OUR
AIR CONDHIONING & HEATING®
Always On TIme..Ar You Don't Pay Diner
655 NW 118 ST • Miami, FL 33168
305 - 865 - 1220.305- 865 -7779
Cell Phone
❑ Premier Comfort
System
.❑ Heat Pump
❑ Premier Heating System
❑ 10Year Full Guarantee
O 20 ?ear Heat Exchanger
Guarantee
❑ Premier Cooling System
O 1 0 Year Full Guarantee
❑ System to Include
❑ Advanced Craftsman
Installation
❑ Stringent Code
Compliance
❑ All Required Permits
❑ Exclusive Talking
Thermostat® Performance
Control Center
❑ Premier Humidification
Control
❑ OxyQuantum® LED
❑ MicroPower Guard® Air
Cleaner
❑ One Year Comfort CIubT^^
Membership
,>r
11500
Authorization:
Notice to Buyer: You the Buyer, may ca el this transaction at any time prior to
the midnight of the third business day after the date of this transaction. See the
attached notice of cancellation form for an explanation of this right.
Date AQ k Work Order
State
Zip
,Deluxe Comfort
System
O Heat Pump
O Deluxe Heating System
J$' 5 Year Full Guarantee
❑ 10 Year Heat Exchanger
Guarantee
Email N A \ V\ 2 U'
O Deluxe Cooling System
420 5 Year Full Guarantee
.ice 10 Year Compressor
Guarantee
1t/14 -r STAT '
❑ System to Include
A' Craftsman Installation
Stringent Code
Compliance
lar All Required Permits
Ar One Year Comfort Club'
. Membership
` T'RA E. X1Z t$
L
.00
oCOAAO
oft) 44
or n
53
❑ Basic Comfort
System
❑ Heat Pump
0
❑
0
❑
Z(1,0
❑ Bask Heating System
❑ 1 Year Full Guarantee
❑ 10 Year Heat Exchanger
Guarantee
❑ Basic. Cooling System
❑ 1 Year Full Guarantee
❑ 5 Year Compressor
Guarantee
System to Include
Basic Installation
Stringent Code
Compliance
All Required Permits
Date: 0 11.11. ,? t
328.07 52007 Clodmik Home Services, Inc A9 Rights Reserved