MC-10-94 i
Miami Shores
10050 N.E. 2nd Avienue��e� ) @�
Vi
Miami Shores, FL 33138-0000
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Phone: (305)795 -2204
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f; Expiration: 0 71241201 0
Project Address Parcel Number Applicant
359 104 Street 1121360130130
Miami Shores, FL Block: Lot:
CARLOS PEREZSTABLE :&W j
Owner Information Address Phone Cell
CARLOS PEREZSTABLE &W & MARIA h 359 NE 104 ST
MIAMI SHORES FL 33138 -2017
Contractor(s) Phone Cell Phone Valuation: $ 7,364.00
TYCOON FLOW CONTROL (305)828 -6655
.,..... __..::. Total Sq Feet: 0
Tons: REPLACE OF A/C 3 TONS For Inspections please call:
Additional Info: 3 TONS
(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 $4.80 MC -1 -10 =36857 $ 294.02 $ 244.02
Education Surcharge $1.60 MW
Permit Fee - Additions/Alterations $278.22 MC -1 -10 -36857 $ 294.02 $ 294.02 $ 0.00
Scanning Fee $3.00 Check #: 6445
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $6.40
Total: $294.02
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.
January 25, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 25, 2010 1
Miami Shores Village R CE9VE
Building Department JAN 2 0 2010
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 - - - -
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No. 1 ►rto — q L i
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type MECHANICAL
Owner's Name (Fee Simple Titleholder) 4za`�a - �9&nzor - Phone #
Owner's Address 3!59 /' ®.� SY
Ciry fiy,' State Zip
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being >done)
�,'
City Miami Shores Vi)laae County Miami -Dade . Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's, Company Name �j��� �� Phone # --�3ZP ' °rye low �i
Contractor's Address ma c/ ��i�, g¢ 9
City _..' ✓��e2� State �� Zip � 3/��i
Qualifier Nani Phone # ✓� 4 �� ': ,a� °
State Certificate or Registration No. d% gZZ4el, _706 Certificate of Competency No.
Contact Phone
Architect/Engineer's Name (if applicable) Phone #
7
Value of Work For this Permit o Square / Linear Footage Of Work:
Type of Work: ❑Addition []Alteration []New Repair/Replace ❑ Demolition
Describe Work ,O / &cc oV e, AZ
\ ubmittal Fee $ -•� � t
Permit Fee $ ` ► O�� CC CO /CC $
Notary $ Training/Education Fee $ �• Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ d 44 ' 06
See Reverse side ->
4� 2l Vv
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signatu ,
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this /' The foregoing instrument was acknowledged before me this / C �
day of P�0 , 201 o by day of , 20/a, by ,
who is personally known to me or who has produced who is personally known to me or who has produced
�r As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print:_ :..
i
Print:
My Commission Expires: �g.,,M 2 213 My Commission Fp .� % Feb=ry 7, 2012
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�e�s 64e3roY$ r�YaY�Y #9r�Y9t4r3ssY9e�ir$nY�e� ������ ArdrsY,sH9r dr dedt3e�Y: 41k�e3e�Sr4c3eikn43e+ YoY* 9e��Y it9ek3: �k�Yde* klrkk4edr�ir4r�Y�kvY�zF4e�3e9c& �4e� 'z *s$9F�k:6:Y4r�Y4r *9eir�Ydr9nY
APPROVED BY Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07XRevised 06/10/2009)
MAMI-DA'DE COUNTY 2009 LOCAL BUSINESS TAX RECEIPT :.• iQ ,. �' FIRST -CLASS
i TAX COLLECTOR MIAMI -DARE COUNTY - STATE OF FLOFtj�D . U.S. POSTAGE
140 W. FLAGLER ST. EXPIRES SEPT. 30,2010 := ,a,. �;s,'�: PAID
lot MOOR MUST BE DISPLAYS AID. PLACE OF BUSINE� j �� ;�: MIAMI, FL
MIAMI, " FL' 33130 PURSUANT TO COUNTY *JOLTS, CHAPTER'B/ -- 9IT` '.I PERMIT NO. 231
THIS IS NOT A BILL DO NOT PAY
516497-5 / c� T1�y RENEWAL '
BuT�F�S��aM�L�W CONThL CORP STATE CAC1813706 -b
2500 W 78 ST BAY fit
33016 HIALEAH
OWNER FLOW CONTROL CORP
8 "i9E SPEC MECHANICAL CONTRACTOR WORKED /S
THIS IS ONLY A LOCAL
SUSINM TAX RECEIPT. IT
DOER NOT PERMIT THE
HOLDER TO VIOLATE ANY
ZONING REGULAT
LAWS O FR'TH E DO NOT FORWARD
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERYR OR LICENSE
REQUIRED SY LAW. THIS IS TYCOON FLOW CONTROL CORP -
TTEH ER'SOU" AF FELIPE D SOLER PRES
TIONS. 1271 W 62 ST.
PAYMENT RECEIVED HIALEAH FL 33012
MUUIFDADE COUNTY TAX
COLLECTOR:
08/04/2009
60000000543
000045.00
SEE OTHER SIDE
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rnt 20/01/2010 at 10:06:27 – from – to 305 826 9166 p2/9-
11H1111110114
Prorosal o af Jet 1. $' Sean Home Improveme Products, Inc.
Gustoner Nara � _ P.O. Box 522290
vfJS —C 2– ; _Mg�IE 1024 Florida Central Parkway
Customers Home Phone Gus%mers Work Phone H6me Impr PrOdifC1S Longwood, FL 32752 -2290
Sit- .S 30 39 - 7_T9 P hone (800)469 -4663 _
Street Address ESTIMATE AND PROPOSAL oonractor UcenseiReaistration Nu*rber
Cty �C 014 sate zm. 1ode Heating & Cooling HVAC#CMC1 9514
h) 1 %og ; 31/ 3g Is installation within city limits
In stallation Address curlty a �+ _ L.Ofes ❑ N
Billin Address (n direrent from }
cn i. ta:e Zi Coda P (i ikable)
C y p Project co Cor�s�nant Name 8 license Nn. f app
08= 11`14116111 o the ct and DeecrlpOml of the S M ate to be Used and Equipment to be Ina ftil le d
SYS INFORMATION: Equipment Brand: t uns , L2 System U Package O Dual Fuel t- 0"R -410A
SEER (up to) _ Cooling BTU _ K _ 0 C ool Cl He at Pump ❑ R -22
INSTALLATION TYPE: 0 New Q Replacement ❑ Conversion FURNACE FUEL: ❑ Gas ❑ oil ❑ LP Gas ❑ Electric
❑ Remove and disca olc system AFUE (up to)' Heating BTU
E'IlUIPipIENT SPECIE GA to to '- �–
Existing New MODEL # OF NEW COMPONENT ❑ CONNECT TO EXISTING ELECTRICAL
C] . ®-- FURNACE/FAN COIL ft t1X W ❑ INSTALL NEW— AMP MAIN PANEL
❑ 0' CONDENSER UNIT – tlfk4S6 CAP 13 NEW DISCONNECT ❑ FURNACE ❑ CONDENSER
❑ ❑ EVAPORATOR COIL _ ❑ NEW GFi OUTLET ❑ ATTIC LIGHT & RECEPTACLE
❑ ❑ PACKAGE UNIT Other:
L� •0'° THERMOSTAT – DUCT 119 RK:
0 ❑ HUMIDIFIER ,J2"RE -USE EXISTING DUCT SYSTEM
❑ ❑ AIR CLEANER ❑ INSTALL NEW DUCT SYSTEM WITH NEW RUNS
❑ 0' IN LIGHT e i ❑ REBUILD PLENUM ❑ Supply 1:1 Return
❑ ❑ EVAP COOLER ❑ NEW TRUNK LINE(S) ❑ Supply ❑ Return
MISCELLANEGUS: ❑ NEW RETURN GRILL($) _ X _ X
❑ ❑ LINE SET 0' PAD x ❑ REPLACE REGISTER(S)/
❑ ❑ DRAIN LINE _ ❑ CONDENSATE PUMP ❑ DUCT CLEANING
❑ ❑ AUXILIARY DRAIN PAN ❑ Other Oth er:
FLUE YEHTINO AND/OR CHIMNEY ❑ Use existing vent or chimney ❑ instal( new chimney liner Sim:_
❑ PVC Vent Pipe for High - Efficiency Furnace ❑ Horizontal ❑ Vertical ❑ Type -S Vent Pipe ❑ Stainless Steel Vent Pipe
O 1 Pipe Installation ❑ 2 Pipe Installation ❑ Comb ustion Ai ❑ Existing ❑ Modify
SPECIAL INSTRUCTIONS: S` j_ 4 �o F , � � aZ �
Ail of the above check boxes have been re»ievred and explained to rne. -- Cu me s)init)als
APPROXIMATE START DATE and APPROXIMATE COMPLETION TE: 0 The work will start approximately t � 5_0ximate Start
Date) and will be substantially completed by approximately (Approximate Completion Date). These dates are subject to change
at the time the contract is accepted by Sears Home Improvement Odom Inc. ("Sears - ) or at any other time by mutual written agreement. Customer
understands that the Approximate Sta Data is only an e stimated date and the Customer will be contacted prior to this date to schedule the actual start date,
®E • Tills Estimate and Proposal assumes that there are no asbestos containing materials ( "ACMe) that would be disturbed in the
p6rf0rnl211ce of the lilSta work. If upon further inspection by the contractor or others It is learned that ACMs have to be disturbed to perform vvvrk,
then Customer mus, arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. if Customer fails to
arrange for necessary asbestos abatement within thirty (30) days. Sears may cancel this contract upon written notice to Customer.
_ Customer(s) initials
PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pre - existing conditions of any ductwork, piping. electrical
supplies or equipment not being replaced at this time. It additional work is required, R e iif be tha Customer's responsibility. Any additional charges will
be quoted and approved ririor to the sta of arnr addit cinal work. Customers) initials,
THE DN kCT PRICE INCLUDES A copy of the terms and conditions of the Master Protection
-Year Master Protection Agreement ❑ Agreement or Repair Protection Agreement ave -been
_ -Year Repair Protection Agreement ❑ provided to Customer. Cu s Initials
The TOTAL PRICE including all labor. material, taxes and any applicable discount ist ontract Price S
I State %)
�� Local Sales Tax � rol _
Customer Paymem is d prior to Sears' placement of Special Orde fo products. mount lie it
The form and methoc by which the Customers) will pay is described In a separate Cas=redlt Card Payment Addendum ma e a part of arfd incorporated
into this contract by reference.
– - -- – !_ Customers initials
OTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
°IFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE BB OR OLDER) AFTER THE DATE OF THIS
RANSACTION. SEE THE ATTACHED NOTICE OF CANCELLA FORM FOR AN EXPLANATION OF THIS RIGHT.
liddlUa pr ovlae01118 of thi contract are stated an the pages founwing. Customer(s) initial.
un -n aebormR
NOTICE OF COMMENCEMENT I I�IIII VIII Itl�f IIII� ill! III! Il�11 IIII I11I
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
OR Bk 27155 Ps 1585; (fps)
PERMIT NO. TAX FOLIO RECORDED 01/21/2010 10 :33 :36
HARVEY RUV'IN8 CLERK OF COURT
STATE OF FLORIDA: MIAMI -DADE COUNTYP FLORIDA
COUNTY OF MIAMI -DADE: LAST PAGE
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, -and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
Space above reserved for use of recording office
1. Legal description of property and street1address: '-S�Aos'
2. Description of improvement:
3. Owner(s) name and address: _ ��/i� /y //yj �� y� 3�� IF /psi
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name, address and phone number 1 -
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number. STATE OF FLORIDA, COU6M OF FADE c
I HEREBY CERTIFY that this Is to the �® e ►e °" ,���
8. In addition to himself, Owners designates the following persor4��i otice a v 4
713.13(1)(b), Florida Statutes. _ , A D
Name, address and phone number: WITNE y hand and "c Seal.
an n s
9. Expiration date of this Notice of Commencement:
(the expiratiffn date is 1 year froA the ate of recording unless a different date Is specified)
WARNING TO OWNER. PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of �f� -wne uth �r /�1 or /Partner/Man a��f
Prepared By c `G � a ared By (N - -f-'d e c �olgc'
Print Name g 2.500 SJ 7 � + DQ`/ q F1 okk (
Tiltle/Office Title/Office
STATE OF FLORIDA -
COUNTY OF MIAMI -DARE
The for instrument ws n atfknowledged before me this day of a/� nI�iGD
By - -IyC) r A N1 • NtC 1'Y�GiK�Z cf r
❑ Individually, or ❑ as for
❑ Personally known, o produced the following type of Went cati /=
Signature of Notary Public:
Print Name: -r
(SEAL) Oduasltl.ZOfS
Yle�i 1Me NMry!lWr1e lirirrrlrs:
VERIFICATION PURSUANT TO SECTION 92.5M, FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signatur ) Owner(s) or ne uthorized Officer/Director/Partner/Manager who signed above:
By By
123.01 -82 PAGE 10/09
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795 -2204 Fax: (305)756 -8972;
Inspection Number: INSP 133899 Permit Number: MIpA -10 -94
Scheduled Inspection Date: February 09, 2010 Permit Type: Mechanical' - Residential
Inspector: Perez,JanPierre j�6 Inspe Type: Final
Owner: Work Classification: C Replacement
Job Address: 359 NE 104 Street
Miami Shores, FL Phone Number
Parcel Number 1121360130130
Project: <NONE>
Contractor: TYCOON FLOW CONTROL Phone: (305)828 -6655
Building Department Comments
Inspector Comments
Passed
Ng
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 08, 2010 For Inspections please call: (305)762 -4949 Page 15 of 25