MC-09-167806 -03 -10 15:07 From - ASSOCIATED AIR
lug 03'1U ui:ump
'roject
Wontractor:
Passed
Failed
Correction
Needed
<NONE>
Re- Inspection
Fee
nspection Number INSP4126980
Inspection Date: February 09, 2010
Inspector. Perez, JanPierre
Owner CHURCH, ST ROSE OF LIMA CATHOLIC
Job Address: 415 NE 105 Street _
Miami Shores, FL
ASSOCIATED BUILDING & Ii1R PRODUCTS
Building Department ents
30 tun package unit located on south side of g Im 86
Nn Additional inapostions can to scheduled until
f iflspectioa fee i5 paid.
9543849880
T -573 P.09 /10 F -865
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -23044 Fax: (305)756 -8972
Inspector Comments
NEED FIRE ALARM LOG ROOK OR SMOKE TEST JPP
For In inertilnrin nl a .-eU- itnciveri seen
Permit Number MC-10-09-1678
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number J3152§11-0539
Parcel Number 1122310430010
A la
Phone: (994)217 -1080
NOTICE OF COMMENCEMENT
A RECORDED COPT MUST BE POSTED ON THE JOD SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOUO NO.
STATE OF FLORIDA
COUNTY or MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that Improvements wIH be made to certain
real property, and in accordance with Chapter 713. Florida Statutes. the foltovWi
information is provided in this Nonce of Commencement
a nd s treet/address: sr A.'S'c D F 4(1,401 o At c .44_ �e h
1. Legal de�oripfibn of property
2. D3soriptitx of im, .proven ent .__, so 73
3.Owner(s) name and address:
Interest In property:
Name and address of fee simple titleholder.
4. Contractor's name and address:
2 / C
5. Surety: (Payment bond required by owner from co = t• r, if any)
Name and address:
Amount of bond $
6. Lender's name and dress:
,rii .7. Persons with the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 7'13.1 1)(a)7., Florida Statutes.
Name and address: Pr
8. In addition to himself, Owners designates the following person(s) to receive a cOPY of the Lienor's Notice as provided
bf in Section 713.13(1)(b). Florida Statutes.
Name and address: k1ifr
9. Expiration date of
dlfterett date i
My commission expires:
(sue)
919 - l0 /10•d IPI -1
/1/j •
Notary Public
Print Notary's Name / (2 0b �~ 6-0 • 0
98E88111198+
bly 031yI3Q$sy -woo4
CFN 2009R0197220
OR Bic 26792 Pe 0766 Ups)
RECORDED 03/18/2009 1422313
HARVEY RLJVIN. CLERK OF COURT
HIAfI —DACE COUNTY' FLORIDA
LAST PAGE
Commencement~ (the expiration date is 1 year from the date of recording unless a
1
lt...• r ` l�l �1 /fir
Si , • Own
' � fi by lam' l
L _��
Print Owner's Name /6 to � •
a = GtRi,. 1
Sworn to and subscribed before me this „ day of 20 ° r floft 1 /� 53 )
90:El 80 -E040
BUILDING
PERMIT APPLICATIO
FBC 2004
City M. • 542 4 f State ,f4C •
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
(RECEIVE
CT 13 009
Permit Type: Mechanical
Owner's Name (Fee Simple Titleholder) 5 Rust. p ( h , � r itone #
¶ Owner's Address "/ �. /0.1 I • �
Architect/Engineer's Name (if applicable) r /44
Value of Work �� �
o k For this Permit t?' •
Zip
Aie co s r .
Phone # ti//A
Master Permit No.
Permit No:HC — I (&i
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name AS'S OL ► 8 L (z . dt C E Phone # %s " I g6 8 776.4
Contractor's Address 2 /lr At • 4:W 114ft Le4 Pt4/
City WL'5I ) 441 State /-L, e Zip 33J24 ^�
Qualifier Name TO kW e•OttIV ICAO R - Phone# 94 ... g-6 7 z3 To
State Certificate or Registration No. cA C 0 I'.'3 / Certificate of Competency No. Cl; GO / 33' 3 /
E -MAIL:
Phone #
Square / Linear Footage Of Work:
Type of Work: Addition ❑Alteration
❑New Repair /Replace ❑Demolition
Describe Work:.. To Au f ASI A 4 $ u Nit l .40‘47Z6 ado S12147"A
51�sti.old
67 .
ie�enY***..xxxx &o4w***xxx ..w*xxxaYx*** F�sw¢ wlivw& xxxxxdr xxxxxx aYfrxoFx &xxxxxxxxxxxetxx
Submittal Fee $ Q Permit Fee $ b CCF $ CO /CC
Notary $ 'raining /Education Fee $ 7. Tech logy Fee $ � • 2
Radon $ DPBR $ Zoning $
Bond S. • Code Enforcement $ • Double Fee $
Structural Review. $ Total Fee Now Due $
qc : (oS
See Reverse side -->
Bonding Company's Name (if applicable) /�
Bonding Company's Address
City State Zip
a
Mort e Lender's Name (if applicable) d gg
Mortgage Lender's Address
City State Zip
P ,
Application is hereby made to obtain a permit to do the worts iinstaltatipns,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 , e ap ro ' d - a7 a ° , ' • , ection fe - will be charged.
-A AU
Signature
As identification and who did take an oa
NOTARY PUBLIC: ( ep ,v t 3 %, Dell Marie Springer
Commission # DD566868
(1 _ 'Y o Expires August 25, 2010
men Inc 800385.7P19
APPLICATION APPROVED BY:
(Revised-02/08/06) .
Owner or Agent
The fore' oing instrument was acknowledged b re me this /® The foregoing instrument was acknowledged before me this 7 /
day o / , 20 , by �'1(et� °'�, day of , 20 07, by M e ° '�i
i
is pe- ■ a y nown , ,e or who has produced who is personally k ow
nn to me or who has produced
as identification and who did take an oath.
Si
' AP i L r -Pe-r
My Commission Expires: 5 2 - —5 ""
q;xx,t}yeaY****xrx *de.*** c****** Sex **' 3e **** *xxxxxxxx4cxa4****xxxxx** A xxx nY********xxxxx oY9e***
NOTARY PUBLIC , BRENDA FAY GORDON
A MY COMMISSION # DD 524514
�� EXPIRES' s 15, 2010
.. ✓i '.ii u N Und
Sign: ���lo� U '
i A %�
Print:
My Commission Expires: 1—S-12
xx xxw`xaY'xxxZx****xn ***
Plans Examiner
Engineer
Zoning