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MC-09-1681 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 126988 Permit Number: MC-10-09-1681 Scheduled Inspection Date: February 09, 2010 Permit Type: Mechanical - Commercial Inspector: Perez, JanPierre Inspection Type: Final Owner: CHURCH, ST ROSE OF LIMA CATHOLIC Work Classification: A/C Replacement Job Address: 415 NE 105 Street Miami Shores, FL Phone Number (305)758 -0539 Parcel Number 1122310430010 Project: <NONE> Contractor: ASSOCIATED BUILDING & AIR PROD UCTS Phone: (954)217 -1080 Building Department Comments Replace 3-4 ton c/u #22, 24, 25 Inspector Comments Passed 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 8 of 25 7� Miami Shores Village A Uo�� . 10050 N.E. 2nd Avenue �r Miami Shores, FL 33138-0000 h° Phone: (305)795 -2204 A�c 11 Expiration: 05/041201 Project Address Parcel Number Applicant 415 105 Street 1122310430010 Miami Shores, FL Block: Lot: ST ROSE OF LIMA CATHOLIC CI Owner Information Address Phone Cell ST ROSE OF LIMA CATHOLIC CHURCH 9401 BISC BLVD (305)758 -0539 MIAMI FL 33138 -2970 Contractor(s) Phone Cell Phone Valuation: $ 8, 100.00 ASSOCIATED BUILDING & AIR PRODI (954)217 -1080 _... _ .._ Total Sq Feet: 0 S Tons: For Inspections please call: Additional Info: (305)762 -4949 Classification: Commercial Available Inspections: Approved: In Review Inspection Type: Comments: Date Approved:: In Review Final Date Denied: Type of Work: Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $5.40 Education Surcharge $1. MC - 10 - 09 - 36142 $ 300.27 $ 300.27 $ 0.00 Permit Fee - Additions/Alterations $283.00 Permit Technology Fee $7,07 Scanning Fee $3.00 Total: $300.27 11 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 November 10, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 10, 2009 1 NOTICE OF COMMENCEMENT R Sk 26M Ps � 86; U PS 2�� REE 03 11812W 14122213 A RECGROW COPY NOT M POOTED aN THE JOB arm At TwF. OP Pmr INSPEMON A R V EY DADi: t�.F CWT PERMIT NO TAX FOLIO NCl. LAST PAGE sTATE OF FLORIDA COUNTY OF MIAMI -BADE: THE uNDERSMED hereby gives MW= the "mveeenls wtil be made to cart"' Mal infamod 10 provldsd io this NCU co noemer�t.Flonda 5ttatutes. the fo 1. Legal ripfibn � property and streettaddress: Jr At t01«t 4e 'At t A a3� . r + 2. D"ar(pt M of h!?i !e e, 4( M+t 3.Owner(s) name and address: Interest In property: Name and address of fee simple tittefwyldor • 4. Cort#tact © name and addrm. I r/ • / rte lrJE �► s 5. SUMV. (payment bond requited by owmer from co r, if any) Name old addnass: Amount of bond $ a. Lender's name and address: •7. Persons m ft the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.1 1 }(a )7., Florida $WAss. Name and address: X $. In addi0on to Nmaelf, Owners designates the following persons) to receive a copy of the t3ettor's Notice as provided in Simon 713.13(1 Florida Statutes. Name and address. - 9. Expir Lion date of f Commencement: (the expiration date is 1 year from cite data of r+eaurding unless a different data I stifled} Sign owner 1�. 120/ red by a Print Ctwner's Name Swam to and subsoribed before me this day of —99V -- . 20 mom Notary Public gWKFAYri n74 klY�'i# Notary's Name Itt �ee my commission expires' (seal) 919 -d t 0/ l0 ' d IV I -1 988811IM26+ S i v 030130SP -anj d t0:61 80 -E0 -ti0 Miami Shores Village Building Department 10650 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING RECTMED) Permit No C _ I ®''0q —) � U ,I PERMIT APPLICATIO a 1,3 2004 Master Permit No FBC 2004 Permit Type Mechanical Owner's Name (Fee Simple Titleholder) Cllftc Phone # Owner's Addr Y /,r- V E � zb j' .177, City /1Q • �4�— State /. Zip _ Tenant/Lessee Name AI Ar Phone # E -MAIL: Job Address (where the work is being done) _1(/r- /J E 1 %4 ,S j City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO nn � Contractor's Company Name 46see-. 3 ��• RI/✓ lwt Phone Contractor's Address -p/ f t Al . e®"" /fte eg e K R V city r&A) State Zip 33 a L Qualifier Name �� • �� pje Y�jQ„ • I �' Phone. # Q,S ��o � 7 ?mil State Certificate or Registration No. Certificate o E-MAIL: f Competency No. Architect/Engineer's Name (if applicable) ¢ Phone # Value of Work For this Permit $ Square /Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New DR air /Re lace p p El Demolition Describe Work: 7j� j �' o& -4 T 76 xeY 4e nt sYx4e4exxx4r YxaYxYxdex4cx�xet v5•sYair4r tF e4xxeexnYx�.' SxdexxY 4ed 9e drxde sYx�xxxxdcxxx�fe nYxe@xxxx4cxxxxac r'c �t 4e e4xx Submittal Fee $ 0 Permit Fee $ CCF $ % 0 CO /CC Notary $ ® Training /Education Fee $ f J Technology Fee $ �fl ScanninO Radon $ DPBR•$ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ U See Reverse aide —>. . Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Lender's Name if applicable) Mortgage L ( pp ) Mortgage Lender's Address City State Zip E Application is hereby made to obtain a permit to do theivork aii"nstallations as itidicated. 1 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 a oved and nspec ' n fee will be charged Signature Signatu Contract Owner or Agent c.�.h or The for oing instrument was acknowl ged before me this �� r The foregoing instrument was acknowledged before me this 9 day o , 20M, by I�YI QJ�JI_.IC�.C� I1?� day of SC ng ®r , 20 0 by who ' o ally known tome has produced who is peLsonallyJmown to me or who has produced As identification and who did take an oath. Pub as identif r II \ \ \ \NII r�� BRENDA FAY GORDO NOTARY PUBLIC: &0' P us Deli Marie Springer NOTARY PUBLIC: � *= MY COMMISSION #DD524514 o �, EXPIRES: April 5, 2010 ,, Commission # DD566868..•g�a 7,,,, �m,yu Expires August 25, 200110 Si Sign: QQ __,_ Print: i l Print: \��91 Z ® My Commission Expires: m My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised- 02/08/06)