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MC-10-167908 -03 -10 15:06 From - ASSOCIATED AIR Rog 03 10 01 : 08p str©SeOt t i ma Inspection Date: April 20, 2010 Inspector: Perez, JanPlerre Dwner: CHURCH, ST ROSE OF LIMA CATHOLIC lab Address: 415 NE 105 Street Miami Shores, FL roject ' NONE> :ortiractor ASSOCIATED BUILDING & AIR PRODUCTS ►u11d+n De rtment Comments Two 5 ton a/c systems W /ductwork for kitchen passed Failed Correction Needed Re- Inspection Fee 0 Na Additional inspections can be scheduled until re-inebee ign tee is paid, 4 9A ;A Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone; 1305)7052204 Fax: (305)758 -8972 9543849880 For Inspections please call: (305)762-4949 /10 T -5T3 P.06/10 F -666 Permit Number. MC-10494679 Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification; A/C Replacement Phone Number 30.E 75s - 0538 Parcel Number 112,310430010 Phone: (954)217 -9080 Inspector Comments MIS-3ING OUTSIDE AIR, NEED TO DO SMOKE TEST ALARM LOG BOOK SHOW 5 DUCT DETECTOR MORE ARE REQ AS PER SITE PLAN JPP 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING - Permit No.' 'C' cf"1(Ow PERMIT APPLICATIO s 4 Master Permit No. FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) S t • • IR oS4 *OF 400.414 Chu ,# Owner's Address q 4,5 / City 41 /4. SIiL x4 r State .44, f# Tenant/Lessee Name E - MAIL: Job Address (where the work is being done) w ft/I - i/4 /4.0 City Miami Shores Village County FOLIO / PARCEL # Is Building Historically Designated YES NO Miami Shores Village Building Department RECEOVIED T 13 Miami -Dade Contractor's Company Name ,016?d L • g La • 506 cts /sir c- Contractor's Address al /I/4 �pksi1.41 GZ ?f��/ City (/J s 7o d State ,Ft.. / Qualifier Name 7441 (• Dtu004MJ TR State Certificate or Registration No. Certificate of Competency No. t4 CD/ 36'3 t E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ['Addition DAlteration ONew Describe Work: n.>►e) 7 J ;j / / j e $ Eigµ a) Submittal Fee $ Notary $ Scanning $ O0 Bond $ • I N/A. 0® ******** * * ** * * * * * * *xxxxxx *x xxxx * ** * * *F Permit Fee $ Training /Education Fee $ Radon $ DPBR $ Zip Phone # Double Fee $ Phone # ?J'Y Cf % Zip 3$2 € Phone # Phone # Square / Linear Footage Of Work: Zip Repair /Replace * *xxxxx * *x * * * * ** Demolition CCF $ CO /CC / Technology Fee $ r L • 2 5 Zoning $ Code Enforcement $ Structural Review. $ Total Fee Now Due $. .51 W . t-15 See Reverse side -a Bonding Company's Name (if applicable) /v /� Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) f fi Mortgage Lender's Address City State ' Zip Application is hereby made to obtain a permit to do the work and installations as indicated. l certify that no work or installation has commenced prior to the issuance of a permit and that,p. ,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 , R, ven (7) d s after the building permit is issued In the absence of such posted notice, the inspection will not be fi oyed and a rei pecti. ee will be charged. Lrg Signature II ' l _di At Signature I .s wner or Agent Contractor q ._ The fore oing instrument was acknowledged iefore me this I 0 Imo, The foregoing instrument was acknowledged before me this day o �� b u.7 )')) (� jl day of SEPT , 20 0? , by641I'J C,, h14.14CR14 who y who is personally known to me or who has produced as identification and who did take an oath. Sign Print: (Revised•02 /08/06) NOTARY PUBLIC My Commission Expires: APPLICATION APPROVED BY: roduced ,.. , .._ -► .� nown to me or � v P`1e�, Defl a ° * Commission # DD5668 GXPires August 25, 20. A , � f ath. **** 3ex SeQe ,'ree,k****xz *xxuoYxxxxxxxxxx aYxxxx xx *xx** *it* xxxxxxxxxdc x *le*icxx *' ** �x***xxx'CW* 9cxx *x* *****x te* ***** ** NOTARY PUPA Sign: Print: u,r r��, BRENDA FAY GO RDON ;a MY COMMISSION # DD 524514 EXPIRES: April 5, 2010 Tin Notary Public •l =miters (ge 1 F41° 6 As °k) My Commission Expires: 1 3 ' 2- ®l O Plans Examiner Engineer Zoning