MC-08-657 4
Inspection Worksheet
� Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
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�...��,, Phone: (305)795 -2204 Fax: {305)756 -8972
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Inspection Date: 04/23/2008 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Inspection Type: Final
Owner: FLEURIMOND, MARIE Work Classification: Addition /Alteration
Job Address: 215111 Street NW
Miami Shores, FL 33168- Umw�hone Number
Parcel Number 1121360010660
Project: <NONE>
Block: Lot:
Contractor: FREEZE AIR CORP Phone: 786- 412 -3308
Building Department Comments
Replacing A/C unit 3 ton
ppt 2�
Inspector Comments
Passed 19
Failed E]
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Monday, April 21, 2008 Page 2 of 2
e Miami Shores Village y )?gam T �.
10050 N.E. 2nd Avenue CII�Ittftlfi
Miami Shores, FL 33138-0000 y� r
e� Phone: (305)795 -2204
F tOR� zst�sas��k�� � a : .. � ,
Expiration: 1011 2
t�t.11
Project Address Parcel Number Applicant
215 NW 111 Street 1121360010660
Miami Shores, FL 33168 Block: Lot: MARIE FLEURIMOND
Owner Information Address Phone Cell
MARIE FLEURIMOND 215 NW 111 ST
MIAMI FL 33168 -3301
Contractor(s) Phone Cell Phone Valuation: $ 4,000.0
FRE A IR CORP 786 -412 -3308
_.. _... __ Total Sq Feet: 0
Tons: 3 Available Inspections:
Additional Info: A/C Inspection Type:
Classification: Residential Rough Duct
Approved: In Review Smoke Det Test
Comments: Date Approved:: In Review Hood
Date Denied: Final
ventilation
Rough
Smoke Test
Fees Due Amount Total Amt Paid Amt Due
CCF $2.40
Education Surcharge $0.80 $ 0.00 $ 0.00 $ 0.00
Permit Fee - Additions/Alterations $122.50
Scanning Fee $3.00 Payment Type:
Technology Fee $3.06
Total: $131.76
APR �AI�
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
April 15, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Tuesday, April 15, 2008 1
Al r 0, ". Miami Shores V'
Illage
Building
�
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
APR 14 %2VA
Tel: (305) 795.2204 Fax: (305) 756.8972 �®
BUILDING ----- Permit No. hc
PERMIT APPLICATIO 8002 Master Permit No.
FBC 2004
Permit Type Mechanical
c
Owner's Name (Fee Simple Titleholder) , S A04 7 )�33'
Owner's Address 5 1
City . j State
Zip 149
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name /et6i' A19 6,94710 Phone # Z ?to ® eo l
Contractor's Address
City l� 1 State j�1A Zip 3-3; f,�l
Qii' rifler Name 1;Vt d A Phone # __ w , j W e e`
State Certificate or Registration No: � � �` -�
E-MAIL: `� /�_ Certificate of Competency No.
Arch itect/Engineer's Name (if applicable) Phone #
9 nriail!
Value of Work For this Permit $
. t ,&Yi ". 'L�ise4t�yb9�-
ag _.atib
Type of Work: []Addition . %Alteration ❑ Demolition
Describe Work: 7 t l .
..
Submittal Fee $ Permit Fee $ -� CCF $ 2' VJ CO /CC
Notary Training /Education Fee $ V• Technology Fee $ `
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side -->
Bonding Company's Name (if applicable)
Bonding Company's
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 w6irkian$d iii as indicated. [certify that no work or installation has
commenced prior to the issuance of a permit and that all *or will be performed to meet the standards of all laws regulating
construction in this jurisdiction..[ 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 �t Y PROPERTY.
BEFOR EURECORDINGO O
NOTICE FINANC OF
CONSULT WITH YOUR LENDER OR
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature e Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me thi
.
^ tt
day of !� (' I , 20Q1, by I: f M Ctri e Fl w, g mom day o , 20 og, by
who i ersonall known to me or who has produced
pro
who is personally known to me or who h duc y
F4(� s 57`S6&� identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: �� °•a, JOSE URE14A NOTARY PUBLIC:
N ay Pd a C -- ,� F
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Cam! t W 84911 8 a , «•• MILTON ROAG RO
Sign:
Sign: Print:'�9 op EXPIRES:D� 1
70464
P 'nt , Notaryse
Commission Expir a� aw$ My Commission Expires:
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Plans Examiner
APPLICATION APPROVED BY:
Engineer
Zoning
(Revised-02/08 /06)
1
f ropasal Page No. of Pages
ire coup.
W.140AM., MIAMI, FL
TEL: 266 1 ! G 3 �/ c� /
CACO 57312
PRO L SUBMITT TO — r/ PHONE DATE G✓
S ,Q,F •
STREET _ JOB NAME _
CITY, STA AND ZIP CODS JOOCAT
ARCHITECT DATE OF PLANS 6/ •V' JOB PHONE
We hereby submit specifications and estimates for AIR CONDITIONING SYSTEM
t,/ X. -i AECEOVED
An I
39r Fr op0g r hereby to furnish material and labor — complete in accordance with above specifications, for the sum of:
Payment to be made as tolls: dollars ` )
All material is guaranteed to be as specified. All work to be completed in a workmanlike c
manner according to standard practices. Any alteration or deviation from above specifica• Authorized
tions involving extra costs will be executed only upon written orders, and will become an Signature
extra charge over and above the estimate. All agreements contingent upon strikes. accidents
or delays beyond our control. Owner to carry ..We, tornado and other necessary insurance. Note: This proposal may be
Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us If not accepted within days.
.C1L�p�talµ�ACL1 —The above prices. specifications �J
and conditions are satisfactory and are hereby accepted. You are authorized Signature 42404 A2
Q04 —V&dZ
to do the work as specified. Payment will be made as outlined above.
Date of Acceptance:
Signature