MC-06-2636Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 30581
Inspection Date: 042007
Inspector: Perez, JanPierre
41222101
Owner: WILLIAMS, M JEAN
Permit Number: MC -10-06 -2636
Job Address: 395 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: SERVICE EXPERTS LLC
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132060135930
Lot:
Phone: 305 - 264 -2020
Building Department Comments
CHANGE OUT 5 TON CONDENSER
APR 2 5 2007
Passed
Inspector Comments
q"{)
Z
Ill
,
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Monday, April 23, 2007
Page 1 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 10 t26106 Permit No.
PERMIT APPLICATION J Ce- Master Permit No.
FBC 2004
rf
OC T 2 4 ?006
B m a !��E rep __
l.J�+ Z3
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing ,I
Owner's Name (Fee Supple Titleholder) Jr- WI I 1 ai►4. S Phone # --at) b 5 • 4341• b f 4 ?
Owner's Address 315 �L i S- f -Lth
m
City i 44W1 v' _ State Zip 33 131
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 315 N G 910 V ' f r
City Miami Shores Village County . Miami -Dade Zip 381 p
3 0
FOLIO / PARCEL # 11- 3 2-04 • 013. 5130
Is Building Historically Designated YES NO
Contractor's Company Name 2a VI c€. Ej(per_1 -s Phone # 3p5 c 4 `1 ' ..1044)
Contractor's Address 16.21 A.) W g-1 Ca 4-
City �ov-ct..1 State ' F 9� Zip 3 3 1 74Z
Qualifier Name �e1V 1∎i 1-S P-v t IV Phone # 305 . alp 4 • as' O
State Certificate or Registration No. CA c..... 1 �j 1.3461 Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 31545 Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ['New VRepair/Replace
Describe Work: ,(, J —`177Y1 C✓D n ser'
❑ Demolition
dlr FZ 3060A- I Oo o AA-
* * * * * *** *** ** *** * * *** ** ** * * ***** * *** Fees * ** * ** ** * * * ** * ** * * * * * * ** * * * * * * * * *** * * * * * **
Scanning $ -O' ) Technology Fee $ -5.10
Submittal Fee $ Permit Fee $ a' J1; CCF $ 240 CO /CC
Notary $ n a e Training/Education Fee $
Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $
Total Fee Now Due $
1 JT°
See Reverse side --+
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
conunenced 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
Owner or Agent
The fore ing instrument was acknowledged before me this __ The forego'
day of , 20 by ®�R+ Wi tte:0 , day of
who is personally known toe 7'or who .. produc • I—. II_ who
4 469- = `' (9 i - s i tidcati'on an who did take an oath.
NOT t LIC:
'
Puee JESSICA RAMOS
r * MY COMMISSION t DD 415483
EXPIRES: May 13, 2009
Sign:
P
My Commission Expires:
FQF FL°
Contractor
instrument was acknowledged before me this
y \ VO;S Cret48.
ho has produced
s personall known to me o
as identification and who did take an oath.
NOT . ' UBLIC:
Sign:
Prin
My Commission Expires:
l4611- 1::"'0 JESSICA RAMOS
MY COMMISSION t DD 415483
• C��i±_4 :t"'* EXPIRES: May 13, 2009
sco.,00O Bonded Thai Bu
:l'
**** *, ter *, *** * * * * * *** * ** ** *ter * * *** * * *** * * * ** * **** * ** ** ** * * ** ** ** **** ** * *, ** ** * * ** * * * * * * ** * ** * * * * *** ** *ter***
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
3052550012
Oct 25 06 09:43a
3052650012
Chanin e 762 NW 78 Ave.
Gble Ai (J305) 26� -2020 loll' Fax
�+ (305) 266 87,26
Cromer
A4ldruss e. 56 5f
Address (job location)
City t ` i`i 1�� State
Hbme Phone J0`r'C3' 90)1S tVark Phone Job Site Phone
HOME COMFORT INVESTMENT AGREEMENT
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Entail
code 3313 g
Standard
Air Conditioner
ICI Furnace
'0 Heat Pump
`.❑ Air Handler
Cooling Coil
.❑ Baler
OOOOOOO
NEW SYSTEM
Deluxe Premium
Cpl
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R*
Supreme
a
a
Install Date
INDOOR AIR QUALITY
0!Ductwork Cleaning 0 Ductwork SanidzIng 0 Fresh Air Mixing System 0 Zone Comfort System 0 Humidifier
03U_V. Light 0 Thermostat 0 Flue Liner 0 Dehumidifier 0 HRV 0 ERV
0 Filtration 0 Alr Dietributlon 0 Charcoal Fitter 0 Catalytic 0 Continuous Fan
z
C I Reconnect to Existing Ductwork 0 Ductwork Sealing Changes/Addttione
0 Insulate Ductwork .- (fr'f P&, `,e i
0 balance Air Flow _
0Smoke •- ...
0 CO Detector
Cr Efficiency Ertha
Wise possible Asbestos observed? 0 YES 0 NO
Hips the customer been informed of thew responsibility to remove it? 0 YES 0 NO
WW I5 possible Mald observed? 0 YES 0 NO
Has the customer been informed of the possible presence of mold? 0 YES 0 NO
5 "Spacial Concerns Terms" on the reverse side of this page.
SPECIAL. CONCERNS
CUSTOMER QUALITY ASSURANCF GUARANTEES
Mettillasimialfgaratiga (wereor below are Provided ff checked)
CIA* Conditioner Compressor 7-► year 0 Furnace Pans years 0 Labor
C] ifir Conditioner Parts year 0 Furnace Heat Exchanger year
Tht tooting system will provide a F Indoor temperature on a F summer day.
heating system will provide e F indoor temperature on a F winter day.
Paid Sy: 0 Caeh'Cheick # o'2 7
INVESTMENT AND TERMS
0 Visa O MC 0 Discover ct Other
1 11 j 1 1 11 1 1 1 1! 1
Card Number
Nalme on Credit Card Au h_ Code
Exp. Date
Amount Charged to Card $ Cash S
Financing $
Less Initial Investment $
Balance Due Upon completion $ +✓
Signature
~�� ►,.�'%; A■ signatu k Date
Signature
rotoc ofar erYon fDr in soma eas RIGHT 1T3
You, the buyer, may cancel this transaction at any time prior to midnight of the third bulimia, day after the date of this transacu ,. See the
this right an the reverse eitle of this page. l Ire cac na,nna a 16—w-