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MC-09-1489Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 123852 Permit Number: MC -9 -09 -1489 Scheduled Inspection Date: October 20, 2009 Inspector: Perez, JanPierre Owner: ROVITO, OSCAR Job Address: 1225 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: BLUE BREEZE AIR CONDITIONING Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060143800. Phone: 305 -865 -1220 Building Department Comments REPLACE EXISTING A/C UNIT 4 TONS [b 2-011 Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. October 19, 2009 For Inspections please call: (305)762 -4949 Page 7 of 12 • Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Permit No. Master Permit No. Lr-comn-up SEP042009 Owner's Name (Fee Simple Titleholder) oscies- , goy( O Phone # '©j 751-49S0 Owner's Address 12- 2 S I el G CityKw1'ki 5'3/4ot 3 Tenant/Lessee Name E- MAIL: State R- Zip 3S 13 g- Job Address (where the work is being done) City Miami Shores Village Phone # ia6, mt.," 944 County Miami -Dade Zip FOLIO / PARCEL # 32 ®G ®k„tr\ 3,®o Is Building Historically Designated YES NO , Contractor's Company Name Contractor's Address 6,,4j$ city R A,t Qualifier Name 4 State Certificate or Registration No. E -MAIL: State - `?..teio cAA_ icA S2,16 one # S 1 Q Zip Phone # 5. 13‘,s-- ? 22o Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: OSquare / Linear Footage Of Work: ❑Alteration Repair /Replace ❑ Demolition t� -�-4• `,-3 x ....x �c...... ......xdev....kxnt4ex #ux�1e'k.. Fees' t�rx �Yilr.... �Y�Y....+' r.... �Yacxik *xaFx9rk4ie #....�tx�c�k�Y ��EP � AI�� Submittal Fee $`� »OO Permit Fee $ t ,' ; ni CCF $ 4K0 CO /CC Notary $ • Training /Education Fee $ 1' WO Technology Fee $ 6- Scanning $ WOO Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Zoning $ Total Fee Now Due $ 241 - See Reverse side —+ 1-29 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 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 absent of suc posted notice, the inspection will not��, e _ recnspec a e will be charged. Our 7-0 Owner o Agen�— 3I The foregoing instrument was acknowledged before me this VIV day of ()gaskaec , 200A , by (:).04A, etZ0 who is personally known to me or who has produced `Lys As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature C c ractor The foregoing instrument was acknowledged before me this 34 day of 6,ugv SA , 20O \, by t4li,/ `Toick4A- who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio *** dc******************************************** xezxxae****** * * ** * * * * * * * * ** * * * * * ** * * * * * *,,', ,w * * ** APPLICATION APPROVED BY: (Revised•02 /08/06) (\4 ctlelq Plans Examiner Engineer Zoning sal/ Ag ent Customer Name O5CA-(Z R ©■ t"-it) Date , 31, C3q Work Order # Address P 2'2. N ,,, q City M S+Ao II-LE S State C. 1 /'''�� Home Ph. (605) 75 t- zIQ°i0 Work Ph. (Sas 757- 55RElaii ©SG r0(-"D a44- O €'!- ,S""4--32, Zip 3��5 i ? } N INCLUDES ✓ All labor ✓ Performance Control Center P1 Standard Fl Electronic programmable ✓ All required permits ✓ Removal and proper disposal of old equipment ✓ Check entire system for safety and efficiency ✓ Check and reseal minor leaks in exposed ducts/ ✓ One year scheduled service SPECIAL AIR TMENT PROD FOR ROVING ME QU OF YOUR AIR ❑ MicroGuardian,M Air Scrubber ❑ Quantum 254. UV Sterilizer f I OxyPure. Air Enrichment System Fl OxyQuantum. Combination System I1 Micro PowerGuard, Air Cleaner Fl ToraVacc Source Removal System We hereby propose to complete work as specified above for the sum of: Payment terms: Financed* 2 % • •osit.alance due upon installation Company approval by Date Customer approval by .: -/foci r-d Date Date Customer approval by *Subject to approval by finance company. Certain restrictions apply M.001 VenvesL Irk NI R' his Reserved / Finance option* CO Monthly investment 1/4-4r$ QAUtti, Buyer hereby declares that buyer holds title to property in which merchandise is being installed and has legal author to order the work outlined above. The seller retains title to all materials and property listed herein until payments have been made in full. Accounts not paid within 30 days of invoice receipt are in default and subject to a late payment charge of 1 -1/2% per month or 18% annually. Buyer agrees to any reasonable attomey's and/or collection fees incurred by seller to secure payment of this contract.