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MC-08-386Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 05/07/2008 Inspector: Perez, JanPierre Owner: GRAFE, JOANNE Job Address: 253 99 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: C&R AIR CONDITIONING CO Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060134560 Lot: Phone: 305 -685 -6394 Building Department Comments REPLACEMENT OF 2 TON SPLIT SYSTEM JI-)1S Passed ' Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Tuesday, May 6, 2008 Page 2 of 2 31' \t V wirtAissla wool( aycriactnr °S i1 hat a 1 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 Owner's Name (Fee Simple Titleholder) �' Phone # 2 6,5-- 7S 7 ° .749-3 Owner' Address 2S-3 NE 9C7 City ° / T i�e.�rty� , J o State ® Zip \2 2 ug Tenant/Lessee Name Phone # J a- 717 ° -7(19,7 E -MAIL: Job Address (where the work is being done) . a s- 2 Iv E9 (t31-* City Miami Shores Village County Miami -Dade Zip 3 1 1 3 g FOLIO / PARCEL # Permit No. Master Permit No. MC.Ofi'5,ego Is Building Historically Designated YES NO Contractor's Company Name '� R A CO h d. Phone # 30S- 6 8 - Ip 394 Contractor's s� Address 6 ©1 3 N W 1 6 1 S (T City 17144 14. State e;f` Zip Qualifier Name t t Cieltyfr Phone # State Certificate or Registration No. C. A C- 02C y y Certificate of Competency No. 0 O 80.9...3 E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 41 Type of Work: Describe Work: ®® ❑Alteration Square / Linear Footage Of Work: ElNew Repair /Replace ❑ Demolition *********************************** ** *F * *****Y *** **** ************** ***************** Submittal Fee $ Permit Fee $ CCF $ 3.00 CO /CC Notary $ r---- Training /Education Fee $ 416 Technology Fee $ 'q`• 1 O Scanning $ 3 °OD Radon $ DPBR $ zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 111c • See Reverse side --a 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. l 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature )( �LCJ ""L"' Owner or A ent Signature Contractor The forego instrument was acknowledged before me this 4 The foregoing instrument was acknowledged before me this -1 day of MY)atd ,20®8, by day of pltaPa -% X20®44, by who is o me or who has produced who i ersonally known o me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: II Print: i t0 2Pt V• C My Commission Expires: ;A` '°$!., Robert J. Chryst '� Expires May 24, 2010 Bonded Thee Fain • insurance, in 800385-7019 APPLICATION APPROVED BY: (Revised-02 /08/06) as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: e.1* \-, ral ` 2. 1 My Commission Erts JANET KRANZ ,Yx4e xoY4c &x4e,Yx,Yx,Ydcxxx,ti4is -7iinl er �•:� -- a ires eCe r 6, it� 3 Bonded Thru Troy Fain Insurance BOO T`7019 Plans Examiner Engineer r Zoning ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM BATH TUB DISHWASHER DISPOSAL FLOOR DRAIN SWITCH OUTLETS GREASE TRAP LIGHT OUTLETS RECEPTACLES SERVICE TEMPORARY INTERCEPTOR LAVATORY SERVICE SIZE IN AMPS SERVICE REPAIR/METER CHANGE LAUNDRY TRAY APPLIANCE OUTLETS CLOTHES WASHER SHOWER RANGE TOP OVEN SINK. POT /3 COMP. SINK, RESIDENCE. SINK, SLOP. WATER HEATER SPACE HEATERS UNIT FEE CENTRAL HEATING NC (WIND) S-ru) NC (CENTRAL) 1: ,A I tl DUCT WORK t CO I-N J REFRIGERATION PROCESS AND PRESS PIPING UNDERGROUND TANKS ABOVE GROUND TANKS MOTORS 0 -1 HP MOTORS OVER 1 -3 HP TEMPORARY WATER CLOSET URINAL WATER CLOSET MOTORS OVER 3 -5 HP MOTORS OVER 5 -8 HP MOTORS OVER 8 -10 HP INDIRECT WASTES MOTORS OVER 10 -25 HP WATER SUPPLY TO: NC UNIT MOTORS OVER 25 -100 HP MOTORS OVER 100 HP FIRE SPRINKLER NC WINDOW HEATER -NEW INST. HEATER - REPLACE AIR CONDITIONERS U.F. PRESSURE VESSELS STEAM BOILERS HOT WATER BOILERS MECHANICAL VENTILATION TRANSPORTING ASSEMBLIES ELEVATORS /ESCALATORS FIRE SPRINKLER SYSTEMS COOLING TOWERS VIOLATION REINSPECTION STRIP HEATER LAWN SPRINKLER -WELL SWIMMING POOL WATER SERVICE GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS SEWER CONNECTIONS UTILITY -SEWER UTILITY -WATER SEPTIC TANK RELAY SPECIAL PURPOSE OUTLETS COMMERCIAL SIGN TUBES SIGN TRANSFORMERS SIGN TIME CLOCK FAINFIELD, 4" TILE/RES. FIXTURES PUMP & ABANDON SEPTIC TANK SOAKAGE PIT CU. FT. CATCH BASIN ANTENNA TELEVISION OUTLETS VIOLATION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET REINSPECTION • SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING C &R Air Conditioning Co. 6073 NW 167th Street Suite C-4 Miami Gardens, FL 33015 -4330 • .va uia -•• •v ✓- vVJ -VJIT LJj\V VVf L'.L. 7JP1"VOV 'f79. CUSTOMER P PHONE D DATE ADDRESS $ e W C TY ZIP b EXISTING STRUCTURE We hereby propose to: Furnish, install and service the equipment and materials listed below with the conditions and specifications detailed below. NEW EQUIPMENT System #1 $ Lt 7 7E-1' ' System #2 $ System #3 $ - Rebatels _ - et) Your Investment 4 1 7c . Manufacturer O r tc Condensing Unit Model # H R00;11-140‘ Air Handler Model # 't 1 001 Pa. Package Unit Model # Heating KW '1 Btuh t 0. oo S.E.E.R. t ° Warranties Labor I Yr. Parts S. Yr. Labor Yr. Parts Yr. Labor Yr. Parts Yr. Compressor Yrs. Compressor Yrs. Compressor Yrs. ❑ Condensing Unit Stand . Handler Stand r MISCELLANEOUS V Condensate Line t I 11ICT SYSTEM E ELECTRIC SYSTEM ❑ Package Unit Changeout E 4 qualified air conditionin e rt ' start and test the system and explain its operation. This proposal is good for a two week period from date of proposal and at that time is subject to review. Title to the system shall remain in us until all sums due us have been fully paid. In the event the purchaser fails to comply with any of the requirements of this contract and such default results in litigation, the Purchaser agrees to pay reasonable attomey's fees and all court costs and expenses incident to such litigation. Delinquent payments shall bear 1.5% per month interest from due date until paid. All work is to be performed during our regular work hours unless otherwise specified. This contract contains all agreements. Neither party shall be bound by any representation, warranties nor agreements, oral nor written not herein contained. This proposal shall become a contract when accepted by you and approved in writing by our duly authorized corporate officer. We agree to furnish and install the above described labor and materials on the terms indicated below for System # TOTAL INVESTMENT FPIIDEALER REBATE $ - $ LAT7E. YOUR INVESTMENT $ 411 PERMIT FEE NOT INCLUDED cQ 1(5,..24- 0..39OA0 50% DEPOSIT 50% DUE WHEN Q. READY TO OPERATE $ eo 9 PURCHASER fir_' `` � DATE 3 - ° 08 REPRESENTATIVE JOB NOTES VALID FOR 2 WEEKS