MC-08-1365Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 08/04/2008
Inspector: Perez, JanPierre
Owner: CARR, JOHN
Job Address: 246 101 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: C&R AIR CONDITIONING CO
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132060134630
Lot:
Phone: 305 -685 -6394
Building Department Comments
EXACT REPLACEMENT OF 4 TONS SPLIT SYSTEM
$7.1,/e•
Passed
Inspector Comments
cc
iL
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Friday, August 1, 2008
Page 1 of 2
1I7_ alo$ A` ° "
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)
Owner's Address c2, 46 PE 109 T
City_ d1.1®. State 69.
Permit No.
Master Permit No.
1 JUL 23 21s
oce6
( t v v l Phone # .3O / I Si- .67 t o
Zip 013 O
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) 2 x-16 NE 10 1 scT
City Miami Shores Village
FOLIO / PARCEL #
County Miami -Dade
Zip .3-3 t 2
Is Building Historically Designated YES
Contractor's Company Name C. -1` A
NO
p
IC' Cep . Co. Phone# .2os- A,c63c 4
Contractor's `Address 6073 N �) i ,67 S Ti _ ti
' y
City ., State 6Y.
Qualifier Name Q 13A0 'eVt 3. Cif.f. yaT Phone#
State Certificate or Registration No. C. A t✓ 09,‘ Li 14 Certificate of Competency No.
E -MAIL:
zip Z3O1s-
octg 4Sc2.:
Architect /Engineer's Name (if applicably,
Phone #
Value of Work For this Permit $,
Type of Work: ['Addition
Describe Work:
❑Alteration
Square / Linear Footage Of Work:
u Repair /Replace'I
❑ Demolition
Submittal Fee $
**
Cw xxxxxrxxxxxxxxxxxx'x xxxxx* xx Fees*** xxxxxxx xxxxxxxxx rxxxxxxx*xxxxxx'xxxxxxxocxx
�-� CCF$ 440
Notary $ Training /Education Fee $ I
Scanning $ 3 .00 Radon $
Permit Fee $
/,, CO /CC
Ul� Technology Fee $ eico
DPBR $ Zoning $',
Double Fee $
Bond $ Code Enforcement $
Structural Review. $
Total Fee Now Due $ 331=
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. 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
Ns,/ Left1
Owner or Agent
The foregoing instrument was acknowledged before me this
day of �G1`( , 20 OW, by
who is
Signature
Contractor
The foregoing instrument was acknowledged before me this 1
day of X0111 ,20O r , by
to me or who has produced who personally known no me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires
xx*xr.* xxx xxx w W W W***x
<,„ Robert J. l st
Commission 4 DD5240p2
'e`6onceo
troy Fern • Inwrance, Inc 800995-7019
• APPLICATION APPROVED BY:
(Revised•02 /08/06)
as identification and who did take an oath.
:ww*
NOTARY PUBLIC:
My Commission Expi ta4 JANETKRANZ
xxxxxxxi:uxxxxxxxxxx� ok" pores e * ge M WWx
-es
• ,„cgifZe Bonded Thnr Troy Fein Insurance 800- 385 -7019
Plans Examiner
Engineer
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
ITEM
UNIT
FEE
BATH TUB
SWITCH OUTLETS
,FEE
SPACE HEATERS
DISHWASHER
LIGHT OUTLETS
CENTRAL HEATING 1 = I®icI4D
DISPOSAL
RECEPTACLES
A/C (WIND) I_ lAtrv, A.
/R
FLOOR DRAIN
SERVICE TEMPORARY
NC (CENTRAL) + C. ®vl
GREASE TRAP
SERVICE SIZE IN AMPS
DUCT WORK
INTERCEPTOR
SERVICE REPAIR/METER CHANGE
REFRIGERATION
LAVATORY
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
LAUNDRY TRAY
RANGE TOP
UNDERGROUND TANKS
CLOTHES WASHER
OVEN
ABOVE GROUND TANKS
SHOWER
WATER HEATER
U.F. PRESSURE VESSELS
SINK. POT /3 COMP.
MOTORS 0 -1 HP
STEAM BOILERS
SINK, RESIDENCE.
MOTORS OVER 1 -3 HP
HOT WATER BOILERS
SINK, SLOP.
MOTORS OVER 3 -5 HP
MECHANICAL VENTILATION
TEMPORARY WATER CLOSET
MOTORS OVER 5 -8 HP
TRANSPORTING ASSEMBLIES
URINAL
MOTORS OVER 8 -10 HP
ELEVATORS /ESCALATORS
WATER CLOSET
MOTORS OVER 10 -25 HP
FIRE SPRINKLER SYSTEMS
INDIRECT WASTES
MOTORS OVER 25 -100 HP
COOLING TOWERS
WATER SUPPLY TO:
MOTORS OVER 100 HP
VIOLATION
NC UNIT
•
NC WINDOW
REINSPECTION
FIRE SPRINKLER
AIR CONDITIONERS
HEATER -NEW INST.
STRIP HEATER
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
GENERATORS TRANSFORMERS
SWIMMING POOL
GENERATORS TRANSFORMERS
WATER SERVICE
SPECIAL PURPOSE.
1
1
SEWER CONNECTIONS
OUTLETS COMMERCIAL
UTILITY -SEWER
SIGN TUBES
UTILITY -WATER
SIGN TRANSFORMERS
SEPTIC TANK
SIGN TIME CLOCK
RELAY
FIXTURES '
FAINFIELD, 4" TILE/RES.
ANTENNA
'
PUMP & ABANDON SEPTIC TANK
TELEVISION OUTLETS
SOAKAGE PIT CU. FT.
VIOLATION
CATCH BASIN
REINSPECTION
1
•
DISCHARGE WELL
DOMESTIC WELL
'
AREA DRAIN
,
ROOF INLET
SOLAR WATER HEATER
'
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
&R Air ConditioningCo:
6073 NW 167th Street Suite C-4 Miami Gardens, FL 33015 -4330
DADE: 305- 685 -6394 BROWARD 954 -680 -4494
CUSTOMER
( jut
HOME 30--• -. b 1 Q
DATE
-7- i u . - o O
ADDRESS y T 2 y 6 N 1 0 1
WORK
UNDER CONSTRUCTION
C : n,. .
CELL
T EXISTING STRUCTURE .
We hereby propose to: Furnish, install and service the equipment
NEW EQUIPMENT System #1 $ t t
and materials listed below with the conditions and specifications detailed below.
'
-S. 0O System #2 $ System #3 $
Rebatels - �� e -
'
Your Investment t 294-.00
Manufacturer R u U c4
_
Condensing Unit Model # U A R L Q 4 Q J C .
Air Handler Model # U Q H M 2 1 I._ M S ,
Package Unit Model # R - 410 Ref .
Heating KW I 0
.
Btuh 1-114-00
S.E.E.R 16 s 0
Warranties Labor l Yr. Parts ID Yr. Labor Yr. Parts Yr. Labor Yr. Parts Yr.
Compressor f 0 Yrs. Compressor Yrs. Compressor Yrs.
.
❑ Condensing Unit Stand ❑ Air Handler Stand
MISCELLANEOUS?
❑ Condensate Line
❑ Fire Dampers
a Float Switch ❑ Ref. Line cover
Concrete Slab Kt Thermostat S D PD
EI Auxiliary Drain Pan ❑ Ref. lines ft.
❑Other
DUCT SYSTEM 3 ELECTRIC SYSTEM "
❑ Package Unit Changeout 0 Existing Reconnection
A ' pi
1.i • onnec�oExisting 8y� , 1 ,/,., • , New Electric
❑ ❑.
f.
A qualified air conditioning expert will start and test the system and explain its operation. This proposal is good for a two week peri d '
od from date of proposal an 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 falls 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'n writing by our duly authorized corporate officer.
We agree to furnish and install the above described labor and materials on the teens indicated bel for System #
CO ° (',Qt `JI�6
TOTAL INVESTMENT
FPUDEALER REBATE $ - 7 n.00
YOUR INVESTMENT $ `' Y 1 r 0J l
PERMIT FEE NOT INCLUDED R V U d 0 cb i t C..CI V- `i
I' trN Ra.ud -t o PMRS Cttn.
PURCHASER (,x Co ,�„� � DATE -"'� 7 j g /0 g REPRESENTATIVE
VAL D FOR 2 WEEKS
I 000.°0 {,.,� a„ Q C) S e 6 RZ G
4 S. ® J
5
c,.
0
1 n9nfS` ° 0 READY TO OPERATTE� $ rsc7-(...
pie
JOB NOTES