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MC-07-2128! \ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 12/12/2007 Inspector: Perez, JanPierre Owner: JUANICO, DENISE Job Address: 1280 102 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 1132050220030 Lot: Phone: 305 - 685 -6394 Building Department Comments EXACT RELACEMENT OF 5 TONS SPLIT SYSTEM DEC t 2421/r? 1 MU Passed Inspector Comments ipqf Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Tuesday, December 11, 2007 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795. 204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) rt ttAk 9+'U.%o—h m Phone # Off'• 1 7 ` 1 ! b 0 l . S® Nom- (6,JT State C&' X . rof►�Icn IMOMgWM OCT 17 nOi BY: Permit No. MCXJ b J zr Master Permit No. Owner's Address City Tenant/Lessee Name 4 E -MAIL: Job Address (where the work is being done) . 1.2 to N G 10a 1 zip 3 1 Phone # City Miami Shores Village County Miami -Dade FOLIO / PARCEL # Zip 0 13 C� Is Building Historically Designated YES NO Contractor's Company Name G ta Air c o h c. Contractor's Address Po o x la p'.3 3 l' City t C a (41 r /1 State F Qualifier Name 8 1010 r't c.l - ` tie,/ J1 State Certificate or Registration No. C. A C_ 02.6 4 1 L{ E -MAIL: Phone# 00S-48\r-6.9(1 Architect/Engineer's Name (if applicable) Zip 3 Z / ,g o Phone # �S 0 �� 0 39'4 Certificate of Competency No. 0 4 g" d - Phone #. Value of Work For this Permit $ . 0 Type of Work: Describe Work: Addition Q'0 ['Alteration Square / Linear Footage Of Work: ['New Repair /Replace ❑ Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** es * * * ** ****** * *xxxxxxxxx * * * * * * ** * * * * * * * * **** Submittal Fee $ Permit Fee $ ` b CCF $ 4- 7,0 CO /CC -40 Technology Fee $ 5i(0 Notary $ Scanning $ (ti Bond $ Training /Educat' Ra Cod Structural Review. $ MIAMI SHORES VILLAGE Zoning $ Total Fee Now Due $ 2.62. - See Reverse side -3 c2.....p 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature !..1S i ✓!4 0 er or Agent C 'tractor The foregoing instrument was acknowledged before me this 11 The foregoing instrument was acknowledged before me this 17 day of ®Cfi• , 20 Cl, by , day of Q Gt , 20 0 71by who i personally known to me or who has produced who 's personally known me or who has produced as identification and who did take an oath. As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: • Ober . C -i Jr- My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** ,.al sat4 Robert J. C,. Est ► S24 O2 2.1 . 22318001 9 APPLICATION APPROVED BY: (Revised 02 /08/06) NOTARY PUBLIC: Sign: Print: ,„y JANET My Commission Expiregi; KRANZ * * * * * * * * * * * * * * * * * * * ** xg " m en 109 ' 'R i � "' 9emled Thru Tray Far Insurance 800 888.7019 11 t 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 FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING I = f ® tf,. (A) DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) I- S' T®v, GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK CD t i- Ar l 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. 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 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 C &R AIR CONDITIONING COMPANY below shall be assumed by either us or you, as Waited: E- Erdsling, 14- None, Y You, and U- Us. J_Phase eiedc aI service from aseernbly, erection street to electrical panel Wiring from panel to twit ......................._ Control system wiring Cutting and patching holes for B._.._ ducts, pipess, etc. laudation Palming, redlecorating air conditioning expert vie start and test the systems end explain its operadon. Tits is good fora two week period from date of propoSN and at that time is sublect to ItiVtliW. Tide the system sh rermain in us urn al sums due us have been My paid. In the emit the purchaser fads to amply with any of the requirements of l{ W negation, the Purchaser agreed to pay reasonable altorney's fees and aka cote ctl: to such litigation. DeNnquent payments shell bear 1.5% per month interest from due date paid. Ad is to be performed during our regular work hours unless otherwise *padded. Tanis - contains Ilifveements. Neither party shad be bound by any representation, vrarrandes or wad or written not herein contained. • Parte of 3 shad become a contract when accepted by you and approved in malting by our duly officer. corporate Alit CON'D ON1NG COMPANY Pardoner that receive such %maaies as are erdeirded by the equipment andlor nwrufaoaureis. In addition C & R dpi provide labor to adjust and replace peas for a period of 3155 days from iI wad up date. 10 YEAR COMPRESSOR, 5 YEAR PARTS SUMS kebab LIM Rebate linatameat SOWN •M Deposit 5111120.110 whsn needy to operate SWAN C.D�I� zI�� citt 10 0'70-GO 44 Mao PROS TIME FOR YORK TO sew You CHECK DIRECTLY YOU *010 IN PAPEMBORK BEFORE DUE DATE NOTMK- is accepted bar; Print None: Pose