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MC-11-2110Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 166653 Permit Number: MC -11 -11 -2110 Scheduled Inspection Date: November 21, 2011 Inspector: Perez, JanPierre Owner: NIETO - WINZEY, TANYA & JAMES Job Address: 9777 NE 5 Avenue Road Miami Shores, FL 33138- Project: <NONE> Contractor: RESULTS AIR CONDITIONING CO Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)606 -2897 Parcel Number 1132060180010 Phone: 305 -886 -2534 Building Department Comments exhaust fan 1 ti Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 18, 2011 For Inspections please call: (305)762 -4949 Page 29 of 47 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9777 NE 5 Avenue Road Miami Shores, FL 33138- 1132060180010 Block: Lot: TANYA & JAMES NIETO- WINZEI Owner Information Address Phone Cell TANYA & JAMES NIETO- WINZEY 9777 NE 5 Avenue Road Miami Shores FL 33138 (305)606 -2897 1 Contractor(s) Phone Cell Phone RESULTS AIR CONDITIONING CO 305 - 886 -2534 Valuation: Total Sq Feet: $ 100.00 0 1 Tons: Additional Info: EXHAUST FAN Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: MECHANICAL Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.80 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $159.10 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -11 -11 -42559 11/17/2011 Credit Card $ 159.10 $ 0.00 Available Inspections: Inspection Type: Ventilation Final Hood Rough Duct Underground In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. November 17, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 17, 2011 1 BUILDING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 ��' , Permit No. �' / 'u t PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL t' 1$ VIEWM- NOV 14 2011 IT Master Permit No OWNER: Name (Fee Simple Titleholder): Ma nI v ll � - iv; % � Phone 335 (FJ S- AT" Address:, 010' O C, Ave K.(�[ City: M s S horr.b State: Tenant/Lessee Name: Email- Zip: Phone#: JOB ADDRESS: (111-3* t E �,►J+h Ave, ed City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: 3,313X' Zip: .3 3 5 CONTRACTOR: Company Name: R�s'd�fs- �'� `� 1 ofrr) Phone# was` V�� 3 Address: itr) /Y', W e 3D. Aire ft City: IbLi State: F1-0 Zip: 33 / Ce 4 Qualifier Name: TOSe— /4- e r4 State Certification or Registration #: 8- O Certificate of Competency Contact Phone #: Email Address: %Sv /7S Z i CD �i DL 44 - ne Phone#: }r5 - - .297-g DESIGNER Architect/Engineer: Phone#: Value of Work for this Permit: $ ) CO W Square/Linear Footage of Work: Type of Work: DAddress WAIS1— Description of Work: DAlteration ^ONew DRepair/Replace 1 ODemolition * ** * ** **s.* * * *$ a* x e a e� x. x Submittal Fee $ Permit Fee $ CCF $ sae CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training(Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ • \\Vb. '7"(;) Bonding Company's Name (if applicable) Bonding Company's Address City State Tap 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. 1 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: 1 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 ?f /X C% e% Owner or Agent Contractor The foregoing instrument was acknowledged before me this I The foregoing instrument was acknowledged before me this // day of 6 t , 20 l l • by 1n 14163 41/411(Ref day of t / , 20 11 , by r®60' Ai Co o4 err- who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. ••• "°°t��, Leonor Silva °, �1''? COMMISSION # DD897423 s EXPIRES:JUN.15, 2013 \oat . ;;.`�* NNVW.AARONNOTARYaom NOTARY PUBLIC: Sign: Print: LeoNog. ,1LVA My Commission Expires: 3.1.m 113 l 2.0 i 3 as identificatian-and whn did take an natll NOTARY PUBLIC: Sign: Print 649_4-44 L cie-t u; ("ea.> My Commission Expires: .3)(y O 8 4,2- ELIZABETH RODRIGUEZ MY COMMISSION # DD804481 EXPIRES July 08, 2012 i3 FIorldallotaryServIce.com ******** ** ***** *** * ** ** **s es** . **** **max* * ** *�z***s* *�**** *z **** * * * * * ** * ** * *** *** \A, ti W L\ Plans Examiner Zoning APPROVED BY Structural Review Clerk (Revised 07n0/07)(Rerised 06ilOf20 i9)(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet Multiple units on single sheets are not acceptable. Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ MN Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # . COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.CA AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG . 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature Date: