MC-10-1424Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 169645
Scheduled Inspection Date: February 06, 2012
Inspector: Perez, JanPierre
Owner: WALLACK, JOSHUA
Job Address: 899 NE 99 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: ALL YEAR COOLING AND HEATING
Permit Number: MC -8 -10 -1424
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1132060340170
Phone: (954)566 -4644
Building Department Comments
REPLACE CENTRAL NC SYSTEM 4 TON RHEEM 16
SEER, 10 KW
-•[19 zlGCwz
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 149831. no one home @ 12:30
jpp
February 03, 2012
For Inspections please call: (305)762 -4949
Page 15 of 16
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: MECHANICAL
OWNER: Name (Fee Simple Titleholder
1 /rte
(4/ (51010
Address:
City: 1
FEB 06i 2
Permit No. mQo—N2-9
Master Permit No.
State:`
Phone#: 5, fi 2 �d-l6 7
Zip: 33iX
Tenant/Lessee Name: Phone #:
Email: C 4f (/& W ( �( 7/'6104,
JOB ADDRESS:
Miami Shores
County:
Miami Dade
Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
�.
Address:
City:
NO Flood Zone:
Phone#: 4/76-4-02.5.
Zip: 333/3
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: DAddress ❑Alteration
Description of Work:
A1New ❑Repair/Replace
ODemolition
AO 146e 4i v Cost, -Ki 0741 i 1
o
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
r► �
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 A}kIJAVIT: 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 ATTO '• Y 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 Alicant 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 m ed at the job site
for the first inspection which o' cu s seven (7) days after the building permit is issued. In t ence of such pos ' ;.. notice, the
inspection t be pr ve an a reinspection fee will be charged.
Signature I7 -'-- - _ Si
0 � er or Agent Contractor
The foregoing instrument was acknowledged before me this '' The foregoing instrument was acknowledged before me this
day of , 20 a. _, by C /lG ° 6-% J-1 4449[z , day of , 20 _, by
who is personally known to me or who has produced
C ;Y 63® -6; -21As den
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires: p
0= who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * ** * * * * * * * * * ** * * * * ** * ** *** v* ** * *** *** **a *** * * * * *.,., ;: *** * * * **** **** *wax ** ** *** ** <,, * * *** ** *
APPROVED BY 1/ V 1 Zpts Examiner Zoning
(Revised 07/10/07)(Revised 06 /10/2009)(Revised 3/15/09)
Structural Review Clerk
Invoice
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
'Return to:
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Bill To
JOSHUA WALLACK
899 NE 99 Street
MIAMI SHORES, FL 33138-
Date
Fee Name
Invoice Number: MC -2 -12 -43340
Invoice Date: February 06, 2012
Permit Number: MC -8 -10 -1424
Bond Number:
Comments:
Fee Type
Fee Amount
02/06/2012 Expired Permit Renewal Fee
Calculated
$131.25
Total Fees Due:
$131.25
Payments
Date Pay Type
Check Number
Amount Paid Change
02/06/2012 Credit Card
$131.25 $0.00
Total Paid: $131.25
U
E
H
V
1
Total Due: $0.00 I
NO
ALL `1)01.4-
CiouN._, 7O --
#-� 0� -)Li29 j
Monday,�February 6; 2012