MC-12-222Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 169763 Permit Number: MC -2 -12 -222
Scheduled Inspection Date: March 26, 2012
Inspector: Perez, JanPierre
Owner: SCROGGINS, MATHEW
Job Address: 445 NE 93 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MARS POOLS
Permit Type: Mechanical Residential
Inspection Type: Final
Work Classification: Pool Heater
Phone Number (305)757 -2147
Parcel Number 1132060140390
Phone: (954)214 -2844
Building Department Comments
POOL HEAT PUMP
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 23, 2012
For Inspections please call: (305)762-4949
Page 14 of 37
Miami Shores Village
Building Department
/0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
`2,' '
Permit No. C(
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Mechanical
Owner's Name (Fee Simple Titleholder ) -W h ei ' 5055914 s Phone # w;J`
609- 9 y
Owner' Address _ S b
City
Tenant/Lessee Name
E -MAIL:
Phone #
Job Address (where the work is being done)
City Miami Shores Village / County aMi -Dade
FOLIO / PARCEL # / — 3C206" - of V — 0 2 7
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City / 0
zip
Mac Uc)( loci Phone # ' 1S1.o7Ngg f
Qualifier Name 0 G v l ^t P a ieJ Phone # 95j -.V'0?/V 07
State Certificate or Registrati9n No L G L Certificate of Competency No.
E -MAIL: ili /' S p0615 %i az) ` 0
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 3, O D
Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration , ( ew ❑ Repair/Replace ❑ Demolition
Describe Work: 550 f2/ 7P
'- -,/5,/-1./0 //M 71- Ve)/11P
Submittal Fee $ Permit Fee $ 1 V 5 r (/ CCF $ CO /CC
i
Notary $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Training/Education Fee $
Technology Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side -*
Q Q-9
f
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 Alit IDAVIT: 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
The forego
day of
who is personally known to me or who has produced
As identification and who did take • ' oath.
NOTARY PUBLIC:
Owner or Agent
strument was acknowledged before me this e The foregoing instrument was ackno ed bef e this 7
20/ , by / ,' e) '/�® /I S day of Fir, , 2o) by /AM/ P ,>/e041,7-
who is na y known a or who has produced 5 363 -S56
Contractor
Sign:
Print:
My Commission Expires:
G VENDOLYN B.STEWART
MY COMMISSION M DD961386
34„. ,*d' EXPIRES: April 19, 2014
ass
I -800.3- NOTARY Fl. Notary Dismom Assoc. Co.
APPLICATION APPROVED BY:
(Revised 02/08/06)
v Jai V'1✓ Y��F1FV?f• n.ry^(�(9f'.
60-1//2
NOTARY PUBLI: :
as identification and who did take an oath.
00111111u/0i �
i `�' 0310612092 • ,
NOTARY PUBLIC .
``''�,.f�i•' Commission �
************* * * * * * * * * * * * * * * * ** * * * * * * * *irgarer a�a't �rtka4.• Zbiir`.
GZPlran��.s���amincr
Sign:
Print:
My Commission Expires:
Engineer
Zoning