MC-09-1714Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 127347 Permit Number: MC -10 -09 -1714
Scheduled Inspection Date: March 02, 2011
Inspector: Perez, JanPierre
Owner: PAZ, EMMANUEL
Job Address: 1291 NE 102 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SANSONE CORPORATION
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New A/C System
Phone Number (239)565 -3103
Parcel Number 1132050200050
Phone: 954 -428 -8919
Building Department Comments
NEW SPLIT SYSTEM AND NEW DUCT SYSTEM
211:414
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 01, 2011
For Inspections please call: (305)762 -4949
Page 3 of 44
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
ccT 19 2009 JJJ
BY:
Permit No.'s/ Q j -
Master Permit No. Kim , 1�1
Owner's Name (Fee Simple Titleholder) ' 3z larwil>ew CG Phone # 239 "565 " IO
Owner's Address / 20/ 577 % EZ7
City /rl/l7///l 6fl%Y S
Tenant/Lessee Name
Email
State FL.
Zip 33 /3g
Phone #
Sr
Job Address (where the work is being done) RA( l 7407 10ra-
City Miami Shores Village County Miami -Dade
FOLIO /PARCEL# //- 3ZDS - 020 • res.-0
Is Building Historically Designated YES NO
zip 3515r
Contractor's Company Name s4/V',�jO/li f 6 /% a/4j'7Dj1) Phone #
Contractor's Address 51a 4 001 S1 y /p 41i9
City p l 2 2 3 09‘ State ft Zip 3 i 3 8
Qualifier Name S (,6 S /� j SQ/LiE Phone # % d. 9l 9 . f6�)-
State Certificate or Registration No. e / Z 4 92.40 Certificate of Competency No.
Contact Phone ' Y • 4 Z1 Sq /9
Flood Zone
°���• 9ZV• fqyq
E -mail
Architect/Engineer's Name (if appli able) R * I /'SS D �i/ S Phone # 5j Q3 - ?/ 0 . �r'' J
Value of Work For this Permit $
Type of Work: o ❑Addition EAlteration
Describe Work: /1/ 5 L r
"at /LIi
Square / Linear Footage Of Work:
❑ Repair/Replace ❑ Demolition
7Y) LP A/ Mier 5
*****************+ * ** * Fee * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
$ 10 CCF $ 4 • )?O CO /CC $
Technology Fee $ (0.41 /
Submittal Fee $ Permit Fee
Notary $ rte•
Scanning $ ' ` Radon $
Double Fee $
Training/Education Fee $
�D-a4
DPBR $ t'V • LAM Bond $
Violation date:
Structural Review. $ Total Fee Now Due $ 0511 • CIi
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. 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 of b- approved and a reins ction fee will be charged.
Signature
Contractor
The '. regoing instrument was acknowledged before me this Z The foregoing instrument was acknowledged before me this
day of OCT ,20cog,by , day of l '-Y �` "i 20oq,by
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. as identification and who did take an oath.
NOTARY, PUBLIC: , NOTARY PUBLIC:
Sign: ` 644 G
Print:
My Commission Expires:
APPROVED BY
i
�f,, , LAURAPARLEY
* �_s * MY COMMISSION DD 648761 My Commission Expires: a°`9• •, „� MY( mnAuiIS I N OD X16161
EXPIRES: March 16, 2011 ;,
IXPIRES: March 16, 201 i
a°` Bonded Thru Budget Notary Services
Sign:
Print:
Lcv
1,0 27
1 Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revi'sed 06/10/2009)