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MC-11-1183Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 169030 Permit Number: MC -6 -11 -1183 Scheduled Inspection Date: January 23, 2012 Inspector: Perez, JanPierre Owner: BORUCHOW, IRWIN Job Address: 950 NE 95 Street Miami Shores, FL 33138- Project:- <NONE> Contractor: ALL AIR SOLUTIONS INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050070120 Building Department Comments mechanical work for interior remodel 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- 161507. need access door /cover for air filter in a/c unit in garage jpp January 20, 2012 For Inspections please call: (305)762 -4949 Page 46 of 47 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 Inw ww Phi dosoerapoOPP Permit No. I t` 1183 Master Permit No.RC- 6.° if. 1163 Permit Type: MECHANICAL , A OWNER: Name (Fee Simple Titleholder): e1�Jjk2� v o ok Phone#:( Address: dS1) 0 C qs-- $"r City: ` L ` 514.-re-CS State: ii-- Zip: 33138 Tenant/Lessee Name: N `- Phone #: Email: JOB ADDRESS: City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes County: Miami Dade Zip: NO Flood Zone: CONTRACTOR: Company Name: e-ug1 (,c�,, t 5 Phone #: Address: 204 79( ( ! j " {2 e„rr 1eo City: et1-4/) State:, E -- Qualifier Name: %2-t.- �4J State Certification or Registration # (� 1� fg Certificate of Competency #: Contact Phone#: Email Address: 2-97- OcJ Zip:T3 J Phone #: DESIGNER: Architect/Engineer: U lLA0R- Phone #: .S) 3t 0 ° S-13 Value of Work for this Permit: $ AS S71,J - Square/Linear Footage of Work: Type of Work: DAddress DAlteratio ONew ORepair/Replace UDemolition Description of Work: 44. - ROLL- S k1ft-1 * ****** * ***** ** * * * *** ****** * **** ** Fees************* * **** ** *** * ** ** * *** **** ** **** ** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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, BOTT FRS, 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 approve a reinspection fee will be charged. Signature wn or ent The foregoing instrument was acknowledged before me this day of P3 011 ,20 1/, by who i personally known to me or who has produced O/ As identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC -STATE OF Sign: Print: 0 •lo. -z RIBA �'� r °,� ►', +720 atiddS MN My Commission Expires: APPROVED BY Signature Contractor // The foregoing instrument was acknowledged before me this ./h. day t°'OJ ,20 ((,by who is ersonally known to me or who has produced L' ON 0 Las identification and who did take an oath. NOTARY V WBLTC.STATS of FLORIDA ' 10 2012 BONIIED sail Sign: Print: My Commission Expires: **:***************************** * * *** ** *** * ** ****** * * **** *** *** il* Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk Miami Shores Village Building Department 10050 N.E.2►id Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) f42-b Permit No. MC It - 1183 Master Permit No. RC - t t - It 103 Owner's Address L dv City Tenant/Lessee Name E- MAIL.: State Phone # Zip 3[3g ;Phone # Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name. ] L-1-- 4 Ira sow-r JC 't hone # Contractor's Address ,C)9aci t® cry- City Jet. -A. 1 State r-7t Zip e.3 t Qualifier Name c ' _C:, t Ca r r sC F-j r Phone # State Certificate or Registration No. Certificate of Competency No. E -MAIL: Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ /0 `"� Type of Work: ['Addition Square / Linear Footage Of Work: 30°D Iteration ; ❑New ❑ Repair /Replace ❑ Demolition Describe Work: �y ( ►( / �r * * * ** * * * * * ** * * * * * * * ** * * * * * * * * ** *** * * * * * * * * * * * * * *$r * * * *. * * * * * * * ** Submittal Fee $ Permit Fee $ f !� �` v CCF $ CO /CC Notary $ Training /Education Fee '$ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total .Fee Now Due $1,3 91— See R verse side --> .rya / // Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable)' Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction: I under$tand 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 budding permit is issued In the absence of such posted notice, the inspection will not be approve,, and a reinspection fee will be charged. Oder or Agent The foregoing instrument was acknowledged before me this 2-4" day of. ,20`l,byV fit* Z/®• who is per me or who has produced As identification and who did take an oath. NOTARY PUBLIC '`' g�A TAISLIA'64.7„.7' toe/ 6 Sin: / � I' u„kAkegr.66 ' Sign: Print: �- +.'`� �Ztp�' �� Pri►rfi.�� oop �� l � g tie'' My Commission Expire My CAF, oh *******************************# * * * * * * * * * * ** * * * * * * * * * * * * * * ** * ** * * ****''' ** * *irx , * * * * ** * * ** * * * * ** * ** ** Signature Contractor The foregoing instrument was acknowledged before me this Z. day of SJJ`Q , 20 t , bySY?'t „lz LN-0t';t -.� who is sona 15rk-Wo9 to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ;, APPLICATION APPROVED BY: (Revised 02 /08/06) Plans Examiner Engineer Zoning