MC-12-1121Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 174964
Permit Number: MC -6 -12 -1121
Scheduled Inspection Date: July 09, 2012
Inspector: Perez, JanPierre
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Nat & Health Sc
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: HILL YORK SERVICE CORP
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number 1121360010160 -08
Phone: (305)756 -6501
Building Department Comments
PROVIDE & INSTALL COIL FOR RTU#2
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
tD poi e.//44.;1-
Par 36
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July 06, 2012
For Inspections please call: (305)762 -4949
Page 16 of 26
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
BU LDI G Permit No.
PERMIT APPLICATION Master Permit No. C � ®I 0 21
FBC 20
Permit Type: MECHANICAL
RECEI
JUN 202012
BY:
Owner's Name (Fee Simple Titleholder) �-XDI -.'/ ' Phone #
Owner's Address l
City I c 1 Si ore6 State F�
Zip 33* I
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) 1000 1 &E � N ("V '�'- 44 1AT-4
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address J
City
Qualifier Name Mar f_.
1 yorI-
�. (11ij5 M-
State
rug
Flood Zone
- q 5'L-- (.0, eg --6(27
Phone #
Zip 1(e
Phone #
State Certificate or Registration No. CAea2P 0 Certificate of Com etency No. D� " "1 01 el
Contact Phone 5L -,516'-"a J J�lv
CI
E -mail ilL415 4' , I' y Q VL°
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ a 61/ U .5 Square / Linear Footage Of Work:
Type of Work: JJAdditti�on ['Alteration []New ►��� Repair/Replace El Demolition
Describe Work: ' rVVldx �' 1 J� `i�V & rl4b r K i u*,32
****** ** * ** * * ** * * * * * ** * * * * * * * * * ** * * ** **Fees * ** * **
Submittal Fee
Permit Fee $
CCF $
CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $
Structural Review. $
Violation date: P E ' 00 Total Fee Now Due $
See Reverse side 1120
OMR
c43
07-P
Li*
tsla.
Signature
fi\s-yvk
Contractor
The foregoing instrument was acknowledged before me thisigh
day of ,14,1 r-- , 20 to , by MOM. ' ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission
.
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 not be approved" a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day ofSci, P% , 20 9 Z1, by gD rp ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARYY PUBLIC:
Sign.
Print:
My Commission Expires:
YARISMAR CASTRO
MY COMMISSION # EE109306
EXPIRES August 07, 2015
( 407)3.98-0153 FlaidaNdaryService.com
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APPROVED BY
6 719
Engineer
(Revised 07 /10 /07XRevised 06/10/2009)
Zoning
Clerk checked