RC-05-1413 (2)Q.�
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 09/17/2007
Inspector: Perez, JanPierre
Owner: LUDICKE, ROBERT & ALLISON
Job Address: 9999 13 Avenue NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: C &T AIR SERVICES INC
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Block:
Phone Number (305)754 -2903
Parcel Number 1132050090460
Lot:
Phone: 305 - 888 -6560
Building Department Comments
A/C FOR ADDITION
:m . 2 0 2007
Passed
Inspector Comments
MV
77 )
�f
/
)
Y
MI
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Friday, September 14, 2007
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Per 't No. )'L OG
AU6 2 4 2006 v n
PERMIT APPLICATION Master Perni-N .5 — 3
FBC 2004 BY: / ,
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 1 ° Phone #
Owner's Address \- ‘42_
City ® -A ,,,e,S State d Zip 1
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County . Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES
NO
Contractor's C o m p a n y N a m e , r
Contractor's Address
c,
City /41-. (T, Stag
State Certificate or Registration No. CO- C 7
Qualifier Name
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Phone #
P.1— Crei 0
Zip 3 7z (c
Phone # � � if-4' f C C)
Certificate of Competency No.
Phone #
Type of Work: []Addition ['Alteration
Describe Work: A-t ,
Square / Linear Footage Of Work:
['New
0 Repair/Replace ❑ Demolition
* * ** * * * * * * ** ** * * ** * * * * * * * * * * * * ** * Fees******* ******* *** ** ** *** * *** * * * *** * * *** * ** **
CCF $ 2
Submittal Fee $
Notary $
Scanning $ "5-00
Permit Fee $
Training/Education Fee $
Radon $
Bond $ Code Enforcement $
DPBR $
Technology Fee $
Double Fee $
CO /CC
Zoning $
Structural Review. $ �_ Total Fee Now Due $ 17 ' 56-
See Reverse side -+
SEP 14 PAID
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 COMM ENCEMENT 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
Owner or Agent
The foregoing instrument was acknowledged before me this 7,1
day of , � ,20 C(, , by Lt..-1 LJD14/4.
who is sonally kn,to me or who has produced 1P L
As identification and who did take an oath.
NOTARY PUBLIC:
Signattro
Contractor
The foregoing instrument was acknowledged before me this 2
day of 20Q4, , by 1T s x _ .vA5%LL.Kty0 5 ,
w, • is personally kno o me or who has produced I'D L-
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: Li _ _ Sign:
tai 11 -.. • 1 (� ( ®(c tr �q' d 10 17 QCi
1,1 Print: ►� ; _ .rt±� � _ � e r: ,.' , _ Pant:
„•, ea Expires: OCT. 16, 2009 My Commission Exp
My Commission Expires: ,� - o�s www AARONNOTAAY,C0
t *****, ** *� *** ** * * * * * * *** *,r� *** �l�x * * * * * * ** *** **,tea * ** ** ** * ** ***
‘+ieps, WWW,AARONN OTARY.COffi
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APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning