MC-05-13Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 176568 Permit Number: MC2005 -13
Scheduled Inspection Date: August 01, 2012
Inspector: Perez, JanPierre
Owner: OWNER, Owner
Job Address: 85 NE 110 Street
Miami Shores, FL 33161-
Project: <NONE>
Contractor: ALFRESCO AIR INC
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: <NONE>
Phone Number
Parcel Number 1121360040240
Phone: (305)541 -3827
Building Department Comments
2 1/2 TONS EXAT CHANGE OUT AND DUCTWORK
s-L4
Z
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- 176397. CREATED AS
REINSPECTION FOR INSP- 176315. NO ACCESS
CONDENSING UNIT CLOTH, NEEDS TO BE TRIMMED AROUND. NOT
AS PER MANUFACTURES SPECS. NC IS NOT RUNNING. 7/30/12
July 31, 2012
For Inspections please call: (305)762 -4949
Page 23 of 30
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
U DING
PERMIT APPLICATION
Permit Type: MECHANICAL
t
JOB ADDRESS: 65 ■ E 110 5 -Wm*
�,
FBC 20.
Permit No. toi ms ",
Master Permit No.
City: Miami Shores County:
Folio/Parcel #: t 1 • al ° 3 t, Ot - 0 Z.40
Is the Building Historically Designated: Yes
Miami Dade
Zip: 331to
NO / Flood Zone:
OWNER: Name (Fee Simple Titleholder): 1"'Q1\fl i e Mat.
Address: riOCa if.ertA4, &j C, M.3ty$ al 41 btu
City: 140rich oLNN4 L/1 t1Q9t, State: r �-
Tenant/Lessee Name: ••!
Email: ! t S 1, t ol 1.,4 ci C. s KCci i k"`4 . !rNet ; "
CONTRACTOR: Company Name: Al fresco • C . Phone#: 146140e1A5401
ES
Address: 15'64 °Myra GC /t L B l �_ - 1 a i-
City: �ItY1a � /°�
4,4444-- Phone #:
Phone #: 3 Q5 *As t koLt Otto
Phone #:
Zip: ,33 1.1 l
ts 0 /P/ 2'1
State: F Zip: 331 q5
Qualifier Name:
State Certification or Registration #:
Contact Phone
is t a't
?z/e/7 %7r 'a Email Address:
DESIGNER: Architec:/Engineer: Phone #:
Certificate of Competency #: '0f ' d
'l
i ili D\ , POD
Value of Work for this Permit: 41' Square/Linear Footage of Work:
Type of Work: ❑Address DAlteration ONew ®Repair/Replace UDemolition
Description of Work: f
* * **** **: x*x:: x: u** ****** ***:u*:x** **:x *x:*** Fees * * * **** r***** *: x*********+x ****** ****:x*** *: ***
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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, 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
�
r f�
Signature A101
iropi
Owner or Agent Contractor
The forego *_' . strumenttwas acknowledged be f The foregoing instrument was acknowledged before me this
day of t- , 20 a, by �� 4. day of (4 , 20(:2, by L.„<71-
•. AY 40147
who is personally known to me or who has produced who i . ersonally known : me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Signature
NOTARY PUBLIC:
ore me this
Sign: Sign:
Print: h,JE( C3-0"4-4`.a.,-----7. Print: �� S1r i /1 P.1.1. (mot °v
My Commission Expires: 10,
4
\`� ` My Commission Expires: — — QZ O. 00000000000000
OttisetAEL
,k,k,k Iask,knk,k,k,B,k,ia,k,k ,k,k f�C,k,k�k,k,k,k8ss� 1�,k,�,sk,kak,k , & t,k k�k ,k L,„�tk , `g , k ,k,k,k�k,k,R,B,k=kA�sk$�,Iaa�.e 0 **** ******
�r •O r _
• Or
APPROVED BY rit, - •'VI J � � S g
Plans xamm • _ * .. Zoning • ! "�yy
���/ /fit Q+pp}�r� ° ®`` Structural Review �`°'�s l% s184 % "*.I Clerk
o�
I /STAlip \'
Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
j4fo
3513 alaiTos
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date 16405
Type Insp'n Frvia
Permit No. AC Z(05 I 3
Name kiklIVIKVO 300.iTt_
Address %5 WO ST
Company NfleS{ 0 MY
Phone # 365 1415 (ounicy)
Inspection Date 'St 11(05
Approved
Correction
Ike-Insp'n Pee
:ritItSt (CIA roltipir T6 SCQ
4 CokA i DiviOttOLU .1117/05
fr 11 U1 fl t loos
li
,
5
A-- ,CCE-,-5- I .41fill
H
H
•
f;
H
-
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami ores, Florida 33138
Tel: (305) 795.220 305 756.8972
BUILDING r*, fe- PERMIT APPLICATION �N b� Master Permit No.
may"`
Permit Type (circle): Building Electrical Plumbing lY>e � cha n� i a q Roofing
Owner's Name (Fee Simple Titleholder)' /990 6�2,,hone #F 3 5 a 7 S
Permit No. 1`"`� — °2
FBC 2001
Owner's ddress AOF, / / JP 5
City 7/302/ S - State . .
Tenant/Lessee Name
Zip
Phone #
Job Address (where the work is being done) ,ffrS //P 5 l
City Miami Shores Village
Is Building Historically Designated YES NO 7�--
County Miami -Dade
Zip
Contractor's Company Named f `9 Ateo, ) 0'/ t.. Phone # % 2
Contractor's Address / t�
City /9 /7912/if State Zip a / 2
Qualifier ��� lJ,��`Z� d9 /l�i 17/4 -'
State Certificate or Registration No. Ce19IC 149/36;/9e.) Certificate of Competency No.
Architect/Engineer's Name (if ap • licable) ,.
$ Value of Work For this Permit
Type of Work: ['Addition
Describe Work: Z
Phone #
n/ a
Square Footage Of Work:
Cd
it
DAlteration New Re p p
air/Re lace Demolition l A
--� % tl
A. v
Submittal Fee $ 00 Permit Fee $ ;t I CCF $ c . 4`0 coicc
Notary $ Training/Education Fee $ � � v Technology Fee. $
* * * * * * * * * * * * * * * * * * * * * * * * * * **
Scanning $ Radon $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Zoning
Structural Plan Review. $
4-7,7
Bond $
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 Ziji
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 and a reinspection fee will be charged
Signature
er or Agent
The foregoing instrument was acknowledge ' efore me this
day of
2005, by
Contractor
The foregoing instrument was acknowledged before me this
day of
20 -P 5, by
who is personally known to me or who has produced who is personally known to me or who has produced
NOT
Sign
Print:
As identification and who did take an oath.
NOTARY PUB
Sign: i
Print:
My Commission Expires:
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: ,/i
Cho 05/13/03
as ide
:;r MY COMMISSION # DD 385851
i EXPIRES: January 12, 2009
,ki, •+`P Baked 'aim Notary Public Un derwriters
o A 1/ /-
My Commission Expires:
*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* ** * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED,,THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEWORARY
A/C (CENTRAL) 2 ° 4.72'
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK ,�� ems•
_
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COM'.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEbP0RARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES -'
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
'HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMIMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
:SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
F I XT!..RES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4" TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
_
t
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 -795 -2204
Printed: 2/2/2005
Applicant: MAY
Owner: MATSUMOTO
JOB ADDRESS: 85
Contractor ALFRESCO AIR INC
Local Phone:
Parcel # 1121360040240
NE 110
Mechanical Permit
Permit Number: MC2005 -13
MATSUMOTO
MAY
ST
Contractor's Address: 1442 NW 2 STREET
Page 1 of 1
Legal Description: COLLEGE HEIGHTS PB 42 -8 LOT 25 BLK 1 LOT SIZE 75.000 X 121
Fees: Description Amount
FEE2005 -1372 Building Fee $91.87
FEE2005 -1373 CCF $2.40
FEE2005 -1374 Training and Education Fee $0.80
FEE2005 -1375 Technology Fee $2.30
FEE2005 -1376 Submittal Fee $50.00)
Total Fees: $47.37
Total Fees: $47.37
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/24/2005 Construction Value: $3,625.00
Work: 21/2 TONS EXAT CHANGE OUT AND DUCTWORK
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: