MC-12-1427Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 176483
Scheduled Inspection Date: September 19, 2012
Inspector: Perez, JanPierre
Owner: ANNESE, SALVATORE AND LAURIE
Job Address: 9510 BISCAYNE Boulevard
Miami Shores, FL
Project: <NONE>
Contractor: AIR Q INC
Permit Number: MC -7 -12 -1427
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New A/C System
Phone Number (786)306 -9510
Parcel Number 1132060142880
Phone: (786)486 -7810
Building Department Comments
INSTALL AC MINI SPLIT 1.5 TON
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 18, 2012
For Inspections please call: (305)762 -4949
Page 8 of 27
Miami Shores Village
Building Department
?0050 N.E.2nd Avenue, Miami Shores, Horida 33138
Tel: (305) 7952204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
c ? I 2000. > FBC 20
B ING Permit No. Heigl
PERMIT APPLICATION Master Permit No. Pi2. — " 1Q -14 2S-
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Permit Type: MECHANICAL
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JOB ADDRESS:
City: Miami Shores
FoliolParcel#:
County:
Miami Dade Zip:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER Name (Fee Simple Titleholder): 50.-1 Dais -..-t A awl P G .c Phone#: 3 0 b - 5 7 s•-• 90 ? (
Address: 4 5 t 6 /- s (ae. tf! � t+� Ala i •
City: & I'D et ( IA-4- Y✓ State: (• Zip: 3 3 / 3 ,Y
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: M i Y- 0. 1-'0 c- . Phone#: 116 t i 6 ?PO
A d d er : ci 0 I 0 S (AD 3 Z
M S Z -
City: 1 r 1 i State: C l• Zip: 3'3/ C S
Qualifier Name: gag Q,0 CPI) C.-- cs o Phone #:
State Certification or Registration #: C U C 11-4 4 4 3-0 Certificate of Competency #:
Contact Phone#: 1`'4 0 6 2/ 0 Email Address: a; (I i +. C 01 d 1100 i (-
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 3 i 5 0 0 . 0 "0 Square/Linear Footage of Work:
Type of Work: OAddress ❑Alteration ONew ORepair/Replace ODemo ition
Description of Work: L S tT brr' S o f i S ), T CI e u , 2 �'fiq CI-v s.)
P , P
(v4d00
Submittal Fee $ Permit Fee $ 2,2i'L )CCF $ COICC $
Scanning Fee $ Radon Fee $ DBPR $ , Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL 1NEE NOW DUE $ I ?)4. yJ
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. 1 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: 1 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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this G ih
day of , 20 ___, by , day of 416 #44,15f/.., by R0.061/4ia 40440 ,
who is personally known to me or who has produced who is personally known to me or who has produced 'AZ
As identification and who did take an oath. if feit422 41- as identification and who did take an oath.
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NOTARY PUBLIC: NOTARY PUBLIC:
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Orly CosAMTExpires:
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My Commission Expires:
APPROVED BY
Structural Review
Revised 3/122012)(Revised 07 /10/07)(Revised 0611012O09)(Revised 3/15109)
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Zoning
Clerk