MC-12-1760 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-178811 Permit Number: MC-9-12-1760
Scheduled Inspection Date: October 21,2013 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre
Inspection Type: Final
Owner: FERNANDEZ, DENISE Work Classification: Addition/Alteration
Job Address:1077 NE 96 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060143680
Project: <NONE>
Contractor: JIREH AIR CONDITIONING& REFRIGERATION INC Phone: (305)216-2774
Building Department Comments
RELOCATE Exhaust FAN Infractio Passed Comments
INSPECTOR COMMENTS False
07/08/2013-PERMIT EXTENDED PER LAST APPROVED
INSP.
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 21,2013 For Inspections please call: (305)7624949 Page 1 of 29
Miami Shores village SEP 21 z01Z
Building Department 8SIT:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:(305)756.8972
t INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. �� �
PERMIT APPLICATION Master Permit No.
FBC 20 JZ
Permit Type: MECHANICAL
OWNER:Name(Fee Simple Titleholder): _�E L Z S F L N^Ndti_ Phone#:
Address: ® 77 �J E 2L_rk ST
city: S�O>-e 5 State: L. zip: -3 313S
Tenant/lessee Name: Phone#:
Email:
JOB ADDRESS: 1 ® $�E `���h T
City: Miami Shores County: Miami Dade Zip: 3-3138
Folio/Parcel#: 3 a O 6-61 q 3
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: 11 LIE � /���. 00t �:t-M O VI u q Phone#: 3 0_5 —d-194 1 Z 774
Address: SO Q S UJ L4 a- P L,
City: &1- T state: T- L Zip: 3 31-3 S
Qualifier Name: zo'*� y t S /.'Cd gT N Phone#: 345' . 2- 16 ^Z 7 �y
State Certification or Registration#: CA C'.°-181 5 OL (e® Certificate of Competency#:
Contact Phone#: 3 U5 l b w ? Email Address: AC-0'--t N JT C A 3 3 0A-0 L a C d P-LL
DESIGNS . chit ngineer: C k o-S t-- PL XA-� -t- Phone#: ,J 4s '?z S �-
Value of Work<for_tlais Permit:$ a 50 a Square/Linear Footage of Work:
Type of Work: OAddress ❑Alteration ONew ORepair/Replace ODemolition
Description of Work: LaNvs-a T,!fa;u Z.e.lo 1-^cjEj,
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$ I
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 co i t must be posted at the job site
for the first inspection which occurs seven. (7) days after the building permit is issued. th a.' sence of such posted notice, the
inspection will Nt be approve d a reinspection fee will be charged. °
�/ Pr
Signature Signature
Owner or Agen Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of_'_,20-L4,by aq V&,L day of , t L-- .20 / n by Sc-1u ti-s Id 1 (
who is personally known to me or who has produced who is personally known to me or who has produced
en cation and who did take an oath. _- m&Jdentifi id take oath.
NOTARY C3 SW NOTATE a I
` QNMISSIOW#
PIKES: 2009
Sign: .. F o Tian Servkes Sign:
Priait: Print:
d�Iy Commission Expires: My Commission Expires:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/1=009)(Revised 3/15/09)