MC-13-2667LL 2,66LI
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 203609 Permit Number: MC -11 -13 -2667
Scheduled Inspection Date: February 10, 2014 Permit Type: Mechanical - Residential
Inspector: Perez, JanPlerre
Inspection Type: Final
Owner: SHIPPEE, HELEN Work Classification: Addition /Alteration
Job Address: 1400 NE 104 Street
Miami Shores, FL Phone Number
Parcel Number 1122320320270
Project <NONE>
Contractor: MG EXCELLENCE SERVICE CORPORATION Phone: (786)247 -7067
Isuilding Department comments
TIE IN MICROWAVE EXHAUST TO EXISTING DUCT Infractio Passed Comments
INSPECTOR COMMENTS False
VD
February 07, 2014 For Inspections please call: (305)762 -4949
Page 7 of 44
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 07, 2014 For Inspections please call: (305)762 -4949
Page 7 of 44
Miami Shores Village
Building Department
10050 N.E2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: MECHANICAL
JOB ADDRESS: I 4� C70
NOY2b2013
FBC 20
Permit No. 6 h �-.
Master Permit NoAL 1 —266Y
City: Miami Shores County: Miami Dade Zip: �% �✓'
Folio/Parcel#: "Z- Z1i"•"d Z •� ��
Is the Building Historically Designated: Yes
Zone:
OWNER: Name (Fee Simple Titleholder): 44n1-1E1) 51l T F� Phone#: 3 J`3 9 0L--'�63S
City:
State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company rName: 1 CGS 1i0 Phone#:
Address: JGo l i� �l qs . .
City: H'(w,i' /CVt
Qualifier Name:
State Certification or Registrati on #:
Contact Phone#: 14-ilb ZA4 3
0
Address:
of Competency #:
DESIGNER: Architect/Engineer: Phone #:
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Value of Work for this Permit: $ 5 vegs Square/Linear Footage of Work: _
Type of Work: DAddress OAlteration ❑New ORepair/Replace
Description of Work: � �\) "k c *Z0W --\'1Le - 31q yw
Submittal Fee
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
330M
_ CO /CC $
DBPR $ Bond $
Technology Fee $
N-6
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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: 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 Z01ing.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR MPROVEMENTS 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 cert#W 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
reinspectionfee will be charged
Signature Signature Y
Owner or Agent n r
The foregoing instrument was acknowledged before me this The foregoing instrument was ac owledged be re ^^me this
day of , 20 _, by day of ' Q IM60 20 byM JCWU- 1D� m
who is personally known to me or who has produced who is Personally known to me or who has produced
As identification and who did take an oath. S -dv ? & identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: w
Print: Print I R (!7/
My Commission Expires: My Commission Expires:
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APPROVED BY Examiner Zoning
Structural Review
Revised 3 /07012)(Revised 07/10/07XRevised 06/10 AW)(Revised 3/15109)
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