MC-13-1822Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 205621 Permit Numbe : IVIC- 8- 11 -U22
Scheduled Inspection Date: February 19, 2014 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Inspection Type: Final
Owner: GARCIA, JOHN Work Classification: Pool Heater
Job Address: 169 NW 104 Street
Miami Shores, FL Phone Number
Parcel Number 1121360131370
Project: <NONE>
Contractor: ROSMEL POOL INC Phone: (305)592 -7900
comments
HEAT PUMP
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
INSPECTOR COMMENTS False
'� A V
Inspector Comments
CREATED AS REINSPECTION FOR INSP - 197054.
February 18, 2014 For Inspections please call: (305)762 -4949 Page 22 of 53
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
BUILDING
PERMIT APPLICATION
Permit Type: MECHANICAL
Au G a2%3
FBC2010
Permit No.
Master Permit N b 13 —1 5_4_
JOB ADDRESS:., z Z' /w 16 4:57l
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: -2/_ —013 — / 3 ;70
Is the Building Historically Designated: Yes NO i Flood Zone:
OWNER: Name (Fee Simple Titleholder): 6-Q Phone#.
Address: A4-'J /G��
City: � 1-:5 O
< State• gip; 3 3
Tenant/Lessee Name: /k/ Phone#.
Email:
CONTRACTOR: Company Name: '4('& ✓P�/% �✓s // � Phone #. s iZ 7 7
Address: �v' �$ <tJC eJ s� 5�evO
City: ��'' - State: -;7-L Zip: 33/(-
Qualifier Name: %�%id t i is2 � ��
Phone#:
State Certification or Registration #: 5�7 1'06 l® cY6 Certificate of Competency #:
Contact Phone #: q Email Address:��'�5 /�5- �e�y� -5• ��r
DESIGNER: Architect/Engineer: _;�%1PZ �• Phone #: 3,f) ate /Zs7
Value of Work for this Permit: $ �� SquareAAnear Footage of Work:
Type of Work: DAddress
DAlteration ONew
` ,,,P (1--2,rA eqiU)
Submittal Fee $ • Permit Fee $_L�U1 -1 G� CCF $ CO /CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
(?AV/ qk
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address x 11-t
City
State
Zip
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 o en (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be a ved a rei a 'on fee will be charged.
Signature ya-,'Y
Signature
en Z Contractor
The foregoing instrume�:M kno before me this ✓ Z The foregoing instrument was acknowledged before me this/2-
day of 20 y day of , 2012- y
who is personally known to me or who has produced w is rson own to me who has produced
LAO &UIC -i � As identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sian:
Si
Print: � A 6 FF 0M Print: MARCOS
EXPIRES' M4 My Commission Expire :ibsferoab
B My Commission MYCOkMSSiONiFFi6989
EXPIRES: May 15, 2D11
BMW ltuu No Nypuft Wdmv*M
APPROVED BY P s
Examiner Zoning
Structural Review Clerk
Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10 /2009)(Revised 3/15/09)