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MC-12-1006Miami 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 FBC 20 t0 Permit Type: MECHANICAL M ,, A n OWNER: Name (Fee Simple Titleholder): '1 t t IAJVC Mom a JUN 012012 Permit No. i I _ I l`°` Master Permit No. t2--C-- I L- 1co-t Phone #: ) - 2-O / 0 Address: 363- N6 q,SSr City: p" ' th Tenant/Lessee Name: Email: N(- State: Zip: 33 r 5 S Phone #: JOB ADDRESS: City: Miami Shores Folio/Parcel #: It -3 L (g a (jam Is the Building Historically Designated: Yes County: Miami Dade Zip: NO Flood Zone: CONTRACTOR: Company Name: t \' I■Q cje.LIV•o'ns Phone#: 9S4- %V- (865 Address: 2,0%k 2(1 n16 lts co wric Q-tt City: ... State: F t... Qualifier Name: rj+ascq.As Sitt*4a...A State Certification or Registration #: C A.G \ % S% V$ Certificate of Competency #: Contact Phone#: Y- $gZ - `CDS Email Address: sd.nc.'-Ao80 e, C3 aav4►. NI.4, DESIGNE : Archi gineer: 1 %larbic- (4/41041 P 61 LA-... Phone #: 30 y ,5- ' 313S Value of Work for this Permit: $ !Cal-ZOO .'— Square/Linear Footage of Work: 5ik f I kS. . Type of Work: °Address )13Alteration • n New ORepair/Repl . ce Description of Work: Phone #: Zip: -1-3 ■749 lila- 148 - 'Satz °De olition df � C� (9 Submittal Fee $ Permit Fee $ ` CCF $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Technology Fee $ CO /CC $ Bond $ TOTAL FEE NOW DUE $ 5(,c 1 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. Signature "^ V Signature Owner or Agent Contractor The fore oing instrument was acknowledged before me this �b The foregoing instrument was acknowledged before me this day of + � , 2012- , by A A d rEw La � �E , day of 1 g-1 L , 20 ieZ by brazieto 4L .k-''`�jw� who is personally known to me or who has produced t d who is personally known to me or who has produced ra `gees 6 ►eEnSe5 As identification and who did take an oath. `�L-.* OP Fi�- as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Print: My Comm APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174367 Permit Number: MC -6 -12 -1006 Scheduled Inspection Date: April 22, 2013 Inspector: Perez, JanPierre Owner: MORGAN, MARY Job Address: 307 NE 95 Street Miami Shores, FL 33138- Project <NONE> Contractor: ALL AIR SOLUTIONS INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)606 -2098 Parcel Number 1132060136000 Building Department Comments REPLACE AC UNIT TO INCLUDE NEW DUCT WORK 1,5 Inspector Comments Passed D Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 19, 2013 For Inspections please call: (305)762-4949 Page 2 of 38