MC-14-237Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-206839
Scheduled Inspection Date: February 19, 2014
Inspector: Perez, JanPierre
Owner: DIAMOND, LILIAN
Job Address: 1614 NE 105 Street A-10
Miami Shores, FL
Project: <NONE>
Contractor: MG EXCELLENCE SERVICE CORPORATION
Building Department Comments
RELOCATE CENTRAL KITCHEN AC GRILL
LL"'
Permit Number: MC -2-14-237
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number
1122300530100
Phone: (786)247-7067
Infractio Passed Comments
INSPECTOR COMMENTS False
Passed
Inspector Comments
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
February 18, 2014
For Inspections please call: (305)762-4949
Page 34 of 53
BUILDING
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
PERMIT APPLICATION
Permit Type: MECHANICAL
/
JOB ADDRESS: (0 `7 X62 l Qf— 5)r—
7�cEivED
FEB E07 z 14
FBC 20 LC-->
Permit No. rrC 14 ' e23 —4 -
Master Permit No. / d - / 3-.13
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple
City: Sb/ State: - gip;
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
State Certification or Registration #: " �/0"/ (0 _Certificate of Competency #:
Contact Phone#:'' Email Address:
DESIGNER: Architect/Engineer. hnnel
Value of Work for this Permit: $ �� o —Square/Linear Footage of Work:
Type of Work: OAddress DAlteration ONew `-ftepair/Replace ODemolition
Description of Work: ) 1
Submittal Fee $ Permit Fee $��C/G
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ 1
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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 occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspe=noapprovnd a reinspectionfee will be charged.
Signa Signature
Owner or Agent Contractor
The foregoing instrument was ac wledged be a me this The foregoing instrum was acknow edged befor me this
day o 20 by day of 20 ,, by144CArL-
i
^—
who ' ersonall own to a who has pr ced ' wh ersonally wn vfie or who has roduced
P
As identification and who did take an oath. as identification and who did take an oath.
NOTARY
APPROVED BY
r10MVFUbffC State of %rWa
H= Alvarez
M mission EE 186011
Expires 05118/2016
6 I Plans Examiner
NOTARY
Sign:
Print:
My commission
Helsel Aftrez
My Comm EE 186011
Expires 0.,119/2016
Zoning
Structural Review Clerk
(Revised 3/12/2012XRevised 07/10/07XRevised 06/102009)(Revised 3/15/09)