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MC-06-2084Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FIL C� Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-24091 Permit Number: MC -8-06-2084 Scheduled Inspection Date: March 02, 2015 Permit Type: Mechanical - Commercial Inspector: Perez, JanPierre Inspection Type: Final Owner: VILLAGE, MIAMI SHORES Work Classification: Repair Job Address: 9825 PARK Drive Miami Shores, FL 33138 Phone Number Parcel Number PARC2004-19 Project: <NONE> Contractor: C&R AIR CONDITIONING CO Phone: 305-685-6394 Building Department Comments EXACT REPLACEMENT OF 5 TON SPLIT SYSTEM FOR SOUTH LOCKER ROOM February 27, 2015 For Inspections please call: (305)762-4949 Page 27 of 27 Inspector Comments Passed LQ— Failed Correction Needed ❑ Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. February 27, 2015 For Inspections please call: (305)762-4949 Page 27 of 27 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status: APPROVED Issue Date: 8/9/2006 Expires: 02/05/2007 Permit Number: MC -8-06-2084 Owner's Name: MIAMI SHORES VILLAGE Phone: Permit Type: Mechanical - Commercial Work Classification: Repair Job Address: 9825 PARK Drive Miami Shores Village, FL 33138 Contractor(s) Phone Primary Contractor C&R AIR CONDITIONING CO 305-685-6394 Yes Comments: EXACT REPLACEMENT OF 5 TON SPLIT SYSTEM FOR SOUTH LOCKER ROOM Additional Information Tons: 5 Additional Info: Classification: Commercial In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above-named contractor to do the work stated Fees Due Amount CCF $3.00 Total: $3.00 Building Department File Copy Applicant Signature Parcel #: PARC2004-19 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 4,397.00 Final Invoice Number Amt Due Amt Paid MC -8-06-25845 $3.00 Total: NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status: APPROVED Issue Date: 8/9/2006 Expires: 02/05/2007 Permit Number: MC -8-06-2084 Owner's Name: MIAMI SHORES VILLAGE hone: Permit Type: Mechanical - Commercial Work Classification: Repair Job Address: 9825 PARK Drive Miami Shores Village, FL 33138 Contractor(s) Phone Primary Contractor C&R AIR CONDITIONING CO 305-685-6394 Yes Comments: EXACT REPLACEMENT OF 5 TON SPLIT SYSTEM FOR SOUTH LOCKER ROOM Additional Information Tons: 5 Additional Info: Classification: Commercial In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above-named contractor to do the work stated Fees Due Amount CCF $3.00 Total: $3.00 Finance Copy Parcel #: PARC2004-19 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 4,397.00 Final Invoice Number Amt Due Amt Paid MC -8-06-25845 $3.00 Total: NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Miami Shores Village vv 5(r e dt,5—v o Building Department ?� tt°10 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING- - --� - : Permit No. C -i� -%--Q 084 PERMIT APPLICATIO r Master Permit No. FBC 2001 f� Permit Type (circle): Building Elec a PlumbingMechanical Roofing Owner's Name (Fee Simple Titleholder) Phone # 0 '?al C) q Owner's Address City uhf s D Cs State Ff , Zip _ 3 Tenant/Lessee Name Phone # Job Address (where the work is being done) 9 g )- E 1 0 G City Miami Shores Village X. ty Miami= e Zip Is Building Historically Designated YES NO v/ Contractor's Company Name c— t R A i r Co. Phone # . 2 ®� �j g J�-914 Contractor's Address i® fo O X (off 1 3"D 0 n p City 1i►1 State F Zip -,S (1 Qualifier b -er * �Y . C 1, f .t_F Architect/Engineer's Name (if applicable) Phone # ®o $ Value of Work For this Permit W 1 • Square Footage Of Work: Type of Work: ❑Addition ❑Alteration [--]New �Repair/Replace ElDemo •tion Describe Work: Submittal Fee $ Permit Fee $ �� CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) r r 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 reirs�ection fee will belgarged. Owner or Agent The foregoing instrument was acknowledged before me this day of u 0 S, by who ersonall k me or who has produced As identification and who did take an oath. Signature retractor The fore oing instrument was acknowledged before me this day of g Q1 , 20 D ( by who i rsg know to me or who has produced as identification and who did take an oath. NOTAR I�dk_ NOTARY PUBLI Sign: Sign: VA4'1r� Print: Y tb�Jtk - C t Print: 3c, r1 Q' yt My Commission Expires: Commission # ODS24602 My Commission s: Janet Kranz A4, P91710 � i�� iro9Fain-Insurance, Inc 800306.7018 ?y: �: December 26, 200 , N C Holder) SONDDEDTTHRUTROY FAIN INSURANCE INC State Certificate or Registration No. C A 426 9 ILI Certificate of Competency No. d 4 0 902 "1 APPLICATION APPROVED BY: �f' Plans Examiner Engineer Zoning Chc 12/15/03 ADDENDUM TO BUILDING PERMIT'APPLICATION APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A BASTER PERMIT HAS B. TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Tl6 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM UNIT FEE SPACE HEATERS T LIC#ff OUTLETS CENTRAL HEATINGI.-& V YiAStffR RECEPTACLES A/C (WINO) 'CSAL SERVICE TEWCRARY A/C (CENTRAL) = S 0 h + KING FOUNTAIN SERVICE SIZE IN AIDS DUCT WORK COLcl A CRAIN SERVICE REPAIWTER CHA,'CE REFRIGERATION 5E TRAP APPLIANCE OUTLETS PROCESS Aho PRESS PIPING :RCEPTCR RANGE TCP UNDERGROUND TANKS ;TORY OVEN ABOVE GROUND TANKS ,MY TRAY WATER HEATER U.F. PRESSURE VESSELS KS WASHER MOTORS 0- 1 w STEAM BOILERS KER MOTCRS OVER 1- 3 W HOT WATER BOILERS K, POT/3 COMP. MOTORS OVER 3- 5 W MECWJiICAL VENTILATION RESIDENCE MOTCRS OVER 5- 8 W TRANSPORTING ASSEM3LIES K, SLOP MOTORS OVER 8- 10 W ELEVATORS/ESCALATORS PORARY WATER CLOSET WTORS OVER 10- 25 If FIRE SPRINKLER SYSTEZ NAL MOTORS OVER 25-100 W COOLING TOWERS ER CLOSET MOTCRS OVER 100 FP VIOLATION 'IRECT WASTES A/C WIhCOW REINSPECTION ER S1.PPLY TO: AIR CONDITIONERS .JC UNIT STRIP HEATER IRE SPRINKLER GENERATORS TRANSFORMERS 'EATER -NEW INST. GENERATORS TRANSFORMERS '.EATER -REPLACE GENERATORS TRANSFORMERS .A?N SPRIWLER-WELL SPECIAL PUUZE 'W I w I NG POOLOUTLETS COhNERC I AL EATER SERVICE SIGN TUBES rR CONNECTIONS SIGN TRANSFORMERS LITY-SEWER SIGN TIME CLOCK LITY-WATER FIXTLRES 'TIC Tk(K ANTENNA .AY TELEVISION OUTLETS O NFIELO, 4' TILE/RES. VIOLATION •P & ABANDON SEPTIC TANX REINSPECTION :KALE PIT CU. FT. "OH 8AS IH CHARGE WELL 4 STIC WELL _A CRA I N )f INLET _AR NATER HEATER ' 2E STANDPIPE X PIPING tN SPRINKLER SYSTEM s, RAND iER SET (GAS) > PIPING