MC-13-524Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-211893
Scheduled Inspection Date: May 07, 2014
Inspector: Perez, JanPierre
Owner: JULIANA MIRANDA, PAUL ADAN
Job Address: 500 NE 97 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: UNIVERSAL PLUMBING CORP
tsunaing uepartment comments
MOVE AIR HANDLER AND PLACE NEW DUCT FOR
ADDITION
Permit Number: MC -3-13-524
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
1132060171540
Phone: (305)887-3131
INSPECTOR COMMENTS False
<�l �'l � [ 14
Inspector Comments
Passed
19) C' L) Alc-
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
May 06, 2014 For Inspections please call: (305)762-4949 Page 32 of 34
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
FBC 20
Permit Type: MECHANICAL
Permit Nom Q 5S"?Y
Master Permit No. I —
OWNER: Name (Fee Simple Titleholder): r124 Alt ,f ? "K 57- Phone#:
Address: roo Alf I 7 S7
City: hlf>fMl£. State: Fl zip: _33/ 3 �'
Tenant/Less
ee Name: Phone#
Email: Awe . &OW
JOB ADDRESS: _ S0� ,It/ r � 7�
City: Miami Shores County: Miami Dade Zip•
Folio/Parcew //® 32 06 " C7/7 ISiID
Is the Building Historically Designated: Yes NO a--.— Flood Zone:
COr
Addy
City:
Qualifier Name: i*Z� Phone#: � � _2. f
State Certification or Re69tration #{�/fG 1.25 J 69l %9—Certificate of Competency #:
Contact Phone#: Email Address: wr <<iP /? S L �l�i! S �;est, • ��
DESIGNER: Architect/Engineer: I
Phone#:
G/
Value of Work for this Permit: $ /e 2 00 Square/Linear Footage of Work:
Type of Work: UAddress,I,, DAlteration ONew DRepair/Replace ODemolition
Descriptloa of Work: 07.01) f i 1l�}P" r0_x 491 �4NA ,�L/fG f
/ Z £ w AUG?S wft AM I7/d,41--
Submittal Fee $ Permit Fee $ d 6)6 CCF $ CO/CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ i
6l3
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'SaAFFIDAVIT: 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 $2300, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certifted copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occur seven (7) days after the building permit is issued_ . In the absence of such posted notice, the
inspection will not be a proved aj a reinspection fee will be charged
Signature Signature
O or Agent Contractor
The foregoing instrument was acknowledged before me this The for instrument was acknowledged before me this
day of/s tAd�,'#20/" , by F, - J��6V' day of 20 by
who is personally known to me or who has produced 0e5e-W/ who is personally j j co t me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My Commission Expires:
SCJ •;�= ao � �. ,.
1, X, • �" c, : �.N`6
�k�k�k9nkda��k�kskdtdeikdaak�k�k�#daeRdasRsk�A�k'Ad��&'k�h+kik�k+b�&skd=8 gaga$ 9��R�k�R�R�R�
APPROVED BY
461an
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUB PRUJILLO
N #00905054
UL 06, 2013
Sign: tate Insurartca
My Commission Expires:
Examiner Zoning
Structural Review Clerk