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MC-15-727Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL LIX Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231347 Permit Number: MC -3-15-727 Scheduled Inspection Date: May 20, 2015 Permit Type: Mechanical - Commercial Inspector: Perez, JanPierre Owner: CHURCH, MIAMI SHORES BAPTIST Job Address: 370 GRAND Concourse Miami Shores, FL 33138-2747 Project: <NONE> Contractor: C&R AIR CONDITIONING CO Building Department Comments Inspection Type. Final Work Classification: A/C Replacement Phone Number (305)758-0559 Parcel Number 1132060136040 Phone: 305-685-6394 PULL PERMIT AND BRING 2 NURSERY CONDENSING Infractio Passed Comments UNITS UP TO CODE INSTALLED BY OTHERS. INSPECTOR COMMENTS False May 19, 2015 For Inspections please call: (305)762-4949 Page 12 of 40 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 19, 2015 For Inspections please call: (305)762-4949 Page 12 of 40 rs, Miami Shores Village CCF 10050 N.E. 2nd Avenue DBPR Fee Miami Shores, FL 33138-0000 `b Phone: (305)795-2204 fitOJtivit� $0.40 Project Address Parcel Number Applicant 370 GRAND Concourse 1132060136040 MIAMI SHORES BAPTIST CHURI Miami Shores, FL 33138-2747 Block: Lot: Owner Information Address Phone Cell MIAMI SHORES BAPTIST CHURCH 401 NE 95 ST (305)758-0559 Miami Shores FL 33138 Contractor(s) Phone Cell Phone C&R AIR CONDITIONING CO 305-685-6394 (954)680-4494 Tons: Additional Info: PULL PERMIT AND BRING 2 NURSERY CON Classification: Commercial Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Scanning: 3 Fees Due Amount CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 Valuation: $ 1,095.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -3-15-55001 04/03/2015 Credit Card $ 116.20 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical 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 infa ' n i ur td construction and zoning. Futhermore, I authorize the abov n e� n or Authorized Signature: Owner / all work will be done in compliance with all applicable laws regulating April 03, 2015 Building Department Copy April 03, 2015 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING MAR & x„2015 FBC 20 l Master Permit No. KA Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ® MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP (; CONTRACTOR DRAWINGS JOB ADDRESS:�® �P-«Mj 0 -0R -/Ls = City: Miami Shores County: Miami Dade Zip: 'amu Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): lb i Aw i E4) ®kA� I# n , a r i' Inge c �. Phone#:3 b-5 Address: JID r4N j ( QAi cnay-s City: tn'tate► State: 1 Trp: J I Tenant/Lessee Name: Phone#: Email: 4L,nna=s 6 C- Q- h& -- II s�--r CONTRACTOR: Company Name: C 00 jj -r;b k 0 C • Phone#: -36.-5 ' & 25 - 6 3'-)Y' Address: City: b2 d G= rn; State: Zip: Qualifier Name: G6 C2 4 CP -t- 2pIr Phone#: 3o t - 85 " 6311 State Certification or Registration #: 0 -ac Y l Y Certificate of Competency #: � 2 6) ( -a,3 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ® 2 L ®0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace Description of Work: A/ay- ❑ Demolition Specify color of color thru tile: Submittal Fee $ r Permit Fee $ CF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Reviwd02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ \ TOTAL FEE NOW DUE $ 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 r AGENT The foregoing instrument was acknowledged before me this ,,A'O'y day of e r��.' 20 ) , by _Aiv 7 iI a7 o y i�J' r TC H O ,C who is pers®nally kn rn to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Signi, OL Print: IZ L i_ _ 02 C?��. Seal: Nory Public State or Florida �`. �b9Ale ®ray J� My CIOfl11M11lloA FF 103736 APPROVED BY �\ In s a l b (Revised02/24/2014) as Signature • .t • ; The foregoing instrument was acknowledged before me this day of _p ► `Cl, 1` C k 20 . by Rt, b-er T T C k a 4 0' personally known o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:, Print: Seal:a JANET KRANZ a `= Commission # FF 187298 .;1 Expires May 9, 2019 kmaKWnwlrgrix.Irww 6DO4305 018 trtrMrR�MrlerYNr4+6rP�/rArl�MA�MrY9ryrprYffiMe�r1e r6#rMrkrM+Rrtrtbflr�lrR�B�+irb+PN+Yrk#rU8#8�3r1 Structural Review Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single shegts are not acceptable. Job Address (where the work is being done): 3 I City: Miami Shores Village County: Miami Dade Zip Code: 2 j 12 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS A I DATA SHEET REQUIRED Change disconnecting means: YES ❑ NCIARHI Sheet Attached: YES ❑ NO Contract Attached: YES ❑ 1. Minimum Circuit Ampacity (Wire Size): am 2. Maximum Overcurrent Protection (Fuse/Breaker Size): '30 3. Voltage of Circuit (208/240/480): ®q o 00f+ l 1 IH 4. Size Disconnecting Means: -� T Contractor's Company Name: G R i 1- C o co. Phone: V y �+ �� J State Certificatistr io C /T C ® 2 6 L/i Ll Certificate of Competency No. ® �0 0 0)1-3 Signature Date: _� w I 5-' (Revised02/24/2014) mqh (,3 ®J UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER Y?yh ^® AHU or PKG. UNIT MODEL # COND. UNIT MODEL# 13 AJA 036 M KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU — CUA PKG AHU CU PKG 3) VOLTS LAO (f H AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YES YES NO NEW 4"CONCRETE SLAB YES O YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 0 1. Minimum Circuit Ampacity (Wire Size): am 2. Maximum Overcurrent Protection (Fuse/Breaker Size): '30 3. Voltage of Circuit (208/240/480): ®q o 00f+ l 1 IH 4. Size Disconnecting Means: -� T Contractor's Company Name: G R i 1- C o co. Phone: V y �+ �� J State Certificatistr io C /T C ® 2 6 L/i Ll Certificate of Competency No. ® �0 0 0)1-3 Signature Date: _� w I 5-' (Revised02/24/2014) mqh (,3 ®J