MC-15-2317 Inspection Worksheet
Miami Shores Village ' a r
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-243331 Permit Number: MC-9-15-2317
Scheduled Inspection Date: September 28, 2015 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre
Inspection Type: Final
Owner: MENDEZ, BENIGNO Work Classification: Pool Heater
Job Address:551 NE 105 Street
Miami Shores, FL 33138-2044 Phone Number
Parcel Number 1122310140280
Project: <NONE>
Contractor: G.E POOLS CONSTRUCTION INC Phone: (786)355-3382
Building Department Comments
INSTALL SWIMMING POOL HEAT PUMP. Infractio Passed Comments
INSPECTOR COMMENT False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 25,2015 For Inspections please call: (305)762-4949 Page 18 of 39
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10050 N.E.2nd Avenue NE7\,
Miami Shores, FL 33138-0000
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Project Address Parcel Number Applicant
551 NE 105 Street 1122310140280
Miami Shores, FL 33138-2044 Block: Lot: BENIGNO MENDEZ
Owner Information Address Phone Cell
BENIGNO MENDEZ 551 NE 105 Street
MIAMI SHORES FL 33138-2044
551 NE 105 Street
MIAMI SHORES FL 33138-2044
Contractor(s) Phone Cell Phone Valuation: $ 200.00
G.E POOLS CONSTRUCTION INC (786)355-3382
_...w. _,. ..,. _...,,,,.. . _....... Total Sq Feet: 0
Tons: Available Inspections:
Additional Info: INSTALL SWIMMING POOL HEAT PUMP. Inspection Type:
Classification: Residential
Final
Approved: In Review
Review Mechanical
Comments: Date Approved: : In Review
Date Denied: Type of Work:
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee $2.00 Invoice# MC-9-15-57052
DCA Fee $2.00 09/25/2015 Credit Card $ 108.60 $0.00
Education Surcharge $0.20
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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 ac ate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named r for to do the work stated.
September 25, 2015
Authorized Signature:Owner / Applicant / 5014r c r / Agent Date
Building Department Copy
September 25,2015 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:(305)762-4949
FBC 20 1-Q
BUILDING Master Permit No._Epp is --W 1
PERMIT APPLICATION Sub Permit No.Mc Ik-- Q_SD
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION [--]RENEWAL
❑PLUMBING XM
ECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: C)�s "
City: Miami Shores County: Miami Dade Zip: 3 1 _
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): E t-N16 N ` KIGS Phone#: 30.5" �)5l,2 73-5
J
Address: 5 ) N C /() S S
City:-N t;grn i :S f4OE6 State: I' Zip: 3 )3 0
Tenant/Lessee Name: RE-1,J G No A)-DC- 2 Phone#:
Email: ?367" M ei� �y'� GMAC L� 1)A^ i
CONTRACTOR:Company Name: l? �. • ��(7Ls CC)n-4, y CA a V) .4--n c . Phone#: "78%3 3 3,f 2-
Address: ''42ZC> Sc� 9:70—
City: Imo[l/ in State: F-L Zip: 33 ro
Qualifier Name: ( 3,;, `'/ , { Phone#:7 33 3�� Z.
State Certification or Registration#: C C �gse A; Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$n ®-o Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: T-nsAn(,L SLot MM/a1C' D t' Yf'�,
Specify color of color thru tile: (�
Submittal Fee$ Permit Fee$ �D`� L CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ �-`
TOTAL FEE NOW DUE$ ��JC9
(Revised02/24/2014)
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 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER r AGENTON TOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of_ 20 by — I k _darty of 20 IS by
rte Nlo Mendt who i� s personally known to (��l. PfiND C t ), > C who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: AIDAPEGUERO
Prin . ...:'4�c� AIDAPEGUER
Uv nmwlssiml#FF 165583 Print: * * EXPIRES:October 5,2018
* EXPIRE$:Octobst 5,2018 ipja r rj Bonded Thru Budget Notary Servkes
Seal:
wl'mv Bonded Thru Budget Notary sof*0 Seal:
APPROVED BY � Pans Examiner Zoning
Structural Review Clerk
L Revised02/24/2014)