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MC-07-873 y� Miami Shores Village a� Pex� t,rawr�i ttlie�wl 10050 N.E.2nd Avenue NOW, Miami Shores,FL 33138-0000 Q zr " Phone: (305)795-2204 ': y Expiration: 10130/2007 Project Address Parcel Number Applicant 460 NW 112 Street 1121360010180 Miami Shores, FL 33168- Block: Lot LEO DE LA ROSA Owner Information Address Phone Cell LEO DE LA ROSA 460 NW 112 TERR (305)751-7067 MIAMI SHORES FL 33168-3328 Contractor(s) Phone Cell Phone AIR KING MECHANICAL CONTRACTO 305-823-5888 Valuation: $ 3,000.00 _. ...... Total Sq Feet 0 fr Tons:3 Available Inspection: Additional Info:replacing of the unit Inspection Type: Classification:Residential Rough Approved:In Review Rough Dud Comments: Date Approved: :In Review ventilation Date Denied: Final Smoke Test Smoke Det Test Hood Fees Due Amount Total Amt Paid Amt Due CCF $1.80 Education Surcharge $0.80 $0.00 $0.00 1 $ 0.00 Permit Fee-Additions/Alterations $120.00 Scanning Fee $3.00 Payment Type: Technology Fee $3.00 Total: $128.40--1 N ® 5 A r 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. May 03,2007 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy Thursday,May 3,2007 1 Receipt Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Number: MC-5-07-873 Owner Address: Invoice Number: MC-5-07-28341 460 NW 112 TERR Applicant: LEO DE LA ROSA MIAMI SHORES, FL 33168• Company Name: Job Address: 460 112 Street NW Miami Shores, FL 33168- Date Payment Type Check Number Amount Change Tuesday, June 5, 2007 06/05/2007 Check 2156 $128.40 $0.00 Total Payment: $128.40 Page 1 of 1 Miami Shores Village 05103/0-7w`= Building Department m� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 i BUILDING Permit No. PERMIT APPLICATIO �,� -j �'" Master Permit No. FBC 2004 MAY 0 1 2007 Permit Type: Mechanical BY'--- i°/ Owner's Name(Fee Simple Titleholder) Q, IG -'Ct`hone# ` cc sC e-1`{395 20 Owner's AddressL4 G o lmu) .wbA Ha Th IM City Mi Cr61 i State ( Icd G Zip 33 1 k,':;�> Tenant/Lessee Name 0-p Phone# 0 41 E-MAIL: Job Address(where the work is being done) �jiao KLt o U a rh Rp- City Miami Shores Village County Miami-Dade Zip_3,�S1 �68 FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name Pki,r ".`� y4p-6X04-a CJ Phone Contractor's Address 33t5t i:5uS (a-I-Q. City Wuc-a--%� State 03-C,. Zi Qualifier Name AArn,4y-1:J Phone State Certificate or Registration No.Czz 9`71— Certificate of Competency No. E-MAIL: Architect/Engineer's Name(if applicable) M _Vz:, Phone# N`)L11 Value of Work For this Permit$ Q ,-4V®Q2 Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ® Repair/Replace ❑ Demolition Describe Work: d u— A.G 3 TbKS. 'x aY 9c dcx�xxdexux xacx4exY dcxY isxxxxx4cxxacxxdex i:xxxFees�xx9cxxxxxxx xxacxxuicx aYxxxxxxa:Bexa'-x 9cxr.4r xd:d:xxxxYx Submittal Fee$ Permit FeeU�j1 $� � � CCF$ 11U CO/CC Notary$ Training/Education Fee$ -(20 Technology Fee$ ✓'Q Scanning Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ �t'S Structural Review.$ Total Fee Now Due$_ A K) See Reverse side W 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. l 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: 1 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 po e, the inspection will not be approv fee ' be charged. -- es Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before thisO5 The foregoing instrument was acknowledged before me thiPS day of 1 ,20 0�,by ��`4- day of ,201,by m,c" who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Mercedes CeNrMMT�RV NOTARY PUBLIC: +, MY COMM"ibh�I�28rt3�2 PUBLIC: ,pd� Mercedes f.PMeno p Expires March 30,2008 a My Cr: s a �G'287882 � _II QQ --__ II pfryO� EidiCS iWfirCn 30.2008 Sign:` b Mercedes Centeno Sign: ^!`(kCl.� � E% o My Commission DD287602 Print:-Y%\ Q^ =� ^'Ifer�r�� Print: . res March MMy Commission Expires: My Commission Expires: x aY x4c r.9:xxxxxxxx+4x�a4zYxx4exxxxxxnY Y tYxdexxxaYxdexxxaexxxY a4�ticxxx�exxYxacxok a:xxxxee txxdc'c tx ac 9e xic aYxxx xx4cx x�e&xx4e'xxk aYxxdcxo:xxdc 4eoYx APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06) �► ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED,THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE O DISCIPLINE APPLIED FOR: PERMIT# PLUMBING ELECTRICAL MECHANICAL kRd UNIT FEE ITEM UNIT FEE ITEM UNIT FEE SWITCH OUTLETS ER SPACE HEATERS LIGHT OUTLETS CENTRAL HEATING RECEPTACLES IN SERVICE TEMPORARY A/C (WIND) AP A/C(CENTRAL) SERVICE SIZE IN AMPS DUCT WORK OR SERVICE REPAIRIMETER CHANGE REFRIGERATION APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVEGROUND TANKS SHOWER WATER HEATER SINK.POT/3 COMP. U.F.PRESSURE VESSELS MOTORS 0-1 HP STEAM BOILERS SINK,RESIDENCE. MOTORS OVER 1-3 HP SINK,SLOP. HOT WATER BOILERS MOTORS OVER 3-5 HP MECHANICAL VLNTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP URINALMOTORS OVER 8-10 HP TRANSPORTING ASSEMBLIES LA WATER CLOSET MOTORS OVER 10-25 HP ELEVATORS/ESCATORS INDIRECT WASTESFIRE SPRINKLER SYSTEMS MOTORS OVER 25-100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP A/C UNIT VIOLATION AIC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER-NEW INST. STRIP HEATER HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER-WELL GENERATORS TRANSFORMERS SWIMMING POOL GENJERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY-SEWER SIGN TUBES UTILITY-WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD,4"TILE/RES. ANTENNA PUMP&ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU.FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET(GAS) GAS PIPING li MAY-02-2007 08:30 AM P. 2 ' emwYYWWUNrvr•r• � , t111vrY.•.: RESIDENTIAL COMMERCIAL.- Licensed & Insured MECHANICAL CONTRACTOR INDUSTRIAL• State Mechanical Contractor 2775 West 78th St. #8 - Hialeah, FL 33016 License No.CAC057975 Ph: 305-621.1678 - Fax: 305-621.6013 Date: I ] PROPOSAL & CONTRACT Job No. X00 S Customer: 44W �'/ home Phone:!gf -�� Bus. Phone: Address: � �d1/ //Z x City: Stater/ Zip: SYSTEM EQUIPMENT AND TYPE OF MATERIAL USED: � . A\ 1rtCVM67st A � Job Price$ UNIT SUPPLIES SEER , Tax$ Q:7'.. REMARKS: Rebate$ +�� ,e� 0 KITCHEN E3 DINING ROOM E3 RETURN JOB TOTAL$ o'" ❑BATHROOM ❑FLORIDA ROOM 0 WATER PUMP ❑LIVING ROOM Cl BEDROOM ❑ADDITION C3 FAMILY ROOM ©DEN [7 ❑ ❑ ❑ Punh" S+iWr PurOmer Seiler Local Permiw and Licenses Drain Unea Equipment Foundation Refrigerant Linea Wiring from Building Panel 10 Cutting Holes Unit Bathroom Exhaust Wiring of Control System others NOTE: ►�- W �tZtZla av \O £ts S �jo1 INSTALLATION SCHEDUL r We will be ready to begirt Insta a ap ximat Contract Expiragon nate: Owner PurchMar ACCeptancfDate: Seller Approval: • Installation Date: Salesperson: Customer: WHITE &YELLOW Accounting: Pink I