MC-15-720 )2 C 10,266
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
7Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-248234 Permit Number: MC-3-15-720
Scheduled Inspection Date: November 23,2015 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre Inspection Type: Final
Owner: WALLACE,JOHN Work Classification: A/C Replacement
Job Address:518 NE 106 Street
Miami Shores, FL 33138-2046 Phone Number
Parcel Number 1122310140211
Project: <NONE>
Contractor: AIR SYSTEMS A/C LLC Phone: (786)208-3484
Building Department Comments
NEW AC UNIT AND DUCTWORK 3.5 TON Infractlo Passed Comments
INSPECTOR COMMENTS False
23 15
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 20,2015 For Inspections please call: (305)762-4949 Page 37 of 41
° Miami Shores Village h , � r + 11ii� -Ie�iC�$ al ,
10050 N.E.2nd Avenue NEVol
�lt�+ �lei1.
Miami Shores FL 33138-0000
Ali Az
o '
Phone: (305)795-2204 u`
Expiration: /3012015
Project Address Parcel Number Applicant
518 NE 106 Street 1122310140211
JOHN WALLACE
Miami Shores, FL 33138-2046 Block: Lot:
Owner Information Address Phone Cell
JOHN WALLACE 518 NE 106 Street
MIAMI SHORES FL 33138-2046
Contractor(s) Phone Cell Phone Valuation: $ 5,400.00
AIR SYSTEMS A/C LLC (786)208-3484 Total Sq Feet: 650
Tons:3.5 Available Inspections:
Additional Info:
Inspection Type:
Classification:Residential Final
Approved:In Review Review Mechanical
Comments: Date Approved::In Review
Date Denied: Type of Work:NEW AC UNIT AND DUCTWORK
Scanning:1
I
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.60 Invoice# MC-3-15-54990
DBPR Fee $2'84 03/30/2015 Credit Card $50.00 $157.28
DCA Fee $2.84
Education Surcharge $1.20 04/03/2015 Credit Card $ 157.28 $0.00
Permit Fee $189.00
Scanning Fee $3.00
Technology Fee $4.80
Total: $207.28
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 that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. ermore,I authorize the above-named contractor to do the work stated.
April 03, 2015
Authorized ' a re:Owner / Applicant / Contractor / Agent Date
Pp 9
BuildingDepartment
p Copy
it
April 03,2015 1
Miami Shores VillageT7-
Building Department 4' MAR 3® -2 15
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 `:
Tel:(305)795-2204 Fax:(305)756-8972 - - -
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 20
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.r C 15�_q=Z�0
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: (IDtoC,--r
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: V BFE: FFE:
OWNER:Name
^ r(Fee
Simple Titleholder): �" Phone#: CO3 •_ 7 PW'
! b
Address: �C6 kt i 1�/�b S�
City: N\l �S State: Zip:
Tenant/Lessee Name: Phone#:
Email: n
CONTRACTOR:Company Name: �/l is��� al u 4 Phone#: 2®r7 6 P/ /® �®
Address: '1 U c1 g A)Lj J S-T.
City: ON L®G(K A State: r_71 Zip:
Qualifier Name: Phone#:
State Certification or Registration#: 0} C®3 3 S'-j� Certificate of Competency#:
DESIGNER:Architect/Engineer: � —V,- Cep"v gCZ Phone#:
Address: City: State Zip:
Value of Work for this Permit:$ ()r Square/Linear Footage of Work: (oy I
Type of Work: Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: IggC. j C/-Fg-A(C-9_ M S v-k4 Lp Z
E&D Pac-T
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ L�1 -
(Rev1sed02/24/2014)
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 AJ, WJ9 &0Z1& Signature
OWNER or AGENT CONTRACTOR
T
ng instrum n was acl nowledged before me this The foregoing instrum nt was acknowledged before me this
day ofWQA. ,20 V5 by day of ,20 PS ,by
who is personally known to ecu ` (I-L Q7— who is personally known to
me or who has produced112 as me or who has produced�1= cel �42 as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Si
Print° Print:
Seal: "PL REBECA M.PASTRANA Seal:
Mx COMMISSION#EEST1624 'REBECA M.PASTRANA
N z EXPIRES:February 07,2017 MY COMMISSION#EESM24
EXi sRES•F&mary 07,2017
���R
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)