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MC-15-2121 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241820 Permit Number: MC-8-15-2121 Scheduled Inspection Date: February 01, 2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: SERDA,WILLIAM Work Classification: A/C Replacement Job Address:8739 NE 4 Avenue Road Miami Shores, FL Phone Number Parcel Number 1132060460850 Project: <NONE> Contractor: DYNAMIC AIRFLOW CORP Building Department Comments EXACT CHANGE OUT Infractio Passed Comments INSPECTOR COMMENTS False V Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 29,2016 For Inspections please call: (305)762-4949 Page 9 of 36 v NO Miami Shores Village PB yjfe: Cr )ca ' R sidentis 10050 N.E.2nd Avenue NE wot;#aSStalftrAl �t1 : -• ""` Miami Shores,FL 33138-0000 � �itStaf:A PRC 11ED h e ,� Phone: (305)795-2204 ' FCOR'lD� A tssueate:8t2712€1 Expiration: 23/2016 Ad Project Address Parcel Number Applicant 8739 NE 4 Avenue Road 1132060460850 WILLIAM SERDA Miami Shores, FL Block: Lot: Owner Information Address Phone Cell WILLIAM SERDA 463 NE 100 ST MIAMI FL 33138-2446 Contractor(s) Phone Cell Phone Valuation: $ 2,800.00 DYNAMIC AIRFLOW CORP € .. _. _ Total Sq Feet: 0 I' Tons:3 Available Inspections: Additional Info:EXACT CHANGE OUT Inspection Type: Classification:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# MC-8-15-56786 DBPR Fee $2.00 DCA Fee $2.00 08/20/2015 Credit Card $50.00 $67.80 Education Surcharge $0.60 08/27/2015 Credit Card $67.80 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $117.80 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 II t fo going information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermor ,I i e the above-named contractor to do the work stated. August 27, 2015 Authorized Signature: n Applicant / ontracto / Agent Date Building Department Copy August 27,2015 1 Miami Shores Village Building Department ,AUG 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 t INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 J BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ® MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP p t� ,�/ CONTRACTOR DRAWINGS JOB ADDRESS: C� [3 f� !Y C� (z r14 A el&IBJ u4!F— A lb City: Miami Shores County: Miami Dade Zia• 3318 Folio/Parcel#: // —32&& O aS-(7 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder) s L L /A M e SEI D� , Phone#: 3 0-r 1) 8s- 116 b Address: V-63 itl46 10 el :S7- City: iCity: &-MAS rjV4vA'6-*J s State: l=/- Zip:�.�/.�S Tenant/Lessee Name: LIQ DO /V"A MQ/1E-C.y Phone#:-To-r" 14.7-0300 Email: L 04WX"%-Ak (AJ C.XC— MPA 6)A0L < <'.OX4 CONTRACTOR:Company Name: YAJ A /LL l C A L Ir-7LG w Phone#:-?*X- s<O fCo a t� Address: 427 9 S16-f T�' ! Ci Y: Cit �� �),17� �lQ, P State:_�/ Zip: c Qualifier Name: / - S&I c�hra-7 Phone# 2425 State Certification or Registration#: r, Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ;?Soo Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Re lace p El Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ 0 v C J Permit,Fee$ L C./ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature a 0. Lea- Signature 19 OWNER or AGENTO ACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of tU Gy 20 1 by day of Au(,()'5,7 20 (` by VJ)U 100 C` ST-QMF\ GC,who is personally known to Al2AS$( V-JJ A`bA:11 lho is personally known to me or who has produced � l (,tO N•rE as me or who has produced�� �� C-F) identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: : pt6Y° Notary Pus,lic State of Florida o� °�e Notary PUNIC tato n a Seal Sindia Alvarez Seal: �; Sindia Alvarez y `* M Commission FF 158750J My Commission FF 186750 so o9103l201,5 p�dtC� Expires 0910312018 APPROVED BY �Jalns Examiner Zoning Structural Review Clerk (Revised02/24/2014) b `SMORES Miami Shores Village Building Department ■• �■■•I" 10050 N.E.2nd Avenue Miami Shores, Florida 33138 xCpRipp 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 sheets are not acceptable. Job Address(where the work is being done): AIL Ar/ W/0 City: Miami Shores Village County: Miami Dade Zip Code: 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 AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO ❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER ff-h ", ,w AHU or PKG. UNIT MODEL#Aikp COND. UNIT MODEL# KW HEAT 15, NOM TONS AHU CU PKG 1)M.C.A AHU a.CXU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER / YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT E NO YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): /10 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 30 3. Voltage of Circuit(208/240/480): 410 4. Size Disconnecting Means: Contractor's Company Name: b�4z&lv AOL Phone �:�Z 6iQ( 2c; i State Certificate or Registration No. ( � `�7 Certificate of Competency No. Signature Date: a gnat e) (Revised02/24/2014)