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)