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MC-16-944 y Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-257141 Permit Number: MC-4-16-944 Scheduled Inspection Date:April 20,2016 Permit Type: Mechanical - Residential Inspector: Perez JanPlerre Inspection Type: Final II Owner: JENKINS, MARGARET Work Classification: Addition/Alteration Job Address:1700 NE 105 Street 204 Miami Shores,FL Phone Number Parcel Number 1122300500230 Project: <NONE> Contractor: EDD HELMS AIR CONDITIONING AND ELECTRIC Phone: (305)653-2530 Building Department Comments REPLACE WATER SOURCED HEAT PUMP Infractlo Passed Comments INSPECTOR COMMENTS False RENEWAL OF EXPIRED PERMIT MC 15-1354 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-256532 9543943352 DAVID JENKINS Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 19,2016 For Inspections please call: (305)762-4949 Page 38 of 46 I 7 Ia da i& t. Oyu � Miami Shores Village 10050 N.E.2nd Avenue NE Y Miami Shores,FL 33138-0000 �`' '• Phone: (305)795-2204a ' Expiration: 10/10/2016 Project Address Parcel Number Applicant 1700 NE 106 Street Number: 204 1122300500230 MARGARET JENKINS Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARGARET JENKINS 1700 NE 105 ST#204 MIAMI FL 33138-2139 Contractor(s) Phone Cell Phone Valuation: $4,330.00 EDD HELMS AIR CONDITIONING AND (305)653-2530 Total Sq Feet: 0 Tons: Available Inspections: Additional Info:REPLACE WATER SOURCED HEAT PUMP Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Review Mechanical Date Denied: Type of Work: Underground Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# MC-4-16-59335 DBPR Fee $2.27 04/08/2016 Credit Card $50.00 $128.09 DCA Fee $2.27 Education Surcharge $1.00 04/13/2016 Credit Card $ 128.09 $0.00 Notary Fee $5.00 Permit Fee $151.55 Scanning Fee $9.00 Technology Fee $4.00 Total: $178.09 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certi at II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fu e I aut a the above-named contractor to do the work stated. April 13,2016 Authorized Signarntm of / Applicant / Contractor / Agent Date Building Depent Copy April 13,2016 1 i Miami Shores Village 7BY Building Department PR 0 8 2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. / PERMIT APPLICATION Master Permit No. Permit Type:MECHANICAL �/� JOBADDRESS: /100 `� /05 z / f l 4 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11_Z2-30`o.�n — n2—. n Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Tifleholder): af 41as 4/asPhone# °'/Ls6_1'(z . Address: _ 0 d V City: Adaeau sU _s State: Ar &3f3 ff TenandUssee Name: Phone#: Email: CONTRACTOR:Company Name: c dMS ITCH Phone#: —c?s3o Address: City: /W)1) State• Zip: ._3;�W= Qualifier Name:A&,® 22� / Q-�(� Phone#: State Certification or Registration#: C2 3l!! Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ ��® Square/Linear F tage of Work: Type of Work: DAddress OAlteration ONew 3epair eplace (]Demolition Description of Work: ct, HC Submittal Fee$ 156.`00 Permit Fee$ rte, I CCF$ �' CV CO/CC$ Scanning Fee$ '� Radon Fee$ �. d'� DBPR Bond$ Notary$ J"& Tmining/Education Fee$ Technology Fee$ ° Double Fee$ Structural Review$ _ T TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) Bonding Company's Address CiLy 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 theP erson whoseroe is subject to attachment.p p rtY / Also a certified caPY of the-recorded notice of commencement must be posted at the job site first inspection which occurs seven for the fiP (7) dot's 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. A ' Signature Signature OWNER or AGENT CONTRACTO The foregoing instrument was acknowledged before me this The fore oing instrument was acknowledged before me this day Y of 20 ,/ b j ,w �t�, Y �day of l� 20 � l!/ .by N ,p t•v t� L y! 1�w o is personally known to lr,,',,Avco ersonall known to �� C/� p Y me or who has produced �piu me or who has produced �-`— p ced as identification and who did take an oath. identification and who did take an oath. NOTARY P LIC: NOTARY PUBLIC: Sign Sign. Print: S`NC ��P� Print: fY STACY CUSAN Seal: av P4'F Nota Public State of Fierida Seal: ` s!` fie '1' �- d+• EXPIRES August 30,2018 Sind ia Aluar?z - oQ My Commission FF ISO 0 (407)3980153 FloridallotaryService.com CW Expires 09/03/2018 APPROVED11 in's BY v IExaminer Zoning Structural Review Clerk (Revised02/24/2014)