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MC-16-641 /5- Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-258489 Permit Number: MC-3-16-641 Scheduled Inspection Date:June 08,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: LEVY, RAPHAEL Work Classification: New A/C System Job Address:10276 NE 12 Avenue Miami Shores, FL 33138- Phone Number 3051758-9065 Parcel Number 1132050190020 Project: <NONE> Contractor: METROPOLITAN AIR CONDITIONING INC Phone: 305-264-4646 Building Department Comments NEW INSTALL OF 2 TON AC UNIT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-254487. Failed Correction Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid .lune 07,2016 For Inspections please call: (305)762-4949 Page 13 of 36 Miami Shores Village 10050 N.E.2nd Avenue NES € Miami Shores,FL 33138-0000 Phone: (305)795-2204v> ' „ . ... Expiration: 09/12/2016 Project Address Parcel Number Applicant 10276 NE 12 Avenue 1132050190020 Miami Shores, FL 33138- Block: Lot: RAPHAEL LEVY Owner Information Address Phone Cell RAPHAEL LEVY 10276 NE 12 Avenue 305/758-9065 3051812-3637 MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone Valuation: $4,000.00 METROPOLITAN AIR CONDITIONING 305-264-4646 Total Sq Feet: 0 Tons:2 Available Inspections: Additional Info:INSTALL 2 TON Inspection Type: Classification:Residential Final Approved:In Review Rough Duct Comments: Date Approved::In Review Review Mechanical Date Denied: Type of Work: Review Mechanical Scanning:1 Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# MC-3-16-58979 DBPR Fee $2'10 03!10/2016 Credit Card $50.00 $103.60 DCA Fee $2.10 Education Surcharge $0.80 03/16/2016 Check#:4157 $103.60 $0.00 Permit Fee $140.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $153.60 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 rk done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to th k s March 16,2016 Authorized Signature:Owner / Applicant / Contractor ! Agent Date Building Department Copy March 16,2016 1 Miami Shores Village Building Department MAR 102016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20f"I $44'` BUILDING (waster Permit No. f C—j5-2-4C��' PERMIT APPLICATION Sub Permit No. m G b " CO`{I F-1131.111-DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING 2f MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: k O 91(o k4E \of 4c)W, City: Miami Shores County: Miami Dade Zip: 361'56% Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#-a/ Address: O P4C City: MI Aral t4t®TZF�S State: Zip: 3:�\34� Tenant/Lessee Name: Phone#: Email: f I2ytl cam CONTRACTOR:Company Name: H£-WLi " Imo.. .. Phone#:<3Qr-A( Q-,4(Oy(o Address: (24 i'l nlA-) SO . S*- City: V-4,106-4 State: '�1. Zip:._ 33((060 Qualifier Name: (n Q082Q�- Phone#: State Certification or Registration#: CA&D143ci Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address• ''// City: State: Zip: Value of Work for this Permit:$ V, Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: L$' 10. f1 p�' Q F Specify color of color thru tile: Submittal Fee$ �v Permit Fee$ ` CCF$ ' y C) CO/CC$ 0 Scanning Fee$ Radon Fee$ a �� DBPR$ I Notary$ Technology Fee$ Training/Education Fee$ b Double Fee$ Structural Reviews$��_ Bond$ O� TOTAL FEE NOW DUE$ (Revised02/24/2014) V_ 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature, Signature OWNER or AGENT CONTRACTOR The ffoorgoing instrume t was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 J by day of �1C C,�1 .�20 1 ( ,by -e who i ersonally kno to UA OW- Oo�s2i��.who is personally known to I C2me or who has produced as me or who has produced Pas identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign' Print 96KCrtyPrint Seal: " •. AI.EJANDRA MNlAIIDA Seal: Notary P blic state of Florida j$ Ileans Rodriguez MY COMMISSION 8 PF9Z9798 MY Comma �` 6Pbes 03/116[c i�2474 EXPIRES Dam 18,2018 r2o17 :.OV :ka9t53 R .o0fi �� APPROVED BY 4,Vtis Examiner Zoning Structural Review Clerk (Revised02/24/2014)