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MC-15-2527 V- l&- b0 Inspection Worksheet L Miami Shores Village LL 10050 N.E.2nd Avenue Miami Shores,Fl- Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-244922 Permit Number: MC-10-15-2527 Scheduled Inspection Date:April-13,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: CARLA GRISONI,CANOR PATO Work Classification: Addition/Alteration Job Address:162 NW 109 Street Miami Shores,FL 33168.4317 Phone Number Parcel Number 1121360100220 Project: <NONE> Contractor. AIR SYSTEMS AIC LLC Phone: (786)208-3484 Building Department Comments MECH WORK FOR GARAGE CONVERSION AS PER tnfractio Passed Comments PLANS INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. April 12,2016 For Inspections please call: (305)762.4949 Page 12 of 49 Miami Shores Village 10050 N.E.2nd Avenue NW Miami Shores,FL 33138-00003 Phone: (305)795-2204 � a Expiration:0 13/2016 Project Address Parcel Number Applicant 162 NW 109 Street 1121360100220 CANOR PATO CARLA GRISONI Miami Shores, FL 33168-4317 Block: Lot: Owner information Address Phone Cell CANOR PATO CARLA GRISONI 162 NW 109 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $4,900.00 AIR SYSTEMS A/C LLC (786)208-3484 Total Sq Feet: 0 Tons: Available Inspections: Additional Info:MECH WORK FOR GARAGE CONVERSION AS 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 $3.00 Invoice# MC-10-15-57319 DBPR Fee $2'57 10/05/2015 Credit Card $50.00 $137.64 DCA Fee $2.57 Education Surcharge $1.00 10/16/2015 Credit Card $137.64 $0.00 Permit Fee $171.50 Scanning Fee $3.00 Technology Fee $4.00 Total: $187.64 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 ce that all the foregoing information is accurate and that all work will be done in compliance with all applicable taws regulating construction and zoning. F xpermore,I authorize the above-named contractor to do the work stated. October 16,2015 Authorized Si ature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 16,2015 1 •r A Miami Shores Village OCT 2015 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 T4 FBC 20 BUILDING Master Permit No 5-10 2- PERMIT PERMIT APPLICATION Sub Permit Not&(S - ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP r G� CONTRACTOR DRAWINGS JOB ADDRESS: I V Z PW City: Miami Shores County: Miami Dade Zio• Folio/Parcel#: _r ZI 3 L 0)0 CZZo Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: /� BFE: FFE: OWNER:Name(Fee Simple Titleholder): (. AI;,�. PATO Phone#:�� Address: 2.- City: 4kaftl/6kA St�rw& State: Zip: 33r Tk Tenant/Lessee Name: f" 1 ! Phone#: Email: // / J CONTRACTOR:Company Name: Air -S( S�2 N/ 3 TC_ u (, Phone#: -:Z 10 15 Address: UW 133 City: 04SL�,b,. State: f Zip: ..3 S Ll Qualifier Name: Phone#:-490,S (.a r0 q� State Certification or Registration#: 6 t'( Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: / City: State Zip: Value of Work for this Permit:$��[�.— Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration 1:1 New ElRepair/Replace ❑ Demolition Description of Work: &'bleg /iv(Z Ce;!Y V/ C(M) MZ-� C Specify col%�color thru tile: Submittal Fee$ ` Permit Fee$ e CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$. a (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. ignatur Signature OWNER o AGENT CONTRACTOR The foregoing instrument was ackn wledged before me this The foregoing instrument was acknowledged before me this day of 0C_-'1a ,20 by day of ��t'b1(acr�- ,20 /� by CA:e�- 10AA-0 —,who is personally known to ho is personally known to me or who has produced .- &J L6- as me or who has produc d as identification and who did take an oath. identification and who did take an oath. NOTARY P UC: NOTAR PUBLIC: r� Sign: Sig Print: aS Print• Seal: ,p°` ' e,REBECA M.PASTRANA Seal: REBECA M.PASTRANA � MYCOMMISSION#EE872624 MY COMMISSION#EESM24 a EXPIRES:FeXuary 07,2017 °�� EXPIRES:February 07,2017 APPROVED BY I/ 4ns Examiner Zoning Structural Review Clerk (RevisedO2/24/2014)