MC-16-2105 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-264173 Permit Number: MC-7-16-2105
Scheduled Inspection Date: September 19,2016 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre
Inspection Type: Final
Owner: GRIMBERT, DAVID AND MEGHAN Work Classification: Addition/Alteration
Job Address:824 NE 100 Street
Miami Shores, FL Phone Number (305)323-7700
Parcel Number 1132060340050
Project: <NONE>
Contractor: REGOSA ENGINEERING SERVICES INC Phone: (786)262-2964
Building Department Comments
EXHAUST FAN FOR MASTER BATHROOM. Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 16,2016 For Inspections please call: (305)762-4949 Page 15 of 39
x
MC-746-210V
Miami Shores Village M 1 0 �� nye x0144 ,6 RO dential
r 10050 N.E.2nd Avenue NE
Miami Shores,FL 33138 0000 �k b* ' �� J� t� " tfign.`
l�ilFQw/ APP
1F
�Ft"ox �e Phone: (305)795 2204 .: = . .
819/2'016 Expiration: 02/05/2017
Project Address Parcel Number Applicant
824 NE 100 Street 1132060340050 DAVID AND MEGHAN GRIMBER' 'I
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
DAVID AND MEGHAN GRIMBERT 253 NE 92 Street (305)323-7700 (305)505-7750
MIAMI SHORES FL 33138-
253 NE 92 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 350.00
REGOSA ENGINEERING SERVICES IIS (786)262-2964 (786)344-8720
_......_.,,.,. . ..._ .. _._.. .. _ ............ . ......_ .w_.....,. . Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:EXHAUST FAN FOR MASTER BATHROOM. Inspection Type:
Classification:Residential Final
Approved:In Review Rough Duct
Comments: Date Approved::In Review Review ]]E]�EEJ
Mechanical
Date Denied: Type of Work: Underground
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# MC-7-16-60756
DBPR Fee $2.25
DCA Fee $2.25 08/09/2016 Credit Card $ 164.10 $0.00
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $164.10
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,MECHANIC L,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: 1 th he fo going i formation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and;a g. Fu aut a above-named contractor to do the work stated.
August 09, 2016
Author' re:Owner / App cant / Contractor / Agent Date
B i in Copy
August 09,2016 1
Miami Shores Village
Building Department JUL 2 6 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 By: _
Tel:(305)795-2204 Fax:(305)756-8972 _11
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC20
BUILDING Master Permit No. RC (G—
PERMIT APPLICATION Sub Permit No. W_C(-- 2.105
BUILDING ❑ ELECTRIC ROOFING ❑ REVISION EXTENSION EJRENEWAL
PLUMBING FE-] MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 824 NE 100 STREET
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-034-0050 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):GRIMBERT DAVID Phone#:
Address:252 NE 92 STREET
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: REGOSA ENGINEERING SERVICES, INC Phone#: 786-262-2964
Address: 15700 NE 2 AVE
City: MIAMI State: FL Zip: 33162
Qualifier Name: GUSTAVO VELEZ Phone#: 786-262-2964
State Certification or Registration#: CMC-1249755 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,® New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ ® CCF$ CO/CC$
Scanning Fee$ c� Radon Fee$ DBPR$ oLs 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 excee ' $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochur wi be delivered to the person
whose property is subject to attac ment. Also,a certified copy of the recorded notice of commencem nt m st be posted at the job site
for the first inspection which oc rs seven (7) days after the building permit is issued. In the a enc e of such posted notice, the
inspection will not be approved d qleinspectic n fee will be charged.
Signature Signature
i OW ER or AGENT R
The foregoing instruent was acknowledged before me this The foregoing instrument was acknowledged before me this
day of J v I�/ 120 Icy ,by 5 day of JULY . 20 16 b
personally known to GUSTAVO VELEZ who' sonally known to
me or who has produced l lceo44s" me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC NOTARY PUB
Sign: Sign:
Print: �'((� kp, G�—u V- Print: LDC$
fy,,�rI3 Seal: MY COMMISSIt7N d FF203458
gY A{,6Notary Public State of Florida Seal: EXPIRES March 22,2019
Sindia�.l�rar�=z r oPAy orrmission FF 156750 rPlundallota ySe ice,can'
Expires 09/03,'2018
APPROVED BY
)ks Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)