MC-16-2511 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-267115 Permit Number: MC-9-16-2511
Scheduled Inspection Date: October 31, 2016 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre Inspection Type: Final
Owner: ALPHONSO MARTIN,JAMES MILLS Work Classification: A/C Replacement
Job Address:102 NE 107 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1121360070240
Project: <NONE>
Contractor: GMC AIR CONDITIONING SERVICES Phone: (954)973-5980
Building Department Comments
REPLACE EXISTING 3 TON A/C SYSTEM, RELOCATE Infractio Passed comments
AIR HANDLER TO GARAGE. REPLACE EXISTING 15000 INSPECTOR COMMENTS False
BTU WALL A/C UNIT WITH 1.25 TON MINI SPLIT
SYSTEM
14 VV
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 28,2016 For Inspections please call: (305)762-4949 Page 13 of 31
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s«� Miami Shores Village # #xtlt E�Che yes
10050 N.E.2nd Avenue NE Cf> eSC A/+C �t�°kRt
Miami Shores,FL 33138-0000
h � Phone: (305)79522040.
PBl7�xa&� AF ''
12i}1�i Expiration: 03/28/2017
Project Address Parcel Number Applicant
102 NE 107 Street 1121360070240
JAMES MILLS ALPHONSO MAR'
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
JAMES MILLS ALPHONSO MARTIN 102 NE 107 ST
MIAMI SHORES FL 33161-7032
Contractor(s) Phone Cell Phone Valuation: $ 24,675.00
GMC AIR CONDITIONING SERVICES (954)973-5980_....._._..._ _. _. _...... .... _ .__ .-._ ........ Total Sq Feet: 1972
Tons:4.25 Available Inspections:
Additional Info:REPLACE EXISTING 3 TON A/C SYSTEM, Inspection Type:
Classification:Residential Final
Approved:In Review Review Mechanical
Comments: Date Approved::In Review Review Electrical
Date Denied: Type of Work:
Scanning:4
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $15.00 Invoice# MC-9-16-61295
DBPR Fee $12.96 09/29/2016 Check*23443 $891.55 $50.00
DCA Fee $12.96
Education Surcharge $5.00 09/12/2016 Credit Card $50.00 $0.00
Permit Fee $863.63
Scanning Fee $12.00
Technology Fee $20.00
Total: $941.55
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 foregoin 'nfo ation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore ori b -named contractor to do the work stated.
1 September 29,2016
Auth ig ure:Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 29,2016 1
Ko Miami Shores Village
Building Department ; SEE 1 - 2016
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 1
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER.(305)762-4949 VVV
FBC 20
BUILDING Master Permit No. me
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING 0 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 102 N.E. 107Th Street
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2136-007-0240 Is the Building Historically Designated:Yes NO
Occupancy Type: Sgl Fmly Load: Construction Type: Block Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):James Mills &Alphonso Martin Phone#:786-239-7091
Address.102 N.E. 107Th. Street
City: Miami Shores State: Florida Zip: 33161-7032
Tenant/Lessee Name: N/A Phone#:
Email:jamie102107@bellsouth.net
CONTRACTOR:Company Name: GMC Air Conditioning Services Phone#: 954-973-5980
Address. 2301 N.W. 30Th. Place
City: Pompano Beach State: FI Zip: 33069
Qualifier Name: John Flathe Phone#: 954-973-5980
State Certification or Registration#: CAC1816335 Certificate of Competency#:
DESIGNER:Architect/Engineer: N/A Phone#:
Address..N/A IL f City: N/A State: Zip:
Value of Work for this Permit: Square/Linear Footage of Work: 1972
Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace ❑ Demolition
Description of Work: Replace existing 3 ton A/C system, relocate air handier to garage
Replace existing 15,000 BTU wall A/C unit with 1.25 Ton Mini Split system
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ epi'G3 • CCF$ 00 CO/CC$ J,.
Scanning Fee$J Z •Q) Radon Fee$ 12,9G DBPR$ G Notary$
Technology Fee$ 20° 0S), Training/Education Fee$ E3-o C00 Double Fee$ .0
Structural Reviews$ Bond$ 0
TOTAL FEE NOW DUE$ I • S5
(Revised02/24/2014)
s
Bonding Company's Name(if applicable) N/A
Bonding Company's Address N/A
City N/A State Zip
Mortgage Lender's Name(if applicable) N/A
Mortgage Lender's Address N/A
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 t he issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy / e notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to a ent. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspect hic curs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection w' n e and a reinspection fee will be charged.
Signat a Signature
WONr CONTRACTOR
The for instrume was acknowledged before me this The foregoing instrument was acknowledged before me this
OR
01 ' day ofWL— 20 I by day
day of,,,�=T � 20 I( by
�A/�6 ��^� ,who ispeerssonally known to ��Q a/!' �� � who is personally known to
me or who has produced L Xt— as me or who has produced?4WO �1 1s�� as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: p_Al rAUAJy Print: Nr(at-,;7W A% AXA 6O �—
Seal: MW B.FAR1100,•1R Seal: atolskFARMAS,JR.
W COMIYnSSION I EE NWI MY COWSSIM I EE NMI
EXPIRES:April 25,2017 = EXPIRES:Aprfl 25,2017
Bonded Thm Notary Public UndBnAdters �ilf��t Bonded Thru Notary Public Undenvrirers
�k �k * *xc**�k* �k�kx�*** s<*s<* ** ** **ak+e*�x*
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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