MC-17-2177Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-288701
Permit Number: MC -8-17-2177
Scheduled Inspection Date: December 06, 2017
Inspector: Perez, JanPierre
Owner: VILLAGE, MIAMI SHORES
Job Address: 10000 BISCAYNE Boulevard
Miami Shores, FL
Project: <NONE>
Contractor: SUN STATE MECHANICAL, INC
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1132050200010
Phone: (954)962-1240
Building Department Comments
MISC CHANGE OUTS 12
1
Infractio
Passed Comments
INSPECTOR COMMENTS
False
V - i 2Vg / /
Inspector Comments
Passed
(0'
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
December 05, 2017
For Inspections please call: (305)762-4949
Page 8 of 33
Project Address
10000 BISCAYNE Boulevard
Miami Shores, FL
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
mit
Permit NO. MC -8-17-2177
Permit Type: Mechanical - Commercial
Work Classification: AIC Replacement
Permit Status: APPROVED
Issue Date: 12/5/2017
Expiration: 06/03/2018
Parcel Number
1132050200010
Block: Lot:
Applicant
MIAMI SHORES VILLAGE
Owner Information
Address
Phone
Cell
Contractor(s) Phone
SUN STATE MECHANICAL, INC (954)962-1240
Cell Phone
Valuation:
Total Sq Feet:
$ 48,000.00
0
Tons:
Additional Info: MISC CHANGE OUTS 12
Classification: Commercial
Approved: In Review
Comments:
Date Denied:
Scanning: 3
Date Approved: : In Review
Type of Work: MISC CHANGE OUTS 12
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$28.80
$21 60
$21.60
$9.60
$5.00
$1,440.00
$9.00
$38.40
$1,574.00
Pay Date Pay Type
Invoice # MC -8-17-65013
08/29/2017 Check #: 7293
12/05/2017 Check #: 7459
Amt Paid Amt Due
$ 50.00 $ 1,524.00
$ 1,524.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Mechanical
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 yself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing info
construction and zoning. Futhermore, I authorize the abov
and that all work will be done in compliance with all applicable laws regulating
to dot rk stated.
Authorized Signature: Owner / Applic. t / C
Building Department Copy
December 05, 2017
Date
December 05, 2017 1
BUILDING
PERMIT APPLICATION
ElBUILDING ❑ ELECTRIC
El PLUMBING MECHANICAL
JOB ADDRESS: A d 6v
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type::,/ ,rFlood Zone: BFE: -7FFE:
OWNER: Name (Fee Simple Titleholder): n/7///tr�is1, \C -Ane I'''it, 1z Phone#: _< / 5 2-207Address: 10 v ( d A., 2 /¢,/a
fiZ
City: //fit f J ti -t State: �2i4 Zip:
Tenant/Lessee Name: Phone#:
Email:
Miami Shores Village
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
Master Permit No.
❑ ROOFING ❑ REVISION
PUBLIC WORKS ❑ CHANGE OF
f CONTRACTOR
p/s6jti ,Q
RECEIVED
AUG 29 2017
S1-1C)ie"'
FBC 20.1
Sub Permit No.
EXTENSION ❑ RENEWAL
CANCELLATION ❑ SHOP
DRAWINGS
CONTRACTOR: Company Name: �l//(/,f/•i . M 11--;e7 2
Phone#: 9r@ T 7— /2�7
Address: \j '/' •d ev f r59---
�8Af -
City: (d- Ef 7 / 4414 6-, State: rZip: 9,r'&23
V'"
Qualifier Name: 4 49-c d^
Phone#: 7 (7— J 1'/ 7 /-2/
State Certification or Registration #: C g Gd 2 9'1 022_ Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:[[�� ((�� City: State: Zip:
Value of Work for this Permit: $ 7d / UD Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Al /..r6 / C, -s®d/4
/2— 6 , 7.r.J
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ V\ ik 0 . uV CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I 5 2 `i • CO
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
'Z,1 day of 40, O , 20 __ by ZQ day of , 20 ` , by
1-0V\ , who is personally known to
me or who has produced I as
identification and who did take an oath.
me or who has produced
is personally known to
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print: NV(1,
••• .-••• er-v-s Y'Yv n' vY'
Seal: >. o,.rno
•
rte`.
ort‘
******************ie'~#*
APPROVED BY
(Revised02/24/2014)
Sign:
Print:
Notary Public State of 7'nnda d Seal:
Sindia Alvarez
My Commission FF 1 ;"" s +,
Expires 09/03/2018
as
'ijnN MAHARAI K. GONZALEZ
MY COMMISSION # GG 044602
•v; EXPIRES: November 2, 2020
,gyp ..t t" Bonded Thru Notary Public Underwriters
****s*s*►*#tae********************************************************
ii
an Examiner
Zoning
Structural Review Clerk
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