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MC-17-2178Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-288703 Permit Number: MC -8-17-2178 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 CHANGE OUT 7 112 TON SYSTEM IN LADIES LOCKER ROOM Infractio Passed Comments INSPECTOR COMMENTS False L2-16 I 7 Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments December 05, 2017 For Inspections please call: (305)762-4949 Page 9 of 33 C,5; -�.4 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 10000 BISCAYNE Boulevard Miami Shores, FL Owner Information Permit Permit NO. MC -8-17-2178 Permit Type: Mechanical - Commercial Worts Classification: A/C Replacement Permit Status: APPROVED Issue Date: 9/2912017 Expiration: 03/28/2018 Address Parcel Number 1132050200010 Block: Lot: Applicant MIAMI SHORES VILLAGE Phone Cell MIAMI SHORES VILLAGE Contractor(s) SUN STATE MECHANICAL, INC Phone (954)962-1240 CeII Phone Valuation: Total Sq Feet: $ 8,300.00 0 Tons: 7 1/2 Additional Info: CHANGE OUT 7 1/2 TON SYSTEM IN LADI Classification: Commercial Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved: : In Review Type of Work: CHANGE OUT 7 1/2 TON SYSTEM IN Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $5.40 $4.36 $4.36 $1.80 $5.00 $290.50 $9.00 $7.20 $327.62 Pay Date Pay Type Invoice # MC -8-17-65014 09/29/2017 Check #: 7336 $ 277.62 $ 50.00 08/29/2017 Check #: 7293 $ 50.00 $ 0.00 Amt Paid Amt Due 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 myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, P , MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS constructi at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating re, I author, e the above-named contractor to do the work stated. September 29, 2017 Auth."i . Signature: er / Applicant / Contractor / Agent Building Dep- rtment Copy Date September 29, 2017 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑PLUMBING MECHANICAL 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 ❑ ROOFING El PUBLIC WORKS JOB ADDRESS: /611900 /J %t �JA✓/� City: Miami Shores /County: Master Permit No. Sub Permit No. ❑ REVISION RECEIVED AUG 2 91017 .S.h C4444 FBC 20ILA Vt 17-) -21R g D EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONT CTOR DRAWINGS Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: COUcam/ `� GWS -- OWNER: Name (Fee Simple Titleholder): / 7 //9"1, / \C /C Phone#: �d '-75� 2 Address:/00 S r) .(i/�Li� City: "/fa -1 J' State: f Zip: 7k19 Tenant/Lessee Name: Phone#: Email: / 9 CONTRACTOR: Company Name: \C‘,/,(1. - /49 ,/� %y%�(i/I , �` ' Phone#: fr7 Yod` Address: S"7D(> S 41-/ 02 (s< � 197 - S / Y1 City: w�S % /9�� > J,�State: �G� Zip: � �3 Qualifier Name: (TIG d /v � /7 G Phone#: Icy 2 7,2 /% ior Registration #: C C Certificate of Competency #: State Certification � 0 � � c�v�-� p cy DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ cP-Sec) Type of Work: ❑ Addition D Alteration Square/Linear Footage of Work: ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 1/ / j' /� C/1--- �2 1_ y 0,A-6'1 1-7,4 4%e -/e/ JJo— Specify color of color thru tile: �O , Submittal Fee $ Permit Fee $ CJ t/CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 3:;, DBPR $ 436 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ G �I . G2..., (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 t e e of such posted notice, the inspection win not be approved and a reinspection fee will be charged. Signature / A # OWNER or AGENT The foregoing instrument��ttnt�was acknowledged before me this day of �,'f UST , 20 1 R , by (Sh1�tV , who is personally k to me or who has produced as identification and who did take an oath. NOTARY P + :1LIC: ' Sign: Sign: Print: CZ7��-a�z Print: Signature CONTRACTOR The foregoing instrument was acknowledged beforerme this Z:re1 day of�p'ChAU , 20 L� , by ` ► 1-e ' who is personally (k'n�wn to me or who has produced 1 an Id's. as identification and who did take an oath. NOTARY PUB . : L, , .t -.r y y , Seal: "A et' '0 Notary Public State's =',,ida . Seal: °). ? : Sindia Alvarez { < My Commission FF S„ K, F or n# Expires 09/03/201F t APPROVED BY (Revised02/24/2014) A . J.. ..P...,' PI `s"Exa finer Structural Review Zoning Clerk • • • • • r • • • • • •• • • • • • ••• • • • "• • • • • • • ••• • • ••••• • • • • • • • •• ••. • • ., . •• •• • • • • ••• • • ••. • ••. . AIR CONDIyIQmIN§•REPLAbEMENT DATA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): /d D(, v 12 City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH. SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES NO ARHI Sheet Attached: YES NO 0 Contract Attached: YES 0 UNIT BEING REPLACED DATA NEW UNIT gjlfl GQ,Q/G/7 MANUFACTURER -llit G/9R i/.yn AHU or PKG. UNIT MODEL # I( - 0.7d 2- COND. UNIT MODEL # //Aki G -© 4- KW KW HEAT /gyp NOM TONS 7 '/2._- AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / /PKG UNIT / / 6. --EER 6/, , YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT 6,1NO YES NO NEW 4"CONCRETE SLAB YES 0 YES NO NEW ROOF STAND YES dISY YES NO NEW RETURN PLENUM BOX YES 0 1. Minimum Circuit Ampacity (Wire Size): /-/(l/i 2. Maximum Overcurrent Protection (Fuse/Breaker Size): CDwr, ed/s--) 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: r / Contractor's Company Name: -�/� -('/i1 �? � t • State Certificate or Re/ ratio Signature _4,1_, (Revised02/24/2014) (Qualifier' gna Phone: / y%L X1'2 Certificate of Competency No. Date: .2 ��- /7 4 . ,w .� • . A.9RCERTIFIEb , . www.ahridirectory-.org , .;., • � ;r" • •• • • • • • - •• •• ••• ••• .... 20x0114 25 • Z_tR!0 • • � • • •• • • : • • • • • • • • •• •• Certfficate of Pead�•r• •• • • • • aatoo�i•ls AHRI Certified Reference Number: 30'1831; •;