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MC-17-317 tis�*O1s°,t Miami Shores Village C7 / . I �t1i '_: $►I �tnt� l �. 10050 N.E.2nd Avenue NE Cas$rWcabon:AIC ReplAcert rit Miami Shores,FL 33138-0000 E PermitStat .-APP OV1 Phone: (305)795-2204 FcoRw� Expiration: 08/12/2017 Project Address Parcel Number Applicant 107 NE 91 Street 1132060133300 Miami Shores, FL 33138- Block: Lot: MARC MACHICOTE Owner Information Address Phone Cell MARC MACHICOTE 107 NE 91 Street (305)608-2306 MIAMI SHORES FL 33138- 107 NE 91 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 7,533.50 AIR SOLUTIONS AND REPAIRS LLC (844)566-5247 Total Sq Feet: 0 Tons:5 Available Inspections: Additional Info:A/C CHANGE OUT 5 TON Inspection Type: Classification:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work:A/C CHANGE OUT 5 TON Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4,80 DBPR Fee Invoice# MC-2-17-62870 $3.95 02/13/2017 Check#:2748 $243.35 $50.00 DCA Fee $3.95 Education Surcharge $1.60 02/07/2017 Check#:2747 $50.00 $0.00 Permit Fee $263.65 Scanning Fee $9.00 Technology Fee $6.40 Total: $293.35 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 r nsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,P B G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: cert' tha the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni F I authorize the above-named contractor to do the work stated. February 13,2017 Author' ed Si ra�rtrment wner / Applicant / Contractor / Agent Date Building're Copy February 13, 2017 1 Miami Shores Village � .. � - '� �,�• Building Department -EB 7 2017 S VV 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 s �� FBC 2011.1 BUILDING Master Permit No. M C (� PERMIT APPLICATION Sub Permit No. F-1131.111-DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING CR MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP A.� �+, CONTRACTOR DRAWINGS JOB ADDRESS: Ica nr `SLI City Miami Shores County Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: pb Construction Type: ^ Flood Zone: BFE�:nr- FFE: t_ OWNER:Name(Fee Simple Titleholder): McAm_ , , oi r-n.`loPhone#: Address: l® Mr. �Q k `JT- City: "lC�jy4 `�-� a J rec-.> State: 4_I Zip: Tenant/Lessee Name: Phone#: Email: nn 1 ,L /��. `�111r �I CONTRACTOR:Company Name: /�►11r� �tJT�O�� W%(S _Phone#: oA—,CJW " LP_ Address: '50(OQ L�,W :14AV4e-- City: {M X0V +%t•^ State: Zip: � Qualifier Name: �V Y ` � ������i�n Phone#: State Certification or Registration#: Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: �t LL 1 City: State Zip: Value of Work for this Permit:$ ` "J�"J • CJ® Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New EO Repair/Replace \ El Demolition Description of Work: C✓t• ><u��e QQ_t S TOW_- VI f'A Specify color of color thru tile: 11101 Submittal Fee 1. ' Permit Fee$ 2 i CCF$ �/. �� CO/CC$ Scanning Fee,% 45�1Radon Fee$ 3" 9S DBPR$ �S Notary$ Technology Fee$ 60'Ct b Training/Education Fee$ `' d Double Fee$ Structural Reviews$ Bond$ � TOTAL FEE NOW DUE$ r I�-1 s (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 an a reinspection fee will be charged. Signatur Signature OWNER or AGE T CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 300asl '20 by day of J 20 ,by who is personally kn n to �CL8 Ac :;W J IO lnwho is personally known to me or who has produced �r �'"'j�Un as me or who has produced as identlifi ,on and who did tak a oath. identification and who did take an a h. NOTBLIC: NOTAR UBLIC: Sign: Sign: ,/�PrintPrint: Y `�� "" Seal: may ., Dunia La Seal: Duma Lopez r`- �✓ COQ� .4 EV is.OWN �� INMtsSiORt Aft239b40 Jiaie 10.2019 S EXPIRES:Jum 10,2019 www APPROVED BY \Pla s Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village 'yam Building Department �40Ri1D� 0050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. ✓COPY OF QUALIFIER'S STATE LICENCES B. l%COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. >//COPY OF WORKERS COMPENSATION INSURANCE' (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. ■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrarrrrrrurrrrrr BUSINESSNAME: NAG ayAa y TATEBBUSINESS ADDRESS: '1IT�Y ` STATE— BUSINESS USINESS PHONE: I A :F FAX NUMBER CELL PHONEP S L-O` QUALIFIER'S NAME: C C7 QUALIFIER'S LIC NUMBER: CAC `-4(92,`T(0 s . RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD �a The CONDITIONING / rA �lp��+�.Y� ��yy�. the CLASS AAIB CONDITIONING CONT ACTOR. . 1y'..a::.. 4� • Named below IS CERTIFIED Under the provisions of"Chapter 489 FS.. >� Expiration date: AUG 31,201$ ARASINCION,IVARt SOLUI IONAND C '14832 SW:90Tt1 TI:I�G I'M . - MIAMI G ff -0- z ISSUED: 06/0812016 DISPLAY AS REQUIRED BY LAW SEO# L160608WO0751 10 CERTIFICATE OF LIABILITY INSURANCE ; DATE 01I233223r2/ 017 ........ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. __...._....... -- -- - _--..-_..............._..._ _ subject to IMPORTANT: If the certificat®holder is an ADDITIONAL INSURED,the poilcy(ies)moat be endorsed. if SUBROGATION IS WAIVED, Me terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _.._................__ _.__._........._...._-._._...._._.__......__._._ i CONTACT JORGE L.GONZALEZ RODUCER PHONE 305 225-1243 305 225-5053 lorida Bankers Insurance �AML-I ..E>�i_...._t ) _....._...___ .__..........__ `_.(arc,aor. .._..._....>_._.._... 61-963 SW 122 Ave F Ap gg; jorgeluf @fWdaDankersinsurence.com Aiami,FL 33184 INSURERts)AFFORDING COVERAGEE )hone (305)225-1243 Fax (305)225-5053 !N§1 R a..._._.FEDERATED NATIONAL .._......._.—. _— i dSURED i_INSURER III.... _...._................--__........ .__ - -- ur Solutions&Repair Lk: ndsuRERc_•__.... _.__ __.._. _ __ __._...__� r- -WSURER p AM TRUST OF NORTH AMERICA ;060 NW 74 Ave �._INSURER 4iamiFL 33166- misuRER F �_......_._......_..___— ...__..---._.. ._._.-..--......._.__---_...............__.�------•-•-. REVISION NUMBER: :OVERAGES CERTIFICATE NUMBER; _. - -- - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CCLAIMPoucy SP ................................ — --- ..___,_....._.......__._.--___._-... ISR; ADDL9UBR; - _ _--- -�� TYPE OF INSURANCE POLICY NUMBER MMIDDIY,YYYI I ttt .�.— .....- _.. __ ..__........_.. 1N+R..mtQ}— NCE T$ 1,000,000.00 i ❑/ COMMERCIAL GENERAL LIABILITY EACH OCCURRE i ❑ CLAIMS CLAIMS-MADE © OCCUR ~ E 10 RENTED -� �� PRSpAISEs IEA emmenoe} $ ri + MED EXP(Any one $ 5,000.00 i —_..._.................. _. _............... N N GL-35802-00 ;07/0212016 07rO2r201 PERSONAL a ADv INJURY $ 1,000,000.00 7 -__.._.._..._.__. GEN l AGGREGATE LIMIT APPLIES PER: .._GENERAL AGGREGATE s...••_Z,000+000:-� ❑ POLICY ❑ PRO- ❑ LOC ! PRODUCTS.._C�P/OF AGG... 2+0001000.00 JECT -- $ ❑ OTHER _.. MBINEO SINGLE LIMIT i I AUTOMOBILE LL481LITY } 1 (Ea ac WgrAl i $ BODILY INJURY(Per Psf=) : S ❑ ANY AUTO i ALL OWNED SCHEDULED r� i C BODILY INJURY(Per seddent) $ _.__..._.._. iF AUTOS AUTOS POPERTY-DAMAGE _... NON-OWNED ; } I ❑ HIRED AUTOS ❑ AUTOS j i $ _.........tt...❑....... __._..........._.___...._.. EACH OCCURRENCE ❑ UMBRELLA LUU3 ❑OCCUR --- -- ; EXCESS LIAR ❑CLAIMS-MADE i AGGREGATE _..�- �...__.._... i --1 ---....... -_...._.._...._.__. �_. PER DTH i i WORKERS COMPENSATION -SMUS.E-.�❑ -- i AND EMPLOYERS'LIABILITY YIN 1 r� EACH AC ANY PROPRIETORtPARTNEWEXECUTIVE E.L.._._._.._.__C� _...-..-'�-���'-� � ENT •� D I OFFiCERIMEMBER EXCLUDED? N/A AWC1059752 0310512016 03(0512017 i E.L.DISEASE-EA EMPI OYE $ •00 (Mandatory in NH) - ! K Ye%descrbe undue { ! E.L.DI -POLICY LIMIT 1 $ 5W,000.00_-- DESCRIPTION OF OPERATIONS below -..;. -....._ .._..__... ___..__.._............._......_�....__.__._....__ -1---- ---......_.__........ _.......... ,... DISEASE i ' ! i ji i ; ..._...—_—.....0 ............. .._.__....._ ._..........._._—.-- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addiaonai Remarks Schedule.It mme apace Is Air Conditioner Installation and Repair. k ,j 1 .... ._ .-...... _................_ __....._.....__—...._._.. .....--- _...... . CERTIFICATE HOLDER CANCELLATION -.- _. _......_ _.._. — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT j THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd AVE i MIAMI SHORES FL-33138 AUTHORIZED REPRESENTATIVE 1 � s j ©18813-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101)OF The ACORD name and logo are registered marks of ACORD Local Business Tax Re t Miami—Dade County, State of Eland? 7162646 -THIS 15 NOT A Mt.-DO NOT PAY LBT BUSINESS NAAMLOCATION RECEIPT MM EXPIRES AIR SOLUTIONS AND REPAIRS LLC RENEWAL SEPTEMBER 30, 2®17 5060 W 74 AVE 7"0705 Mum be displayed at place of businus* &VMI FL 33166 Pursuant to county Code Chaptar 8A-Art.9&10 OWNER SEC,TYPO OF BUSINESS AYUMT RECENED AIR SOLUTICINS AND REPAIRS LLC 106 SPEC MECHANICAL CONTRACTOR PRY TAX COLLCCTOR 70 WAN ASENCION MGRA4 CAC18116" Worket(s) 1 575.00 07/12/2016 CREDITCARD—16,--039606 This Local Busism Test RftOiPt 0011 Mfimts Polmol of Itw Local Busimus T".The Race! is Dal a pattalt of a cowifficaliato 81 Iba to d0 huminess. Itaklet ntam comply w.Ll any pmainvAilal w to qvimants whish apply to the b"iness The RECEIPT NO,above most he displayed a0 all rammwclol vuhictre; Miami--DadvCad,See b-216, For More Womb",visit Property Search Application-Miami-Dade County Page 1 of 3 -a w When buying real estate property,you should not assume that property taxes will remain the same.Whenever there is a change in ownership,the IMPORTANT assessed value of the property may reset to full market value,which could result in higher property taxes.Please use our Tax Estimator to MESSAGE approximate your new property taxes. The Property Appraiser does not send tax bilis and does not set or collect taxes.Please visit the Tax Collector's website directly for additional information. Address '; Owner Name Subdivision Name Folio SEARCH: 107 NE 91 ST Suite QJ . . . .... ... . .. . PROPERTY INFORMATION ® i' Folio:11-3208-013-3300 Sub-DivWon: w MIAMI SHORES SEC 1 AMD Property Address ° 1,y 107 NE 91 ST Mlami Shores,FL 33138-2808Owner MARC M MACHICOTE Mailing Address 107 NE 91 ST MIAMI SHORES.FL 33138 Ito 3 7d x s } a d r Primary Zone ,. ',� s € .,4 ' 1000 SGL FAMILY-2101-2300 SO Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY:1 UNIT i_ `+ �'`" y SF * ' Beds lBaths lHalt ayall Floors 1 Living Units 1 -Actual Area Living Area Adjusted Area 2,389 Sq.FtIM Lot Size 13,880.1 Sq.Ft Year Built 1948 Featured Online Tools Comparable Sales Glossary Non-Ad Valorem PA Additional Online Tools Propedy Re ord Cash. Property Search Help Assussmouts o,ppdy Taxes Report Di—epaw,r, Refmrt Homestead Fraud Tax Comparison Tax Estimator TRIM Notice Value Adjustment Buer,� ASSESSMENT INFORMATION ® RE14EFITS INFOONIA'i ION Year Zola 2015 2014 '. Benefit Type 2018 2015 2014 Land Value $346,844 $263,645 $263,645 Save Our Homes Cap Assessment Reduction $335,653 $253,593 $250,698 'Building Value $166,274 $166,274 $161,974 Homestead Exemption $25.000 $25,000 $25,000 Extra Feature Value ._......._._..... $606 $706 .............$706 ._ -- ----.--------- -- --- Second Homestead Exemption 525,000 $25,000 $25,000 Market Value $513,924 $430,625 $426,325 ry__^ Widow Exemptio,� $500 $500 $500 Assessed Value $178,271 $177,032 $175,627 Note.Not ati benefits are applicable to all Taxable Values(i.e.County,School Board. .__., ... City.Reg.onaQ. http://www.miamidade.gov/propertysearch/ 2/7/2017 Property Search Application- Miami-Dade County Page 2 of 3 TAXABLE VALUE INFORMATION 9 FULL LEGAL DESCRIPTION 2016 2015 2014 MIAMI SHORES SEC 1 AMD PS 10-70 COUNTY LOTS 15&16 BLK 24 Exemption Value $50,500 $50,500 $50,500 LOT SIZE IRREGULAR Taxable Value $127,771 $126,532 $125,127 CF 73R21941 SCHOOL BOARD COC 23391-0398 04 2005 5 Exemption Value $25,500 $25,500 $25,500 Taxable Value $152,771 $151.532 $150,127 CITY Exemption Value $50,500 $50,500 $50,500 Taxable Value $127,771 $126.532 $125,127 REGIONAL Exemption Value $50,500 $50,500 $50,500 Taxable Value $127,771 $126,532 $125,127 SALES INFORMATION 9 Previous Sale Price OR Book-Page Qualification Description Previous Owner 1 Previous Owner 2 12J192016 $485,000 30352-1221 Qual by exam of deed DORIS K DALRYMPLE DEBORAH A DALRYMPLE 04/012005 $0 23391-0398 Sales which are disquati8ed as a result of examination of the deed 01/01/1973 $52,000 00000-00000 Sales which are qualified For more information about the Department of Revenue's Sales Qua UBcedon Codes. 2016 d 2015 2014 LAND INFORMATION Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-17.5,R-18.5 1000-SGL FAMILY-2101-2300 SQ Front Ft. 81.00 $263,130 GENERAL R-17.5,R-18.5 1000-SGL FAMILY-2101-2300 SQ From Ft. 25.77 $83,714 BUILDING INFORMATION Building Number Sub Area Year Built Actual Sq.Ft. Living Sq.Ft. Adj Sq.Ft. Calc Value 1 1 1948 2,389 $166.274 EXTRA FEATURES Description Year Built Units Calc Value Patio-Concrete Slab 1948 336 $806 ADDITIONAL INFORMATION The information listed below is not derived from the Property Appraiser's Office records.It is provided for convenience and is derived from other government agencies. LAND USE AND RESTRICTIONS Community Development District: NONE Community Redevelopment Area: NONE Empowerment Zona: NONE Enterprise Zone: NONE Urban Development: INSIDE URBAN DEVELOPMENT Zoning Code: R20- BOUNDARY Existing Land Use: 10-SINGLE-FAMILY.MED.-DENSITY(2-5 DU/GROSS ACRE). Government Agencies and Community Services OTHER GOVERNMENTAL JURISDICTIONS Business Incentives Chiklrern;Trust City of Miami Shores Environmental Considerations Florida Department Of Revenue Florida Inland Navigation District PA Bulletin Board Non-Ad Valorem Assessments School Board South Florida Water Mgmt District Tax Collector The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,we full disclaimer and User Agreement at http:/www.n iamidade.govfiinfo/disclaimer.-p For Inquiries and suggestions email us at httpJAvww.rdamldade.gov/PAPortaVContactForMContactFomiMain.aspx. http://www.miamidade.gov/propertysearch/ 2/7/2017 Property Search Application-Miami-Dade County Page 3 of 3 Version:2.0.3 EXEMPTIONS 8 REAL ESTATE TANGIBLE PERSONAL PUBLIC RECORDS ONLINE TOOLS TAX ROLL BENEFITS PROPERTY ADMINISTRATION Deployed Military 40 Yr Building Appealing your Address Blocking Property Search Appealing your Re-Certification Assessment Assessment Disability Exemptions Change of Name Property Sales Appealing Your Assessment Reports Homestead Assessment Information Search Change of Address Tax Estimator Institutional Defective Drywall Exemptions Change of Ownership Tax Comparison &Title Senior Citizens Folio Numbers Extension Requests Homestead Declaration of Exemption and Mortgage Fraud Filing Retums Condominium Portability More More> More More> More> More> a� Home Privacy Statement Disclaimer About Us ADA Notice Contact Us ©2014 Miami-Dade County.All rights reserved. .,�.� http://www.miamidade.gov/propertysearch/ 2/7/2017 � p y Certificate of Product Ratin AHRI Certified Reference Number: 8439419 Date: 1/27/2017 tul Product:Split System:Air-Cooled Condensing Unit,Coll with Blower Outdoor Unit Model Number:YCE481321 Indoor Unit Model Number:AVC48CX21+TXV Manufacturer:YORK BY JOHNSON CONTROLS Trade/Brand name:YORK Region:Southeast and North(AL,AR,DC, DE,FL,GA,HI,KY,LA, MD,MS, NC,OK,SC,TN,TX,VA AK,CO,CT,ID,IL,IA,IN,KS, MA,ME,MI,MN,MO,MT,ND,NE,NH, NJ, NY,OH,OR,PA,RI,SD, UT,VT,WA,WV,WI,WY,U.S.Territories) Region Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be Installed In all regions until June 30,2016. Beginning July 1,2016,central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. Series name:LX SERIES Manufacturer responsible for the rating of this system combination Is YORK BY JOHNSON CONTROLS Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(Btuh): 48000 EER Rating(Cooling): 12.50 SEER Rating(Cooling): 15.25 IEER Rating(Cooling): Ratings followed by an asterisk(h Indicate a voluntary rerete of previously published date,unless acommanted with a WAS,which Indicates an involuntary rerete. DISCLAIMER •• 000 • • • • • •• AHRI does not endorse the product(s)listed on this Certificate and makes no representation:,wanenleser guarentaes as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for&#Vegas f:,, �RII�drIhsillg� or p:rmance of the product(s),or the unauthorized alteration of data hated on this Certificate.Certified ratings are valid opiy for in the directory at www.ahridirectory.org. •• 000 e• • • • •• TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for Individual,personal and confidential reference purposes.The contents of this Certificate may not,In whale cS Ipdiart,be reproduced;copig4;glaseglinated; ��■ entered Into a computer database;or otherwise utilized,In any form or manner Or by any means,vAcept ter the useris Indhriruel, personal and confidential reference. e • • • • • • • • • AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION • •• • • • • • • • A REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at ww4.%a9ridlr8ctory.o&,•Cik:k oft"Verify d6rtificgte-link we make rife betber- and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which Is listed above,and the Certificate No.,which Is listed at bottom right 1313002119"759410 62014 Air-Conditioning,Heating,and Refrigeration InstituW ; f ER.TIFICATE NO.: ••• 0 0 .rr 0 000 0 0 9 1 ,SNo y Miami Shores Village Building Department Ina mut" 10050 N.E.2nd Avenue Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA 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 �jare not acceptable. Job Address(where the work is being done): ICA 1 hC —`� QK City: Miami Shores Village County: Miami Dade Zip Code: 9fs 139 3 , 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❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG.UNIT MODEL# COND.UNIT MODEL# KW HEAT NOM TONS 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 EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): see "' = = -= . .. . . . . ... . 4. Size Disconnecting Means: • Contractor's Company Name: r '��� t �S Phone'VN' SC4� State Certificaon No.CAC 12'1 V UCertirk. .'of CoPhlietarlgr No. • • Signature te or Re ' i :00 :•• '•Date:.• • (Qualifier's signature) ••• • • • • ••• • • • • • • • • • • • • (Revised02/24/2014) ••• •• •• ••• •• ••• •• ••• •• • Corrected Paid By plicate public user 01/27/2017 Miami-Dade County,Florida Paid 11/28/2016 Receipt# LBX417-085181 $3,850.53 2016 Real Estate Property Taxes Notice of Ad Valorem Tax and Non-Ad Valorem Assessments SEE REVERSE SIDE FOR IMPORTANT INFORMATION FOLIO NUMBER MUNICIPALITY MILL CODE 11-3206-013-3300 MIAMI SHORES 1100 MARC M MACHICOTE Property Address Fxemptions: 107 NE 91 ST 107 NE 91 ST ADDL HOMESTEAD,HOMESTEAD,WIDOW MIAMI SHORES,FL 33138 . • VALOREM Miami-Dade School Board School Board Operating 178,271 7.13800 152,771 1,090.48 School Board Debt Service 178,271 0.18400 152,771 28.11 State and Other Florida Inland Navigation Dist 178,271 0.03200 127,771 4.09 South Florida Water Mgmt Dist 178,271 0.13590 127,771 17.36 Okeechobee Basin 178,271 0.14770 127,771 18.87 Everglades Construction Proi 178,271 0.04710 127,771 6.02 Childrens Trust Authority 178,271 0.50000 127,771 63.89 Miami-Dade County County Wide Operating 178,271 4.66690 127,771 596.29 County Wide Debt Service 178,271 0.40000 127,771 51.11 Fire Rescue Operating 178,271 2.42070 127,771 309.30 Fire Rescue Debt Service 178,271 0.00750 127,771 0.96 Municipal Governing Board Miami Shores Operating 178,271 7.90000 127,771 1,009.39 Miami Shores Debt Service 178,271 0.50540 127,771 64.58 NON-AD VALOREMASSESSMENTS KV F0823 MIAMI SHORES STORMWATER @ 45.0000 1.000 45.00 F0824 MIAMI SHORES SANITATION @ 705.5200 1.000 705.52 Save Time.Pay Online.www.miamidade.gov Combined taxes and assessments $4,010.97 * RETAIN FOR YOUR RECORDS t .........................................................................................................»..........._........................................................................................................... 2016 Real Estate Property + DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + Du licate nublic user 01/27/2017 F00 NUMTaxes I��I�III�I�111111111111111 I) II�I�I�I�� PAY If Paid By Please Pay 11-3206-013-3300 * 1 + 1 1 3 2 0 6 0 1 3 3 3 0 0 + 2 0 1 6 PROPERTY ADDRESS Make checks payable to: 107 NE 91 ST Miami-Dade Tax Collector Nov 30, 2016 $0.00 LEGAL DESCRIPTION (in U.S.funds drawn on U.S.banks) MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 15 816 BLK 24 Amount due May be Subject to Change Without Notice LOT SIZE IRREGULAR Mail payments to: CF 73R21941 200 NW 2nd Avenue,Miami,FL 33128 COC 233 MARC M MACHICOTE 107 NE 91 ST lip- MIAMI i MIAMI SHORES,FL 33138f u, 1000000000000000001132060133300201600000000000000000000003