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MC-13-2708Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-203858 Permit Number: MC -12-13-2708 Scheduled Inspection Date: January 21, 2015 Permit Type: Mechanical - Residential Inspection Type: Final Owner: DEL C NUNEZ, MARIA Work Classification: New A/C System Job Address: 17 NE 107 Street Inspector: Perez, JanPierre Miami Shores, FL 33161-7029 Project: <NONE> Contractor: GABY AC CORP Phone Number Parcel Number 1121360070340 Phone: (786)290-1982 Building Department Comments NEW A/C UNIT AND HANDLER REPLACEMENT DUCT WORK Infractio Passed Comments INSPECTOR COMMENTS False \ -2A \ Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments January 20, 2015 For Inspections please call: (305)762-4949 Page 1 of 37 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-203859 Permit Number: MC -12-13-2708 Scheduled Inspection Date: September 08, 2014 Permit Type: Mechanical - Residential Inspection Type: Rough Duct Owner: DEL C NUNEZ, MARIA Work Classification: New A/C System Job Address: 17 NE 107 Street Inspector: Perez, JanPierre Miami Shores, FL 33161-7029 Project: <NONE> Contractor: GABY AC CORP Phone Number Parcel Number 1121360070340 Phone: (786)290-1982 Building Department Comments NEW A/C UNIT AND HANDLER REPLACEMENT DUCT WORK Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments September 05, 2014 For Inspections please call: (305)762-4949 Page 1 of 19 -052 iG 3c � < Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: MECHANICAL JOB ADDRESS: t4 E ( FBC 20 Permit No. )G 13 _a.7 o Master Permit Not? — City: Miami Shores County: Miami Dade Zip: 1-531, Folio/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder): Sieurea Address: City: NO Flood Zone: OcizilYze gtai Phone#: .� ®S 0 ( ”t. ) State: Zip: '30 (3`� Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company�Name: Address: \� —1 CA Cam (Gtbk-,\ �C�(� Phone#: —1<kAtO c� Ct 2- c --Y1 ` l City: l' \ act\ Qualifier Name: L1 A0(C State Certification or Registration #: Contact Phone#: DESIGNER: Architect/Engineer: State: P 4en1 Iv (I f i_ CAC-- l L1 l �� '�t (. Certificate of Competency #: Zip: 1 Phone#:'1 3CP aCtO t 9 - Email Address9(/ ab Lk o_ nsat\ 0 e_ o -f Y \' n e� Phone#: Value of Work for this Permit: $ ((f- 0 0 Square/Linear Fo tage of Work: Type of Work: ❑Address OAlteration Description of Work: 4 / (- U A + j- t�.'i; New Repair/Repl e ODemolition r*, **************** *********** ****** Fees******** *****, *****************,t*********** Submittal Fee $ Sr) al) Permit Fee $ 1 SI t 51) CCF $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 79. 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 day of DV/ , 20 I& by WO 0 NV\e-1,_ ?_ who is personally known to me or who has produced Uno As i an oath. ?o4?S1YP= BAR8A"A C,Z'3T(i. •:ODRIOUEZ � *� MY COMMI33IU:', EE -053785 7 EXPIRES '-.r.c i,S� 2r)15 7) 398-0153 Flondallotary5= NOTARY PUBLIC: Sign: Print: Filibalrek My Commission Expires: Signature Contractor The foregoing i strument was acknowledged before methis V day of 141) �0 , 201 , by LAV M ice $IOi,et whoersonally kno me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commis ***********************************i*** **** ****sk-0r*****4********&ir*ira'rir,t9******dra+i,t*+i****Jede******* kita**oe+Yir** APPROVED BY 114Examiner Zoning Structural Review Revised 3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09) Clerk T T Miami Shores Village Building Department 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 are not acceptable. Job Address (where the work is being done): 1 V L j 2) S/ City: Miami Shores Village County: Miami Dade Zip Code: 3313,Y 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 ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES i NU ❑ ARHI Sheet Attached: YES 0 Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT i L �� N �?� i� AHU or PKG. UNIT MODEL # ff Wf ‘�,! V )/J J - Y' -©� 7/3 COND. UNIT MODEL# /`44 ji" ` V Ari / (c.4%..)MANUFACTURER to (.,.j KW HEAT / 0 %,,LJ 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 / / 0 EER/SEER i. YES NO REPLACING DUCTS t� NO YES NO REPLACING THERMOSTAT REV NO YES NO NEW 4"CONCRETE SLAB YES IR-) YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES riN10 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3D 3. Voltage of Circuit (208/240/480): 0/ 4. Size Disconnecting Means: 54)9 Contractor's Company Name: . �-`� C,„ Phone: State Certificate or Registration N. t^ / ( i 1 -70V6 6 Certificate of Competency N. Signature (Qualifier's signature only) Date: Certificate of Product DECPLMETTILFIT 02 2013 BY aten9 AHRI Certified Reference Number: 3412455 Date: 11/26/2013 Product: Split System: Air -Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number 14AJM42 Indoor Unit Model Number. RHSL-HM4221+RCSB-H*4821 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD, WEATHERKING Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC. 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): 40000 EER Rating (Cooling): 11.50 SEER Rating (Cooling): 14.00 iEER Rating (Cooling): Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an lnvoiuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Comte and makes no represerdationso.varranties or guarantees as to, and assumes no responsibility*); the productfs) fisted on this Certificate. AHRI expressly disclaims al) liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorbsel alteration of data fisted on this Certificate. Certified ratings are valid ordy forme and configurations listed In the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and lis contents is are proprietary products of AFIRE This Certificate shall only be used for Indhrydual, personal and confidential reference {arm. The contents of ihla Certificate may not; In whole or to part, be reproduced; copied; ; entered into a computer dame; or otherwise tom, In any form or mariner or by any means, except for the use's Individual, personal and confidential reference. CERTIFICATE VERIFICATION ,,, Tire information far the model cited on this a can be verified at vis+ r ahrtdireatory org, !t Air -Conditioning, Healing, click on "Verrty CertifBcate" link and enterthe Aim Certified Reference Number and the date on and Refri otlon Institute which the certificate was issued, which Is listed above, and the Certificate No., which is Rated below. ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130299829269754560 Dec.02.2013 10:15 AM CSA GRODP/CLA CONSTROCTTO 3059140496 PAGE. 1/ CEIVE !I DEC O2Z013 CONTRACT This contract is made effective on .. . day of . November 2013, between Gaby AC Corp (Contractor) and _,,,,,.,, CafIQ — (GC/Owner) Jobsite= Residence at 17 NE 107 ST Miami Shares, FL Work will commence as soon as the deposit payment Is received. Contractor is not lid for any damages, stains to the floor, carpet ar not due to the omega of equipment needed to perfonn work Wits, fortdifts, [ashlers, cranes, etc.). Contractor is not respondble If smoke detectors do not match with the alarm system (eidstent smoke der will be used) ar any work related to the alarm. GC/Owner will pay a total amount of$ 4,800.00 after rebates Payments will be made as fadawst iP payment $2160.00 upon signing of convect for ductwork materials 2's payment: $2160.00 after mush duct Inspection approval to buy units Final payment $480.00 after fine inspection Is approved Payment must be received no later then 10 calendar days after the invoke's date, if payment is not received in a timely manner a penaky of $150.00 per calender day wet be char8ed until payment Is received. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year first above written, with Intent to be legally bound. Ca44. a. sir. Print Na C/Owner Signature GC/Owner 11 1 Date TOO[] Print Name Contractor Contractor Uc, # CAC1817046 IVd OZ:OT 800a/$0/TO 003784 9 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6954573 BUSINESS NAME/LOCATION GABY A C CORP 1779W375T11 HIALEAH FL 33012 OWNER GABYACCORP Worker(s) 1 RECEIPT NO. RENEWAL 723034E LBt EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTr1R CAC1817046 $45.00 07/10/2013 ECHECK-13-004493 This Local Boeings Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a ceddication of the holders qualifications, to do business. Halder must comply with any governmental or nongovernmental ragulatory laws and requirements which apply to the business. The RECEIPT N0. above ntust be displayed an all commercial vehicles - Miami -Dade Code Sec ea -271 For more information, visit www.miamidade.aovhaxcollector