Loading...
MC-17-1277Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit No. MC -5-17-1277 Permit Type: Mechanical - Commercial Work Classification: A/C Replacement Permit Status: APPROVED Issue Date: 5/10/2017 Expiration: 11/06/2017 Parcel Number Applicant 1634 NE 105 Street Miami Shores, FL 1122300010510 Block: Lot: MADELEIN LAURENCE Owner Information Address Phone Cell MADELEIN LAURENCE 1634 NE 105 ST MIAMI SHORES FL 33138-2118 Contractor(s) Phone Cell Phone NO SWEAT A/C CONDITIONING CONT (954)423-9696 (954)557-6179 Valuation: Total Sq Feet: $ 8,500.00 0 Tons: Additional Info: 2-2.5 TON CHANGE OUT W/10 KW HEAT Classification: Commercial Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: 2-2.5 TON CHANGE OUT W/10 KW H Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Amount $5.40 $4.46 $4.46 $1.80 $5.00 $297.50 $3.00 $7.20 Total: $328.82 Pay Date Pay Type Invoice # MC -5-17-63966 05/09/2017 Check #: 22992 $ 50.00 $ 278.82 05/10/2017 Check #: 22993 $ 278.82 $ 0.00 Amt Paid Amt Due -I I 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, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFitAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a 1 zoning. F therm r , I authorize the ab•ve-named contractor to do the work stated. / r/ May 10, 2017 Au oriz:j: Signature: Owner / Ap. nt / Contractor / Agent Date Building Department Copy May 10, 2017 1 c_1 ay- Pi 77 - VA (9 BUILDING PERMIT APPLICATION Miami Shores Village Budding 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 j Rr c FT\ED MA/ 9 2011 FBC 201+ Master Permit No. Mc c 11 - 12 -17 Sub Permit No. ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ PLUMBING MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: is 34/ /lie- /B.l r -) r City: /0/4-41/ Miami Shores Countv:0' Miami Dade Zip: 33/3P Folio/Parcel#: Is the Building Historically Designated: Yes _600 Occupancy Type: Load: Construction Type: Flood Zone: BFE: _ FFE: OWNER: Name (Fee Simple Titleholder): /1,41 DFL 4:-./44e G 7`1.€4 1LCT Phone#: ?ge. ' 9'"' 4'.2- 7 2 - Address: 03, Ne /0 f -(/ City: 44/ out / r State: f t— Zip: S3 13 /' Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 4)0 JI6t**-41-"" n ,i 4, /i745 /'✓L' Phone#: Af`t�j77'6/7? Address: f// xv/u al-- /f-1, City: ,3Ai,Arn State: Zip: 33 3). d qualifier Name: 2t y/J IK /4/2.4,-,,/`n-- '0-4— Phone#: 919 4/77 State Certification or Registration #: '4-402_ 4o 7' /Ti Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: ✓ City: State: Zip: Value of Work for this Permit: $ �Q[ D O Square/Linear Footage of Work: Type of Work:. ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace n Demolition Description of Work: 2, 2 -Jr 70,1 atm -1C efrvr- , ea/ /69 /zev wz-0-/' e—;fiv /4/ ..rfi-"Ncf- L0.c4-/G"'/' /i;?,etf-` ,.~ ; /366..f-eii "CL c -o& C '2(:_QLLc4Z tW z» 4 -t ° rM' \14.-S1'0.m ':..114.:-.i Specify' color of color thru tile: :)Y, .^J -" ('1;l 1 Submittal Fee $ 5 0 Pr) id Permit Fee $ M1 15 UCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ . e__D Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (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 and a reinspection fee will be charged. Signature /Y1 l OWNER or AGENT The foregoing instrument was acknowledged before me this day of //s /J". , 207 , by /AD dr/eV,/ Lt' 6e , who is personally kn n to me or who has produced as identification and who did take an oath. NOTARY PU IC: Sign: Print: Seal: Signature CONTRACTOR The foregoing instrument was acknowledged before me this t 3day of �2`L— ,20 V1 ,by q-Arlfok• , who is personally known to me or who has produced V `— `O—r` itra_ as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: **************************************** ******* * ****************************************************** 0APPROVED BY 'ans Examiner Zoning Structural Review Clerk (Revised02/24/2014) L-41( ( • 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 UIi.DING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL 9Tamwm APk 0 12011 SI Permit No. r\C---t.I-5�0 Master Permit No. OWNER: Name (Fee Simple Titleholder): x40 LTI—C /fir Z../tv.deers,c-c- Phone#: 75 - %Z 61 " G Z 72. Address: /63 `f A/ 4- -City: 44/04"44 / Tenant/Lessee Name: Email: fps' si&r'Er' State: lG JOB ADDRESS: /0 344 �tfc ,'r City: Miami Shores Folio/Parcel#: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: NO Address: t5 // J// /tet 7—e/2_ City: !)/f d'/ Qualifier Name: ,2e-, is ' 1 .-.2 Phone#: /cs _ S•-% —6/ 79 State Certification or Registration #: C4 `�. i' Certificate of Competency #: Contact Phone#: 93-9 --Cr-r7-6/ 7 5 Email Address: 44 s" 4.4/-9"* t— g 19-04 - G o ti DESIGNER: Architect/Engineer: Phone#: County: Miami Dade Zip: 3 3 / 3 .1' NO Flood Zone: Swcfii A -/c. /ie1G Phone#: 9541-537-6/ 7 9 State: iL Zip: 533.E �: a 4./ k1 Square/Linear Footage of Work: Value of Work for this Permit: $ Type of Work: ❑Address Description of Work: Z. DAlteration ONew A:Repair/Replace. ❑Demolition ,�. 5'- 7:94/ e-"At•✓/C^ DTJT uji .4' /o ,t< i.e./ /4,1-4-T E A`l.,iy , el, L- /4/ d>-r:i C L.de- ,triaA/ /G, o sr cit. /S-A-/ .3oel- ri ***************************************Fees******************************************** Submittal Fee $ 50 • 44—)Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO/CC $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) AJj/f Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N// - 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 th.be done in compliance with all applicable laws regulating construction and zoning. #tweill �� "WARNING TO OWNER: YOUR FAILURE TO RECO e p OTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING CE 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent S/ The foregoing instrument was acknowledged before me this.7.�' •„ day of HarGh ,20 11 ,by who is personally known to mor who has produced Signature Contractor The foregoing instrument was acknowledged before me this f /Y.4.2Gi k , 20 (A , by 1Z t-: (Gid l ally known to me or who has produced'.—t i / As identification and who did take an oath. NOTARY PUBLIC: Sign: — —•--•— - Print: /� .��,��_�e • — ; �.. ' RQ . 5� • o My Commission Expires: ' • G�' y" Aug 24 2013 ► My Commission Expires %,.. . *� �o �O� •. ••���y�`O� 1 // . .''. • ` • •• O \�$ •••,���,•`,` ��� ////////////11111 j1}� \`,\� ************************************************************************************************************ as identification and who did take an oath. NO% U/iii \N a • ` s2I - NOTARY PUBLIC: Sign: Print: MILDRED Y. GOMEZ Notary ' u • is a e • • rida My Comm. Expires Commission #E DD 916836 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Ill iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers • or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Al I , Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this By ,Ut f c 4) iI L/ X961 day of /04-72 , 20 /7 who personally kno ) o me or has produced Ir identification. ! ex- v C NUM REFRIGERATION & HEATING INC. April 13, 2017 State of Florida County of Miami Dade Before me this day personally appeared Regis K Kramer Jr who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 1634 NE 105 Street, Miami Shores, FL 33138 Signed: Sworn to (or affirmed) and subscribed before me this day of MC . 2017 who is personally known to me produced identification Ty of identification produced Y►' ' l jC' nSt Pri ' t, s e or Stamp Name of Notar YANADY PRIETO ;.: MY COMMISSION # FF 214031 EXPIRES: March 25, 2019 d" Bonded Thru Notary Public Underwriters I' 511 Sumter Avenue • Davie FL 33325 • Broward (954) 423-9696 • Dade (305) 623-1500 FROM : NO SWEAT A/C INC. FAX NO. : 954 916 8992 Apr. 08 2011 10:31AM P1 "NO SWEAT 51 AIR CONDITIONING, REFRIGERATION, & HEATING, INC. 511 Sumter Avenue / Davie, Florida 33325 Broward: (954) 423-9696 / Dade (305) 623-1500 Customer Name 4P iri—iiitif 4 4 a". -447,v(4 -6-r- Phone 7c56 — ..76 9- 4;2 lz. Address .,, . . Ak'T . /I $T .. CityAf/Alow/ 1Wee-Y State /`2.-- ZIP 3/3S Jab' Address• .2,7.,, ..,i ' : ; ••• ".::. ; , , . :. Proliiiiy, Legal DeScriOr:M:"Of _ /1-,b7...7 3.4 — Oil •'--.'..'• Blobk • • ., ' • ••••., .: : . : , : enziesiiimineliererieerami s ,I=Iiiiiemmelimrimeizo===a, H.imiiensillom DUCT SYSTEM , . , ( ) Supplies wkh Dampers ( ) Rectangular or Square ( ) Round ( ) Sidevdall ( ) Fberboard ( ) !mutated Metal Duds ( ) kberboard Plenum ( 4:T10(0W Is.:.; }.2,_.$1: • etarn.:( )•. Free:Air ( ) Lined Plenum (:: ). Existing Plenurn,( ) Ducted ( , ) Filter Grip ,. : . hizOby'Sl.itiMit speCifioatiOni:ind estimates for• EdUIPMENT ALTERNATE A • . . • • . • ,. , " • .. ' .:-. , ( ) Package Uri ' • tons . •-- Model NO.' • • • • SEER •• . ' :. ••••• - . Btuh • . MheAtivms Condenser „?..-s• tons Model No. 4-..x - a.--.36-SEER ra,...ge, Btuh „RS, &Oa heA44/04. ..Air Handlor, • - • 47 •• • tons Model No. 4.13.sc.R. 7 crii .^-0... . dm . Ja o!..0. . .veri. 04 heft. ( ) ,. ( . ),______,, . • •-; • • • ! . • Col • • • • - . .. • • tons,. coil Model NO. blower sec, Model No. " - " — • • " (X)HeatIng 4,--c.).4:4, -reedr.-/. • • . ,A9 K.W. ( ) Condensate pump ( )Electronic air cleaner Model No. 1 ) Heat recovery un k Model No. 1.4ISCELEANEOUS '.. •, '-'• :-7...":' .• °,:•••"..' ••' .*:•• ..: ••• 4,L ,•,:. .._ • , Itierntditat:(X:cheal (41..000l..1; T).•set bar*..r-v‘....7/ r. 4--. • ( . ) PreCist slab...for..cond. :Unit: .., • .. 1 . l" •,• ....... Ref. Mee ft'. Sudion _in. liquid in 9//e7.44 • t ) Ref: lkieccnier - " ....„...... .. ,. .; • .. . ••,..... . (4) Plans -permit -clean up tenderisara.line,.. COruiedionlo-adetitsite 0 , ' ••••, • -.•• • ••• - ';*. ( • ) Electrical • connectionby othort . • . ••••:••• ..: : • •-• .•. .' ,..,..., . •-• ':.).1-leat Rectivei•Y•Reconnecr • •:•••• -. •••• ... - • •• • • - •.: • • • ., •:• . ' • •• - • •• :-,"•' • '• :- '•-•-: l'••••• • •-• • ' ,..P4 -L -r -.7*Y.:-. ;,:4)G...i.*,4ij)0.." /11/7S JA/.5,"4-c...4 Se- A-i,s..4,/,‘,..sr• — .2A2- /Ait_,AP-- s' -..000.• " • W.e,.a9133,* !0,.urrask.P14:talliglik:alp,.p,r, described labor d material op the terms eated below for the .. , . TOTAL CONTRA PRICE OF '' ' $ -•*$74"AF'77. ••:-:`'•/‘,P;41. • • • ,•••••,•:„egw ' v=====. • - '• 4•1!".14441 -76. - Florida -Power & LighrRebala $ EQ PMENT ALTERNATE B ( ';':.1.1';'4 • ' :. ! P,ckage'Unitons:Model No... • SEER ( ) Condenser tons Model No. SEER Btiih - - - (:-) • ••• ,: rtons Model No. d vett.( ).horiz. ( ), ( ); ' ' tons, coil Model NO. • blower see. t IteEdinci" • ' : '' (1 . -' : ; • ConderiSide ) Electrbeibeircleaner Model No. • ( ) Heal recovery unit I No. MISCELLANEOUS . }..7111Arn)9ste.4 ).t0 .( ••••• ) cog! •(•• )...sat. back .1 ).Ref.• :•• in.: Squid • in CoixtenSere' the' • • • " • • • • ( ) Connection to adequate electrical ( ) Heat Recovery Reconnect ( ) We agree to fu • . • ( , ,) precast slab kir cond,,unk • ) Rot • :••••••• •.,•;* ; ( )Plans;perrnir-ilean ••-•" • •• • ••••••;': •••::,,"•• ( ) Electrical-connection:by .others and install the above described labor and material on the temisindcated be TOTAL CONTRACT PRICE OF ••,csoiseitc•f(ibtio :•• -• ••,..• •• • : ..• • • • .•::•••• ' WARRANTY: AND GUARANTEE.. ( ) ,1.6072-6- Year manufacturers extended warranty on compressor. Condenser coil ( ) custoffier,AchnOwledges:_thatTriorip...signing this contract:Ile uporksigning,coutrant• . .$ bas reed theIerms'and conifttiOns herein and hereby accepts 'this •• • % when doors arerouohod• ' • • '•••• • contract Including the conditions on the revemeSide' hereof *Which are pact -Of the oontract:.and further agrees to make payments as % on start up of system $____Zglitd____e* % Financed "BUYERS RIGHT TO CANCEL" Ibis is a woe Gacktanuis, indifyou.eo.not won thg goods er services, you may cancel tela agreement by maitng t oise to to seller, This notig, must be postmarked before MIMI of the tlig ' ea aper aryous.nUis e/g. tl you cancel Mb memenc, tree seBar may keen all or of any CO diwirtnaYmenl, nee m armed the lesser of 5 mem cif the cash • Year Warraniljen parts installed by No'SweaiAir Conditioning delivery Of units.' •$•••••' 0• •••0 •• " follows: j7 • Dated ACCEPTED: Purchaser This contract may be withdrawn by seller If not accepted within tea (10) days. Sales Engineer r .This combination qualifies for a Federal Energy C E RT I� F I E D TM) Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. www.ahridirectory.org r Certificate of Product Ratings AHRI Certified Reference Number: 3665051 Date: 3/30/2011 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14ACX-030-230-11 Indoor Unit Model Number: CBX27UH-036-230*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: 14ACX SERIES Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, 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): 28600 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 • Ratings followed by an asterisk (•) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. 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 whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's Individual, personal and confidential reference. CERTIFICATE VERIFICATION Ali C71MD The information for the model cited on this certificate can be verified at www.ahridirectory.org, ��^••1 Air -Conditioning, Heating, click on "Verify Certificate" Zink and enter the AHRI Certified Reference Number and the date on I a er r 13E Da and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2011 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129459603113628685 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): /l 3 ' A/ /os she E7 City: Miami Shores Village County: Miami Dade Zip Code: 3 3 / 3d'-' 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 ❑ NO ARHI Sheet Attached: YES/XI NO ❑ Contract Attached: YES Fg UNIT BEING REPLACED DATA NEW UNIT d ^ A�Aiti-Q MANUFACTURER Lcdv•A/aic. 2• s— Ta^/ klilior PKG. UNIT MODEL # 2- cg X� 7e//1 •- 036 A - . s" 7'o" COND. UNIT MODEL # - /iIA-GX - 030 a - /O KW HEAT ;L- io 07. J- NOM TONS a. f' AHU J"5 CU PKG 1) M.C.A AHU5 CU .30 PKG AHU 6O CU PKG 2) M.O.P AHU a CU /7 PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES REPLACING DUCTS YES ITY ® NO REPLACING THERMOSTAT NO YES 410 NEW 4"CONCRETE SLAB S ura� YES L • NEW ROOF STAND YES grre YES '. NEW RETURN PLENUM BOX YES V 1. Minimum Circuit Ampacity (Wire Size): - 2. Maximum Overcurrent Protection (Fuse/Breaker Size): k,11)- G o 3. Voltage of Circuit (208/240/480): 2 #1--2-36. V' 4. Size Disconnecting Means: G a / z o oma o Contractor's Company Name: i✓' Phone: 14—‘74— s^` 7 G/ 7 9 State Certificate or Registration N. G'¢ 'B ,R644/ o Certificate of Competency N. Signature /4% (Qualifier's signature only) Date: '/3 %/ RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CACO26410 The CLASSAAIR CONDITIONING CONTRACTOR* Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 f 44* KRAMER, REGIS KENNETH; R NO SWEAT A/C REFRIG &`HTG"INC DAVIE FL 3.33252 -r� 511 SUMTER AVE '€"""` ISSUED: 07/24/2016 L. � 1I S '°� u 1. 6 L L ' _�L is 4 DISPLAY AS REQUIRED BY LAW SEQ # L1607240001473 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2016 THROUGH SEPTEMBER 30, 2017 Receipt #:HEAT NG/AIRCONDITION CONT Business Type: (A/c CONTR) Owner Name: K KRAMER JR REGIS Business Opened:05/18/1995 Business Location: 511 SUMTER AVE State/County/Cert/Reg:cAco26410 DAVIE Exemption Code: Business Phone: 423-9696 DBA: Business Name: NO SWEAT A/C REFRIG & HEATING INC Rooms Seats Employees 1 Machines Professionals For Vending Business Only Number of Machines: Vending Tvoe: Tax Amount Transfer Fee NSF Fee . Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: K KRAMER JR REGIS 511 SUMTER AVE DAVIE, FL 33325 This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2016 - 2017 Receipt #1CP-15-00019968 Paid 08/17/2016 27.00 08/16/2016 Effective Date ARIW COU® E5 CERTIFICATE OF LIABILITY INSURANCE DATE (MDDNYYY) 7/11/2016 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. IMPORTANT: ff the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the 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). PRODUCER Jackson Insurance Agency 2075 West 76th St Hialeah FL 33016 CONTACT Maria Benitez NAME: PHONE Ext): (305)824-3464 fFplX No):(3os)822-es3s ADDRIESS:mbeniteIejacksoaagency.com INSURER(S) AFFORDING COVERAGE NAIC INsuRERAAmerican Empire Surplus Lines 35351 INSURED No Sweat Air Conditioning, Refrigeration, And 511 Sumter Ave . Davie, FL 33325 INSURER 0 : 16CG0202761 INSURERC: 5/20/2017 INSURER D : $ 300,000 INSURER E : INSURERF: E COVERAGES CERTIFICATE NUMBER:2016-2017 COI REVISION 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 REQUIREMENT, 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLBUBR INSD WVD POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP IMWDpryYVY) LIMITSLTR A E COMMERCIAL GENERAL LIABILITY _ • 16CG0202761 5/20/2016 5/20/2017 EACH OCCURRENCE $ 300,000 CLAIMS -MADE E OCCUR PRMt0 RENTED PREMDAMAGE GE (Ea occurrence) 100 � 000ISES $ MEDEXP(Anyoneperson) $ 5,000 PERSONAL & ADV INJURY $ 300, 000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 600,000 PRODUCTS - COMP/OP AGG $ 300,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, desaibe under DESCRIPTION OF OPERATIONS below N/A PER 0T14 - E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 11 more space Is required) This certificate is solely for the use as " Evidence of Insurance" License 4 CACO26410 CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ed Jackson/PCAMP ACORD 25 (2014/01) INSO25 opium ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD