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MC-17-2862 Inspection Worksheet . � Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-293349 Permit Number: MC-12-17-2862 Scheduled Inspection Date: January 23,2018 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: HYNES,KIMBERLY Work Classification: A/C Replacement Job Address:302 NE 100 Street Miami Shores, FL Phone Number Project: <NONE> Parcel Number 1132060135470 Contractor: ANACHRIS A/C & REFRIGERATION INC Phone:,305-899-1187 Building Department Comments F EXACT CHANGE OUT OF 4 TON RESIDENTIAL A/C Infractio Passed Comments SYSTEM INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. I January 22,2018 For Inspections please call: (305)762-4949 Page 11 of 28 Permit NO. MC-12-17-2862 Miami Shores Village Patmit Type:Mec'Ianical-Residential 10050 N.E.2nd Avenue NE work Classification:A/C Replacement Miami Shores,FL 33138-0000 Perlill- Petmii`Status:<APPROVED SopN ` Phone: (305)795-2204 �'CO(tiDp` issue Date: 1/1012018 Expiration: 07/09/2018 IF k Project Address Parcel Number Applicant E 302 NE 100 Street 1132060135470 « Miami Shores, FL Block: Lot: ANTHONY HYNES Owner Information Address Phone Cell KIMBERLY HYNES 302 NE 100 ST MIAMI SHORES FL 33138-2421 Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 ANACHRIS A/C&REFRIGERATION IN 305-899-1187 Total Sq Feet: 0 i Tons:4 Available Inspections: Additional Info:EXACT CHANGE OUT OF 4 TON RESIDENTI Inspection Type: Classification:Residential Final i _ F Approved: In Review Review Mechanical, Comments: Date Approved: : In Review :j: Date Denied: Type of Work:EXACT CHANGE OUT OF 4 TON RES Scanning:3 i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# MC-12-17-65816 DBPR Fee $2.77 01/10/2018 Credit Card $ 156.74 $50.00 DCA Fee $2.00 Education Surcharge $1.00 12/05/2017 Credit Card $50.00 $0.00 Permit Fee $184.97 Scanning Fee $9.00 Technology Fee $4.00 Total: $206.74 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, WS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoi infortion is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. uther+ oriz -named contractor to do the work stated. January 10, 2018 Authorized Signature:Own-T/ / Contract / Agent Date Building Departure Co January 10,2018 1 - r Miami Shores Village �"° DECD 2017 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 0-1 J BUILDING Master Permit No. Mc (4- 2S 62 PERMIT APPLICATION . Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING VMECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /t CONTRACTOR DRAWINGS JOB ADDRESS: AE, I,Q y S�' City: Miami Shores County: Miami Dade zip: 331'SQ Folio/Parcel#: nn Is the Building Historically Designated:Yes NO Occupancy Type: RkS, Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name(Fee Simple Titleholder): AAoA.)(/ Phone#: -",7 1�d Address: -3 0 a N e 1 0 0 St - City: d4 t H W)l j I l*7t f S State: )r-,/ . Zip: 33 ( 30 . Tenant/Lessee Name: Phone#: Email: /� / CONTRACTOR:Company Name: ANA 6 / Phone#: -I/S7 Address: 9-.5 / Gly�.- /U��2 ',s-t I 1 / City: ISeel3jAilt, �i State: r � • Zip: � � 14?1 Qualifier Name: �� 0 2. i'(/I/�rri-Z, Phone#: State Certification or Registration#:_ O��S9�' Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: ''1 y city: State: Zip: Value of Work for this Permit:$ _ Square/Linear Foo a of Work: Type of Work: ❑ Addition ❑ Alteration EJ New yL Repair/Replace ❑ Demolition l Descrip ion of Work: :C4-c"r Specify color of color thru tile: Submittal Fee$ 00 Permit Fee$ �4( fl CCF$ CO/CC$ Scanning Fee$ Radon Fee$ 2 ' DBPR$ 2 " Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) i. T 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 osted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature, Lv-Q,� OW or AGENT CN CTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowedged b fore me is day of 1�l��— 20 rl byA��Of--.R:' �'�—sonally C— 20 by ry `�"1t�� t'T l who is personally known to known to me or who has produced rL)Z as me or who has produced le=�-- kms/ nl + as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: ����«1111t11111////� NOTARY PUBLIC: ION i Sign: •• � Sign: 111111111//�/ Print: ��; s R9:a= Print: ���1�._.a ;pop— s oao2 �5. �. Seal: _ate; o9[bss�� o; Seal: ir'•:�b/dX3P1��• �� :yam "Xisao��•�Q� I'F APPROVED BY "' Ilans Examiner o•fOIPS 1�IN��Zoning Structural Review Clerk (Revised02/24/2014) .r r � r ,15 C I S y Miami Shores Village Building Department uu � wnM 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 ORtDp 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): :36 -L N 100 S 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 ❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT &I/11-" k4hvC S &bl MANUFACTURER 144fJO CRA) ,6T N/3ae& . M Ho Itg. AHU or PKG. UNIT MODEL# /jr a To COND. UNIT MODEL# W; KW HEAT s KGl7 , Trn> NOM TONS AHU50 CU 46 PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU aL1&KG 3)VOLTS q zAo -- AHU CU PKG PKG UNIT / / PKG UNIT See e- EER/SEER YES O REPLACING DUCTS YES NO E O REPLACING THERMOSTAT ES NO ES NO NEW 4"CONCRETE SLAB ES NO ES 0 NEW ROOF STAND N YES 0 NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): 40 A'- � �l41UIJ . 2. Maximum Overcurrent Protection (Fuse/Breaker Size): <,l© A- •1?,,e C c/L 3. Voltage of Circuit (20 /240/ 80): 4. Size Disconnecting Means: Contractor's Company Name: / 67 Phone: .30�'�% State Certificate or Registration No. eAfnta'!9_9e Certificate of Competency No. Signature Date: 7. (Qua' er's ignatu (Revised02/24/2014) uc lrrun ncmc . RICK SCOTT, GOVERNOR, KEN LAWSON,SECRETARY a STATE OF FLORIDA DEPARTMENT OF BUSINESS-AND PROFESSIONAL REGULATION CONSTRUCTIOM'INDUSTRY-LICENSING BOARD" 4� i... ,CAC042596 The-CLASSAAIR CONDITIONING CONTRACTOR:' Named below IS CERTIFIED — ry 'k r Under,the pravlslons t3f Chapter"489-FS `Ex iratlon"date .AUG 31.201&-;- _ - -,�. � � ,.sem .-"" .. ��,..:�- �� ",,,,,�"wad,��'s�.,.,,a "�+•4�+., l'-�g� :.,'S�`.,., h'`yY � '41 M . ' 11NUNE2 9ERb1O`RICAR ,� ANACHRIS AIRCONDITJ 6& REFRIGTIIVC 821ANE,1'09-S1 N > ISSUED: 09/04/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1609040001144 { 001160 Local Business Tax Receipt Miami-Dade County,State of Florida —THIS IS NOT A BILL—DO NOT PAY ­ LBT E 2724053 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ANACHRIS AIR CONDITIONING&REFRIGERATION IIRENEWAL SEPTEMBER 30, 2018 821 NE 109 ST 2853852 Must be displayed at place of business BISCAYNE PARK FL 33161 Pursuant to County Code Chapter 8A—Art.9&10 t OWNER ' SEC.TYPE OF BUSINESS PAYMENT RECEIVED ANACHRIS AIR COND&REFRIG'dNC 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR Worker(s) 1 $45.00.08/26/20T7 CREDITCARD-17-056108 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 6a-276. For more information,visit www.miamidade.govAoxcollector t I ' 4 ACORO /28/20YYYY) CERTIFICATE OF LIABILITY INSURANCE DATE( oasno17 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 CONTACT NAME: GEICO Insurance Agency,Inc. GEICO Insurance Agency,Inc. Pnrcii Ext: 877515-2191 FAX No: PO Box 5316 E-MAIL Binghamton,NY 13902 ADDRESS: commercialservi homesite.com INSURER(S)AFFORDING COVERAGE NAIC S INSURER A: Midvale Indemnity Company 27138 INSURED INSURER B: ANACHRIS AIR CONDITIONING S REFRIGERATION,INC. INSURER C: 821 NE 109TH STREET INSURER D: MIAMI FL 33161 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 209553139404100122860828 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 INSURANCEVivoADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR VD MMIDDIYYYY MMID GENERAL LIABILITY EACH OCCURRENCE $1,000,000 MAGE TO RENTED A X' COMMERCIAL GENERAL LIABILITY Y N GLP1001038 06/03/2017 06/03/2018 PREM SES Ea occurrence $100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000,000 X POLICYRO - LOC CT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS Per accident HIREDAUT NON-OWNED PROPERTY DAMAGE AUTOS Per accident) UMBRELLA LIAB DCCUR EACH OCCURRENCE$ EXCESS LIAB CLAIMSMAD AGGREGATE DED RETENTION$ WORKERS COMPENSATION INC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS I ER ANY PROPRIETOR/PARTNER/EXECU f -TIVE OFFICER/MEMBER EXCLUDED. N/A E.L.EACH ACCIDENT (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE H yes,describe under i DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT PROFESSIONAL LIABILITY OCCURRENCE AGGREGATE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) I Heating,Venting and Air Conditioning Services v ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD BID 013 20130603 Pagel of 2 i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED MIAMI SHORES VILLAGE BUILDING DEPT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138 1 ©1988-2010 ACORD CORPORATION. All rights reserved. r , , M w I r ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD BID 013 20130603 Page 2 of 2 'f K JIMMY PATRONIS CHIEF ANANICAL OFFICER STATE OF FLORIDA i DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION "*CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW*" CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 10/11/2017 EXPIRATION DATE: 10/11/2019 PERSON: NUNEZ SERGIO R FEIN: 650403009 i BUSINESS NAME AND ADDRESS: ANACHRIS AIR CONDITIONING& REFRIGERATION, INC. 821 NE 109TH STREET , MIAMI FL 33161 SCOPE OF BUSINESS OR TRADE: Healing,Ventilation,Air- Conditioning and Refrigeration Systems Installation,Service and Repair,Shop,Yard& Drivers IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation ti,at any time alter the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no lorhger meets the requirements of this section for Issuance of a certificate.The department shall revoke,a certificate at any time for failure of the person named on,the certificate to meet Dire requirements of this section. DFS F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 • l'2a ThRIS Air Conditioning and Refrigeration Inc. 821 N.E. 109 Street • Miami, FL. 33161 • Tel.: (305) 899-1187 • Fax: (305) 899-1187 Name/Address Estimate Tony Hynes 302 NE 100 St. Miami Shores, FL Date Estimate# 11/24/2017 161 Description Total We respectfully propose to supply and install one 4-ton American Standard 5,285.00 super high efficiency 17 SEER central air conditioning unit in replacement of existing. Install new concrete condensing unit base pad. Install new heat/cool digital thermostat and 7.5 kW heat strip. Connect to existing electrical, condensate, refrigerant piping and ductwork; modify as necessary to accommodate. Flush refrigerant lines to accommodate the new environmentally friendly 410a refrigerant. System comes with a 10-year manufacturer parts warranty and one year labor. Permit fees are additional. k 1 60%due on acceptance, and balance due upon completion. Total $5,285.00 Signature miss 'I ", Miami shores Vff illage Building Department 4,fi�vRivA. 10050 N.E.2nd Avenue i 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. § 440.0 i allows corporate officers in the construction industry to exempt themselves from this requirement for any come trucuon project prior to obtaininga building permit. Pursuant to the Florida Division of NN'6o kers' Compensation Emplo}'er Facts Brochure: I t• An employer in the c-ol;struction industry who employs one or more part-time or full-time l employees.including the owner,must obtain workers` compensation coverage. Corporate officers i or members of a limited liability company (LI-C) in the construction industry may elect to be j 1 exempt if: r 1 1. The officer owns at least 10 percent of the stock of the corporation. or in the case of an I._LC,a statement attesting to the minimun2 10 percent ownership: 2. The officer is listed as an officer of the corporation in the records of the Florida i -Department of State.Division of Corporations,and I Y �. The corporation is registered and listed as active with the Florida Department of � State. Division afCorporaror:s. + i i No II10re (}iai7 ihf,^e corporate Otilec'.1-i pc'r l:OrpOra`1L7;1 01- limited lial?Ihi:: company iii-embers are i 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 Di ision. i Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she v.ill not use ' day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will 1; be the only person allowed to:vork or;Lour nroie.et. In these circumstances. Miami Sher es inane does not require verification of workers'compensation insurance coverage from the contractor's! company for day labor,par time employees or subcontractors.BY SIGNING BELOW' ACK`Oti��I.FDGE THAT YOU HA ,-E READ THIS NOTICE AND L\DERSTAN71) ITS { CONTENTS. t � ' Signature: .4 N) { Owner + State of Florida + County of'vlianni-Dade i The foregoing was acknmvled=e before me this 0 day of�1�_.__ Byl I S who is personally known to inc o,r i as produced c=► — t i as identification, No MAHARAI K.GONZALEZ MY COMMISSION#GG 044602 SEAL: .a EXPIRES:November 2,2020 '•.;;o:F�q.•`' Bonded Thru Notary Public Underwriters i i 4 I Ana Air Conditioning and Refrigeration Inc. 821 N.E. 109 Street • Miami, FL. 33161 • Tel.: (305) 899-1187 • Fax: (305) 899-1187 January 10, 2018 State of Florida County of Miami-Dade Before me this day personally appeared SERGIO NUN o being duly sworn,deposes and says: That he or she will be the only person working on the project located at 302 NE 100th Street. Sworn to (or affirmed) and subscribed before me this '4 day of _34zt�U,',� 2018, by Personally know OR Produced Identification Type of Identification Produced` -_N2-i� (_kC;r-7 t,-C Print,Type or Stamp Name of Notary b V P(y Notary Public State of Florida ? .. Sindia Alvarez % c My Commission FF 156750 ?oFpoQ� Expires 0910312018 it This combination qualifies for a Federal Energy N%m MEN CERTIFIED Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2016. Certificate of Product Ratings AHRI Certified Reference Number: 8936362 Date: 12/3/2017 i Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number:4A7A6049J1 Indoor Unit Model Number:TEM6AOC48H41+TDR+UF/HRZ Manufacturer: AMERICAN STANDARD Trade/Brand name:AMERICAN STANDARD Region:All(AK,AL,AR,AZ, CA, CO, CT, DC, DE, FL, GA, Hl;ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC,SD,TN,TX, UT,VA,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:-GOLD-16 " Manufacturer responsible rthe'ratIng of this system combination is AMERICAN STANDARD Rated as foll�s n accords`cewith AHRIiSta I dard°;210124o-2008 for Unitary,Air-Conditionin end Air-Source t + e I g :< HeatiPump Equipment and`subject-to-verlfication bf rating.accuracy by AHRI-spon� b�rre`d, independent,third party testin `� M 1 t] 1 1 o�, I Cooling Capacity(Btuh): 48000 (1(01 II C'�I t o CQ)TT EER Rating(Cooling): 14.00 � SEER'Rating"(Cooling):µ 17:00 - IEER Rating(Cooling): J , Ratings followed by an asterisk(')indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. I DISCLAIMER AHRI does not endorse the product(s)fisted 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 a 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. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTrFUrE The information for the model cited on this certificate can be verified at www.ahridirectofy.org,click on'Verify Certificate"link we life bei,. 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. 131568242259365984 ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: