Loading...
MC-17-2954Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-298835 Permit Number: MC -12-17-2954 Scheduled Inspection Date: March 08, 2018 Inspector: Perez, JanPierre Owner: NOWAKOWSKI, ANTHONY Job Address: 1238 NE 98 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: DIRECT AIR CONDITIONING INC Permit Type: Mechanical = Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132050090331 Phone: 305-596-2666 Building Department Comments AC CHANGE OUT I Infractio Passed Comments INSPECTOR COMMENTS False (--(// \) Y1) )ti Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-294008. missing lock caps March 07, 2018 For Inspections please call: (305)762-4949 Page 31 of 34 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. MC -1 -17-2954 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: APPROVED Issue Date:12121 /2017 Expiration: 06/19/2018 Parcel Number Applicant 1238 NE 98 Street Miami Shores, FL 33138- 1132050090331 Block: Lot: ANTHONY NOWAKOWSKI Owner Information Address Phone Cell ANTHONY NOWAKOWSKI 1238 NE 98 ST MIAMI SHORES FL 33138-2561 Contractor(s) DIRECT AIR CONDITIONING INC Phone 305-596-2666 Cell Phone Valuation: Total Sq Feet: $ 10,200.00 0 Tons: Additional Info: AC CHANGE OUT Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 2 Date Approved: : In Review Type of Work: AC CHANGE OUT Fees Due CCF DBPR Fee DCA Fee Education 'Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $6.60 $5.36 $3.57 $2.20 $357.00 $6.00 $8.80 $389.53 Pay Date Pay Type Invoice # MC -12-17-65921 12/21/2017 Check #: 2571 $ 339.53 $ 50.00 12/15/2017 Check #: 12153 $ 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, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I -rtify that all the foregoi • information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zon' . .. Futher , . uthori above-named contractor to do the work stated. uthorized Signature: 0 Applicant / Contractor / Agent Building Department Copy December 21, 2017 Date December 21, 2017 1 AcoRIJ CERTIFICATE OF LIABILITY INSURANCE 4.......----- DATE (MM/°D YYYY) 12/21/2017 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(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 Automatic Data Processing Insurance Agency, Inc. 1 Adp Boulevard Roseland, NJ 07068 CONTACT NAME: (NC, No. Ext): FAX No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 11 INSURER A : Technology Insurance Company, Inc. i 42376 INSURED DIRECT AIR CONDITIONING INC 12200 SW 129th Court Miami, FL 33186 INSURER B : INSURER C INSURER D : $ INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 800253 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADEDAMAGE OCCUR TO REN I EU PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO - JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ 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 LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ AANY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N/A N TWC3670851 12/01/2017 12/01/2018 x PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CAC057328 IFI ATE HOLDER CANCELLATION Miama Shores Village 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 ACORD 25 (2014/01) A© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department /0050 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 FIN7ED D 2017 GUI. FBC 20,1f S111 Permit No.M C — 29 SI Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: /o. 3 J' 7 / .-Cf City: Miami Shores County: Miami Dade Zip: 33/3S› Folio/Parcel#: Is the Building Historically Designated: Yes NO i< Flood Zone: OWNER: Name (Fee Simple Titleholder): f'�'�'� AWY C X6(. -A --2i Phone#: .30,/—•' 06- 6-�(�� Address: /2.'J ///Z 7f rti $'T City: "47//4, 7 / %f4'2e t State: /' Zip: 3341P Tenant/Lessee Name: A'1/47 Email: /0/Y7,5-'6 /)///57 0 6/y1/3/G . c- 22 CONTRACTOR: Company Name: 'D' ec - A v' C a+ l� ow 1 n Phone#: 6c sq b' 666 Address: /c1-(?- 0 0 Su) / ,)-9,_e+ City: IAA 1 0i lA16 State1 Zip: Qualifier Name:/` U lit i\ S/�6� �U loas Phone#: State Certification or Registration #: ( r4C_ OS i DI. Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Phone#: Value of Work for this Permit: $ Type of Work: ❑Addition Description of Work: ,a6 0 Square/Linear Footage of Work: New ORepair/l4eplace ❑Demolition PIC Ck&Ok A cye cru ❑Alteration Color thru tile: ************************************* eS******************************************** Submittal Fee $ SO PC; d Permit Fee $ I t O U CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ...3 9" • 53 _ 4 * 3^' ^ ./ . '` / ° 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 pertnit with an estima promise in good faith that a copy of the notice of commencement and construction lie whose properly is subject to attachment. Also, a certified copy of the recorded notice for the first inspection which occurs seven (7) da s s • • building permit is issue inspection will not be approved and a fee will be c ged. Signature Owner or Agent The fore oing instrument was ackn1 day of c.. , 20 j,, by ged before pie this who is personally known to me or who has produced As identification and who did take an oath. NOTARY Sign: Print: UB My Commission -moor r xpires: ********************** APPROVED BY Notary Public - State of Florida Commission a GO 153539 My Comm. Expires Oct 22. 2021 Border! through Natioral Notary Assr. Signature The foregoin day of ed valu law broch xceeding re w commence In the 2500, the applicant must e delivered to the person st be posted at the job site of such posted notice, the instrument wa trac or acknowledv, d before (e this , by JJat Cf../- '-• , who is personally known to me or who has produced as i entific NOTARY PUB Sign: Print: IC: 1 Itetwiggirr TO n and who did take an oath. My Commission *********************************************** `tip Plans Examiner Zoning Clerk JOSE GONZALEZ Notary Public - State of Florida Commission: GO 153539 r'/ My Comm. Expires Oct 22, 2021 Borded through Natioral Notary Assr. ****** * - ** Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Direct Air Conditioning 12200 SW 129th Court Miami FL 33186 Phone: 305-596-2666 Fax: 786-429-1455 CAC057328 Anthony Nowakowski 1238 NE 98 ST Miami FL 33138 Direct Air Conditioning 3100 South Congress Ave. # 7 Boynton Beach, FL 33426 Palm Beach: 561-404-1100 Broward: 954-281-4004 Fax: 561-336-2567 12/14/2017 INVOICE 0000012552 Anthony Nowakowski 1238 NE 98 ST Miami FL 33138 305-206-6186 0001789 COD ARTURO BARRO 1.00 • cod 85.00 cod 305-206-6186 from 9 am not working Notes added 10:32:38 Unit is old 2 units,3 ton Estimated stand,float float switch,install 1 year labor Estimated stand,float float switch,install 1 year labor Total price Approved Estimated to 12 noon properly by tech ARTURO BARRO on 12/14/2017 AM and low on freon, customer wants an estimated for in 1st floor and 2.5 in 2nd floor. for 3 ton unit lennox cbx27 whit e116 16 seer,ah switch,hurricane tie downs,auxiliar drain pan whit stick uv Iight,10 years warranty in parts and warranty,permit included. for 2.5 ton unit lennox cbx27 whit e116 16 seer,ah switch,hurricane tie downs,auxiliar drain pan whit stick uv Iight,10 years warranty in parts and warranty„permit included 10200.00 thru greensky $0.00 Customer Signature TOTAL 001533 local Business Tax eceipt Miami -Dade County, State of Florida -THIS ,IS'NOT A BILL -DO NOT PAY 3630473 BUSINESS NAME/LOCATION DIRECT AIR CONDITIONING INC 12200 SW 129 `Cf MIAMI :FL:33186 OWNER DIRECT AIR CONDITIONING INC C/O JUAN SOTOLONGO Worker(s) 10 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER. 30, 2018 3793271 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OFBUSINESS 196 SPEC MECHANICAL CONTRACTOR CAC057328 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 08/28/2017 CREDITCARD-17-056325 This Local Business Tax Receipt only confirms payment 'tithe 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 NO. above must be displayed on all commercial` vehicles: tylia T ile ode Sec 8a-276. For more information, visitwww.miam' a CERTIFIED® www.ahridirectory.org This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings o3 AHRI Certified Reference Number: 10259409 Date: 8/16/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: EL16XC1S036-230B** Indoor Unit Model Number: CBA27UHE-036-230*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: LENNOX . . . .. . • . •. • . • • .• . . • . .... . ; . . ...... ..•• Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SIC,.TbI, 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 eli• ible t• o 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.• • • •• • •• Serie f me:.ELITE.EL16XC,SERIES Manufacturer respon s ibl i for the rating•o� his.system combination is LENNOX INDUSTRIES, INC. \'\ Rated as follows in_accordanceiwith AHRI Standard,210/24O 2008 for,Unitary;Air-Conditioning and Air -Source y nEquipment-arid subject to -verification of rating_ accuracy by AHRI-sponsored; independent;third parttesting: 1 Cooling Capacity (Btuh): EER Rating (Cooling): SEER .Rating -(Cooling): 34600 NNAr1,��.)l 13.00 16.00. IEER Rating (Cooling): ---� ---C Miami Shores Vill_ge 7ONII\ G DEPT r ql D( DEPT * Ratings followed by . asterisk (*) indicate a voluntary rerate of previously published data, unless:accompanied withS WAS pwhich indicates an involuntary rerate. -,i IH V F; LF C A 4 : R�r ILAT( J AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guaranteeNSs 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.ahrldlrectory.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 The information for the model cited on this certificate can be verified at www.ahrldlrectory.org, click on "Verify Certificate" Zink 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. DISCLAIMER ©2014 Air -Conditioning, Heating, and Refrigeration Institute r-11.111 a ko lk I AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE we make life better" CERTIFICATE NO.: 131473622784815204 •.f 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): City: Miami Shores Village • .. . .. . .. . . • • .• • . • •. • . . County: Miami Dade Zip•c(14, _ • ...• . ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLIMNCRC I' LAr••. ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOODp.Fv,4TION • •• • 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 4\ ;-tM MANUFACTURER Lenn0 X P3Tl a. 15 \L,�\ AHU or PKG. UNIT MODEL # C.2A.171U f 1 Epe/ ' -lkik P, 0a(off/Vok. COND. UNIT MODEL # gG io<C16 OU, KW HEAT q n a5 of NOM TONS i g •5 AHUM CU ..PKG 1) M.C.A AHU IL CU \0 PKG AHUOCU 50 PKG 2) M.O.P AHU CppCU g()PKG AHU.L(Q CU .24 PKG 3) VOLTS AH44I)CU APKG PKG UNIT / / .: ; ' PKG UNIT / / EER/SEER (a YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT ES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO Minimum Circuit Ampacity (Wire Size): Ak\ CO -10 2. Maximum Overcurrent Protection (Fuse/Breaker Size): A \ c, CU -30 3. Voltage of Circuit 240/480): aq-A1-\--(0® U- 50 AmP5 U 4. Size Disconnects Contractor's Compan State Certificate or Reg Signature (Revised02/24/2014) Phone: Certificate of Competency No. Date: AIR CONDITIONING REPLACEMENT DATA iami 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. tacI1 spit chatnge-out must• '•:' be on its own data sheet. Multiple units on single sheets are not acceptable. ' • .. Job Address (where the work is being done): • • • City: Miami Shores Village County: Miami Dade •••• Zip teals:. • • ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID.CONCRETE.SLAB •' • . • ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD EL'EVATIION • • A COPY OF THE CONTRACT 1S REQUIRED WITH ALL SUBMIT:A.LS• • • • AHRI DATA SHEET REQUIRED • • •; Change disconnecting means: )(ESE] NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT -- MANUFACTURER L-erm\o v_k.cikr y FD-) 60N (Q6 AHU or PKG. UNIT MODEL # C 8Y TIU H 2 03() t O COND. UNIT MODEL # rLj G'C.Io 0 KW HEAT 8 NOM TONS b AHU5;,1- CU `{ PKG 1) M.C.A AHU. CU CI PKG AHU(00 CU9O PKG 2)M.O.P AHUCpCU 60PKG AHq 4O CU9,51-0PKG 3) VOLTS ,, AHU j4OCU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES (Nt) YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES 0 YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): k (D ' (JU JQ 3. Voltage of Circui : _ 240/480): ;._4( v 0 \ I Z /\4—(3 CU 4. Size Disconne Contractor's Com State Certificate o Signature ' Date: (Qua,'er'ss Phone: Certificate of Competency No. (Revised02/24/2014) • • •