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MC-18-512 f ' r 1� 1 1 I 8 1 Ck- ��/,1 a I i 1 i 1 t � 1 r { i f k } I Permit NO. MC-2-1&512 �sN°R�s y Miami Shores Village M Permit Type:Mechanical-Commercial 10050 N.E.2nd Avenue NE e r m work Classification:A/C Replacement Miami Shores,FL 33138-0000 PPermit Status:APPROVED Phone: (305)795-2204 LtNT�M! Expiration: 10/13/2018 Issue Date:4/16/2018 fll Project Address Parcel Number Applicant 1628 NE 105 Street Number: A-4 1122300530040 r UBALDO PEREZ JR s [ Miami Shores, FL Block: Lot: f Owner Information Address Phone Cell r UBALDO PEREZ JR 1628 NE 105 Street (305)219-2640 MIAMI SHORES FL 33138- 1628 NE 105 Street ` MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,500.00 ULTRA WEATHER CORP (786)615-4559 Total Sq Feet: p Tons:3 Available Inspections: Additional Info:EXACT A/C CHANGE OUT. Inspection Type: Classification:Commercial Approved:In Review Final Review Mechanical Comments: Date Approved::In Review j Date Denied: Type of Work: Scanning:3 i 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# MC-2-18-66605 1 $2.00 02/28/2018 Credit Card $50.00 $74.40 i DCA Fee $2.00 Education Surcharge $0.80 04/16/2018 Check#: 1700 $74.40 $0.00 Permit Fee $105.00 Scanning Fee $9.00 ` Technology Fee $3.20 Total: $124.40 31 i i { - 1 In consi 'ration of issuance to me of this permit,'I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaini thereto arVd 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 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. Futhermore,I authorize the above-named contractor to do the work stated. April 16, 2018 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 16,2018 1 { { 1 t� Inspection Worksheet Miami Shores Village ' 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 l Inspection Number: INSP-304715 Permit Number: MC-2-18-512 Scheduled Inspection Date: May 22, 2018 Permit Type: Mechanical;- Commercial i Inspector: Perez,JanPierre Inspection Type: Final Owner: PEREZ JR, UBALDO Work Classification: A/C Replacement Job Address:1628 NE 105 Street A-4 r Miami Shores, FL Phone Number (305)219-2640 t Parcel Number 1122300530040 Project: <NONE> i r Contractor: ULTRA WEATHER CORP Phone: (786)615-4559 i Building Department Comments EXACT A/C CHANGE OUT. Infractio Passed comments t INSPECTOR COMMENTS False I Naranjo, BO' ' 03-01-2018 1. According to a complaint received from the ZZ l condominium association the mechanical work and or AC equipment are to be repair and or replaced through the association. Please check with the condominium association i Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-298282. NEED TO SEE C/U 1 Failed Correction ❑ 6 I Needed 4t Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. t 1 � May 21,2018 For Inspections please call: (305)762-4949 , Page 29 of 29 a a i { y r }1 { 4 SN�RFs s� �► Miami shores' Village Building Department. TIES 1104 10050 N:E.2nd Avenue ORNA Miami Shores,,Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 r 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 forexempt 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 i employees,including the owner,must obtain workers' compensation coverage. Corporate officers 1 or members of a limited liability company (LLC) in the construction industry may elect to be 1 exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of I 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 are4 allowed to be exempt. Construction exemptions are valid for a period of two years or until a 1 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 1 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. t Signature: Owner R t State of Florida County of Miami-Dade {O The foregoing was acknowledge before me this b��t� day of E161 ,20 . By_ ��� ��c-Z �.�L who is 15QK5k me or has produced ' as identification. j JOSEFINA RUBIO t Notary: -{�� � : MY COMMISSION#FF937623 ° f �'Y EXPIRM November 19,2019 SEAL: (407)398.0153 Flori&NotaryService.eom r + lt I 1 i I Miami Shores Village ' Building Department EB 20 618 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: �j Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 l��o BUILDING Master Permit No. McN- iiq PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 1 ❑PLUMBING ® MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1 tea? N • kc)sj ' - City: Miami Shores County: Miami Dade zip: Folio/Parcel#: J1-Aa1ZD-1915-�S-0046 Is the Building Historically Designated:Yes NO I Occupancy Type: Load: n I iConstruction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):' UI�cCL�d,Q p�f�Z�Z- Phone#: '�+�C7 a&46 II Address:'-1 691 OZ. 1 Q5 S A ^-� l City: IW-nI i�_��J State: FL Zip: 3313 Tenant/Lessee Name: ' U 1@ .1C�� l��Z .J Q, . Phone#: :I Email: CONTRACTOR:Company Name: 1 Q(,� Pi(� t.�iJ Phone#:_��i��AP- -'}M Address: I rfq s� `a r City: "tam* I State: EL Qualifier Name: 1--cX-`7 ( Phone#: State Certification or Registration#: �gp�rjgrj Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: r i Address: City: State: Zip: Value of Work for this Permit:$ t5r'Ub -d'(570 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New [[ Repair/Replace ❑ Demolition { I Description of Work: , Specify color of color thru tile: + Submittal Fee Permit Fee$ v CCF$ CO/CC$ Scanning"Fee$ Radon Fee$ DBPR$ Notary$ -Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ r� (Revised02/24/2014) i } I Bonding Company's Name(if applicable) I ,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 i RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND j TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 1 Notice to Applicant: As a condition to the issuance o a building pp f g permit with an estimated value exceeding$2500, the applicant must 1 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 I inspection will not be approved and a reinspection fee will be charged. 1 Signature Signature OWNER or AGENT CONTRACTOR The foregaoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this t �° day of deb�l�l�-C�/ 20 1' by o day of Fel�f"w- 20 �� by , I c-��•- a-Cef?--7Z:Je,who is personally known to V-Cxr—('Q lAz)44D k• ,who i ersonally kn n to t me or who has produced as me or who has produced as I identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 1 Sign: Sign: { Print: A UBIO W= " FF9376 23 Print: 66N#FF931623 I Seal: p. Seal: EXPIRES•November 19,2019' ,f f• EXPIRES November 19,.20'19 (407)398.0153 FloridallotaryService.com (107)398-0153 FlorideNotaryService.com � I APPROVED BY Pta �Examiner Zoning I Al Structural Review Clerk (Revised02/24/2014) { Miami Shores Village Building Department .� 10050 N.E.2nd Avenue Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8472 I AIR CONIDMONING REPLACEMENT DATA I PERMIT NUMBER: MG ' This form must accompany ALL air cord6flordng replacement permit moons.Each unit change-out must be on its own data sheet.Multiple units on single sheets are not blel. /� Job Address(where the work is being 1 dorw): 09'9 1\)-E- 1 Q 5 �j T A- aw Miami slimes vlliage cowar. Miami Dade rip Code: 35 I �� ALL CONDENSING UNITS MUST BE ON A 41NCH 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[] PHO❑ ARHI Sheet Attached:YES❑ NO❑ Contract Attached:YES I❑ I UNIT BEING REPLACED DATA NEW UNIT 2Q(Y1 MANUFACTURER 2erY1 i(1 -4- MU or PKG.UNIT MODEL C U GOND.UNIT MODEL# WHEAT NOM TONS AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CUPKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT /► / /13 ESVSEER 1(10 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND NO YES NO NEW RETURN PLENUM BOX YES NO i 1. Minimum Circuit Ampacity(Wire Size): g 2. Maximum Owerawent PaAectio n(Fuse/Breaker Size): 3. Vdtagge of Circuli(208/240/480); 9,-08 h-zo S►r��2 1 4. Size Disconnecting Meares ContractoesCompany Name: Phorm Ts(0-aaT-1}x-1- , State Carbilicift or l..Ae,lg I4A'15 Cerocate of competency No. 77 Signature Date: 14 aq lN (Revs M2124/2014) h This Combination qualifies for a Federal Energy Efficiency tax Credit when o placed in service between Feb 17,2009 and Dec 31,2016. 0%1 No ILI CERTIFIED Certificate of Product Ratings MRI Certified Reterenae Number-2012135991 Date:02 28-2018 Model Sraffts :Active Old AHRI Reference Number:7942207 AM Type:RCU-A CB 1 Series : Outdoor Unit Brand Name :RHEEM Outdoor Unit Model Number (Condenser or Single Package) :RA1636AJ1 indoor Unit Brand Name : t Indoor Unit Model Number(Evaporator and or Air Handles) :RHIT3617STAN Furnace Model Number: Region :AN(AK AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,ID,IL,IA,IN,KS,KY,LA,MA,MD,ME,MI,MN,MO,MS,MT, NJ,NM,NV,NY,OH,OK,OR,PA,Rl,SC,SD,TN,TX,UT,VA,Vr.WA,WV,WI,WY,U.S.Territories) Region Note :Central air conditioners manufaeha d prior to January 1,2015 are eligible to be installed in ad regions until June 30.2016. Begirinft July 1.2016 cents air conditioners can only be installed in region(s)for which they meet the regional efficiency The Manufacturer of firs RHEEM product is responsible for the rating of this system combination. r Rated as follows in accordance with lite latest edition of ANSVAHRI 2101240 with Addenda 1 and 2,Perforrrnance Rating of Unitary Air Condifiormtg &Air-Source Heat Pump E4vlpment and subject tDrating aeairacy by erden third party"testing: I -* i D * SEER :16.00 EER )- or K0 Stage(95F) :13.00 LEER I rAcOW Model Stahm arefioee lust an AHS Cedificadon Progrmn Policilnt is currently prodtichhg AND eeeng orofferbg for ode:OR new modetstthd are being marketed but aro not yet being produ at"Prodlbion Sthpped'Modd Stabs are those that an AM Ge on Program Participant is no longer pro I rig Bifr is still ee" fthat �0faaeamperhised by WAS mdkd&an n oluntan . The now Published rating is shown cion with the orevious ft e.WAS)raeno. 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 I 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 usees Individual, personal and Confidential reference. AIR-CONDITIONING,HEATING, I CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org,dick on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, we make life better- which is listed above,and the Certificate No.,which is listed at bottom right. ©2018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 13lrA299a8700101 2/27/2018 Property Search Application-Miami-Dade County I When buying real estate property,you should not assume that property taxes will remain the same.Whenever there is a change in ownership,the assessed value of the property may reset to full IMPORTANT market value,which could result in higher property taxes.Please use our Tax Estimator to approximate your new property taxes. MESSAGE The Property Appraiser does not send tax bills and does not set or collect taxes.Please visit the Tax Collector's website directly for additional information. 1 Address Owner Name Folio II, SEARCH: I 1628 ne 105 st Suite 7 ^I CL I I Print Results 1 1 1 EXACT MATCH NOT FOUND FOR SEARCH CRITERIA ENTERED. 1 POSSIBLE MATCHES)ARE LISTED BELOW. Click on the Folio number to view property details. I I FOLIO: 11-2230-053-0040 t SUB-DIVISION:HARBOUR CLUB VILLAS CONDO OWNER: UBALDO PEREZ JR I LIANNE RUIZ PROP.ADDR: 1628 NE 105 ST UNIT#A-4 MIAMI SHORES 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,see full disclaimer and User Agreement at http:/Avww.miamidade.govli'nfo/dL,daimer.asp For inquiries and suggestions email us at httplhwvw.miamidade.gov/PAPorteVContactForFn/ContactFormMain.aspx. Version:2.0.3 r i I , EXEMPTIONS 5 BENEFITS y I Deployed Military I Disability Exemptions Homestead Institutional I Senior Citizens I i More> REAL EffATE t t f http://www.miamidade.gov/propertysearch/#t 1/1 I i 1 Ultra Weather Corp 17851 SW 152nd Ct Miami , FL 33187 786-615-4559 CAC1816585 " Miamiiceac@grmail.com Date: 2-27-2018 i State of Florida County of Dade Before me this day personally appeared Larazo K. Alberto who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 162 & NF 10 A-4 Miami Shores FL 33138 Cont or Signature Sworn to (or affirmed) and subscribed before me this 27 day of February. 2018 By Lazaro K. Alberto Personally Known X Or Produced Identification Type of entifis tion Pro ed �►'�"�x� JOSEFINA RUBIO MY COMMISSION#FF937623 sefina Rubi EXPIRES November 19,Zoos" Print,Type or Stamp Name Of Notary ?1398-0153 Floridallo,aryService.com � t t k R II 7j1 f � .. .�. ....:. 'as 5d#75 E.SC5t5s&#Peel, 84x+ras,MOA 83138* o"993.8578 k � 3/20/2018 t Village of Miami Shores t Building Department 10050 NE 2 Avenue } Miami Shores Village, FL 33138 { k } t Attn: Village of Miami Shores Building Department, We authorize the owner of 1628 NE 105th Street Miami Shores, FL 33138 to have their air conditioning unit replaced with proper permitting by Miami Shores Village. r , i Sincerely, r 6/4�f Kacey Schock, Preside For the Associ tion. 4 r II F 4 4 1 I k