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MC-17-2512 1 Inspection Worksheet r } Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-305859 Permit Number: MC-10-17-2512 Scheduled Inspection Date: June 07, 2018 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: SCHOFIELD,JOHN CHRISTOPHER& Work Classification: A/C Replacement Job Address:18 NE 106 Street Miami Shores, FL 33138-2035 Phone Number % Parcel Number 1121360060070 Project: <NONE> Contractor: PROSERV AMERICA LLC Phone: (954)450-5323 Building Department Comments STRAIGHT A/C CHANGE OUT Infractio Passed Comments INSPECTOR COMMENTS False P Inspector Comments Passed to — CREATED AS REINSPECTION FOR INSP-290993. MISSING LOCK CAPS AND SCREWS 1" FROM EDGE t PAPER WORK AND INSPECTION PLANS AT FRONT DOOR Failed. Correction ❑ Needed Re-Inspection ❑ Fee a No Additional Inspections can be scheduled until re-inspection fee is paid. June 06,2018 For Inspections please call: (305)762-4949 Page 26 of 34 � I Permit Na. MC4 0-17-2512 �eKO1s o,� Miami Shores Village t Permit Type:Mechanical-Residential 10050 N.E.2nd Avenue NE Work Classification:A/C Replacement �- Miami Shores,FL 33138-0000 r Phone: (305)795-2204 Permit Status:i�►PPRUVED yLEN- O - F�ORtDA issue Date:312112018 Expiration: 09/17/2018 Project Address Parcel Number Applicant 18 NE 106 Street 1121360060070 JOHN CHRISTOPHER&MARLEI Miami Shores, FL 33138-2035 Block: Lot: Owner Information Address Phone Cell JOHN CHRISTOPHER&MARLENE 18 NE 106 Street -- -- - - MIAMI SHORES FL 33138-2035 18 NE 106 Street MIAMI SHORES FL 33138-2035 Contractor(s) Phone Cell Phone Valuation: $ 4,075.00 PROSERV AMERICA LLC (954)450-5323 (954)557-2887 Total Sq Feet: 1484 Tons:3.5 Available Inspections: Additional Info:STRAIGHT A/C CHANGE OUT Inspection Type: Classification:Residential Final Approved=:In Review Review Mechanical Comments: Date Approved: : In Review Date Denied: Type of Work: Scanning:3 r Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# MC-10-17-65426 DBPR Fee $2.14 DCA Fee $2.00 10/20/2017 Check#:3105 $50.00 $ 113.76 Education Surcharge $1.00 03/21/2018 Check#:3533 $ 113.76 $0.00 Permit Fee $142.62 - Scanning Fee $9.00 Technology Fee $4.00 Total: $163.76 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 i n t conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting'this perm; as me responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELEC ICA ,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFF AVI : I cert; h all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction d z mg. Fut r re, I authorize the above-named contractor to do the work stated. March 21, 2018 A o re:Owner / Applicant / Contractor / Agent Date Building Department Copy March 21, 2018 1 ��.���'_ CSL � .��� � � � . _ F „ y. Miami Shores Village CRUVED Building Department r 2 2017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY. l 1 �• Tel:(305)795-2204 Fax:(305)756-8972 r INSPECTION LINE PHONE NUMBER:(305)762-4949 ; r F6C 20 N J BUILDING Master Permit No. I"[ , 2S(2— PERMIT 2— PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING EfMECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 15 N:E lO ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: It 213 X00 bo ()70 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): SC- ,Q�,��(;1� hone#: (150 3:56"96Y,6 `Address: / 't;� 'hic jobj� -,q- City: g(,Gtnx. 5 hore S State: T"L Zip: 3 3136 . Tenant/Lessee Name: Phone#: (+&0-) 'g6Y6. Email: •rt- SC` o 73 e, ATT-. f"e.T CONTRACTOR:Company Name: 74,V'V AM-'P'-CCL Phone#:�05Y)1 y50 -532-j Address:'_Ob ) SW 1071-b z1UC City:i t &L(-f., Pk-0,1 State: F- . Zip: 3-JD z7 Qualifier Name: VAa"Cwt ORwcfG-- Phone#: (-'OS),58O -S2*�C, State Certification or Registration#: CAW-7.&Y/ Certificate of Competency#: �f DESIGNER:Architect/Engineer: A Phone#: t Address: City: State: Zip: Value of Work for this Permit:$ -/�a s.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration,�/ /❑ New ��Repai Replace ❑ Demolition Description of Work: �j�`(GUICI -t A C. l.kC(,A9. K, lY�i Specify color of color thru tile: Submittal Fee$To • W Permit Fee$ l CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$_ { Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) ou - t Bonding Company's Address li: 7 A(A�NINIe 0mx ll� r 1�111U. l( _ "( + City %1)114P_('ff)PpfP. State �L Zip `b41go Mortgage Lender's Name(if applicable) Mortgage Lender's Address N 4 City r /7 t State N /j�- 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;areinspection fee will be charged. 57 Signature Signa re tER or AGENT NTR The foregoin instr s ackn wledged before this The foregoing instr ent was acknowledged before me this day of 20 1 by day of Q 20 t v7 by 0 A e who is personally known to fa(a who is personally known to me or who has produced %.1 4�-'-1b3-lb; 2.1-as mg or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: ✓� r t Print: Print: C+; )0 LW; Notary Public State of Florida Seal: Tarlara Rubio-Urqulza Seal: ?o k*, Notary Public State of Florida Ex Commission FF 975769 Tamara Rubio-Urqulza Expires 04/03/2020 C ,�� My Commission FF 975769 or coo° Expires 04!03/2020 ******************************************* ***************** * * ************** APPROVED BY P ns Examiner Zoning Structural Review Clerk (Revised02/24/2014) —AProserv® INVOICE _ A/R A N0 HEAT Date Invoice# 833 SW 167 Avenue,Pembroke Pines,FL 33027 8/9/2017 11827 Dade: (305)374-1060 Broward: (954)450-5323 www.ProservAmerica.com Ship To: JOHN SCHOFIELD (786)356-9646 MARILENE SCHOFIELD 18 NE 106 ST MIAMI SHORES,FL 33138 a Due Date Technician Rep Tech Time 8/9/2017 ERIC ERIC Description Quantity Price Each Amount RHEEM 3.5-TON 16 SEER. 1 4,225.00 4,225.00 BTUH 41500 CONDENSER MODEL NO.RA1642AJ 1 NA AIR HANDLER MODEL NO.RH 1T4821 STANJA. HEATER MODEL NO.RXBH-1724C1OJ ARI NO.7942888 INCLUDES: DIGITAL THERMOSTAT SAFETY FLOAT SWITCH NEW LIQUID LINER DRYER NEW LOCKING CAPS FOR FREON LINES HURRICANE TIE DOWNS FOR CONDENSER VIBRATION PADS UP-TO 5'OF NEW REFRIGERANT LINES,AS NEEDED UP-TO 5'NEW ARMOR FLEX INSULATION FLUSH OUT FREON LINES TO REMOVE OLD R-22 REFRIGERANT FLUSH OUT EXISTING DRAIN LINE(60-DAYS WARRANTY) FLUSHING OF COPPER LINES FROM THE OLD R-22 REFRIGERANT TO THE NEW R-4IOA SEAL EQUIPMENT CONNECTIONS SPRAY FOAM BOTTOM OF THE LINE CHASE 4 NEW VIBRATION PADS CONNECT TO EXISTING COPPER,ELECTRICAL,DRAIN LINE AND DUCT WORK. MASTIC SEAL INSIDE PLENUM TO ENSURE NO LEAKS REMOVAL AND LEGAL DISPOSAL OF OLD EQUIPMENT. FILTER RACK NEW CONCRETE SLAB FLORIDA POWER&LIGHT REBATE. -150.00 -150.00 Upon signing this receipt,customer is fully satisfied. Total Pagel Cr V11/70SIEs"VM INVOICE A/R AND HEAT Date invoice# 833 SW 167 Avenue,Pembroke Pines,FL 33027 8/9/2017 11827 Dade: (305)374-1060 Broward: (954)450-5323 www.ProservAmerica.com Ship To: JOHN SCHOFIELD (786)356-9646 MARILENE SCHOFIELD 18 NE 106 ST MIAMI SHORES,FL 33138 Due Date Technician Rep Tech Time 8/9/2017 ERIC ERIC Description Quantity Price Each Amount ONE(1)-YEAR LABOR AND TEN(10)-YEARS MANUFACTURER'S WARRANTY ON PARTS AND COMPRESSOR. CITY PERM IT,EXPEDITING FEES,AND DAY OF INSPECTION,IF REQUIRED BY CITY. *ANY ELECTRICAL UPGRADES ARE THE HOME OWNERS RESPONSIBILITY* i Upon signing this receipt,customer is fully satisfied. Total Page 2 Pr serve INVOICE 1 A/R AND HEAT Date Invoice# 833 SW 167 Avenue,Pembroke Pines,FL 33027 8/9/2017 11827 Dade: (305)374-1060 Broward: (954)450-5323 www.ProservAmerica.com Ship To: JOHN SCHOFIELD (786)356-9646 MARILENE SCHOFIELD 18 NE 106 ST MIAMI SHORES,FL 33138 Due Date Technician Rep Tech Time 8/9/2017 ERIC ERIC Description Quantity Price Each Amount 5 YR. SERVICE AGREEMENT BEGINS AFTER 12 MONTH OF INSTALLATION DATE. IT INCLUDES: Check thermostat operation. Check system temperature split. I Refrigerant check. Inspect disconnect. Inspect fuses. Inspect wiring. Tighten electrical connections. Inspect contactors,relay and pressure controls. Inspect electrical safety circuits. Check voltage and amperage to all motors. Compressor check,amp draw and Connections. Inspect indoor blower and motor for dirt build-up. Inspect condenser motor. Inspect bearings&lubricate moving parts(if needed). Inspect condensate drain. Algae tabs condensation treatment. Inspect condenser and evaporator coil. Inspect duct seal at unit and secure panels. Leak check.exclude nitrogen testing. Safety control inspection. Run and test system. 10%Discount on all Repairs. One service per.calendar year. ****This Service Agreement shall be voided if any Company other than PROSERV AMERICA,LLC.,services unit Upon signing this receipt,customer is fully satisfied. Total Page 3 AA1r,. A... e"v® INVOICE -A- HEAT Date Invoice# 833 SW 167 Avenue,Pembroke Pines,FL 33027 8/9/2017 11827 Dade: (305)374-1060 Broward: (954)450-5323 www.ProservAmerica.com Ship To: JOHN SCHOFIELD (786)356-9646 MARILENE SCHOFIELD 18 NE 106 ST MIAMI SHORES,FL 33138 Due Date Technician Rep Tech Time 8/9/2017 ERIC ERIC { Description Quantity Price Each Amount State of FLORIDA) County of BROWARD) 'p Sworn to(or affirmed)and subscribed before me this + o day of AlJ&t'�T,2017,by MANUEL R.BARRERA,who is personally known by me. The undersigned Notary Public of the State of Florida, acknowledges that HE/SH e uted it,approving a/c model and price of unit ng' s e"°"e. Notary Public Sta of Florida ?' Tarnara Rubio- rquiza 1 ra, ual' ^�� g� My commission F975769 of f Explres 04/03/20 o �V Notary P tc,as to Co ract s Signature. i State of FLORIDA) County of BROWARD) Sworn to(or affirmed)and subscribed before me this 9 day of AUGUST,2017,by JOHN SCHOFIELD/MARILENE SCHOFIELD, who provided FDL#: as Identification. ersigned Notary Public of the State of Florida, acknowled t HE HE executed it,approvin a/ unit bei insta e . IVdt9ry public State of Flori pt Tit ora Rubio-Urqulza 66mmoj nFF 8'75'76 J HN S HO M LENS S !� 1 Notary Pu lic 'O'W''O'W'P Sig re. Upon signing this receipt,customer is fully satisfied. Total $4,075.00 Page 4 8/8/2017 Property Search Application-Miami-Dade County �I Ilia S 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. Address Owner Name Folio SEARCH: 18 NE 106 ST Suite Q PROPERTY INFORMATION Folio:11-2136-006-0070 Sub-Division: DUNNINGS MIAMI SHORES EXT NO 2 Property Address 18 NE 106 ST Miami Shores,FL 33138-2035 Owner 'JOHN CHRISTOPHER SCHOFIELD MARILENE SCHOFIELD Mailing Address 18 NE 106 ST MIAMI SHORES,FL 33138 PA Primary Zone I 1000 SGL FAMILY-2101-2300 So I Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY:1 UNIT Beds/Baths I Half 2/2/0 Floors 1 Living Units 1 Actual Area Living Area Adjusted Area 1,220 Sq.Ft Lot Size 9,225 Sq.Ft Year Built 1939 3 I L Map View. Layers - - http://www.miamidade.gov/propertysearch/#/ 1/3 8/8/2017 Property Search Application-Miami-Dade County r it -I- - .' PAMFr 1w Ilk 2016 Aerial Photography Eft Featured Online Tools Comparable Sales Glossary Non-Ad Valorem Assessments PA Additional Online Tools 1 Property Record Cards Property Search Help Property Taxes Report Discrepancies Report Homestead Fraud Tax Comparison Tax Estimator TRIM Notice Value Adjustment Board ASSESSMENT INFORMATION �- Year 2017 2016 2015 Land Value $230.638 $198,007 $163,894 Building Value $68,076 $68,108 $68,140 Extra Feature Value $36,912 $37,340 $25,588 Market Value $335,626 $303,455 $257,622 Assessed Value $255,056 $249,810 $248,074 TAXABLE VALUE INFORMATION 2017 2016 2015 COUNTY Exemption Value $50,000 $50,000 $50,000 Taxable Value $205,056 $199,810 $198,074 SCHOOLBOARD _ Exemption Value $25,000 $25,000 $25,000 Taxable Value $230,056 $224,810 $223,074 CITY Exemption Value $50,000 $50,000 $50,000 Taxable Value $205,056 $199,810 $198,074 REGIONAL - - ♦_ -__ __- --_ _ http://www.miamidade.gov/propertysearch/#/ 2/3 8/8/2017 Property Search Application-Miami-Dade County Exemption Value $50,000 $50,000 $50,000 Taxable Value $205,056 $199,810 $198,074 BENEFITS INFORMATION i Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $80,570 $53,645 $9,548 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Board,City,Regional). FULL LEGAL DESCRIPTION DUNNINGS MIAMI SHORES EXT NO 2 PB 41-78 LOT 7 BLK 202 LOT SIZE 75.000 X 123 OR 15232-2787 1091 1 SALES INFORMATION Previous Sale Price OR Book-Page Qualification Description Previous Owner 1 05/22/2013 $318,500 28660-2705 Qual by exam of deed DENISE ADELE CONROY 10/01/1991 $69,000 15232-2787 Sales which are qualified I For more information about the Department of Revenue's Sales Qualification Codes. 2017 2016 2015 LAND INFORMATION. Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-17.5,R-18.5 1000-SGL FAMILY-2101-2300 SO Front Ft. 75.00 $230,638 1 BUILDING INFORMATION Building Number Sub Area Year Bulk Actual Sq.Ft. Living Sq.Ft. Adj Sq.Ft. Calc Value 1 1 1939 1,151 $64,226 1 2 1966 69 $3,850 EXTRA FEATURES Description Year Built Units Calc Value Patio-Brick,Tile,Flagstone 2004 500 $4,840 Pool 6'res BETTER 3-B'dpth,tile 250-649 sf 2004 1 $26,400 Wood Fence 1992 291 $3,632 •Patio-Terrazzo,Pebble 1992 413 $2,040 ADDITIONAL INFORMATION The information listed below is not derived from the Property Appraisers Office records.It is provided for convenience and is derived from other government agencies. http://www.miamidade.gov/propertysearch/#/ 3/3 . i . ,SNORES D,�t logo _ ,.,..?m Miami Shores Village Building Department ORiDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: i A. J- COPY OF QUALIFIER'S STATE LICENCES B. //, COPY OF LOCAL BUSINESS TAX RECEIPT , C.�✓ COPY OF LIABILITY INSURANCE* D. ✓ COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) i IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: ' A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. ................. ........................................................................ BUSINESS NAME: V ) L BUSINESS ADDRESS: ?? 60 1 V ' TNS- CITY&h(�k ' STATE ZIP I i BUSINESS PHONE: (q `�3�"3 FAX NUMBER( 9J ) � -�? CELL PHONE (o )�17�"0��7 QUALIFIER'S NAME: Honud &fffo. QUALIFIER'S LIC NUMBER: DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION cis, 4�- CONSTRUCTION INDUSTRY LICENSING BOARD p CACO26413 The CLASS AAIR CONDITIONING CONTRACTOR , Named below IS CERTIFIED Under the provisions of Chapter 489 FS. G0 kol ' Expiration date: AUG 31, 2018 t ' BARRERA MANUEL-RA MON _ ' PROS ERV AM ERICA Lk 14842 .SW 42 CTS fvIIRAMAR FL;33027 M- 1 .�±,, i'.3a' ISSUED. 08/03/2016 �X DISPLAY AS REQUIRED BY LAW SEQ# L1608030001310 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2017 THROUGH SEPTEMBER 30,2018 i I p 183-238072 DBA: Receipt#:HEATING/AIRCONDITION CONT TR Business Name:PROSERV AMERICA LLC Business Type: � t Owner Name:MANUEL RAMON BARRERA (QUALIFIER) Business Opened:12/20/2010 j Business Location: 833 SW 167 AVE State/County/Cert/Reg:CACO26413 PEMBROKE PINES Exemption Code: Business Phone: i Rooms Seats Employees Machines Professionals 3 For Vending Business Only j Number of Machines: Vending Type: j i Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid i 27.00 0.00 0.00 0.00 0.00 0.00 27.00 i i i THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT 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 WHEN VALIDATED 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 I it is in compliance with State or local laws and regulations. j i Mailing Address: i PROSERV AMERICA LLC Receipt #1CP-16-00020260 833 SW 167 AVE Paid 08/22/2017 27.00 PEMBROKE PINES, FL 33027 08/21/2017 Effective Date i 2017 - 2018 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/20/2017 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(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: Jessica MOrneault ---> 561-253-3248 PrimeGroup Insurance Services, Inc. PNONE (813)288-8270 A No: Ie13>ee5-+711 5402 W. Laurel St. E-MAIL ADDRESS: rou morneault@P 4 P rime ins.com Suite 220 INSURERS AFFORDING COVERAGE NAIC# Tampa FL 33607 INSURERA:Old Dominion Insurance Company 40231 INSURED INSURER B:Associated Industries Ins Co 23140 PROSERV AMERICA LLC INSURER C: 833 SW 167TH AVE INSURER D: w INSURER E: PEMBROKE PINES FL 33027-1425 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1742017207 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 ADDL SU POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD MM/DD/YYYY LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $ MPG7285G 12/02/2016 12/02/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: -GENERAL AGGREGATE $ X POLICY 0 JPERCOT F�LOC PRODUCTS $ 2,000,000 OTHER: EPLI $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT; $ Ea accident ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED id Per accent AUTOS AUTOS BODILY INJURY( ) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE Per $ AUTOS accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONX PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N❑N/A B (Mandatory in NH) AWC1081541 04/26/2017 04/26/2018 E.L.DISEASE-EA EMPLOYEE $ 500,000 0 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE---POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) HVAC CACO26413 I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 Ed Ellsasser/KAMM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) T c 0 ash°RES y Miami Shores Village Building Department eggs essgsM 10050 N.E.2nd Avenue Miami Shores, Florida 33138 MT N y dxIDA COPUTel:(305)795.2204 Fax:(305)756.8972 / 0 4 IR CO DITIONING REPLACEMENT DATA PERMIT NUMBER: MC �Q� ( (This, mm st ac ompja�nyS4LL air,conditioning replacement permit applications. Each unit change-out must bdonits ov`' da a shut. 6tiple units on single sheets are not acceptable. GJob/Add e�s( here the work is being done): (Q ity, VIiaQ i Shores�/illage �' County: Miami Dade Zip Code: .3'�T Com' Q0 q�/ (f ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB 0 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 i ARHI Sheet Attached:YES [I/NO ❑ Contract Attached:YES Ul UNIT BEING REPLACED DATA NEW UNIT 30(1 Aa 4n&A(-d MANUFACTURER _rwf o P 1 D AHU OF 4296--WNF MODEL# t 2 S A COND.JcOALA AAIIJ �Q KW HEAT 10 S NOM TONS 2).5 AH CU.25 PKG 1)M.C.A AHU!jQ CU'j. PKG AHU CU PKG 2)M.O.P AHU' CU PKG AH 20 U,2,Zo PKG 3)VOLTS AHU;2WCU,_b6 P1436.j% PKG UNIT PKG UNIT•_•/ ,/— 00.0•• EER SE 10 .. �....• ....:. ; YES O REPLACING DUCTS YES ...:. 0 E NO REPLACING THERMOSTAT ••••NO •• �••••� S NO NEW4"CONCRETE SLAB ••••NO 0 00 •0••• YES NEW ROOF STAND YES 00:00 .00000 •0.00*0*0000 YES NEW RETURN PLENUM BOX YES NO • 0 /�A % 00000 1. Minimum Circuit Ampacity(Wire Size):_ U Y� �U 7� .. . 000 2. Maximum Overcurrent Protection (Fuse/Breaker Size): • 3. Voltage of Circuit(208/240/480): -7'al / 2 qQ 4. Size Disconnecting Means: u &0 eu Contractor's Company Name: (Q 5"Vl'�r,a I'd&I k_. O' Phone: 1 State Certificat on N ogo`I I Certificate of Competenc12 y �Q V 1 Signat a Date• V Qu ifier's ature) — OCT 2aj� (Revised02/24/2014) c This combination qualifies for a Federal Energy slim anal CERTIFIE ' Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 7942888 Date: 10/17/2017 Product: Split System: Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1642AJ1 Indoor Unit Model Number: RH1T4821STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: All(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, 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: r Manufacturerresponsiblefor the`rating of this,system combination is RHEEM SALES COMPANY, INC. Rated as follows in'accordanceiwith AHRI�'Sta i dard:210/240-2008 for,Unitary Air,Conditioningland Air-Source Heat=Pump Equipment-arid subject-toof rating�ac6drra�cy by AI HRl-spofnsored; independent,4third party testing: [,.�. �_ i �""`' Ij 1_! 1 E:i Cooling Capacity(Btuh): 41500 W011 EER Rating(Cooling): 13.00 SEER:Ratin Coolie 16:00__ 00*000• ••••• IEER Rating (Cooling): •• .••••. •. ...... .... ••••• ••••• .... . .. ..... ...... .... ..... •••••• •0000 0 ••000 Ratings followed by an asterisk(`)indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indinvEluntary rate. • •icatdR an 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.abridirectory.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. AIR-CONDITIONING.HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make life better- 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. 131527192393545889 ©2014 Air-Conditioning,Heating,and Refrigeration Institute [CERTIFICATE NO.: MIAMI-DADS MIAMI-RADE COUNTY, PRODUCT CONTROL SECTION 11805 SW 26 Street,Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES(RER) Miami,Florida X33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE (NOA) www.niiRnildade.gov/economy Rheem Sales Company,Inc. 5600 Old Greenwood Rd. Fort Smith,AR 72917 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed and accepted by Miami-Dade County RER-Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Product Control Section (In Miami Dade County) and/or the AHJ(in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone. DESCRIPTION: Mechanical Unit Steel and Aluminum Tie-Down Clips for Grade and Rooftop Applications APPROVAL DOCUMENT:Drawing No. 15-2543GA,titled"Wind Load Certification of Mechanical Unit Cabinetry and Steel/Aluminum Tie-Down Clips:At Grade and Roof Mounted Applications",sheets 1 through 7 of 7,dated 05/14/2015,revised on 11/20/2015,prepared by Engineering Express,signed and sealed by Frank L.Bernardo,P.E.,bearing the Miami-Dade County Product Control approval stamp with the Notice of Acceptance number and approval date by the Miami-Dade County Product Control Section. MISSILE IMPACT RATING: None LABELING:.Each unit shall bear a permanent label with the manufacturer's name or logo,city guff;,- ...... model/series,and following statement: "Miami-Dade County Product Control App?QVd',unless.QUrwise noted herein. 6.6 6.6 0 00000 0 0 6 6:6 RENEWAL of this NOA shall be considered after a renewal application has been filed aM MrS has been$o change:....: in the applicable building code negatively affecting the performance of this product. 0....6 6666 0 .. •..6• TERMINATION of this NOA will occur after the expiration date or if there has been a m4&1p>i or charlgAip the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of a8y p5JUct,foz..... sales,advertising or any other purposes shall automatically terminate this NOA.Failure to own fly.-With any section of this NOA shall be cause for termination and removal of NOA. 6 0..:. 0000.. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County„Flolrft, and followed by tltq....; expiration date may be displayed in advertising literature. If any portion of the NOA is disD)'aye8,then3P NICbe dole in its entirety. 1 0 INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA consists of this page I and evidence page E-1,as well as approval document mentioned above. The submitted documentation was reviewed by Carlos M.Utrera,P.E. NOA No. 15-0903.08 MIAMI-DADE COUNTY Expiration Date:February 25,2021 Approval Date:February 25,2016 Page 1 Rlteein Sales Comnanv,Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Drawing No. 15-2543GA,titled"Wind Load Certification of Mechanical Unit Cabinetry and Steel/Aluminum Tie-Down Clips: At Grade and Roof Mounted Applications", sheets 1 through 7 of 7,dated 05/14/2015,revised on 11/20/2015, prepared by Engineering Express, signed and sealed by Frank L. Bennardo, P.E. B. TESTS 1. Test report on Uniform Static Air Pressure Test per FBC, TAS 202-94 along with marked-up drawings and installation diagram of Rheem RA Series Mechanical Units, prepared by American Test Lab of South Florida, Test Report No. 0323.01-15, dated 05/18/2015, signed and sealed by Stephen W. Warter,P.E. C. CALCULATIONS 1. Anchorage calculations prepared by Engineering Express,dated 11/20/2015,signed and sealed by Frank L. Bennardo,P.E. D. QUALITY ASSURANCE 1. Miami-Dade Department of Regulatory and Economic Resources(RER) E. MATERIAL CERTIFICATIONS • • 1. None. • ••••:• ...... .... ...... F. STATEMENT •••• +• • • 1. Statement letter of code conformance to the 5th edition(2014)FBe issued•by••• ••;••. Engineering Express, dated 08/24/2015,signed and sealed by BeaS bio,P.F 2. Statement letter of no financial interest issued by EngineeringX.41;=s,dated. •• 11/20/2015,signed and sealed by Frank L. Bennardo,P.E. ••••:• 3. Distributor agreement dated 11/12/2015. • . . 02 1gf2016 Carlos M.Utrera,P.E. Product Control Examiner NOA No. 15-0903.08 Expiration Date:February 25,2021 Approval Date:February 25,2016 E-1 FRANK BENNARDO,P.E. RHEEM SALES COMPANY, INC. �,,,,,,1 PE46519 WIND LOAD CERTIFICATION OF MECHANICAL UNIT CABINETRY AND STEEL/ALUMINUM TIE-DOWN CLIPS: AT GRADE MOUNTED APPLICA5�. ) }� 4 1 }1.0-00' J35 510 �� A 1 J35 j51M`►x JS��Fy� 0.313"' I I ' L 0.750' * s: o srarE o Z y x qx 1.25o . FS,•.�ORIO zONAL LU 18-GA ASTM _ A653 PAINTED O L m W a W STEELp CABINETRY 0 O W N ul 3 �iti�3 Y Uiul w ® O .bi O o SIUI.IU t Bur SIM.TO(A)nll"IOO o ON OPP.FAC[ ON OPP.TACO C,.. (� 0 A C Z 0.187" i e o z og Z F� SUPPORTING CONCRETE CONCRETE 0 d SUPPORTING N €p STRUCTUREBY O Z 8 STRUCTURE BY B OTHERS,TYP. D 0.306' 0 6 B OTHERS,TYP. CONTROL BOX TYP• U 1 MECHANICAL UNIT 2 MECHANICAL UNIT RES N.T.S. FRONT ISOMETRIC N.T.S. BACK ISOMETRIC 1-T1�• Q °D 1 1 TIE-DOWN CLIP x THESE ISOMETRICS ARE INTENDED FOR ^w DIAGRAMMATIC AL PURPOSES ONLY;ALTERNATE RHEEM W E MIAMI TECH CLIP:14GA(0.07")ASTM A653 c LD UNITS LISTED HEREIN MAY VARY IN APPEARANCE Fu-90 KSI STEEL(CUTD10)OR 0.080' _ (4)-510 INTERNAL POST 5052-H32 ALUMINUM(CUTDA30),MIAMI m O SMS PER ADJACENT TO TECH KIT,t RRCUTDLK OR RRCUTDALK Y CLIP,TYP. CONTROL BOX i B OLIVER S PANEL, �.��..�..._.. - s TYP. P@8G 137.25"-- f l7 CLI UNIT BASE "c UNIT BASE 0Q UNIT BASE I ' ANCHOR PER PAN PAN PAN SCHEDULE II N M �LI D F 3000 PSI MIN. •'.. <... CONCRETE BY •• CLI A DIM.1 0 ' ° OTHERS,TYP. © O&© •• ••1�J 1• • • • • •• •"�CONTROL p g ®&©ARE SIM • •��••• • IP F IMENSION SHALL _ __`BOX_ a g Q. &.—_._._.—.—._ - AND OCCUR ON •• • = : : Bj T:TjIfROM j IS SIDE ONLY DATUM FACE DPP.FACES •• ••• •• • • • *00 3 TIE-DOWN CLIPS 4- TIE-DOWN CLIP LAYOUT 1 N.T.S. ELEVATION ll1 N.T.S. PLAN 15-2543GA pkcWk QWeB•pyya4eYr acALET ANCHOR SCHEDULE: •0• •• •S -D•NNICIP OFFSETS: APPLICABLE MODELS: Ddt- ib 51-T LUNITIPT1oNI SUBSTRATE DESCRIPTION • • • • Tt i RA1642A,RA1648,RA1660,RP1360, 3d,Tlr &NRS • • • • • • DIM.BL 0.506 MAX OFFSET FROM DATUM FACE 9B,76•x3s7°•FOOT aNT (t)•ua D CARBON STEEL SIMPSON STROM BOLT 2,11P•N EMBEO.O • uw RP7480,RP1548,RD1448,RP1560, m CONCRETE: CONCRETE,'MIN.EDGE DISTANCE,3'MIN.SMiNi TO Ary IONADJACENFrEMBEDWO110R. [M.2 'MI FSET FROM DATUM FACE RD1460,RANA174B,RAAW760, 7 (4'THICK l..i (I)-114'0 CARBON STEEL POWERS WEDGE BOLT+,2)'EMBED TO CONCRETE,3• DIM.3 31.00"MIN OFFSET FROM DATUM FACE RANA2048,RANAZO60,RPNP7748, y 7000 PSI MIN.MIN) MIN.EDGE DISTANCE,3'MIN.SPACING TO ANY ADJACENT ANCHOR. RP,UP1760,RP)UP2048,RP,UP2060, a 3 SUPPORTING CONCRETE SUBSTRATE DEPTH SHALL BE A MINIMUM I.SxANCNOR EMBED. DIM.4 13.00•MAX OFFSET FROM DATUM FACE tl EITHER ANCHOR FROM THIS SCHEDULE MAY BE USED FOR INSTALLATION. • • • • • • • • • • • •• •• • • • •• ••