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MC-18-1861Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Permit- NO. MC-7-18-1861 ■ Permit Type: Mechanical - Residential Work Classification: AFC Replacement Permit Status: APPROVED Expiration: 01/23/2019 Applicant 29 NE 102 Street Miami Shores, FL 33138- 1132060131650 Block: Lot: CARLOS ANDRADE Owner Information Address Phone Cell CARLOS ANDRADE 29 NE 102 Street MIAMI SHORES FL 33138- (786)351-1699 29 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) AC MECHANICAL SOLUTION, INC Phone Cell Phone Valuation: Total Sq Feet: $ 2,625.00 0 Tons: Additional Info: REPLACE AN OLD WALL UNIT A MINI SPL Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.00 $2.00 $0.60 $5.00 $100.00 $9.00 $2.40 $122.80 Pay Date Pay Type Invoice # MC-7-18-68186 07/11/2018 Credit Card 07/27/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 72.80 $ 72.80 $ 0.00 Available Inspections: Inspection Type: Final Review Building Review Building Review Mechanical Review Mechanical 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 AFFID T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an• z. 'ng. Futher ore, I authorize the above -named contractor to do the work stated. July 27, 2018 Date thorized Sig •ture: Owner / Applicant / Contractor / Agent Buil • ing Department Copy July 27, 2018 1 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 C MNTED J01$ BY:. Olt FBC 20 P_Th Master Permit No. M_O-) C `( 86 I Sub Permit No. El BUILDING ❑ ELECTRIC 0 ROOFING ❑ REVISION ❑ EXTENSION 0 RENEWAL PLUMBING ® MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR , DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: .33/3S-- Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: 29 N6- t 02 S Jam. "t JU rf 4,i o i JP. City: , / t " 4 ' State: �G Tenant/Le e N me: f ��@°! Phone#: Email: l_:.adDsMGl,ect . 5'1,�ri`',/' co Gil.. Phone#: CONTRACTOR: Company Name: tC /7'G 4U4/i64/ j i -427,hid Address:- /// J 1v6 Zip: s-l-I6714," -53/ 3i Phone#:� �%� d2 53 City: jf/f/lrv//1i State: F747t1.-13''¢ Qualifier Name: //r4y6f' State Certification or Registration #: . (/}C- �"/. - %y4{' Certificate of Competency #: Zip: ?1G/ Phone#: 6Pd _ 22o-- eC253 DESIGNER: Architect/Engineer: s. Address: Value of Work for this Permit: $ ` Z jr. Square/Linear Footage of Work: ❑ Addition ❑ Alteration n New Repair/Replace ❑ Demolition Phone#: Type of Work: Description of Work: City: State: Zip: Specify color of color. thru tile: ' M� A5, Submittal Fee $ �''' y.�. PermitrFee $ � - Radon Fee $ 03 Scanning Fee $ Technology Fee $ Structural Reviews $ CCF $ CO/CC$� DBPR $ — a-L ci Notary $ Training/Education Fee $ Double Fee $ Bond $ ,per TOTAL FEE NOW DUE $9 2 ' UV (Revised02/24/2014) • • BonfdinglCompany's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 1 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 $25d0, the applicant must promise in good fai' t •t a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject o atta hr\►ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection w ich curs s n (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be app oved and • r pection fee will be charged. ' Signature OWN :RorAG' T The foregoing instrument was acknowledged before me this (( day of "DUL--- ' rr ,20 ( ,by n_a - 4._ ( � j (S ri t who s personally, known to me or who has produced es .. i identification _ nd who did take an oath. NOTARY PUB I : Sign: Print: Seal: }, .yY-ylerevVvYbv r ti yr',e'y 5 aite:ra� Notary Public State of Florida d Slndia Alvarez (' At My Commission FF 156750 r i ***************** * Q9r90M2o'1€********* ***********'*** '****** "...A.A..4i...Oar., ti / :' t APPROVED BY Plans Examiner '(Signature CONTRACTOR • The foregoing instrument was acknowledged before me this 20 0 by* ( day of ho is personally known to me or who has produced `—/Z)Ct 2 ULEta� identification and who did take an oath. NOTARY PUB !L : (Revised02/24/2014) Sign: Print: Seal: Stew 9/z77/4i %3 /drat. Sc (D i..pak� Y71r VL'1 - • • ,, .Pare Notary Public State of Florida if a," • Sinditt Alvarez is o 'My Commission FF 156750 C , ' Expires 0910312018 Zoning Clerk Property Search Application - Miami -Dade County PR Summary Report Property Information Folio: 11-3206-013-1650 Property Address: 29 NE 102 ST Miami Shores, FL 33138-2322 Owner CHRISTIAN ULVERT CARLOS ANDRADE Mailing Address 29 NE 102 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,744 Sq.Ft Lot Size 11,400 Sq.Ft Year Built 1948 Assessment Information Year 2018 2017 2016 Land Value $284,848 $284,848 $284,848 Building Value $177,502 $177,502 $177,502 XF Value $33,049 $33,423 $33,796 Market Value $495,399 $495,773 $496,146 Assessed Value $495,399 $495,773 $496,146 Benefits Information Benefit Type 2018 2017 2016 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). Short Legal Description MIAMI SHORES SEC 1 AMD PB 10-70 LOT 15 & LOT 16 BLK 12 LOT SIZE 100.000 X 114 OR 20132-0809 12 2001 1 COC 21752-3084 10 2003 1 R Page 1 of 1 Generated On : 7/11/2018 Taxable Value Information 2018 2017i 2016 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $445,399 $445,773 $446,146 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $470,399 $470,773 $471,146 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $445,399 $445,773 $446,146 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value I $445,399 $445,773 $446,146 Sales Information Previous Sale Price OR Book -Page Qualification Description 07/19/2017 $585,000 30633-1673 Qual by exam of deed 02/24/2014 $510,000 29063-3603 Qual by exam of deed 10/01/2003 $333,000 21752-3084 Sales which are qualified 12/01/2001 $275,000 20132-0809 Sales which are qualified 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://www.miamidade.gov/info/disclaimer.asp Version: https://www.miamidade.gov/propertysearch/ 7/11/2018 'RIGK SCOTT; GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA .. DEPARTMENT OPBUSINESSANL PROFESSIONAL REGULATION, CONSTRUCTION INDUSTRY LICENSING BOARD r LICENSE NUMBER `The CLASS:B AIR.CONDITIONING Named, tieloily"IS.CERTIFIEfl.� Under:the provrsrtms of,Chapter 480Sr ' Expiration date.-AUG 317: ;HAVES; M71DRA AC,MECHANICAL SOLD - " 1'115,NE�11OTH TERRACE IAMI°: EL03318: ISSUED; tl6i14/2016 DISPLAY AS REQUIRED Y'LAW SEQ # L1606140000731 0 spa Local Business Tax*Receipt Miami -Dade County, State of Florida -THIS IS NOT A Bit.L -DO NOT PAY 7177720 BUSINESS NAMHtLOCATIGN AC MECHANICAL SOLUTION INC OPERATING IN DADE COUNTY RENEWAL 7487771 RECEIPT m EXPIRES SEPTEM3ER 30, 2018 Must be displayed at ptacee of business Pursuant to County Coda Clraptar 8A - Art. 9 & 10 OWNER,. t SEC. TYPE OF BUSINESS AC MECHANICAL SOLUTION INC 196 SPEC MECHANICAL CONTf C/O MAHENORA HAYES, PRESIDENT' ''CAC1817994 • 1 Workers) el Business Tax Race ipt onto certification of the atder npovvemmarttat rtnials1011 laws The RECEIPT N0. above must be drspleyed on all t o PAYMENT RECEIVER BY TAX COLLECTOR _ $75.00 09/25/2017 CREDITCARD-'17-062634' `I '.: Tax. T s Receipt is not a license; f=� must &purply With one tov yrnme> t! ' =e - Miami -Dade Code'Seo Ea:476. • etaldarta.gonrtaxcMtectot M ACMEC-1 OP ID: JB ACORb" CERTIFICATE OF LIABILITY INSURANCE `-� DATE(MM/DDIYYYY) 07/10/2018 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 Tropical Insurance Agency 8700 West. Flagler St. Ste 401 Miami, FL 33174 Nestor G. Rivero, CIC CONTACT PHONE FAX (NC. No. Extl: (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC / INSURER A : Granada Insurance Company INSURED AC MECHANICAL SOLUTION INC 1115 NE 110 Terr Miami, FL 33161 INSURER B: INSURERC: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP IMMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 600,000 A X COMMERCIAL GENERAL LIABILITY 0185FL00064453 11/07/2017 11107/2018 DAMAGES (EaRENTEDrcence) PREMISES (occu S 100,000 CLAIMS-MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 7 POLICY n PRO- LOC JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ _ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS -MADE AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION LIABILITY WC STATU- OTH- TORY LIMITS ER AND EMPLOYERS' Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required) AC install and service or repair CERTIFICATE HOLDER CANCELLATION MIAMISH Miami Shores Village 10050 N.E 2nd Avenue Miami Shores, FL 33138 SHOULD AN,Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ,�EXPJRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORp'ANCE WITH THE POLICY PROVISIONS. Pi it AUTH RIZ D REPRESENTATIVE Nes or . Rivero, CIC • ; ( / © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2010/05) JEFF ATWATER CHIEF FINANICAL OFFICER STATE OF FLORIDA 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: 12/1/2016 EXPIRATION DATE: 12/1/2018 PERSON: HAYES MAHENDRA FEIN: 472140272 BUSINESS NAME AND ADDRESS: AC MECHANICAL SOLUTION, INC. 1115 NE 110TH TERRACE MIAMI FL SCOPE OF BUSINESS OR TRADE: Heating, Ventilation, Air - Conditioning and Refrigeration Systems Installation, Service and Repair, Shop, Yard & Drivers 33161 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 if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer 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 the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 AC MECHANICAL SOLUTION INC Date: 07/11/2018 State of FLORIDA County of MIAMI-DADE Before me this day personally appeared I "�A4a� l.t�S who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: Sworn to (or affirmed and subscribed before me this t day of 1.0 l . 20 (6, by Personally know OR Produced Identification Type of Identification Produced UGC U(21" Print, Type or Stamp Name of Notary 40 Po Notary Public State of Florida Sindis Advaroz My Commielsiar FF 1f835R nOF ExpimcQ919V1016 Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU A KNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this ( I day of J() t&-j , 20 E . By OpR,L_0 S I S PN7 (Lxc who is personally known to me or has produced L C-1J as identification. Notary: SEAL: .,par O. Notary Public State of Florida r Sindia Alvarez a '!yMy Commission FF 156750 r. ?W Apim 0010312018 ` Signature Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade 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. /ti1� St/ Zip Code: 3341 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 [I. NO ❑ Contract Attached: YES [XI UNIT BEING REPLACED DATA NEW UNIT J/e,t,',i a Gu9'U i' TY MANUFACTURER AHU or PKG. UNIT MODEL# re- l3/S/12OU/ej'. COND.((U UNIT MODEL # G T✓s ?6 /-/P23 0✓1390 KW HEAT NOM TONS 3 No AHU CU PKG 1) M.C.A AHU CU 24( PKG AHU CU PKG 2) M.O.P AHU CU [fo PKG AHU CU PKG 3) VOLTS AHU CU.2 PKG PKG UNIT / / PKG UNIT / / EER/SEER ,-7A//� YES NO REPLACING DUCTS YES YES REPLACING THERMOSTAT YES YES NEW 4"CONCRETE SLAB YES YES NEW ROOF STAND YES A YES N� NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: 14-6 / 4-7 Xht Phone: 6-2o--62S3 State Certificate or Registration No. 4L_ g! /-”1( Certificate of Competency No. (7//cf"07” Date: - /j14041' signat (Qualifier's re) (Revised02/24/2014) Alk LIMP Aram No CERTIFIED® www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number : 9956328 Date : 07-10-2018 Model Status : Active AHRI Type : HRCU-A-CB-O Outdoor Unit Brand Name : GREE Outdoor Unit Model Number : LIVS36HP230V1 BO Indoor Type : Mini -Splits Indoor Model Number(s) : LIVS36HP230V1 BH Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (95F) : 33600 EER (95F) : 8.20 SEER : 16.00 High Heat (47E)::,34600 Low Heat-(17F) : 20600 HSPFi8.20 Sold in? : USA, Canada 1-"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being marketed but are not yet being produced."Production Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied by WAS indicate an involuntary re -rate. The new published rating is shown along with the previous (i.e. WAS) rating. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. 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 ,Hake 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. ©2018Air-Conditioning, Heating, and Refrigeration Institute ,CERTIFICATE NO.:= r '131757100197347639 1111111111111111111111 illll IIIII (IIII jIll liil CFN 201S .W:4,3010S OR EK 31062 Ps 4393 (1Pss) RECORDED 0i ,`1 : 21 1,_ 09: , :04 H RVEY RUVIN? CLERK OF v COURT (h ANI--DACE COUNTY? FLORIDA PREPARED BY: DECLARATION OF USE KNOW ALL MEN BY THESE iI .` PRESENTS: WHEREAS, the undersigned � 1 J 1 I LINT. Aare the fee simple owner(s) of the following described property ("Property") situated and being in Miami Shores Village, Florida: �n Lot(s) 1 j k LP Block 1 of 1 1 l�r C 1 �/�tI C.t IU r-QS (Subdivision), according to the plat thereof, as recorded in the Plat Book Page of the Public Records of Miami -Dade County, Florida, (address) � 102- 1 , 'n/ . m1 �1 Wand WHEREAS, the undersigned owner(s) have sought certain development approval from Miami Shores and are providing this document in consideration thereof and to induce the Village to grant same: NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is acknowledged, the undersigned do(es) hereby declare and agree: 1. That the Property will not be used in violation of any ordinance of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 2. That the property will be used for a single family residence only. 3. That he/she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and title to the above Property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance with the codes, rules and regulations of said Village then in effect. IN WITNESS WHEREOF, the undersigned has/have caused hand(s) and seal(s) to be affixed hereto on this day of 200 WITNESS(ES) w 1ATt Ot I'.ORtOA, 00UNTY OF DAOE ' HEREBY CERTIFY that is a true copy of the onainal filed in this office o*I V I1 8 2018,e ,AD0 Signature WITNESS my hand and Official Seal. .IARVEY RUVtTI, CLERK, of c . County Courts and Print DG Signature and Print STATE OF FLORIDA COUNTY OF MIAMI-DADE kIiVS`igntv�nlatur 6 ` V and Prin1..Y re14— Signature and Print Cki : ; v//L I HEREBY CERTIFY that on this day personally appeared before me 7 / a- d who is personally known to me or has produced ic C/ y/7-/r0-t.'d (type of identification) as identification and he/she acknowledge that he/she executed the foregoing, freely and voluntarily, for purposes therein expressed. SWORN TO AND SUBSCRIBED before me on this / 16 day of 3) / / , 20Pg. My commission expires: as-23 =t222 Dianelys GarridTTARY P COMMISSION # GG221549 EXPIRES: May 23, 2022 Banded lhru Aaron Notary BLIC, STATE OF FLORIDA