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MC-18-1407—boy FCORtDp` Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. MC--18-1407 Permit Type: Mechanical - Residential Perillolt Work Classification: A/C Replacement Permit Status: APPROVED Parcel Number Issue Date: 5/25/2018 1 Expiration: 11/21/2018 Applicant 1280 NE 102 Street 1132050220030 Miami Shores, FL 33138-2618 Block: Lot: MARK & DENISE JUANICO MARK & DENISE JUANICO 1280 NE 102 Street MIAMI SHORES FL 33138-2618 1280 NE 102 Street MIAMI SHORES FL 33138-2618 Contractor(s) Phone Cell Phone AMI AIR CONDITIONING (954)966-2380 0ns: dditional Info: AC CHANGE OUT AND REPLACE SUPPLY AN lassification: Residential proved: In Review nents: Denied: ning: 3 Fees Due Amount CCF $7.80 DBPR Fee $6.50 DCA Fee $4.34 Education Surcharge $2.60 Permit Fee $433.58 Scanning Fee $9.00 Technology Fee $10.40 Total: $474.22 Phone Cell Valuation: $ 12,388.00 Total Sq Feet: 0 Date Approved:: In Review Type of Work: AC CHANGE OUT AND REPLACE SU Pay Date Pay Type Amt Paid Amt Due Invoice # MC-5-18-67661 05/23/2018 Check #: 3716 $ 50.00 $ 424.22 05/25/2018 Check #: 3719 $ 424.22 $ 0.00 Available Inspections: Inspection Type: Final 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 AFFIDAVIT: I certify that all the foregoing information is accurate and construction and zoning. Futhermore, I authorize the above -named contractor to Oc Authorized Signature: Owner / Applicant / Contractor Agent all work will be done in compliance with all applicable laws regulating May 25, 2018 Building Department Copy 1 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 BUILDING PERMIT APPLICATION r-IBUILDING ELECTRIC ROOFING Y 3 2 18 FBC 20)1 bt+1 Master Permit No. mc. 16 — 4oi Sub Permit No. REVISION EXTENSION RENEWAL PLUMBING Q MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1280 NE 102 STREET City: Miami Shores County: Miami Dade Zip: folio/Parcel#:11-3205-022-0030 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): DENISE JUANICO, MARK T JUANICO Phone#: 786-252-3519 Address: 1280 NE 102 STREET City: MIAMI SHORES Tenant/Lessee Name: Email State: FL Zip: 33138 CONTRACTOR: Company Name: AMI AIR CONDITIONING Address: 4717 ORANGE DRIVE ne#: ne#: 954-966-2380 City: DAVIE State: FL Zip: 33314 Qualifier Name: DENNIS MULLINS State Certification or Registration #: CAC1814995 DESIGNER: Architect/Engineer: Phone#: Certificate of Competency #: 6054043 ne#: Address: City: State: Zip: Value of Work for this Permit: $ 12,388.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New FEW Repair/Replace ❑ Demolition Description of work: AC CHANGE OUT AND REPLACE SUPPLY AND RETURN DUCTS Specify color of color thru tile: Submittal Fee $ S li Permit Fee $ i Scanning Fee $ Radon Fee $ 3 Technology Fee $ Training/Education Fee $ Structural Reviews $ _ DBPR $ in • �V Notary $ Double Fee $ _ Bond $ ( ' TOTAL FEE NOW DUE $ 4c--;2 (Revised02/24/2014) c 11 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature—Z � Si natu g g OWNER or AGENT / The foregoing instrument was acknowledged before me this -_ I (a_ day of 201 by who is personally known to me or who has produced - L> QJ`O as identification and who did take an oath. NOTARY PUBLIC: CONTRACTOR The foregoing instrument was acknowledged before me this I J� day of 4 11 20 1`b by ritd►S )'VI kAL-LI r►3 who is personally known to me or who has produced 12efs r%r-% Y`►�Ex•>� as identification and who did take an oath. NOTARY PUBLIC: Sign:_ ,�A_x,t� Sign: hi Print: Print: y A ULLINS M�v � NotaryPuofFlurda , • Notary Public - State o/Fiartda Seal: Seal: . Commission I GG 142'68Gommis5i0n f GG '90495My Comm. Expires Sep 13.2021.pMy Comm. Expires Apr 11, 2022 ; Bonded through National Notary Assn, Bonded through National No6>,y A,sn. *********************************************************************************************************** APPROVED BY J fans Examiner Zoning Structural Review Clerk (Revis6d02/24/2014) RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE,OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC1814995 Tha t^.I ASR A AIR CONnITInNING CONTRACTOR" Z Z-° Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 MULLINS;:DENN18 T •''_ AMl:AIR-CONDI-T.,IONING����� _ 4717 ORANG��DR ?-�--' ,� r- DAME ,FL�3531F4� ISSUED: 06/20/2016 DISPLAY AS REQUIRED BY LAW 0i \;, ENyypp i SEQ # L1606200000432 009601 Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 5806253 _.y .,:.•_,,,...._ LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES AMI AIR CONDITIONING. RENEWAL SEPTEMBER 30, 2018 DOING BUS IN DADE".Co 6054043 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS FROZEN SOLID CORP 196 GENERAL MECHANICAL CONTRACTOfrAYMTAX COLLECTOR ENT RECEIVED CAC1814995 Y Worker(s) 1 $75.00 07/17/2017'- CHECK21-17-065987 This Local Business Tex Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, j 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 — Miami —Dade Code Sec 8a-276. I For more information, visit www.miamidade.gov/taxcollector- Propert Search Application - Miami -Dade County Page 1 of 2 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-022-0030 Property Address: 1280 NE 102 ST Miami Shores, FL 33138-2618 Owner DENISE JUANICO MARK T JUANICO ................ Mailing Address _ .................. ....... .. 1280 NE 102 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY : 1 UNIT Beds / Baths / Half __..__...__..........................................................................- 3/3/1 .._._._ Floors ........_._.__....... ................ _................... . 1 Living Units 1 Actual Area 3,314 Sq.Ft Living Area 2,326 Sq.Ft Adjusted Area 2,881 Sq.Ft Lot Size 12,862.6 Sq.Ft Year Built 1961 Assessment Information Year 2017 2016 2015 Land Value $462,829 $430,486 $392,085 Building Value $200,518 $200,518 $200,518 XF Value $17,922 $17,946 $12,643 Market Value $681,269 $648,950 $605,246 Assessed Value $303,7451 $297,498 $295,430 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Assessment $377,524 $351,452 $309,816 Cap Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead Civilian Disability Exemption $500 $500 $500 ............ _._............................... ..----- Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). 'Short Legal Description 155342 AMD PL OF PORT OF REV PL OF MIAMI Generated On : 5/23/ Taxable Value Information 2017 2016 2 _....... County Exemption Value $50,500 $50,500 $50. Taxable Value $253,245 $246,998 $244. School Board Exemption Value $25,500 $25,500 $25. Taxable Value $278,245 $271,998 $269. City Exemption Value $50,500 $50,500 $50. Taxable Value $253,245 $246,998 $244 al ion Value $50,500 L $50,500 $50 Value $253,245 $246,998 $244 Sales Information Previous OR Book Price Qualification Description Sale Page 27946- Corrective, tax or QCD; min 12/28/2011 $100 3431 consideration 18677- Sales which are disqualified as a rest 07/01/1999 $0 2009 of examination of the deed 18653- Sales which are disqualified as a rest 04/01/1999 $0 0317 of examination of the deed 16128- 11/01/1993 Sales which are qualified 1$225,000 2178 I SHORES SEC 8 PB 41-64 1 1A/1 /9 I nT 9 1 FRR Rd AFT nF Wr,1 AFT https://www.miamidade.gov/propertysearch/ 5/23/2018 01/01/2002 01:35 3057579960 JUANICO PAGE 01 A.M.I Ir Broward 954-966-2380 Air Conditioning Dade 305-625-8332 r-ro"o Wid Corp. Fax 9g4-985-2645 4717 Onwge Drive Qtlallty Service Davie, Al. 33314 since 1970 1 IIM I elll Our Estimate To: MarkJuaaito 1280 NB 102 st, Miami Shores, FL 33In Re: Equipment Replacement Attn: Shaun, General Contractor Phone: Date: May 15, 2017 Fax:___ --ll�.11 I I IIIII II I I I ww hereby propeee W Fumleh, ieetAll, and ■ervloe tho equipment and metenNe hater b4aw whh the with ft cunmdone and spechimWne eel forth In thro propoesl New Equipment System 1 $5,038.00 System 7, System 3 Manufacturer York _ Cond. unit YCt_y6OB2I S Aar Handler A,HX61174PI2 Coil n/a n/a n/a_ _ Package unit n/a n/a n/a Thcrtnosm Honeywell Digital Neat Strip IOkw Other n/a n/e n!a Capacity S to Seer 16 Pi*g N/E existing Condensate exietirt0 Warranties Labor Yr 1 Parts Yr 10 Compressor Yr 10 Electrical Ductwork, Nseellaineous Items Other iteMo X Connect to existing Circuits X Connect to txisting ductwork —_New X Aluminum coed. Stand New Outside Discotmect supply grills X Condensate overflow shutdown , _ New 8rcak"T New duct system X 1lutricarte tie downs Total Price System 1 $5,038.00 System 2 System 3 Fpl Rebatc _$150.00 Other Net Payable $4,888.00 Please installs stem 0 Net Due $ Deposit $ Balance Due $ Payment Terms: 75% down for equipment balance due upon oompleHan NOTE: This estimate doesi not Include any building code upgrades that may be required. All work must be done during normal business hours. By AMI: This estimate Is valid for So days orcy Mullins General Conditions: I have authority to order the work as outlined dboVe, It IS agreed that the salter will retain We to any equipment or materials that may be fumlShed until final payment to made. In case the total charges are wilacted by suit or upon demand of an attorney, the purchaser hereby agrees to pay reasonable attomey's fees for the making of such collection. ' 05/09/2018 16:08 3057579960 JUANICO PAGE 01 A.M.I Broward 954.966.2380 • M • Air CondHioning Dade 305.625-8332 Frozen "Id Corp. Fax 954.985.2645 4717 Otaulto Drive quslity Service Davis, Fi. 333) 4 Since 1970 Our Estimate To; MarkJuinlco 1280 NE 102 st. ]viiami Shores, FL 33138 Re: Equipment Replacement Attn: Shaun, General Contractor Phone: Date: May 9, 2018 Fax: wont return ducts water damage caused by ;Demo existing duct system Thirteen (13) new supply registers Four (4) new return registers Trunk lines and distribution boxes New supply and return plenums Hanging and supporting Remove air handler and reinstall on new InsulAted return air box New white grilles 1ltemoval of trash and debris from jobsite Design, drawing and building permit frma with new R6 duct system including: permit fees, painting and patching are excluded from this proposal AMI can not be hold responsible and will not be held liable for delays out of Ws control, Such as delays In manufacturing, delivery, or damage incurred during shipping. In addition the amount of this quotation may be altered if any significant price increases were to occur in the market. Any such increase will be documented by AMI- HMI's Price Payment Terms: 30% down balance due upon completion 7 5 .0 NOTE., This estimate does not Include any building code upgrades that may be required. All worts must be done during normal busineim hour*. By AMI: This astirnate is valid for 30 days Corey Mullins General Conditions, I have authority to order the work as outilned above. It is agreed that the seller will retain title to any equipment or materials that may be fumished until final payment is made. In case the total charges are collected by sult or upon demand of an attorney, the purchaser horeby agrees to pay reasonable attorneys fees for the making of such collection. Authorization to Procood t� � 0/fir natur pate' r c r • 7 AMIAI-1 �� 4k- R- CERTIFICATE OF LIABILITY INSURANCE D DDNYM DATE 01/31/2018 01/31/2018 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 have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER 954-776-2222 & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 CONTACT Scott H. Buser, CRIS NAMEBrown PHONE 954-776-2222 Fax 954-776-4446 A/c, Ne, Ext): (A/C, No Ep AIL P.O. Box 5727 Ft. Lauderdale, FL 33310-5727 Scott H. Buser, CRIS INSURERS AFFORDING COVERAGE NAIC # INSURER A: Old Dominion Insurance Co. 40231 INSURED Frozen Solid Corp dba INSURER B: Associated Industries Ins. Co. 23140 AMI A/C & Refrigeration Frozen Solid Corp. INSURERC: 4717 SW 45th Street INSURER D : INSURER E : Davie, FL 33314 INSURER F : CAVFROr,F-R CFRTIPICATF NI IMRFI?• Dcvtrtnwt KI tasceD. 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 LTRPOLICY TYPE OF INSURANCE ADDL SUB POLICYEFF NUMBER POLICY POLICY EXP LIMBS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR MPG76188 01/03/2018 01/03/2019 EACH OCCURRENCE 1,000,000 DAMAGE TORENTEDREMISES occurrence) $ 500,000 GEN'L MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY1:1 %coi LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY B21376188 01/03/2018 01/03/2019 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident $ X ROPERTY AMAGE Peraccident UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE AGGREGATE DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCi O98682 02/01/2018 02/01/2019 PER OTH- E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE 11000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 A Commercial Applica Commercial Appli MPG76188 01/03/2018 01/03/2019 OFOPONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) �rEOSC T insurance; HVAC CAC #1814995 MIAMISH Miami Shores Village Attn: Building Dept. 10050 NE 2nd Avenue 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 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD This combination qualifies for a Federal Energy Efficiency tax Credit when ' o placed in service between Feb 17,2009 and Dec 31, 2016. Certificate of Product Ratinas AHRI Certified Reference Number: 8903414 Date: 05-16-2018 Model Status : Active _ r ` " AHRI Type: RCU-A-CB I AY 9 z 18 ) Outdoor Unit Brand Name: JOHNSON CONTROLS Outdoor Unit Model Number Single r (Condenser or Package) : YCG60621 Indoor Unit Brand Name: YORK BY JOHNSON CONTROLS Indoor Unit Model Number (Evaporator and/or Air Handier): AHX61 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, Ivl�, • MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WY, WI, W-?,u$.' Territories) • • • • • • • • • • •• Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed in all••regi•:on•s • • • � • • � until June 30, 2016. Beginning July 1, 2016 central air conditioners can only be installed in r�grnj�for : • • ' • which they meet the regional efficiency requirement. •: • 000000 • • 000000 • • The manufacturer of this YORK BY JOHNSON CONTROLS product is responsible for the rating of this system e0ro b rva�tion. • • • Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Perforrnand%lkog ina of Unitajy, • • • • • • Air- _ Air-ConItiornn Air- urce Heat Pump Equipment antl,subject to rating accuracy tyAHRI-sponsored, independent,.thied parlAtegtjn� : Ci Cooling act A2 =Sin le or Hi Stage (95F), btuh: 52500 SEE :.16, q ( Sing or igh Stage (95F) A . 13.00 ` 0 } I 'h M-Rrri Shr_res Viil ZCf IN3 DLPf _... mot. �EI'T 3,t3JECT 10 CCMI'tjF.NCE WI fH ALL FEUERAL t"Active" Model Status are those that an AHRI Certification"Pr&gfa,, 7�r `ci�6t,idd�i ie�4' r igihhy'R Y selling or off_erir jfor sale; OR new models that are being marketed but are not yet being produced."Production Stopped=Model Status -are-those`that-AW"AHRI-C-e7 icf anon' Program Participant is no longer producing BUT is still selling or offering for sale. Ratinas that are accompanied_ by WAS indicate an involuntary re -rate. The new Dublished rating is shown along with the Drevious (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.abridirectory.org. TERMS AND CONDITIONS MRS. 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.shridirectory.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. ©2018Air-Conditioning, Heating, and Refrigeration Institute . CERTIFICATE NO.: 131709687547863860 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):1280 NE 102 STREET City: Miami Shores Village County: Miami Dade Zip Code: 33138 . . .••. .•..•. ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID COAhZEITE F SVA.*- .,•;;. ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVPMf) - A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS. " 0, ; • • AHRI DATA SHEET REQUIRED • '' • • • • • ..... Change disconnecting means: YES ❑ NO 0■ ARHI Sheet Attached: YES 0 NO ❑ Ctyrttjg�,Attached AYES 0 0 * 0 •: • • 1. UNIT BEING REPLACED DATA NEW UNIT . ' YORK MANUFACTURER • YeRK •• . AVY48D3XH21A AHU or PKG. UNIT MODEL # AHX61D4P12 • • • HRD060 COND. UNIT MODEL # YCG6M21s 10 KW HEAT 10 5 NOM TONS s AHU CU PKG 1) M.C.A AHU CU 32.4 PKG AHU 60 CU 50 PKG 2) M,O.P AHU 60 CU 50 PKG AHU 230 CU 230 PKG 3) VOLTS AHU 230 CU 230 PKG PKG UNIT / / PKG UNIT / / EER/SEER 16 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4" CONCRETE SLAB YES NO X YES NO NEW ROOF STAND YES NO X YES NO NEW RETURN PLENUM BOX YES x NO Minimum Circuit Ampacity (Wire Size): 6 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company State CertificateswRO Signature iQual flees signature) 240 :,ONDITIONING Phone: gsa_gRR_g�Rn 1814995 Certificate of Competency No. _ _6054043 Date: 5 / a 3 I s1 (Revised02/24/2014) . . ... . . . ... . . . . . . . . . . iCOPt:: oTo 1 T�NerNSTls,t�iTg.tiJ '�` �j �''j 1 iCORP. 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Electrical Notes: 6) Reuse existing electrical MECHANICAL REVI APPROVED DATE Z General Not** S E W N .... . .... ..... .. • ... 00. . ..... 0000 ... .. . • ... . .. ..... .... . . ..... .. .... .... .. No. R.v4ran/4.u. Dal. logo F Name and Address AMI ir Conditioning 4717 Orange Drive Davie, Florida 33314 roject Name and Address Juanico Home 1280 NE 102 Street Miami Shores. Florida eVroject Sheet Date A oe 'V�� 1 4" = 1'