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MC-06-23-1595Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: MC-06-23-1595 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: Approved Issue Date:07/11/2023 Expiration: 01/11/2024 Location Address Parcel Number 1259 NE 98TH ST, Miami Shores, FL 33138 1132050090250 Contacts TERRI ROSE Owner 1259 NE 98 ST, MIAMI SHORES, FL 331382562 Mike's AC Service Contractor MIGUEL MAYTA P.O.BOX 4384, MIAMI BEACH, FL 33141 Business: 3059860702 mikesacs@msn.com Description: REPLACE 4 TON AIR CONDITIONING & HEATING Valuation: $ 7,950.00 Ins ection Requests: SYSTEM. EXACT CHANGE OUT 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 DBPR Fee $4.17 DCA Fee $2.78 Education Surcharge $2.40 Permit Fee $228.25 Scanning Fee $9.00 Technology Fee S27.83 Total: $329.23 Payments Date Paid Amt Paid Total Fees $329.23 Credit Card 06/26/2023 $50.00 Credit Card 07/11/2023 $279.23 Amount Due: $0.00 Building Department Copy 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 )"'formation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhgrmore�,authorize the above named contractor to do the work staled. Owner / Applicant / Contractor / Agent Date July 11, 2023 Page 2 of 2 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 F-IBUILDING ❑ ELECTRIC ROOFING o � 2 0 T JUN 26 2023 By`\ FBC 202Z Master Permit No. me -clp-2J--(M Sub Permit No REVISION EXTENSION FIRENEWAL F-IPLUMBING Q MECHANICAL ❑ CHANGE OF M CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1259 NE 98 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3205-009-0250 Is the Building Historically Designated: Yes NO .,w Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): TERRI P ROSE d ,«.1259 NE 98 STREET City: MIAMI SHORES Tenant/Lessee Name: Email: State: FLORIDA Zone: _ BFE: FFE: 305 951-7898 33138 CONTRACTOR: Company Name: MIKE'S AC SERVICE Phone#: 305 751-5814 Address: 775 NE 79 STREET Email: mikesacs@msn.com Qualifier Name: MIGUEL MAYTA PhoneM 305 751-5814 State Certification or Registration #: CAC 039619 Certificate of Competency #: DESIGNER: Architect/Engineer: N/A Phone#: Address: City: State: Zip: Value of Work for this Permit: $7950.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: REPLACE 4 TON AIR CONDITIONING & HEATING SYSTEM EXACT CHANGE OUT Specify color of color thru tile: Submittal Fee $ DCJ. Permit Fee $ 2.7-0 2 CCF $ "l- CO/CC $ Scanning Fee $ DCA Fee $ Z . —19 DBPR $ Ll - 1-1 Notary: Technology fee $ 7-1 Training/Education Fee $ Z _ L(O Double Fee $ Structural Reviews $ P&Z Review $ Bond $ _ TOTAL FEE NOW DUE $ (Revised04/05/20221 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State N/A 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 a reinspection fee will be charged. Signature� F " T OWNER or AGENT The foregoing instrument was acknowledged before me this .�I day of � 20 21 by �tm "US . who is personally known to me or who has produced identification and who did take an oath. NOTARY PIUBLIC:�f Sign: V'-k '^ Print: T ISABEL R. PERQ Seal: ,f'tr"'tb WOOMMISSIONMHH350624 B(PIRES: FEB OS, 2027 Boned through tat State Irwin e tiii\iii#tttrt iiii\iitt!! !!Y!!!it\tt\ APPROVED BY IRevised04/05/2022j as Signature�`��( CONTRACTOR The foregoing instrument was acknowledged before me this 17, day of J uyi { . 20 23 . by �Yl / G"d G %lgti o is personally known to me or who has produced L b (. as identification and who did take an oath. NOTARY PUBLIC: Sign: — Print: Seal: i�ilitiltittltltttitiRftttttR �Pns Examiner Structural Review SAMUELCANO Notary Public - State of Florida Commission X HH 291719 My Comm. Ezplres Apr 27, 2027 !tt!!tt Zoning Clerk ;:x OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-009-0250 Property Address: 1259 NE 98 ST Miami Shores, FL 33138-2562 Owner TERRI P ROSE Mailing Address 1259 NE 98 ST MIAMI SHORES, FL 33138-2562 PA Primary Zone 1400 SGL FAMILY - 3001-3250 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds l Bathsl Half 2/2/0 Floors 1 Living Units 1 Actual Area 2,145 Sq.Ft Living Area 2,145 Sq.Ft Adjusted Area 2,028 Sq.Ft Lot Size 8,175 Sq.Ft Year Built 1950 Assessment Information Year 2022 2021 2020 Land Value $474,134 $308.834 $308,834 Building Value $212,940 $152.100 $152,100 XF Value $28,176 $28,530 $28,883 Market Value $715.250 $489,464 $4891817 Assessed Value $267,032 $259,255 $255,676 Benefits Information Benefit Type 2022 2021 2020 Save Our Homes Assessment $448 218 $230,209 $234,141 Cap Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description EARLETON SHORES PB 43-80 LOT 14 BLK 2 LOT SIZE 75.000 X 109 OR 13695-129 0588 1 Generated On : 6/16/2023 Taxable Value Information 2022 2021 2020 County Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $217,0321 $209,255 $205,676 School Board Exemption Value $25,000 $25,000 $25.000 Taxable Value 1 $242,0321 $234,2551 $230.676 City Exemption Value $50,0001 $50,000 $50.000 Taxable Value 1 $217,0321 $209,2551 $205,676 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value1 $217,032 $209,255 $205.676 Sales Information Previous Sale Price OR Book -Page I Qualification Description 05/01/1988 1 $115,000 13695-129 Sales which are qualified 10/01/1972 1 $48,500 00000-00000 ISales 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 Appreiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://w.miamidade.gavrinfoldisclaimer.asp Version: o 9MM TMD JUN 26 2023 By f+ AIR CONDITIONING REPLACEMENT DATA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. 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):1259 N E 98 Street City: Miami Shores Village County: Miami Dade Zip code: 33138 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 ❑■ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT RUUD MANUFACTURER RUUD RHPN-HM4824JC AHU or PKG. UNIT MODEL k RH2TZ4821STANNJ UASL-048JEC COND. UNIT MODEL# RA14AZ48AJNALHP KW HEAT 10 KW 4 TON NOM TONS 4 TON AHU Cu PKG 1) M.C.A & L CU PKG S CJ AHU Cu PKG 2) M.O.P AHU dfW PKG 1,r'0 AHU Cu PKG 3) VOLTS U' gXY PKG O PKG UNIT / / PKG UNIT EER/SEER 14.30 SEER2 YES NO REPLACING DUCTS YES NO NO YES NO REPLACING THERMOSTAT YES NO NO YES NO NEW 4"CONCRETE SLAB YES NO YES YES NO NEW ROOF STAND YES NO NO YES NO NEW RETURN PLENUM BOX YES NO NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractors Company Name. MIKE'S AC SERVICE Phone: 305 751-5814 State Certificate or Registration No. CAC 039619 Certificate of Competency No. Signature Date: 06/26/2023 (Qualifier's signature) (Revised02/24/2014) ii4 iff.. . '., A;,;t ZI 5 72V "I rlrl t: dIRV : 14 1 r.,; ;, "', i ),� , 2i'? .),q " JUN 26 2023 Certificate of Product Ratings AHRI Certified Reference Number: 209429778 Date: 06-24-2023 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RUUD Outdoor Unit Model Number (Condenser or Single Package) : RA14AZ48AJlN Indoor Unit Model Number (Evaporator and/or Air Handier): RH2TZ4821 STANN 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, Vr, WA, WV, WI, WY, U.S. Territories) Region Note: On January 1, 2023, efficiencyy standards increased for central air conditioners. Beginning January 1, 2023, central air conditioners can only be installed in region(s) for which they meet the new regional elrciency requirements. The manufacturer of this RUUD product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210240— 2023, 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 (AFug— Single or High Stage (95F), btuh : 46000 SEER2 : 13.80 EER2 (AFwf)— Single or High Stage (95F) : 11.20 t'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 tale. The new published rating is shown along with the previous (i.e. WAS) mung. The Department of Energy has published updated energy efficiency metrics for central air conditioners and heat pumps. This publication reflects both the 1987 metric (SEER) and the 2023 metric (SEER2). Efficiency requirements are published at 10 C.F.R. 430.32(c). Please rater to wwwAHRlnel.org for more information about updated energy efficiency metrics. 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.ahridlrectory.org. TERMS AND CONDITIONS it "IMF This MS AND 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; SIU .. `' entered Into a computer database; or otherwise utilized. in any forth or manner or by any means, except for the user's Individual, personal and confidential reference. AIR-CONDITIGNING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information forthe model cited on this certificate can be verified at www.atirldirectory.org, click on'Verlfy Certificate" link 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute !,CERTIFICATE NO.: 133320871231062571 Ron DeSantis, Governor Melanie S. Griffin, Secretary 01 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND: PROFEIONAL REGULATION f CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER: CAC039619 EXP1RA7iON DATE: AUGUST 31, 2024 THE CLASS A AIR CONDITIONING CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES MAYTA, MIGUEL MIKE'S A C SERVICE INC P O BOX 414384 MIAMI BEACH FL 33141 ISSUED: a8/12✓2022 Always verify licenses online at MVRoridaUcense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. MIi(ESAC564 U INC 198 SPEC M CE HMICAL CONTRACTOR erg uma CAC039619 $45.00 08/18/2022 Worker(s) 10 1NT-22 391250 This Local BudumTax Recelptonly coafirmpaymutafthe Local Business Tax. The Raceipt is aat a ucme, parent; or s ce0loadoa otoo, holders Mcaftwitadob2simm &WWmast com* with aay Bo anw or aoagaveraaae� regalamry laws regwranisat�v�hicd apply to.th6 -_ _. T1;&_f 4 NQ abon mast be dolajed ao sti commidd "kk1es- -Dade Cods Sec Eta-m ACOR" CERTIFICATE OF LIABILITY INSURANCE °"'ADD 01/05/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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: N the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 endorsement(s). PRODUCER C MACT ME: Heather Chase -Cass Brown & Brown of Florida, Inc. PHONE (954) 820-7894 FAX (305) 714.4401 EMAIL s: heatherchase-cass@bbrown.aom ADDRE 8825 NW 21atTerrace INSUREIt(s)AFFORDING COVERAGE NAIL r INSURERA: FCCI Commercial Insurance Company 33472 Doral FL 33172 INSURED INSURER B : Technology Insurance Company, Inc. 42376 Mike's AC Service, Inc. INSURER C : INSURER D : P.O. Box 414384 INSURER E Miami FL 33141-0384 1 INSURER F : COVERAGES CERTIFICATE NUMBER: 23-24 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. LTR TYPE OF INSURANCE tm WVDPOLICY NUIR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,0D0,000 CLAIMS-MA13E ® OCCUR DAMAGE TO RENTED PREMISES occurrence) $ 100.000 MED EXP (Any one neon) $ 5,000 A GL10003421305 01/01/2023 01/01/2024 PERSONAL BADVINJURY $ 1,000,000 GEWLAGGREGFITE LIMIT APPLIES PER: GENERALAGGREGATE S 2.000.000 POLICY JC LOC PRODUCTS - COMPIOP AGG S 2,000.000 $ OTHER: AuroNWIl.E I $Asa= COMBINEDiSINGLE LIMrr $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNE13 AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ DAMAGE PROP n ll $ $ U&MPX .LA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LAB DED I I RErEN11ON $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETORIPARTMER/EXECU 11VE OFFICERIMEMBEREXCLUDED? a (Mandalay In NN) NIA TWC4188100 01/01/2023 01/01/2024 PER STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT S 1,000,000 11 yes. describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Rwrarlcs Sdodule, may be aldehed If mom Spam Is required) " Workers Comp Information "Proprietors/Partners/Executive Officers/Members Excluded as per form #WC 00 03 08: Gerarda Mayto Miguel Mayta Heating, Air Conditioning Contractor - No liquid gas Air Conditioning Contractor -License #CAC039619 r_caTlcrr_ATa unr nop CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Dept. ACCORDANCE WfTH THE POLICY PROVISIONS. 10050 Ne 2Nd Avenue AUTHOR® REPRESENTATIVE Miami Shores FL 33138 ®1988 2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD