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MC-11-20-2635, 1298 NE 95th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1298 NE 95TH ST, Miami Shores, FL 33138 1132060144030 Contacts Yuri Morales Owner Yuri Morales Applicant 302 Ne 92 st, Miami, FL 33138 302 Ne 92 st, Miami, FL 33138 Business: 3057903849 yurimorales@gmail.com Business: 3057903849 yurimorales@gmail.com Mobile: 3057903849 Mobile: 3057903849 SEASONS AIR CONDITIONING INC Contractor MARK GUANAGA 415 NW 63 AVE, MIAMI, FL 33126 Mobile: 7862991841 mguanaga@gmail.com Inspection Requests: Description: INSTALL 2 SYSTEMS AND DUCTWORK Valuation: $ 30,000.00y�1011Total E�a' E € Sq Feet: 1.001m „., Fees Amount Application Fee - Other $50.00 CCF $18.00 DBPR Fee $13.50 DCA Fee $9.00 Education Surcharge $6.00 Permit Fee $850.00 Scanning Fee $3.00 Technology Fee $22.50 Tota I : $972.00 Payments Date Paid Amt Paid Total Fees $972.00 Credit Card 11/03/2020 $50.00 Credit Card 02/05/2021 $922.00 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fobprmore, I authoriz0he above named contractor to do the work stated. Authorized Signature: Owner February 05, 2021 / Agent Date Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1298 NE 95TH ST, Miami Shores, FL 33138 1132060144030 Contacts Yuri Morales Owner Yuri Morales Applicant 302 Ne 92 st, Miami, FL 33138 302 Ne 92 st, Miami, FL 33138 Business: 3057903849 yurimorales@gmail.com Business: 3057903849 yurimorales@gmail.com Mobile: 3057903849 Mobile: 3057903849 SEASONS AIR CONDITIONING INC Contractor MARK GUAIVAGA 415 NW 63 AVE, MIAMI, FL 33126 Mobile: 7862991841 mguanaga@gmail.com Ins ection Re uests Description: VNSTALL 2 SYSTEMS AND DUCTWORK Valuation: $ 30,000.00 Ii y Total Sq Feet: 1.00 tiY Iom- ,"I'll", Fees Amount Application Fee - Other $50.00 CCF $18.00 DBPR Fee $13.50 DCA Fee $9.00 Education Surcharge $6.00 Permit Fee $850.00 Scanning Fee $3.00 Technology Fee $22.50 Total: $972.00 Applicant Copy Payments Date Paid Amt Paid Total Fees $972.00 Credit Card 11/03/2020 $50.00 Credit Card 02/05/2021 $922.00 Amount Due: $0.00 For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. February 05, 2021 Page 1 of 2 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑PLUMBING EACHANICAL IVlldllll JIIUICJ VIIIdgu 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 BY: j r^�ff FBC 20 1� Master Permit No. �C. - D 7 - I �j --I;�7 (,:. Sub Permit No. - (" z5 3 S ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: I —`�� % " `� 03 0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: t OWNER: Name (Fee Simple Titleholder): 7y n A4 g Phone#: -20S -7el `J�y Address: -f3 C)z tv 0 q S City: in Dv y-i State: rC- Tenant/Lessee Name: Phone#: Email: N'VV-i 0A Oy-c'i 1tj (_M A w, e'-' I ln.t CONTRACTOR: Company Name: _ Address: L' I S N W GA S '> N^5 A ✓ "I 4-� o�. ® L.% �S ,4V,-e- p: Phone#: --l'gL Zq 9 —� V I City: M \ CA1n/11 State: �- Zip: 5 -S C/L' Qualifier Name: MA vkt-6nz4v, �^t � Phone#: '72 L lei c7 -) 8 H State Certification or Registration #: CA't-- I �1`) Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ p� a 0 a Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: U( Specify color of color thru tile: Submittal Fee $ So - (51Z) Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE S �� G ' Ct7Z� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 ILL OWNER or AG NT The foregoing instrument was acknowledged before me this ! `\ ' day of ��1 20 & by .,)&A �� who is personally known to me or who has produced '<i/ \��1�� ' WV ,Q as identification and who did take an oath. NOTARY PUBLIC: Print: IGOR GONCAIVES g • �� Seal: Notary Public State of Florida -+• Commission # GG 284408 My Comm, Expires Dec 13, 2022 Signa ure CONTR CTOR The foregoing instrument was acknowledged before me this 1 0� day of ( U St 20 2 by MA r u &tW4 1 4k who is personally known to me or who has produced D> AIM L.r ct In S-C, as identification and who did take an oath. NOTARY PUBLIC: Sign: --r-1,4 Print: - a u Seal APPROVED BY Plans Examiner Structural Review •ussd /ie3oN ieuoi3eN 45noi43 papuog ZZOZ '61 daS saiicx3 wwoDlw _veo 00ZZZZ DD # uoisslwWo) epuol j;o 83eiS a.Ignd UeloN VI)OD V11S3a31 y�y ******************************************* Zoning Clerk 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): I Z 01)? ! / C ss City: Miami Shores Village County: Miami Dade Zip Code: 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 [X ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # AM 0 C �00 COND. UNIT MODEL # O KW HEAT / p NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES 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: Contractor's Company Name: �Q �� F�'1 `r `-"�"� I 0—N-' j Phone: —7 $ L State Certificate or Registration No. I 1 Certificate of Competency No. Signature Date: O — $ (Qualifi signatu 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): 120I `$ N C q s- City: Miami Shores Village County: Miami Dade Zip Code: DOT 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 MANUFACTURER AHU or PKG. UNIT MODEL # TA.M IT h O COND. UNIT MODEL # 'IVOW k 0 KW HEAT to NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER 730 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES 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: Contractor's Company Name: 5 e G, Gi 1 `� l e"- i41 D, I `J Phone:- � � ^z e? `5 —/Pf State Certificate or Registration No. C,6<— �g i �%y Certificate of Competency No. Signature Date: I o 09 (Qualif s signatur G www.ahridirectory.org Certificate AHRI Certified Reference Number : 10230604 Date : 11-03-2020 Model Status : Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: XR17 Outdoor Unit Brand Name: TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TTR706OAl Indoor Unit Model Number (Evaporator and/or Air Handler) : TAM9AOC6OV51 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. The manufacturer of this TRANS, product is; responsible for the rating of this system Combination. Rated as follows in accordance with the latest edition of AHRI 2101240 with Addendum 1, Perforit anCe-.Rating.of Unitary Air-Coriditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) =; Single or High Stage (95F), btuh : 57000 SEER: 16.25 EER (A2) - Single ou ligh Stage �06F) 1? 5fi 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 AHR I Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratin s that are accom anted b WAS indicate an involuntar re rate. The new ublished ratin is shown alon with the revious i.e. WAS ratin . 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,ahrldlrectory.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 hett&- 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. r ",-'-""`' ' ©2020Air-Conditioning, Heating, and Refrigeration institute [dRTIFICATE NO.: 132488954136753187 S'c �r -'7 11 W1 11 40 '=* 71;, [jj?,!.TTj A � , I I'M A it 141 jai litu a MF= AHRI Certified Reference Number : 10230604 Date : 11-03-2020 Model Status : Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: XR17 Outdoor Unit Brand Name: TRANE Outdoor Unit Model Number (Condenser or Single Package) : 4TTR706OAl Indoor Unit Model Number (Evaporator and/or Air Handler) : TAM9AOC6OV51 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, INC, 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. 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. Ratinas that are accompanied by WAS indicate an involuntary re -rate. The new published ratina is shown alona with the previous (i.e. WAS) ratina. 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, MMM 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. _.. FlItERTIFICATE '� 132488954136753187 ©2020Air-Conditioning, Heating, and Refrigeration Institute NO., bt eC@« F o R Hd«R&pdf f (1 page) i ..�.... ... \�:.\\ } Loicals\,» '`/ .,,& Miami D #■` County, State of e. a THIS IS NOT t: ■, NOT ', _#laccAD ?a2 » A■IC■IP¥ ran * CERTIFICATE OF ELECTION TO BE EXEMPT FROM LORIDA WORKE iS` OM NATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION �Ey{FFyE�eCTIVE;bA�t�7yyE: y1g1.�Ii 31X202 PERSOW MARK GUANA A.. FEINT 80018 775 BUSINESS NAME AND ADDRESS: SEASONS AIR CONDITIONING INC 415 NW 63 AVE MIAMI, FL 33126 SCOPE OF BUSINESS OR TRADE- Heour , VooNafioo, Aar- Loft ti wv and ReIrWyakm Systems IAstall;3rkm, aetw* and Rwair, Shop, Yard & Drwere EXPIRATION DATE. 1111312022 EMAIL: MGUANAGAOGMAIL.COM WKWANT, Pursuant to subsection 440.0*(141. F. s.. an officer of a corporation who elects exenpbot from this chapter by filing a certif ate of election under this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440,05112), F.S., Certificates of eledion to be exempt tssued infer Subsection 13) shall,applyirrss#y to the corporate officernamed on the mice of election to be exempt and apply only wither the scope of the business or trams listed out the nolice of efectian W be exempt, Pursuant to suasecu 44€ ,06(13)VS , rashes of ton to be exempt and ' of eto be exert t to sxutsject to i if, at an time after the fits of file notice or the .Kwame of the oar tcale, the person named on tt notice or certificate no r meats the requirernerAs of fts section for issuame of a certificale. The dep rtnAent shaft revoke a coniticatti at any lime for laifum of the person named on the certificate to meet the requirepmms, of this section. DF -F-OWC-262 CERTIFICATE € F ELECTION TO BE EXEMPT REVISED 1 13 E01256110 Oil TI S? (OW) 413-1 W3 t�IC' 93I L�tOR,�A Notice to Owner - Workers' Corn Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 on 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 ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. / Signature: State of F1i County of Miami -Dade The foregoing was acknowledge before me this 10 Aday of J � v, v—& �' � , 20 I . By Yi.r y r u w) b ev" .h MB vat /85 who is personally known to me or has produced J_ D 1 v.1-t. L I C Zak 5e__ as identification. Notary:Jt.t }lt SEAL: — — — LUPE WONG PEAOZ Notary Public - State of Florida My Comm. Expires Sep 4, 2021 SEASONS AIR CONDITIONING Date: c3Z I State of: County of: Before me this day personally appeared M^Jt who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: worn to (or affirmed) and subscribed before me this 114n- U (-)-P,.Cq , Personally know day of X*9 by 2k:�IIZA OR Produced Identification Type of Identification Produced l i Z-E �-Rk`LKCE NSL i RINT, TYPE or STAMP NAME OF NOTARY SINDIAALVAREZ ,� • :*: MY COMMISSION # GG 238273 EXPIRES: September 3, 2922 �Foi F ;°.•' Banded ThN Wen( PYbk U11Q61WINMS