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MCC-10-23-2478Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 415 NE 105TH ST, Miami Shores, FL 33138 Contacts ,.. Permit No.: MCC-10-23-2478 Permit Type: Mechanical - Commercial Work Classification: Addition/Alteration Permit Status: Approved Issue Date:10/30/2023 I Expiration: 04/30/2024 Parcel Number 1122310430010 EDW AMCCARTHY-ARCHBISHOP Owner PERFECT AC SOLUTIONS Contractor 9401 BISCAYNE BLVD, MIAMI SHORES, 33138 RIMAJ BARRIENTOS Business: 3057580539 MPINDER@SRLSCHOOL.COM 4662 SW 74 AVE, MIAMI, FL 331S5 Mobile: 3862593056 Business: 7865129165 perfectacsolutions@gmail.com Description: INSTALLATION OF 1.5 TON SPLIT SYSTEM FOR SAINT JOSEPH ROOM - INSTALLATION OF 2 MINI -SPLITS 1.5 AND 9000 BTU'S - 5 TON CHANGEOUT FOR CONVENT ROOM - 3.5 TON CHANGEOUT SCHOOL OFFICE Fees Amount Application Fee - Other $50.00 CCF $25.20 DBPR Fee $18.90 DCA Fee $12.60 Education Surcharge $12.60 Permit Fee $1,210.00 Scanning Fee $18.00 Technology Fee $126.00 Total: $1,473.30 e Valuation: $ 42,000.00 Ins ction Re uests: Total Sq Feet: 0.00 r Payments Date Paid Amt Paid Total Fees $1,473.30 Credit Card 10/30/2023 $1,473.30 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 c nstruction and zoning. Futhe5more, I authorize the above named contractor to do the work stated. L'-% S (?A / 0 - 3U 3 Autho / Applicant / Contractor / Agent Date October 30, 2023 Page 2 of 2 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 BUILDING ❑ ELECTRIC ❑ ROOFING PLUMBING 0 MECHANICAL ❑ CHANGE OF CONTRACTOR III OCT 0 6 N23 FBC 202-0 -:T� Master Permit No.W- AO -23 —224N� Sub Permit REVISION ❑ EXTENSION RENEWAL CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: 1�J"'C `5'—T 4 I C J N� IUS S' City: Miami Shores County: Miami Dade zip: 13\ SS Folio/Parcel#: (i - 2 Z OU I u Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): O� IMiA�ln1 Phone#: JOS- �Lloa' /03a Address: -�11y7�Fi�1��STz City: IA A0-1\ 'NoQT-S State: L 3. Zip: 3 1 3d Tenant/Lessee Name: .:�7 Rcsr- OF LV-4A Phone#: 305--}S`3-OSM Email: %%01N�Fc2C(�SR�SCHOO�.COy \ CONTRACTOR: Company Name: -kZT:E(Z1 Arr— (v A(') VA S Phone#: } ()b S ( )-- 61 I �S Address: 4(0 r.2 SW Email: 5Ca �vWtAIL . Qualifier Name: �L\�,AA\ Phone#: 3&-SlZ- 11 65 State Certification or Registration M Certificate of Competency #: t" Arc- -I? I SOl } DESIGNER: Architect/Engineer: _Zip: Value of Work for this Permit: $�-.fts-OU f/ "j L/ � ' � Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New © Repair/Replace Specify color of color thru tile: Submittal Fee $ �56•zv Permit Fee $ (210.0D CCF $ , • 2Z:) CO/CC Scanning Fee $ (46. DCA Fee $ t2'C-0 DBPR $ «al!) Notar Technology Fee $ 1•� Training/Education Fee $ _L2^' (Q 0 Double Fee. Structural Reviews $ FI7 P&Z Review $ Bond TOTAL FEE NOW DUE $ (RevisedN/05/2022) ❑ Demolition 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 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 Signature j OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this 6T" dayof Ot4nNL 20 `L3 by SIR. 962 Wq+ W O Ui// ,who is personally known to ` mg or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Q7�� ' — Print:/Tt^r'([- 4 Seal: •ssssssss ssssss APPROVED BY (Revised04/05/2022) as w�! PAWEL KOBRZYNSKI MY COMMISSION# HH 06Z 0 _ •;>e' EXPIRES: November 17, 2024 . `�FoYE ,• Bonded Thru Notary Public Undetwdters The foregoing instrument was acknowledged before me this �22 dayof tUtkE 202-N by lw A\ 1792Q 1TcMrt[i5 who is personally known to me or who has produced TL021D 4 a t� as identification and who did take an oath. NOTARY 1;) Plans Examiner Structural Review Notary Public • State of Florida commission # HH 059695 My Comm. Expires Nov 1. 2024 ,d throuth National Notary Assn. Zoning Summary Report Folio 11-2231-043-0010 Property Address 10690 NE 5 AVE MIAMI SHORES, FL 33138-2000 Owner EDW AMCCARTHY-ARCHBISHOP Mailing Address 9401 RISC BLVD MIAMI, FL 33138-2970 Primary Zone 8000 COMMUNITY FACILITIES Primary Land Use 7144 RELIGIOUS - EXEMPT: RELIGIOUS Beds / Baths /Half 0 / 0 / 0 Floors 2 Living Units 0 Actual Area Living Area Adjusted Area 86,472 Sq.Ft Lot Size 358,934 Sq.Ft Year Built Multiple (See Building Info.) 0- ir Year 2023 2022 2021 Land Value $1,076,802 $1,076,802 $1,076,802 Building Value $10,888,259 $10.921,017 $9,639,323 Extra Feature Value $1,376,799 $1,392,184 $1,407,569 ----------------- Market Value $13,341,860 $13,390,003 $12,123,694. Assessed Value $13,341,860 $13,336,063 $12,123,694. Benefit Type 2023 2022 2021 Non- Assessment Homestead Reduction $53,940 Cap Religious Exemption$13,341,860 $13,336,063 $12,123,694 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board,: City, Regional). 17 31 52 42 8.24 AC MIAMI SHORES SEC 5 PB 43-48 TR A LOT SIZE 358934 SQUARE FEET Generated On: 10/06/2023 Year 2023 2022 2021 COUNTY Exemption Value $13,341,860 $13,336,063 $12,123,694 Taxable Value $0 so $0 SCHOOLBOARD. Exemption Value $13,341,860 $13,390,003 S12,123,694 Taxable Value $0 $0 $0 CITY Exemption Value $13,341,860 $13,336,063 S12,123,694 Taxable Value $0 SO $0 REGIONAL Exemption Value $13,341,860 $13,336,063 S12,123,694 Taxable Value $0 $0 $0 Previous Sale Price OR Book- Qualification Page Description 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 10/6/23, 1:48 PM Detail by Entity Name C ivisioN OF CORPORATIONS rg C ��°'`�Isu�' -��rt �,� er�l �'�r�ra� taj �"8��r,"fly �c��l.��•r��, ar2artment of State / Division of CorpqLeLi n / Search Records / Seared. Entity Name / Detail by Entity Name Florida Not For Profit Corporation ARCHDIOCESE OF MIAMI, INC. FllIng Information Document Number N99000001604 FEI/EIN Number 65-0909504 Date Filed 03/15/1999 State FL Status ACTIVE Principal Address 9401 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Changed: 01/14/2008 Mailing Address 9401 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Changed: 01 /14/2008 &gistered Agent Namit & Address FITZGERALD, J. PATRICK ESQ. 110 MERRICK WAY SUITE 3-B CORAL GABLES, FL 33134 Name Changed: 04/29/2009 Officer/Director Detail Name & Address Tide PD WENSKI, THOMAS GERARD 9401 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Tide VPD https:Hsearch.sunbiz.org/lnquirylCorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=ARCHDI... 1/3 10/6/23, 1:48 PM Detail by Entity Name WORLEY, ELIZABETH SISTER 9401 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Title Treasurer, Director CASCIATO, MICHAEL A 9401 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Title AS FITZGERALD, J. PATRICK ESQ. 110 MERRICK WAY, SUITE 3-13 CORAL GABLES, FL 33138 Title Director, Secretary DELGADO, ENRIQUE, MOST REV 9401 BISCAYNE BOULEVARD MIAMI, FL 33138 t1 ic�•l. Report Year Filed Date 2021 02126/2021 2022 02/18/2022 2023 03/01 /2023 Document Imaggj 1 View image in PDF format T View image in PDF for View image in PDF format T ' View image in PDF format 01/26/2019 -- ANNUAL REPORT View image in PDF format 01 /16/2018 -- ANNUAL REPORT View image in PDF format 01/23/2017 — ANNUAL REPORT View image in POF format 01/21/2016 -- ANNUAL REPORT View image in PDF format 01/11/2015 — ANNUAL REPORT View image in PDF format 01/10/2014 — ANNUAL REPORT View image in PDF format 01/25/2013 --ANNUAL REPORT View image in PDF format I 03/28/2-012 -- ANNUAL REPORT View image in PDF format 02/23/2011 -- ANNUAL REPORT View image in POF format 06/14/2010 -- ANNUAL REPORT View image in PDF format 03102/201Q -- ANNUAL REPORT View image in PDF format 09/1612009 -- ANNUAL REPORT View image in PDF format 04/29/2009 -- ANNUAL REPORT View image in PDF format 01/14/2008 -- ANNUAL REPORT View image in PDF format 4/10/2007 — ANNUAL REPORT View image in POF format https:llsearch.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityNameBdirectionType=lnibal&searchNameOrder=ARCHDI... 2/3 MOODY`ELECTRIC INC. E— www.moodyelectric.com 603 N. 21st Avenue • Hollywood, FL 33020 Tel: (305) 758-2000 Fax: (305) 754-1333 C ITY/ COPY��sa. 00 � R- N..t ?mot i 04J 9 PW4? . yz- 1201M uAc A/L '3 ope WIrb UPI N L Notitry Public - State of Florida Commission; HH 429756 gt My Comm. Expires Ba, g, 2027 Banded through National Notary Assr. sED a OCT 06 2023 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 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 ❑ ARHI Sheet Attached: YES V❑ NO ❑ Contract Attached: YES Q V UNIT BEING REPLACED DATA NEW UNIT e\ 6 MANUFACTURER AHU or PKG. UNIT MODEL # fA SlitA COND. UNIT MODEL# UAl LPA S 1 KW HEAT Vu NOM TONS AHU Cu PKG 1) M.C.A AHU, CU KG AHU CU PKG 2) M.O.P AHU0_'&U 15 PKG AHU CU PKG 3) VOLTS AHU CU,140PKG a4o V PKG UNIT / / PKG UNIT EER/SEER l¢ - 2 YES NO REPLACING DUCTS YES NO V YES NO REPLACING THERMOSTAT YES v NO YES NO NEW 4"CONCRETE SLAB I YES NO YE I YES NO✓ YES NO NEW RETURN PLENUM BOX I YES NO 1. Minimum Circuit Ampacity (Wire Size): #� wi IzTz- 2. Maximum Overcurrent Protection (Fuse/Breaker Size): ),0 �RT ✓kKFt� 3. Voltage of Circuit 4. Size Disconnecting Contractor's Company State Certificate or Registration No. CAL.- lj 1Certificate of Competency No. Signature Date: �- - 3- (Qualx eh si nature) (Revised02/24/2014) FU ITSU n i RSTAG E SUBMITTAL 18LPAS1 job Name Engineer ^r'11" . Submitted To Construction Submitted By Unit No Reference Drawing No PRODUCT FEATURES Auto Changeover Weekly & 24 hr. Timer Auto Louver., Up/Down Minimum Heat Mode (WI-R Adapter required) Wireless Remote Control Included Auto Restart Economy Mode Energy Saving Program(ESP) Outdoor Unit low Noise Schedule NUMBERSMODEL Indoor Unit - - — _ _ ASUH18LPAS Outdoor Unit - ADUHIBLPA51 5 stem 18LPA51 EFFICIENCIES SEER 0 SEER 20 _. EER _. 12 _ EER2 _ - __- - 12 HSPF _ __ _, 11 HSPF2 _ _. 10.5 COP kW/kW _ _ _ 3.96 COP _ Btu/hW 13.5 COP2.. __-___. crr.ur _.._.__.. 3.96 ____—._ ____.. _ 13.5 'F('C) Cooling Min. -Max _4,000-19,o00 Btu/h- -� 1 Rated 8000 Heating - --- 2.803-24.000i Connection Method Liquid Gas Pre -change length Minimum Length Max. length in (mm) it (in) 0 1/4 01/2 R �v Net(H -W. D)_ _ - in (mm) 11138-9116 19-//Ib t[au• 9au tool Gross (H . W • D) 12-11116 - 42-7116: 13-5/8 (322. 7,078 346) Vol Net Weight Ib (kg) 29 (13) 37 (17) Gross Weight r rrrr r Net (HxWxD) 24-718. 114-3/4(692 Gross (HxWxD) in (tom) -- 27-114 * 37 • 14-3/441692.940.375) -1/4 - 37 ,rW - 375) -- —86 Net Weight Gloss Weigh[ Ib Ikgl --_ (39) --- — -_95 (43) _ _. _ ME Es 7 Year Compressor, 5 Year Parts out -of -the -box Warranty 10 Year Compressor, 10 Year Parts Warranty when registered within 60 days of installation in a residence 12 Year Compressor, 12 Year Parts Warranty when registered within 60 days of installation in a residence, and installed by a Fujitsu Elite contractor This system combination is Energy Star qualified *App available in Apple* App Store and Google° Play Store. Due to continuous product improvements, specifications are subject to change without notice. Please log In to the Fujitsu Portal for the most up-to�daw documentation FU 1TSU n I RSTAG E SUBMITTAL 18LPAS1 r. . HIGH 530 (900) 'Cooling MED_ _�-- i LOW 471 (800) 377(640) Indoor Unit Airflow, rate rate --------- ---- 241 (410) 506(860) . .HIGH - MED_ _ (FM (m31h) 406(690) ,Heating LOW 330 (560) DUIET 247 (420) Outdoor Uni[Airflow Cooling - � _ 1,348(2,290) rate Heating 1,348 (2,290) 50UND PRESSURE HIGH 44 Cooling MED 42 LOW 37 Indoor Unit QUIET HIGH 26 43 MED dB (A) 39 Heating LOW 34 QUIET 28 Outdoor Unit Cooling 5o 50 Heating Type R410A Charge lb oz 21b 16 oz 1350 Oil Type 9 RB68 DIMENSIONS: 1918JI1111410 Voltage/Frequency/Phase 2081230V-60 Hz Available Voltage Range 187-253 V Cooling Rated 6.7 Current Heating Rated 5.9 Maximum Operating Current Cooling Heating 9.9 A 11.9 Starting Current _ -_ ,_._. _ 6.7 MCA 14.7 Maximum Circuit Breaker 15 Cooling Rated 1.5 Input Power Min. -Max. 0.15-1.90 kW 1.33 Heating Rated Min. -_Max. 0.15-2.70 Power Factor Cooling % 97.3 98 Heating t Moisture Removal pines/h (Uh) 4.0 (1.9) Energy Star _---- _ Yes Material PP, HOPE Drain hose Tip diameter in(mm) 017132 (013.8) (I.D.), 05/8 to 21/32 (015.8 to 16.7) (O.D.) Cooling _ F (°C) 64 to 90 (18 to 32) Operation Range _ %RH —_ 80 or less _ Heating_ F ('E1 Bfi or less (30 or less) Units: In. (mm) Wall Bracket Data: Fujitsu General America, Inc. ° 340 Changebrige Rd, Pine Brook, NI 07058 • Toll Free: (B88) 888-3424 ° www.firlitsugeneral.com FUJITSU SUBMITTAL 18LPAS1 n I RSTAG E DIMENSIONS Indoor Unit Outdoor Unit Sideview s� 4-M10 We =-t 3n615401 beta 0. Pact, of E f v ioetelleaon Top view Front vie'., Side view Airlbw t Bottom view Side view (Valve part) Units: In. (min) no top.b9ois a wwMcide rademahof Fyinuwoeral Uoti4d M,Ao ageb9oaM tome uaxvld radewa of N. s,,wr uom are reed w the lbwoo.,odoxon F.j. isnnal llmlhdaW earo2utued radwwt in 1a,w%the M and uhn cowrieswa— C,,6,hl 20U Fgipo Coding: Inflow tvwwa wd ePf l26.tt111& (19.4'Q n wit wtJoo, mpmhee d 951(M) alvtsr(am GMetaIPTAka.lm. full0u's produce ere mjert. twwurt h io owK Nieu cesasa Me Nht to modily,wwr M aearn9: bdom tem rwnro 4 JOS (21.1%) Di1UPF 115.M W aM wmluu l� of M j8LrQ 09I4W dw,n, sper&wws aM inlonoww in the bm we wwou now, aM snthou lwumn9 wry Wgarwu 16.111M Root gth:25h.(1.sm), eeyM dianence: W(0o) Iaerdwr unit -ndoor wit). Certificate of Product Ratin AHRI Certified Reference Number: 207131734 Date : 07-03-2023 Model Status : Active AHRI Type: HRCU-A-CB-O (Mini -Split Heat Pump, with Remote Outdoor Unit Air -Source, Free Delivery) Outdoor Unit Brand Name: FUJITSU Outdoor Unit Model Number: AOUHI8LPAS1 Indoor Type : Mini -Spins (Non -Ducted) Indoor Model Numbers) : ASUH18LPAS Rated as follows in accordance with the latest edition of AHRI 2101240 - 2017 with Addendum 1, Performance Rating of Unitary Air -Conditioning 8 Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third parry testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 18000 SEER: 20.00 EER (A2) - Single or High Stage (95F) : 12.00 Heating Capacity (H12) - Single or High Stage (47F) : 18000 HSPF (Region IV) : 11.00 Rated as follows in accordance with the latest edition of AHRI 210/240 — 2023, Performance Rating of Unitary Air -Conditioning 8 Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (AFtul) — Single or High Stage (95F), btuh : 18000 SEER2: 20.00 EER2 (A Full) — Single or High Stage (95F) : 12.00 Heating Capacity (H1Full) — Single or High Stage (47F), btuh : 18000 HSPF2 (Region IV) : 10.50 Sold in? : USA, Canada 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 -rate. The new published rating is shown along with the previous (i.e. WAS) rating. 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 refer to www.AHRlnetorg for more informafion about updated energy efficiency metrics. DISCLAIMER AHRI does not endorse the products) 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.ahrldirectory.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; Am 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-0ONDITIONING, HEATING, CERTIFICATE VERIFICATION a REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.urg, Click on "Verify Certificate" link we make life better^ antl 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.: 133328931694373761 Certificate of Product Ratings AHRI Certified Reference Number, 207131734 Date : 07-03.2023 Model Status: Active AHRI Type: HRCU-A-CB-O (Mini -Split Heat Pump, with Remote Outdoor Unit Air -Source, Free Delivery) Outdoor Unit Brand Name : FUJITSU Outdoor Unit Model Number: AOUH18LPASI Indoor Type : Mini -Splits (Non -Ducted) Indoor Model Number(s) : ASUH18LPAS Rated as follows in accordance with the latest edition of AHRI 2101240 - 2017 with Addendum 1, 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 (A2) - Single or High Stage (95F), btuh : 18000 SEER : 20.00 EER (A2) - Single or High Stage (95F) : 12.00 Heating Capacity (H12) - Single or High Stage (47F) : 18000 HSPF (Region IV) : 11.00 Rated as follows in accordance with the latest edition of AHRI 2101240 — 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 (AFuI —Single or High Stage (95F), btuh : 18000 SEER2: 20.00 EER2 (AFull) — Single or High Stage (95F) : 12.00 Heating Capacity (H1Fu19 — Single or High Stage (47F), btuh: 18000 HSPF2 (Region IV) : 10.50 Sold in?: USA, Canada 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 -rate. The new published rating is shown along with the previous (i.e. WAS) rating. 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 refer to www.AHRInet.org for more information about updated energy efficiency metrics. DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the products), 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; Am 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 ve 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133328931694373761 4%, ,.vLAICSo1utions Invoice 4662 SW 74th Ave DATE 07/05/2023 Miami, FL 331SS (786) 512-9165 / (305) 853-6083 INVOICE# 10598 PerfectACSolutions@gmail.com TERMS Due Upon Receipt DUE DATE 07/05/2023 BILL TO }` SERVICE LOCATION St. Rose Of Lima Catholic School Michele Pinder 425 NE 105th St Maintenance Lunch Room Miami, FL 33138 425 NE 105th Street Miami Shores, FL 33138 B# DATE, PO/RER 187 07/05/2023 ob Charges Qty Rate Total 3intenance Lunch Room stallation of a 1.5 Ton Mini Split by Fujitsu, with Freon R410A. Installation dudes: new digital thermostat. Reconnect low and high voltage wiring. !w drain line, New refrigerant lines. Hurricane Tie Downs for Condensing lit. 1.00 arranty on Compressor 5 years, 1 year parts, as per manufacturer,. $4,850.00 $4,850.00 arranty on Labor by us the Installers 1 year. )te: Client must provide high voltage with a pull-out disconnect for CU tit. ad 5 Business days. )sts of Permits are NOT included. Should they be required, costs to be 1.00 $0.00 $0.00 imbursed to us. ib Subtotal $4,850.00 ib Total $4,850.00 CUSTOMER MESSAGE Invoice Total: Deposits (-): Payments (-): Total Due: $4,850.0 $O.0 $4,850.12 $O.0 ,]I OCT 06 2023 AIR CONDITIONING REPLACEMENT DATA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): 4 aS T47 L S 51 Q City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO 21 ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES Q UNIT BEING REPLACED DATA NEW UNIT -e�� I)LA MANUFACTURER D —C© Lb-- AHU or PKG. UNIT MODEL # 2 C Z t2 C JT COND. UNIT MODEL # tc-6- 10 law KW HEAT I %uJ 5 -T N NOM TONS S -IC> AHU Cu PKG SS-- 1)M.C.A AHU CU PKG 5C-6( AHU CU PKG O—"}p 2) M.O.P AHU CU PKG u--4U AHU Cu PKG ,^a,Ll 3) VOLTS AHU CU PKG %.40 PKG UNIT / / PKG UNIT I q_ EER/SEER Ib qD S r 2 YES NO ✓ REPLACING DUCTS YES NO YES ✓ NO REPLACING THERMOSTAT YES L NO YES NO v NEW 4"CONCRETE SLAB YES NO YES NO ✓ NEW ROOF STAND YES NO v YES NO ✓ NEW RETURN PLENUM BOX YES NO U 1. Minimum Circuit Ampacity (Wire Size): lk (� lw �2$ 2. Maximum Overcurrent Protection (Fuse/Breaker Size): (' (1 �03 3. Voltage of Circuit (208/240/480): -�40 V 4. Size Disconnecting Means: Contractor's Company Name: Phone: -06' D -cJ/6Y State Certificate or Registration No. C Certificate of Competency No.. Signature —� Date: �S e -.2 3 IRevisedG2/24/20141 Certificate of Product Ratings AHRI Certified Reference Number; 208663376 Date : 10-05-2023 Model Status; Active AHRI Type : SPY -A (Year -Round Single -Package Air -Conditioner, Air -Cooled) Outdoor Unit Brand Name: RUUD Outdoor Unit Model Number (Condenser or Single Package) : RACAZR060AJT 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 : On January 1, 2023, efficiency 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 efficiency 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 210/240 — 2023, Performance Rating of Unitary Air -Conditioning 8 Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (AFelt) — Single or High Stage (95F), btuh : 56000 SEER2 : 13.40 EER2 (AFull) — Single or High Stage (95F) : 10.60 }"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. 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 refer to www.AHRlnet.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 This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and all confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; capied; disseminated; JrW 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.ahrldirectory.org, click on "Verify Certlflcate" 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133409891097290937 III Certificate of Product Ratin AHRI Certified Reference Number : 208663376 Date : 10-05-2023 Model Status: Active AHRI Type : SPY -A (Year -Round Single -Package Air -Conditioner, Air -Cooled) Outdoor Unit Brand Name : RUUD Outdoor Unit Model Number (Condenser or Single Package) : RACAZR060AJT 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, SO, TN, T), UT, VA, VT, WA, WV, WI, WY, U.S. Territories) Region Note : On January 1, 2023, efficiency 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 efficiency 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 2101240 — 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 (AFulf) — Single or High Stage (95F), btuh : 56000 SEER2 : 13.40 EER2 (A Full) —Single or High Stage (95F) : 10.60 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 -rate. The new published rating is shown along with the previous (i.e. WAS) rating. 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 refer to www.AHRlnet.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.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 AMM 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 users individual, personal and confidenllal reference. AIR�CONDITIONING, HEATING, REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION 8 The information far the model cited on this certificate can be verified at www.ahridlrectory.org, click on "Verify Certfffcate' link wa make lifc better"' and enter the AHRI Certified Reference Number antl 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.: 133409891097290937 ®Fwut�LAlCSolutions Invoice 4662 SW 74th Ave DATE 08/11/2023 Miami, FL 33155 (786) 512-9165 / (305) 853-6083 INVOICE# 10710 PerfectACSolutions@gmail.com TERMS - Due Upon Receipt I DUE DATE 08/11/2023 BILL TO SERVICE LOCATION St. Rose Of Lima Catholic School Michele Pinder 425 NE 105th St Classroom 10/20 III Miami, FL 33138 425 Northeast 105th Street Miami Shores, FL 33138 c. 120331 08/09/2023 Job Charges Qty Rate Total I Installation of a 5 ton Package Unit System by Ruud, high efficiency 14 SEER, with new Freon R410A. Complete Installation Includes: New digital thermostat. Retrofit return and duct plenum. Rewire low and high voltage. Hurricane Tie Downs. Warranty: 5 years on compressor. Labor warranty by us the 1.00 $7,980.00 $7,980.00 Installers 1 Year. Cost of Crane Included. Note: Unit not in store stock, lead time approximately 4 weeks. Please let us know as soon as possible so we can order the unit. Costs of Permits are NOT included, to be reimbursed. 1.00 $0.00 $0.00 Job Subtotal $7,980.00 Job Total $7,980.00 CUSTOMER MESSAGE Invoice Total: $7,930.00 Deposits (-): $0.00 Payments (-): $7,980.00 Total Due: $0.00 III OCT 06 2023 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 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 LI ARHI Sheet Attached: YES a NO ❑ Contract Attached: YES E�' O UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # SU O COND. UNIT MODEL # KW HEAT 3. vM NOM TONS 4, ccc -tU AHU Cu PKG 1) M.C.A AHU CU -3. j PKG AHU Cu PKG 2) M.O.P AHUDZ CM.q PKG AHU Cu PKG 3)VOLTS AHU CLaXPKG PKG UNIT / / PKG UNIT EER/SEER " (L, a0 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES i- NO r� YES NO NEW 4"CONCRETE SLAB I YES NO ti YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO V 1. Minimum Circuit Ampacity (Wire Size): cn a1^ j 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 24u 4. Size Disconnecting Means: Contractor's Company Name: Phone: 76C -5 ` L - q ( C6 State Certificate or Registration No. Cif \YJ ( SO �L� Certificate of Competency No. Signature Date: (Qu x i . na (Revised02/24/2014) Eligible for 2022 Federal Tax Credit* Certificate of Product Ratings AHRI Certified Reference Number: 206909902 Date: 07-03-2023 Model Status : Active AHRI Type : HRCU-A-CB-O (Mini -Split Heat Pump, with Remote Outdoor Unit Air -Source, Free Delivery) Series Name : H-Series Outdoor Unit Brand Name : FUJITSU Outdoor Unit Model Number: AOUH09LPAS1 Indoor Type: Mini -Splits (Non -Ducted) Indoor Model Number(s) : ASUH09LPAS Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1, 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 (A2) - Single or High Stage (95F), btuh : 9000 SEER: 20.00 EER (A2) - Single or High Stage (95F) : 12.50 Heating Capacity (H12) - Single or High Stage (47F) : 10000 HSPF (Region IV) : 11.00 Rated as follows in accordance with the latest edition of AHRI 210/240 — 2023, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, Independent, third parry testing: Cooling Capacity (AFtnl) — Single or High Stage (95F), btuh : 9000 SEER2: 20.00 EER2 (A Fullo —Single or High Stage (95F) : 12.50 Heating Capacity (1-11FOO — Single or High Stage (47F), btuh : 10000 HSPF2 (Region IV) : 10.50 Sold in?: USA, Canada 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 -rate. The new published rating is shown along with the previous (i.e. WAS) rating. 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 (SEE82). Efficiency requirements are published at 10 C.F.R. 430.32(c). Please refer to www.AHRlnetorg for more information about updated energy efficiency metrics. Eligibility for the 2022 Non -Business Energy Property Tax Credit provided on this AHRI Certificate is not intended to constitute tax or legal advice; instead, it is for general informational purposes only. Eligibility for tax credit may not constitute the most up to date information. AHRI makes no representation or warranty, express or implied or assumes any legal liability or responsibility for the accuracy, completeness, any third parry's use of, or the results of the use of eligibility for the 2022 Non -Business Energy Property Tax Credit disclosed on the AHRI Directory for Certified Product Performance and/or the AHRI Certificate. Individuals considering eligibility for the tax credit are advised to confirm eligibility win their equipment installers and tax attorneys or preparers. DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the produces) 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. AN TERMS AND CONDITIONS This MS D and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and Ins 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, CERTIFICATE VERIFICATION a REFRIGERATGERATINION INSTITUTE HEATING, 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133328800201435370 Eligible for 2022 Federal Tax Credit' Certificate of Product Ratin AHRI Certified Reference Number: 206909902 Date: 07-03-2023 Model Status : Active AHRI Type : HRCU-A-CB-O (Mini -Split Heat Pump, with Remote Outdoor Unit Air -Source, Free Delivery) Series Name : H-Series Outdoor Unit Brand Name : FUJITSU Outdoor Unit Model Number: AOUH09LPAS1 Indoor Type: Mini -Splits (Non -Ducted) Indoor Model Number(s) : ASUH09LPAS Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1, 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 (A2) - Single or High Stage (95F), btuh : 9000 SEER: 20.00 EER (A2) - Single or High Stage (95F) : 12.50 Heating Capacity (H12) - Single or High Stage (47F) : 10000 HSPF (Region IV) : 11.00 Rated as follows in accordance with the latest edition of AHRI 2101240 —2023, Performance Rating of Unitary Air-Conditoning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, thfrd parry testing: Cooling Capacity (AFu9 — Single or High Stage (95F), btuh : 9000 SEER2: 20.00 EER2 (AFal9 — Single or High Stage (95F) : 12.50 Heating Capacity (H1Fulq — Single or High Stage (47F), both : 10000 HSPF2 (Region IV) : 10.50 Sold in? : USA, Canada f"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. The Department of Energy has published updated energy efficiency marries 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 refer to www.AHAInet.org for more information about updated energy efficiency metrics. ' Eligibility for the 2022 Non -Business Energy Property Tax Credit provided on this AHRI Certificate is not intended to constitute tax or legal advice; instead, it is for general informational purposes only. Eligibility for tax credit may not constiRute the most up to date information. AHRI makes no representation or warranty, express or implied or assumes any legal liability or responsibility for the accuracy, completeness, any third party's use of, or the results of the use of eligibility for the 2022 Non -Business Energy Property Tax Credit disclosed on the AHRI Directory for Certified Product Performance and/or the AHRI Certificate. Individuals considering eligibility for the tax credit are advised to confirm eligibility with their equipment installers and tax attorneys or preparers. 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 products) 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; ftim 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 &REFRIG TFRIGERATION ( INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link make fife 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 133328800201435370 FUJITSU SUBMITTAL 09LPAS1 A I RSTAG E job Name Engineer Submitted To Submitted By PRODUCT FEATURES Auto Changeover Weekly & 24 hr. Timer Auto Louver: Up/Down Minimum Heat Mode (Wt-Fl Adapter required) Wireless Remote Control Included Auto Restart Economy Mode Energy Saving Program (ESP) Outdoor Unit Low Noise Schedule rr Indoor Unit ASUH09LPAS Outdoor Unit A01,11,091-PA51 5vstem 09LPAS7 SEER 20 SEER 2 20 EER - 12.5 'EER2 - 12.5 HSPF __. 11 _ HSPF2 - 10.5 COP kill" JIM COP _ 13.5 {OP2 _._BIUIhW_ _ kWIkW 3.96, r rrr rr 'Cooling_ •F(•C) - _..14to 1151-10 to 46)'. Heatin 5to7S(-15to24) Rated 9000 Cooling Min. -Max. Btu/h -- 3,300-10,800 Rated 10000 Heating Min. -Max. 2600-12,52,500, r , Connection Method _ Flare' Liquid in (tom) - 0114 (06.35) Gas __.8318(09.52) Pgechaigeleogth _ 49(15) Minimum Length It (in) _ 16(5) IMax.lerr�th 66 (20) Net (H•W•D) in(mm) to-Wili x M-tvto•o-arn lUU'o8 'GGq _ Gross (H . W x D) 10-718. 36. 13-1116 (277 * 914 - 332) ___. Net Weight _ lb kg) _.__.. _ 21(9.5) GrossWei ht 261f2.0- ) r rtr r r Net (H x Wx D) -' in (tom) 21-5/16. 26-1/8- 11-7116 _._ Grass (H z W z DI 23-11/16 - 31-518.14314(602 •804 - 375) Net Wei ht _ 51(23) w--._._ lb (k9) - Gross We57(26) ight Approval Drawing 07Y—aa 7 year Compressor, SYear Parts ou[bf-the-box Warranty i1'ear 10�r 10Year Compressor, 10Year Parts Warranty when registered within rT� 60 days of installation in a residence `12Year 12 Year Compressor, 12 Year Parts Warranty when registered within 60 days of installation Ina residence, and installed by a Fujitsu Elite "^P"" contractor 'APPavailable In APPte'APP Store and Cuogle• ^� Play Store. Due to continuous product Improvements, spalOcations are subject to change without notice. Please log into the Fujitsu Portal for the mostup-to-date daumentation FUJITSU SUBMITTAL 09LPAS1 A I RSTAG E FAN DATA HIGH 4121700) MED _ 330(560) Cooling LOW 253 (430) Indoor Uni[Airflow rate ---- HIGH 159(270)te 441 (750) _ MED '— CFM (m37h) 359 (610) Heating LOW - - 277(470) QUIET 194 (330) _ Outdoor Uni-tAlrflow Coaling 959 (1,630) rate Healing 959 (1,630) r r., HIGH 40 Cooling MED 34LOW 29 QUIET 19 Indoor Unit ,HIGH dB(A) 42 Heating MEO-- 36 LOW 31 QUIET 21 Outdoor Unit Cooling _ 47 48. Heating TYP.e_._ '_ _.-.. R410A'. _ Iboz- llb9oz. Charge-700 - Oil Type_ _ _ VGA DIMENSIONS: r Voltage/Frequency/Phase 2081230 V - 60 Hz - Available Voltage Range 187-253V Current Cooling Rated 3.5 Healing Rated 3.7 Maximum Operating Current Cooling Heating_ _ 6.4 A 7.9 Starting Curtent 3.7 MCA 9.7 Maximum Circuit Breaker 15 Cooling Rated_"___,_0.72 Input Power -- _ - Min. —Mai 0.14-1.18 kW Rated_ 0.74 Healing Min. -Max. -�- 0.13-1.23 Power Factor Cooling Hearing _ % 89.4 86.9 r Moisture Removal pintsih UJId 2.7 (1.3) Energy Star yes Material PP+HDPE Orain hose Tip diameter _ _ in (mm) 017132 (013.8) (I.D.), 019132 to 21132 (015.0 to 16.8) (C.D.) "FCC) 64 to 90(1S to32) Cooling Operation Range /aRFI -_ L _ 80 or less _ Heating- F ("C) _ 60 to 8606 to 30) Units: in.(mm) Wall Bracket Data: (32-13/16 (8341) 2-5/8 67 12-7/8 327 12-718 327 4-7/16 113 Outline of indoor unit o„..o i� L ... .... o o e s `. I] _ - ran prpe htete2-8nsHIM nor p1w wetm ZW18_� 2-1/2(64) 2-7/16 62 1-7/8(48) 3-5/16 84 13-5/8 (346) 14 (356) Fujitsu General America, Inc. • 340 Changebrige Rd, Pine Brook, NJ 07058 • Toll Free: (888) 8683424 • www.fujitsugeneral,com FUJITSU SUBMITTAL 09LPAS1 ARSTnG E DIMENSIONS Indoor Unit Outdoor Unit Side view a_ pft Oabndbaforfina Top view Units: In. (mm) Front view Side view Airfbw nmwel wew The Fujlau loggis a waWwitle trademandFujibu fiencal umiad. ThetiNagelogo antl name. a xaMwideaad.d,al Fujasu6enaal nmitd and. an M,netl trademahin)apan. JIe MaMaides mudnes vama. raIanghQM Fujian rennal Tmeha.Inc FViaJspduaamsubla[bcmEnimis6nparcmenh Fujlau taenelbe nglnm madly pdut dagn. Wdlkatims and inkmutim In MsbtoAue NMaanoke and-tMat kmmy anyad9atlms Side view (Valve part) N.: Sp ikaknsaebasil mke Mkvnn9twditio,¢ (ualmg: Ildaar ImMam da (26.1T1MrF(114.0 Wa andaad.WrneamedWF(39) �5F(23.M 1 Neating:Indm, temperabae dM(21.IC)6ebVF n5.M Wa udad4oa6vnpes+basil an IM W4W (6.MWN. N, knglb:25k 113m1."Itd a,.66-(anl(Oaldaaaat-bldaaa,al. Fujitsu General America, Inc. a 340 Changebriqe Rd, Pine Brook, NJ 07058 a Toll Free: (888) 888-3424 a v .fujitsugenerai.com A;< min (2) ... brddcets ..... per urOt Mini -Split Wall -Mount Equipment Support M.T.S.Scale Barneft I 0.12S* 6W1_T6 Aluminum in channel at wau Scale., 1:2 (2) anchors per bradwt to concrete, masonry, or wood t*a *ucWfe. V4- nw Tapam 1`,10 min anted Zj- min edge dist 400 lb max r4.1 f may vary) find we' W*,. an pa& (optional) L Unit centered at V max Length may vary n2 Typical Bracket Installation Scale: VT 0 V-W Side Elevabon 0.12r �Z 6WI-T6 Aluminum 1.7V it Channel at RAe. 1-2 .. 1. Design 6- in rewrements of OWMIng Code for wboe the t4h zone ("Altz). V.,11 2. Design wind baWbO. this generic englnet�rin9 determined per separate accordance with aboveTtoted Code requirements. 3. The edsting host WUM" MILa be capable of suppor" the toaded system as Yesby building departmefd or ardABCt I engineer of record. No warranty, either 6WMW or unpmA is contained herein. 4. System shag be as noted herein. Aft referermes, to components, moons, & dher 1nsWbUW afteft shall amform to du of qVkWe product approval &/or ffies specs. S. 7M spedfic3fion is generic and rwtspedftto3nY-prCj=Sb_1 When cuddons deviate from dxW ftm WG this plan, separate sft-jpwft engu=tng e%,Wuadw shall be reqtdred. 6. &qveer seal affixed hereto validates struc-urad design as shown Qrjy. Use, Of this spWficadon by contractor, et, al. bukrvinlFies & sum hanutess this engineer nor ad wd & damages kxhidV W fbm & appellate fees resawq from deAMions from " plan, 7. Any moOkations of aWKW6 to this document *10 invaiwate ervirwmes certiftaWn. & &xept as expressly WvAded herein, no additional cerffkad" Or affurnations are kftxkxL rk.1IL �LA1CSolutions ---- 4662 SW 74th Ave DATE Miami, FL 33155 (786) 512-9165 / (305) 853-6083 INVOICE# PerfectACSolutions@gmall.com TERMS DUE DATE BILL TO - I St_ Rose Of Lima Catholic School '.. 425 NE 105th St Miami, FL 33138 B# DATE PUIREl 202 07/05/2023 ,b Charges Invoice 07/05/2023 10594 Due Upon Receipt 07/05/2023 SERVICE LOCATION Michele Pinder Cafeteria Storage Room 425 NE 105th Street Miami Shores, FL33138 ty Rate Total ifeteria Storage Room stallation of a 9000 BTU Mini Split by Fujitsu, with Freon R410A. stallation includes: new digital thermostat. Reconnect low and high ,Itage wiring. New drain line, New refrigerant lines. Hurricane Tie Downs r Condensing unit. 1.00 arranty on Compressor 5 years, 1 year parts, as per manufacturer,. arranty on Labor by us the Installers 1 year. )te: Client must provide high voltage with a pull-out disconnect for CU lit. ad 5 Business days. )sts of Permits are NOT included. Should they be required, costs to be 1.00 imbursed to us. ib Subtotal rb Total �( CUSTOMER MESSAGE Invoice Total: Deposits (-): Payments (-): Total Due: $4,250.00 $4,250.00 $0.00 $0.00 $4,250.00 $4,250.00 $4,250.0 $O.0 $4, 250. C $O.0 509[ 0 T M OCT 0 6 2023 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 City: Miami Shores Village County: Miami Dade Zip Code: 3 3A 3 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 Ej NO ❑ Contract Attached: YES Q a UNIT BEING REPLACED DATA NEW UNIT Jti MANUFACTURER l zi l AHU or PKG. UNIT MODEL # LUft COND. UNIT MODEL# GA 5 I KW HEAT 5 X0 NOM TONS i� 9 -rnN AHU CU PKG 1) M.C.A AHU40 CU ab PKG AHU Cu PKG 2) M.O.P AHU 35 CU jj.QKG AHU CU PKG 3) VOLTS AHU AOCU 290 PKG PKG UNIT / / PKG UNIT EER/SEER I5� "0 c R.' YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES +r NO YES NO NEW 4"CONCRETE SLAB YES NO jX YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES (/ NO 1. Minimum Circuit Ampacity (Wire Size): 4—J UJ`� 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 40 I'KIAkz2 3. Voltage of Circuit (208/240/480): a 4. Size Disconnecting Means: ?ULL U Contractor's Company Name: Phone: ML- Cia iiLS State Certificate or Registration No. C AC- Certificate of Competency No. Signature Date: t-> - 9,U2'�___ (Qualifier 54 tore (RevMd02/24/2014) Certificate of Product Ratings AHRI Certified Reference Number: 210990503 Date: 06-30-2023 Model Status: Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series : 15 SEER2 AC Outdoor Unit Brand Name: CARRIER Outdoor Unit Model Number (Condenser or Single Package) : GA5SAN418"WA' Indoor Unit Model Number (Evaporator and/or Air Handler) : FJ4DN'Al8L' 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: On January 1, 2023, efficiency 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 efficiency requirements. The manufacturer of this CARRIER product is responsible for the rating of this system combination. Rated as follows in accordancewith 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 parry testing: Cooling Capacity (AFull) — Single or High Stage (95F), btuh : 17900 SEER2 : 15.50 EER2 (AFull) — Single or High Stage (95F) : 13.00 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 am 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. 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 refer to www.AHRinet.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 wild 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 antl confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; AMM 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,EFRIGETI(HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified atwww.ahridlrectory.org, click on 'Verify Certificate- link we make fife 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13332633176297809E Certificate of Product Ratings AHRI Certified Reference Number: 210990503 Date: 06-30-2023 Model Status: Active AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series : 15 SEER2 AC Outdoor Unit Brand Name : CARRIER Outdoor Unit Model Number (Condenser or Single Package) : GA5SAN418"WA' Indoor Unit Model Number (Evaporator and/or Air Handler) : FJ4DN'Al8L' 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 : On January 1, 2023, efficiency 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 efficiency requirements. The manufacturer of this CARRIER Product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 — 2023, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third parry leafing: Cooling Capacity (AFw9 — Single or High Stage (95F), btuh : 17900 SEER2 : 15.50 EER2 (AFull) — Single or High Stage (95F) : 13.00 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 -rate. The new published rating is shown along with the previous (i.e. WAS) rating. The Department of Energy has published updated energy efficiency metrics for central air conditioners and heat pumps. This publication reflects both the 19e7 metric (SEER) and the 2023 metric (SEER2). Efficiency requirements are published at 10 C.F.R. 430.32(c). Please refer to www.AHRlnet.org for more information about updated energy efficiency metrics. DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) 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 limed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.a h rid l rectory.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; fiffim 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, INSTITUTE 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 ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13332633176297809E I. 1, 5 Tb,�-f REMBICEO M GENERAL. NOTES SYSTEM NOTES YAMMUSEWMmy "TSYm DONFlC�!lRNTIOi�r, lillA7fON M Wa 110 Aye. AiLE1S�T DESIGN SCHEDULE 2 1 3mia is WALL -MOUNTED A/C EQUIPMENT STAND WELDED ALUMINUM CONSTRUCTION AMAC�OO MAYSNAtWCObMtOMMA�iE6TWEEm 1MKRAREAAT@ M _W oo�b�r'SSSECiIOMFFOE= BATS I0 �� . . FOR�w!�WI� ADRRS[SiA � ��.0000 orex-(itouss°u°0""TAHDY wiw�w�■ wA�rarw..w.�w.. SCAB~ M.T.S. ANCHOR SCHEDULE mmsm. ANCM Wit Now OONCRE7E VV Ii1Y TAPOOMS ar ELC� to 2 1 {314215tMQQ MIM r �, r* filW a VWTAUMB or E1,CA M WOOD •14 WOOD SCREW 3 2 (cpo��mq rtaMerrw&mor, WrMIM�Rt��lil@IOA1mlS ADODSDkK�wm� aWHO fAtmex6mm 11 OEaa =sTu000►ffi%MoR RM �f�aATTW&W OF 0=ASAWST nos imcmistu aimsmowm ToFew. ORME L3x3x IM AL MWM M51 T6 ALLOW) 65PSF ma uMfrwaoff Pm Rm V x •W a 12 MW (mIaTARBAATa" MlAOWTYP VWM — wmm E9M' P081f ...OR.. mw,pm,ff n4tt Y� INSTALLATION SECTION sm'. Us v8tT56CRON t�SiS�[RUC�ti� T M$Cxr sun (1) i` BMT' TV mcm t+Yut BRACKET ASSEMBLY g of 1. S To t--t WALL -MOUNTED A/C EQUIPMENT STAND ONLY VALED FOR (1) WELDED ALUMINUM CONSTRUCTION MOM OR U14T. I GENERAL NOTES SYSTEM NOTES VALID FOR USE WITH ANY iPMBii SYSTEM, ODNfIG�tATtONS, PROVMPRMWKV DIXa�B TfON Zo ETCAS SFIOWN EfRfIIU ALL EXCEPT AtaA+�lU WALL MOUNT® M DESIGN SCHEDULE FMM MAx t1bT wEtatr 2 300 tB 3 6mtD AMACBYT UNITS NAY StWtE COMMON L3RWU BEi1YEEa1 MAX 06IGN WBiD PRL?551JRE: 65PSF MAX tINITAREAAT8iD5: . O SL3.TION MAR Affumsaism FORMNROF ANCHOR SCHEDULE H05TST w. am �� BOTTOM AKM GOMCREME 4 1TW TAPOONS or H= ULTRACM 2 1 (3142 PJ MiIQ IW KW 5= 2$r KIN EDGE OW, GROUT ITW TAPOONS w ELCO ULTRACM 3 2 BLrOUC MO! WED, 2W NN EDGE CST, (m PSI WZT) r im Pik WOOD #14 WOOD SCREW 3 2 (G4S KN) r MIN Empkg�m Dfff, MMNFACt En PIANCHDRS S O . A�RDANCf WITH OWNWr AND EDGE D SMJM 003M SI1=, FO K BRIM OR UMI aSWRWALLFINiSIL FWANDORATTOPQBOTIMOFBRAOUME1MKAl1r5T H08T SiRUCIURE SHALL BE IH5TALIID WITt@l r OF em �--- W 65PSF MAX KNIT wEiGHT PER pmoscHma gW x'W' =12 K4X 0WAREAATBm H BRAWFRWYV — msmzm u 80%or"wemw uttW Mffl M BRAC07: gta�nTnL+NK OR°�... �MWIMLEODAtTT $� VI INSTALLATION SECTION SWE: N.T.S. Yt3CT SECTION I y� L srnAN°1°urn�ETD x 1' ATT EACH ]DIM PRQl6 M (ONE EAON LR MAY VARY �LaR a� SPACING [ DVOKOPTVA ®ANC BRAm L 3x 3 x Ila ALUMINUM (606148 ALLOY) 60 (1) N BOLT, TYP �4�9 ALL BRACKET ASSEMBLY SCALE: N.TS. L5 KmC x w o j • tL 28 _u_ H J J � Q � �ze O g ,l t� z rig � O SD-1 rlia»UtkANCSo!ofions 46O2SvV74thAve Miami, FL3315S (786)512'9165/(305)853'0083 DATE |NmJ|CE# TERMS DUE DATE � " N��U�d mw��~w~w. V5/]0/2023 10499 - ' Due Upon Receipt 0600/2023 BILL TO SERVICE LOCATION St. Rose 0fLima Catholic School Michu|ePinder 425NE1V��hS1 S��Jo��R�m Miami, � 425NvAhno��105�GU�� ` °----'-------------------'---------------�--'---'----- YNiamiShn000. FL33138 ~. .~',~ -- -___---_-_--__-'-___-,-_--_-'-_-_---_-_---_�_- 071 00/21/7023 ob Charges Qty Rate Total sta||atiunofa1.5ton Split System byCarrier SEER2,with new Freon 110A. AHU to be installed in attic this includes new refrigeration lines, new ndensingunit brackets, new PVC drain lines, new low voltage for AMU, ernnostat,and Condenser unit, new overflow switch, hurricane straps for eCondensing Unit. 1.00 $11/500.00 $11/500.00 sta||aUnnof4new supply grilles with duct work, returns for each room. )te:Client need tohave licensed electrician tuprovide high voltage 24O .|tsfor AHUand Condenser unit arranty:5years nnCompressor, asper manufacturer. Labor warranty by , the Installers 1Year. 1.00 $0.00 $0.00 )sisofPermits are NOT included, tobereimbursed. /hSubtotaU $11,500,00 ^bl[wtaU $11'500^00 �- ! CUSTOMER MESSAGE Invoice Total: $11'500. C Deposits $O.0 Payments $11,500I Total Due: $OJ 5rgT0T� OCT 0 6 2023 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): 4 01S Ny 105 9 a City: Miami Shores Village County: Miami Dade Zip Code: 3 3 (3 O 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 [A- ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES U s UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER Q Q_ w pi_ 2. Jac AHU or PKG. UNIT MODEL# J H 2L6(b COND. UNIT MODEL8 CA44)_ww KW HEAT 1Q� S NOM TONS AHU 4 5 CU aS PKG 1) M.C.A AHU 3S CU L-S PKG AHU CU40 PKG 2)M.O.P AHU(o0 CU jS PKG AHU 2. CU AAU PKG 3) VOLTS AHU 1A0 CU 2.40 PKG PKG UNIT / / PKG UNIT EER/SEER Is Fi'(CSZ o1 YES NO REPLACING DUCTS YES NO L YES NO t/ REPLACING THERMOSTAT YES 1L NO YES NO v NEW 4-CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO V NEW RETURN PLENUM BOX YES NO v 1. Minimum Circuit Ampacity (Wire Size): *S w ''r, 2. Maximum Overcurrent Protection (Fuse/Breaker Size): Go Pd,VS 3. Voltage of Circuit (208/2' 4. Size Disconnecting Mean Contractor's Company Name: State Certificate or Registra 'onid ANC I tU S02�- Certificate of Competency No. Signature Date: I - S— 23 (4u le nature 5' (Revised02/24/2014) � Son sual CERTIFIED" Certificate of Product Ratings AHRI Certified Reference Number: 210989984 Date: 10-04-2023 Model Status: Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series :15 SEER2 AC Outdoor Unit Brand Name: CARRIER Outdoor Unit Model Number (Condenser or Single Package) : GA5SAN442"WA' Indoor Unit Model Number (Evaporator and/or Air Handler) : FJ4DN'C42L' 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, NIT, 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: On January 1, 2023, efficiency standards increased for central air conditioners. BBeegqinning January 1, 2023, central air conditioners can only be installed in region(s) for which they meet the new regionafefficiency requirements. The manufacturer of this CARRIER product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 -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 (AFu11) -Single or High Stage (95F), btuh : 45000 SEER2: 15.00 EER2 (AFA -Single or High Stage (95F) : 12.50 t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling a 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. The Department of Energy has published updated energy efficiency metrics for central air conditioners and heat pumps. This publication reflects both the 1ga7 metric (SEER) and the 2023 metric (SEER2). Efficiency requirements are published at 10 C.F.R. 430.32(c). Please refer to www.AHRlnet.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.ahrldIrectory.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; PJM 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�CONDTIONING, HEAn NG, CERTIFICATE VERIFICATION a.REFRIOEMTION INSTRIITE The Information forthe model cited on thiscertificete can be verified at www.ahrldirectory.org, click on"Verify Certificate' link wemakelife beuer- 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. 02023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133,10e307496962500 Certificate of Product Ratings AHRI Certified Reference Number: 210989984 Date: 10-04-2023 Model Status; Active AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Series: 15 SEER2 AC Outdoor Unit Brand Name: CARRIER Outdoor Unit Model Number (Condenser or Single Package) : GA5SAN442"WA' Indoor Unit Model Number (Evaporator and/or Air Handler) : FJ4DN'C42L' 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, LIT, VA, VT, WA, WV, WI, WY, U.S. Territories) Region Note: On January 1, 2023, efficiency 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 efficiency requirements. The manufacturer of this CARRIER product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 — 2023, Performance Rating of Unitary Air-Condifioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (AFuIi) — Single or High Stage (95F), btuh : 45000 SEER2 : 15.00 EER2 (AFuI) — Single or High Stage (95F) : 12.50 t"Active" Model Status are those that an AHRI Certification Program Participant is cunentiy 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. 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 refer to www.AHRlneLorg 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), orthe unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridIrectary.org. TERMS AND CONDITIONS it "15' This Certificate and Its contents are proprietary products of AHRI. This Certificate shell only be used for Individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or In part, be reproduced; copled; disseminated; A. On ILOentered 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-CONDITIONING, HEATING, CERTIFICATE VERIFICATION 6 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. ©2023Air-Conditioning, Heating, and Refrigeration Institute j CERTIFICATE NO.: 17496962500 iu�AJCSolutions 4662 SW 74th Ave Miami, FL 33155 (786) 512-9165 / (305) 853-6083 PerfectACSolutions@gmail.com BILL TO St. Rose Of Lima Catholic School 425 NE 105th -St Miami, FL 33138 OB# pATE: _ POEREF# 0435 09/11/2023 Invoice DATE 09/11 /2023 JNVQICE#_ 10829 -TERW Due Upon Receipt D.UE .DATE 09/11 /2023 ,SERVICE' LOCATION Michele Pinder School Office 425 Northeast 105th Street Miami Shores, FL 33138 lob Charges Qty Rate Total nstallation of a 3.5 ton Split System by Carrier, high efficiency 15 SEER2, vith new Freon R410A. :omplete Installation Includes: Jew digital thermostat. tetrofit duct plenum. Jew overflow switch. tewire low and high voltage. iurricane straps for the Condensing Unit. 4ew metal Air Handler Stand. Narranty: 10 years on Compressor, 10 years on Parts, 10 years on Coils as )er manufacturer. (Unit must be registered with manufacturer within 60 lays from installation otherwise base warranty is 5 years on compressor.) _abor warranty by us the installers 1 Year. :osts of Permits are NOT included, to be reimbursed. lob Subtotal lob Total 1.00 $5,862.00 $5,862.00 1.00 $0.00 $0.00 CUSTQMER MESSAGE Invoice Total: Deposits (-): Payments (-): Total Due: $5,862.00 $5,862.00 $5,862.a $0.0 $5,862.0 $0.0 TETLquiT OCT 06 2023 D By 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 17X3uIII 11p, PI578;1i;2&[6 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 sheetsarenot acceptable. /, Job Address (where the work is being done): Z1 a J � IC- I D 5 S 1 City: Miami Shores Village County: Miami Dade Zip Code: 33 13 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 2 ARHI Sheet Attached: YES ® NO ❑ Contract Attached: YES 0 UNIT BEING REPLACED DATA NEW UNIT foQ_t'' MANUFACTURER O O AHU or PKG. UNIT MODEL # a 2"O� 13-1 a ' (L p V I L� COND. UNIT MODEL# Aw -• O V-W KW HEAT \ " -tor NOM TONS ' -to 1- AHU Cu PKG 1)M.C.A AHL41. CU35 PKG AHU CU PKG 2) M.O.P AHU W CU .0 PKG AHU Cu PKG 3) VOLTS AHU_240CU;,�40 PKG PKG UNIT / / PKG UNIT t0 (1— EER/SEER W a SO S �- YES NO 2f REPLACING DUCTS YES NO 2f YES ✓ NO REPLACING THERMOSTAT YES 25- NO YES NO X NEW 4"CONCRETE SLAB YES NO _�s YES NO NEW ROOF STAND YES NO 'T YES NO )C NEW RETURN PLENUM BOX YES NO 1' 1. Minimum Circuit Ampacity (Wire Size): -4c' VR)a- 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 iL 3. Voltage of Circuit (208/240/480): a110 V 4. Size Disconnecting Means: Contractor's Company Name: Phone: S (-z FI ( 5 State Certificate or Registration No. C i�C- 191 SO ),-I- Certificate of Competency No. Signature Date: 0- � -2b2 ) T(Ardlifie gnature) (Revised02/24/2014) Certificate of Product Ratings AHRI Certified Reference Number; 201383636 Date : 10-04-2023 Model Status: Discontinued Model Discontinued Date : 11-07-2019 Old AHRI Reference Number: 8237813 AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name : RHEEM Outdoor Unit Model Number (Condenser or Single Package) : RA1460AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-25 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, Po, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S. Territories) Region Note: On January 1, 2023, efficiency standards increased for central air conditioners. Beginning January 1, 2023, central air conditioners can only be installed in regions) for which they meet the new regional efficiency requirements. The manufacturer of this RHEEM product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 2101240 - 2017 with Addendum 1, 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 (A2) - Single or High Stage (95F), btuh : 56000 SEER:IQ.9O EER (A2) - Single or High Stage (95F) : 11.70 ttDate when model status changed to Discontinued tModels with "Discontinued" Model Status are those that an AHRI Certification Program Participant no longer produces AND is no longer 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. 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 G.F.R. 430.32(c). Please refer to www.AHRlnet.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.ahrld Irectory.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. AIROONDMONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified of www.ahrldlrectory.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. ©2023Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133409270931525376 Certificate of Product Ratin AHRI Certified Reference Number: 201383636 Date: 10-04-2023 Model Status : Discontinued Model Discontinued Date : 11-07-2019 Old AHRI Reference Number : 8237813 AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower) Outdoor Unit Brand Name: RHEEM Outdoor Unit Model Number (Condenser or Single Package) : RA1460AJ1 Indoor Unit Model Number (Evaporator and/or Air Handler) : RBHP-25 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: On January 1, 2023, efficiency 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 efficiency requirements. The manufacturer of this RHEEM product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of AHRI 210/240 - 2017 with Addendum 1, Performance Rating of Unitary Air -Conditioning 8 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 : 56000 SEER': 1 f,$0 EER (A2) - Single or High Stage (95F) : 11.70 ttDate when model status changed to Discontinued tModels with "Discontinued" Model Status are those that an AHRI Certification Program Participant no longer produces AND is no longer 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. 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 refer to www.AHRlnet.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.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; Pill 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.ahrldlrectory.org, click on "Verify Certificate" link we metre life hatter"' 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.: 133409270931525376 ®FeatuLA1CSolutions 4662 SW 74th Ave Miami, FL 33155 (786) 512-9165 / (305) 853-6083 PerfectACSolutions@gmall.com 20504 BILL TO St. Rose Of Lima Catholic School 425 NE 105th St Miami, FL 33138 09/27/2023 Invoice DATE 09127t2023 INVOICE# ....._.. .__._ ....... .. ......... .............1 10871 TERMS ___.. .... _... ._._ _... . _..� Due Upon Receipt DUE DATE 09/2712023 53 SERVICE LOCATION Michele Finder Convent Room 425 NE 105th St Miami, FL 33138 Job Charges Qty Rate Total Installation of a 5 ton Split System by Rheem high efficiency 14.5 SEER, with new Freon R410A. Complete Installation Includes: New digital thermostat. Retrofit duct plenum. New overflow switch. Rewire low and high voltage. Hurricane straps for the Condensing Unit. New metal Air Handler Stand. Warranty: 5 years on 1.00 $7,650.00 $7,650.00 Compressor, 5 years on Parts, 5 years on Coils as per manufacturer. (Unit must be registered with manufacturer within 60 days from installation otherwise base warranty is 5 years on compressor.) Labor warranty by us the installers 1 Year. Type Air Handler: Short Costs of Permits are NOT included, to be reimbursed. 1.00 $0.00 $0.00 Job Subtotal $7,650.00 Job Total $7,650.00 CUSTOMER MESSAGE Invoice Total: $7,650.00 Deposits (-): $0.00 Payments (-): $0.00 Total Due: $7,650.00 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.: ELC-10-23-2479 Permit Type: Electrical - Commercial Work Classification: Addition/Alteration Permit Status: Approved Issue Date:11/07/2023 Expiration:05/03/2024 Parcel Number 415 NE 105TH ST, Miami Shores, FL 33138 1122310430010 Contacts EDW A MCCARTHY-ARCHBISHOP Owner PERFECT AC SOLUTIONS Applicant 9401 BISCAYNE BLVD, MIAMI SHORES, 33138 RIMAI BARRIENTOS Business: 3057580539 MPINDER@SRLSCHOOL.COM 4662 SW 74 AVE, MIAMI, FL 33155 Mobile: 3862593056 Business: 7865129165 perfectacsolutions@gmail.com 10HN B MOODY 603 N 21 STAVE, HOLLYWOOD, 33020 Business: 9543675989 barney@moodyelectric.com Description: INSTALLATION OF 2 MINI SPLITS UNITS 30 AMP Valuation: $ 4,200.00 Ins ection Requests: EACH -I SPLIT UNIT AIR HANDLER CONDENSOR 11/2 TON i, 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $3.00 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.50 Permit Fee $76.00 Scanning Fee $18.00 Technology Fee $12.60 Total: $165.10 Payments Date Paid Amt Paid Total Fees $165.10 Credit Card 11/07/2023 $165.10 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 AFFI AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co tr dion and z- ing. Futhermore I authorize the above named contractor to do the work stated. --1 vv vlr\e- DOLL Authorize ig ture: wner / Applicant / Contractor 4ent Date November 07, 2023 Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (3O5)756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION F-IBUILDING LX ELECTRIC ❑ ROOFING F—JPLUMBING Ej MECHANICAL PUBLIC WORKS FBC 202b Master Permit No. MIL-1 23.2.4 Sub Permit NoYE(IQ-10--Mc 2`• - ❑ REVISION ❑ EXTENSION RENEWAL CHANGE OF CANCELLATION ❑ SHOP rr)NTR ArTr1R nR A 1An nIGC Folio/Parcel#: It- 7-L 3 1- 043 6(b Iy Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: / Flood Zone: BFE: FFE: OWNEI"acne(Fee Simple Titleholder ):XfY��/X/6CC.�/ ^/.zz L,,e?, c. Phone#: 301-1(;Z--J0J1 AddresAA City: State: Zip: 33�3/J Tenant/Lessee Name: 't 9CO(�/ tea' i� 1, inot� Phone#: Email: i/Jp2YG�SrMSL'-Lt1O�q/�'��jn� CONTRACTOR: Company Name: / f C�{�Phone#: *5- ` %�lJ '=aoerj Address: -,03 A) 5T City: / tate: 1 Zip:1 q��,,�,�� Qualifier Name: �� Phone#: 3f>S 75z?tYC-C� State Certification or Registration #: Certificate of Competency - DESIGNER: Architect/Engineer: Phone#: Address: City: State:Zip: Value of Work for this Permit: $ -J7' IX 450 Square/Linear Footage of Work: Description of Work: Specify color of color thru tile: Submittal Fee $ ✓�� Permit Fee $ 1(0tb CCF $ 3 f6 CO/CC $ Je Scanning Fee $ {� Radon Fee $ 2• i DBPR $ Notary $/6 Technology Fee $ I2-•�P� Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 1 Va. IL) (RevisedO2/24/2014) 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 i 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 on 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. The foregoing instrument was acknowledged before me this day of c%KM'E 20 z—Zi by 54, �'wz.+Vtx+ IJ0epey, ho is personally known me or who has produced as Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of J U hr 20 23 by `ilf) .0 - MI[QdLJ who is personally known to me or who has produced I as identification and who did take an oath. identification and who did take an oath. NOTARY PAUBLILI�C::�./max NOTARY PUBLIC: Sign: v Sign: Print: L YN Print: :e.C! PAWEL KOBRZYNSKI a:. t Seal: MY CC4AMISSIONNHH 062310 Seal: REBECA M Notary ems• e, EXPIRES: November 17, 2024 -�'�fr�^,•' �. .; `� Public - S Commission M GO Bonded 7Aru Notary Public Underxtite(a'�'arn My Camm. Expire Bonded throe h Nati n,7 n##'#M# #++++####+ APPROVED BY ?„>O�/23Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)