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MC-10-2197Miami Shores Village 191WW,WSh Building Department p 'Lola 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Doe Owner's Name (Fee Simple Titleholder) 44 n Owner's Address 1060 1 t.3- Ave. BY: .................. Permit No.A C,)10 �p�m Master Permit No. Phone # locg4 /t9°2% City m 6110106 State iS° Zip 13481 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) . I05D 1 V £ `- .@',.... City Miami Shores Village County Miami -Dade Zip 7j 8 FOLIO /PARCEL# 11—'2°7=31 O/'3C? Is Building Historically Designated YES NO S.— Contractor's Company Name k i o'" Phone # *110 0 Contractor's Address 515 ILIC (, 4.0 City (1t 't.. State Zip elf rie/ Phone # Ci 4001"/D State Certificate or Registration No. r %' Certificate of Competency No. E -MAIL: Qualifier Name Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Pjpne # Square / Linear Footage Of Work: Type of Work: ❑Addition °Alteration ❑New ,_Repair/Replace El Demolition Describe Work: ****** *** * * * * * * * * * * * * * * * * * * * * * ** * * * ** Submittal Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ Permit Fee $ F -7, * * * ** 1 ** DPBR $ *** * * * * * * * * * * * * * * * * * * * * * * * ** * * * * ** CCF $ CO /CC Technology Fee $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Total Fee Now Due $ Structural Review. $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 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 0. Ls Owner or Agent The foregoing instrument was acknowledged before n1e this day of ,20l',by J3' 1i I whds'(.rersonally known to or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Com Signature Contractor The foregoing instrument was acknowledged before me this 13 day of , 20 it), by 441 0'1 , w Hall kny own to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Com ******* ***x ****************************** i *** ** ****x********** ******** APPLICATION APPROVED BY: (Revised•02/08 /06) js 1z y omm. spire' s: Commission Bonded Th o N 13 $ **„*11.34t * Plans Examiner Engineer Zoning 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): 10 City: Miami Shores Village County: Miami Dade Zip Code: F" 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 ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO "ARHI Sheet Attached: YES M/N/0 ❑ Contract Attached: YES UNIT BEING REPLACED MANUFACTURER DATA NEW UNIT AHU or PKG. UNIT MODEL # 'l i 67e 4m co q A- COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU • VU/PKG 2) M.O.P AH CU PKG AHU OCU PKG 3) VOLTS AH906 C PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YES NO NEW 4 "CONCRETE SLAB YES • YES NO NEW ROOF STAND YES ■ YES NO NEW RETURN PLENUM BOX YES N� 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker r): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: I/0 40 14 '° Phone: .)q/10 State Certificate or Registration N. C A-co 1 I Certificate of Competency N. Signature fit alifier's signature only) Date: I a /13/Iv Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 154210 Permit Number: MC -12 -10 -2197 Scheduled Inspection Date: January 04, 2011 Inspector: Perez, JanPierre Owner: HARPER, DORSETT AND JOAN Job Address: 10501 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Contractor: AFFORDABLE AIR & HEAT & ELECTRIC CONTRACTOR Phone Number (305)758 -6002 Parcel Number 1122310130730 Phone: 305 - 770 -4167 Building Department Comments REPLACE 3 TON A/C W 8K HEAT Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. g FL" January 03, 2011 For Inspections please call: (305)762 -4949 Page 9 of 19 www.ahridirectory; This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. AHRI Certified Reference Number: 3984775 Date: 12/10/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTB4036E1 Indoor Unit Model Number: 4TEE3CO3A1 +4AYTXVH3D3642A Manufacturer: TRANE Trade /Brand name: XB14 Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240 -2006 for Unitary Air - Conditioning and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 34800 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2010 Air - Conditioning, Heating, and Refrigeration Institute Air - Conditioning, Heating, ran VALI and Refrigeration Institute CERTIFICATE NO.: 129364662535458124 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): 10q2 1 N‘/-19(4-1#4.e.-- _ 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 ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO 'ARHI Sheet Attached: YES U NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT ,R / /%i7 MANUFACTURER IYG ne AHU or PKG. UNIT MODEL # 4TEG 4 A' r COND. UNIT MODEL # j E v KW HEAT �� NOM TONS AHU CU PKG 1) M.C.A AH GU�` PKG AHU CU P G 2) M.O.P AHU CU PKG AHU /49 • PKG 3) VOLTS AH'1' CIPKG PKG UNIT / / PKG UNIT / / EER/SEER i fr YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YE 0 YES NO NEW 4 °CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES N 1. Minimum Circuit Ampacity (Wire Size): ��11 2. Maximum Overcurrent Protection (Fuse /Breaker Siz ): 4 L7 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: _ 40 AA Contractor's Company Name: V'YJVX State Certificate or Registration N. 0k/041111 Signature fi,Jr Phone: Certificate of Competency N. ualfie s signature only) Date: /2////0 r ./ C E RT I F I E D TM www.ahridirectory . org This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. Certificate of Product Ratings AHRI Certified Reference Number: 3984775 Date: 12/10/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTB4036E1 Indoor Unit Model Number: 4TEE3CO3A1+4AYTXVH3D3642A Manufacturer: TRANE Trade/Brand name: XB14 Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240 -2006 for Unitary Air - Conditioning and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): EER Rating (Cooling): SEER Rating (Cooling): 34800 13.00 16.00 • Ratings followed by an asterisk ( *) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. 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; 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. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on 'Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2010 Air - Conditioning, Heating, and Refrigeration Institute ifik ® Air- Conditioning, Heating, A� $ ®® and Refrigeration Institute CERTIFICATE NO.: 129364662535458124 itif ni lcl a f iectricai C CAC048111 ntracto -s WHERE QUALITY IS AFFORDABLE 515 N.E. 190th Street • Miami, FL 33179 Dade (305) 940 -0777 Broward (954) 987 -9943 WORK # JOB NAME: EC0001140 OPERATING COST DESCRIPTION OF SERVICES PERFORMED AIR DISTRIBUTION: Ductwork will be designed, fabricated and installed in accordance with accepted engineering practices and in compliance with all building codes in force on above date. DUCTWORK: System of fl fiber andlor dam- ductwork with outlets and returns. Subj ct to modification according t structural or other requi ements. LABOR WARRANTY: Service will be provided free by us for a period of A / B C year(s) from date of installation during regular working days & hours. MANUFACTURER WARRANTY: Parts Warranty (Yrs.) A ,,...S B C Compressor Warranty (Yrs.) A /O B C EXTENDED WARRANTY: Provided through A/A- for AFFORDABLE AIR & HEAT, INC. WILL PROVIDE: INSTALLATION OF EQUIPMENT REFRIGERATION LINES ( ) OR FLUSH ( ) GRILLES ( ) RETURNS ( ) PERMIT FEE(S) & PLANS, IF REQUIRED DRAIN PIPING ( ) OR FLUSH ( ) AIR HANDLER SUPPORTS CONDENSATION PUMP EMERGENCY FLOAT SWITCH HURRICANE TIE -DOWNS CONCRETE SLAB NO l ❑ year(s). EXISTING ❑ Title to the above merchandise remains with Affordable Air and Heat, Inc. (seller) until paid for in full. In case of default in any terms of this contract, the seller shall have the right to take immediate possession of said merchandise and full amount of the purchase price then unpaid shall become immediately due and payable at the seller's option without notice or demand. All monies paid shall remain with the seller as liquidated damages. In the event the services of an attorney are required to enforce the interest of the seller, the purchaser shall be required to pay all reasonable attomey's fees together with interest and all costs thereto. No warranty service shall be performed on accounts with an outstanding balance. Labor warranty excludes, existing ductwork, existing electrical systems, and maintenance related repairs. In the event the purchaser refuses to allow seller to commence work after the contract has been executed, purchaser shall be responsible to the seller for 25% of the total price as liquidated and agreed damages. Seller shall not be responsible for any existing building or electrical code violations. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the contract specifications involving extra costs will be executed upon written orders and will be subject to charges over and abov: this estimate. Initial Here THERMOSTAT CARPENTRY j BALANCE AIR FLOW REMOVAL OF JOB SITE DEBRIS ,® ELECTRICAL WIRING (POWER CONTROL) ❑ CONNECT TO EXISTING SERVICE/PANELS INCREASE ELECTRICAL SERVICE AMPS ❑ OTHER ❑ OTHER ❑ OTHER ❑ YES f► EXISTING 0 .❑ COST REBATES /CREDITS TOTAL COST A B c S29 ' Payment to be made as follows: — Hwy FINANCING AVAILA LE ,v0$0 Authorized Company Signature, * 4i' 2 deposit, balance upon start-up. Date /2 /0 This proposal subject to acceptance within (!i days and is void there after at the option of the seller. THE ABOVE PRICES, SPECIFICATIONS ANO CONDITIONS BY PTED. YOU AUTHORIZED TO DO ME WORK AS SPECIFIED. PAYMENT WILL BE MADE AS BUTW OM Option Chosen /4 Signature � `JUG. Date / � C�