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MC-10-2001Inspection Number: INSP - 153239 Permit Number MC -11-10 -2001 Scheduled Inspection Date: November 16, 2010 Inspector: Perez, JanPierre Owner: Job Address: 11016 NW 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: KARIBE CONSTRUCTION INC Building Department Comments November 15, 2010 TTO /L00 [it Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C. 1 Y Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1121360020250 Phone: (305)258 -9185 REPALCEMENT OF CONDENSER UNIT AND AIR HANDLER 2.5 TON l a Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments LOCK BOX #4581 For Inspections please call: (305)7624949 Page 16 of 23 MUMS 01aI3 NVOS V,LV0 OE9L 589 008 T %VA L£ :9T OTOZ /9T /TT BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL � l y�, }�- L p OWNER: Name (Fee Simple Titleholder): i" " S I l 01)St Q�e' ® YiNS e#: 20s- s 9- Eli p.p f Address: no /tee O `'C °#� ac, c P W City: M 1 O..W 1 State: -- L Zip: 3 I R" Tenant/Lessee Name: ,& JA- Phone#: Email: 111■ W\®o rves 0- 0..1,. cow JOB ADDRESS: 1 AN (0 I j (1t) 2 .n u ,2 City: Miami Shores County: ' Miami Dade Zip: 331 log Folio/Parcel #: it 2-1 1 6 00 aOa S 0 Is the Building Historically Designated: Yes NO \� Flood Zone: CONTRACTOR: Company Name: art rt be (on S frCC h oil the . Phone#: 31' .3' g q i g 5 Address: .�[.l' 6`4 g(.O 1 09_ V . Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. ' C 10 C 1 Master Permit No. cit m ) a m I , • state: FL zip: 55D?? Coy/ Qualifier Name: (o' / 0 3 Per r) Qy) Qj m� State Certification or Registration #: C /VC )� 9 7 5l % Certificate of Competency #: Contact Phone#: sip 3[p " 3 ®/ `j Email Address: / be con 3truefi O n hip /l S'o1Ltii DESIGNER: Architect/Engineer: Phone#: Phone#: A -a 36 -36 / �J NOV 0 2010 Value of Work for this Permit: $ Cr° Square/Linear Footage of Work: Type of Work: °Address °Alteration °New *epair/Replace °Demolittioon __ � // Description of Work: .f A C °/4Pa eF C.o if�ei? C/�t✓, I 41:n_g9/� . ' T *****a **a* ** ** ********xe***** *** F * ******* *+a*+ six **** ****a ** * * * * * * * ****a**** ** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ 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 FT FCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 approve# '.< a reinspection fee will be charged. Signature Signs Owner or Agent The foregoing instrument was acknowledged bef me s ©� The foregoing instrument was acknowl ged before me this �® day of A/0 1 J• , 20 / l7, by V/ Y e I% day of Lv " € , ,,t ®0 by D- who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PiBTIUB Sign: Print: My APPROVED BY Tres: ATE OF FLORIDA Lamothe 67384 13 (Revised 07!10 /07)(Revised 06/10/2009)(Revised 3/15/09) /0/4. Plans Examiner • Structural Review NOTARY PUBLIC: ***************************** ***** *M* ** * ** ** ***** ***************** ******* Contractor :� / Prin l�i®‘ E T4 5 g LL o My Commission Expires. • la_ ` VIOLETA BELLO 15 MY COMMISSIONS DDS9 0 . p EXPIRES July 0 9,2013 hon4440TARr FL *OW n; .., Zoning Clerk UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER �� reA4 • i ki AHU or PKG. UNIT MODEL # LLS /4^1%/90A. /q45/41 ir t5 5' COND. UNIT MODEL # KW HEAT NOM TONS P 5 4 AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / 1 EERISEER I Si /4 YES ; REPLACING DUCTS YES f0' YES .ti REPLACING THERMOSTAT YES del YES �' NEW 4 °CONCRETE SLAB YES (�� ' YES io ••, NEW ROOF STAND YES YES • NEW RETURN PLENUM BOX YES 0,' 1. Minimum Circuit Ampacity (Wire Size): /3 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (20:% 80): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration N. C Signature (Qualifier's signature only) 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): /> OM AAA, A tl f - City: Miami Shores Village County: Miami Dade Zip Code: 1.x/63 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 ❑ NOX ARHI Sheet Attached: YES X NO ❑ Contract Attached: YES 'I�JA�7`'7ZP.!✓ +� Phone059 a.56 2 0 7 0 %5 — Certificate of Competency N. Date: // /0 /R ®fa CONSTRUCTION. INC. 23654 SW 107 Court Miami, FL 33032 a licensed and insured co. Date: Customer ID: Customer address: Customer tel: Customer fax: Customer email: We hereby submit specifications and estimate for: Page 1 of 1 Carlos A. Fernandez General Contractor A/C Mechanical Contractor E -mail: karibeconstructionPbellsouth .net Dade tel: 786 - 236 -3015 Croward tel: 954-553 -2211 Fax: 305 -258 -3838 11/4/2010 Adanac Development & Construction, Svcs Inc. Attn: David Harder 11016 NW 2 Avenue Miami Shores, FL 33168 305- 987 -2995 866 - 381 -2107 david@adanacdevelopment.com Amount Rheem 16 Seers, 2.5 Tans, R410: Condenser M ls: Jlel #: 14AJM3OA01 Air Ha yller M, , iel *: RHLLHM3617.IAA Install new air handler and condenser nit. Install new wires for condenser unit. Install existing iron bar cage to cover condenser unit. Flush and vacuum system. Note: Parts and compressor have ten warranty by manufacturer. Karibe Construction, Inc. will provide one year warranty on labor from the date of start up. ` ERGISrJZz Sig% psywnsomi:: os elms vuov N = NsUmnss elms up©st esrapOsQien We accept credit cards asterG, VISA l $ 2,300.00 $ 2,300.00 We propose hereby to furnish material and labor - complete in accordance with above specifications. This proposal may be withdrawn by Karibe Construction, Inc. if not accepted within 30 days. ACCEPTANCE OF PROPOSAL - The above prices and specifications are satisfactory and are hereby accepted. You are authorized to do the work as specified. Customer Signature of Acceptance and Date: 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 above specifications involving extra cosis, will be executed upon written approval and will become an extra charge over and above the estimate. All agreements contingent upon stirkes, accidents or delays beyond our control. Karibe Construction, Inc. will retain title to equipment /materials furnished until final payment is made. If payment is not made as agreed, we will remove said equipment /materials. Any damage resulting from said removal shall not be the responsibility of Karibe Construction, Inc. Certificate of Product Ratin s AHRI Certified Reference Number: 3805937 Date: 11/10/2010 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number 14AJM30 Indoor Unit Model Number: RHLL- HM3821+RCSL- H*3821 Manufacturer RHEEM MANUFACTURING COMPANY Trade/Brand name: RHEEM 14AJM SERIES Manufacturer responsible for the rating of this system combination is RHEEM MANUFACTURING COMPANY Rated as follows in accordance with AHRI Standard 2101240.2006 for Unitary Air -Conditioning and Air- Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: far am) a Mare °i =teas stab VEAS. ¢mare. DESCIAIMER AM flees aat =Ms antificata awl makes no tapraseatagramvagamtlas cargastio. and assumes no respatethilitafma the 6stedaudits Ctatintata.AHRI exiwasVdisaktas ail &Meat ( afaay BirataristagmEdtarthe useaa a afFo craft Mead anWs Cestificatia.Cezfilad Wags are �idaai far waders and onaligarattuas gated ra Os ethrectowat =Imo hridirectoryr.org AND Ws Certificate and ifs e are pospridaysy maids cdFAHNL19his Ceditkatesha9 marybe used for radlorduaL pemsond and like caatents eats Cistacatainawnat, UmvaluPe put attend Leo a Bmany *mu aarmanaerar esristaams.exceptflartkaalseris indlatitral, mammal and casilifenffal asd Ike barannallan Sant * =del cited an Ws caltilkata eke iredfbat at Eakon'Verify Ceriificate"Mend esitartheANRE Cadged Ramose Number and the date au isticlEtbacesitrasatewas Issuart,ettfirta Med a aadtheetratara Eta. adiffiEs listed h 2010 Air-Conditioning, Heatiss and RefrIgeration 1 CEFMFICATIE NO.: 1 740 Cooling Capacity (Btuh): 29600 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. Air - Conditioning, Heating, and Refrigeration Institute THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N(�gg A TYPE OF INSURANCE I wd�p POLICY NUMBER POLICY ( D %I LIMITS GENERAL GENERALL!ABIIJTY n COMMERCIAL GENERAL UABIUTY • 0 CLAIMS -MADE 0 OCCUR = NAm s INSURED Kadbe Construction, Inc 23654 SW 107 Ct Homestead, FL 33033- TMATE002572 08/25/2010 08/25/2011 EACH OCCURRENCE $ 1,000,000.00 PREMISES (Ea occurrence) $ 50,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 • PD DED 500 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: 5 POUCY U E8i • LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE LIABHJY COMBINED SINGLE OMIT (Ea acddent) $ II ANY AUTO BODILY INJURY (Per person) $ ALL OWNED NED AUTOS BODILY INJURY (Per sodden* $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ Ill HIRED AUTOS MI NON -OWNED AUTOS $ $ • II UMBRELLA LIAB • OCCUR ❑ EXCESS LIAB ❑ CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ • DEDUCTIBLE 1 RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFEICER/MEMBEREXCLUDED? 1 (Nlandatony In NH) I yes, describe under DESCRIPTION OF OPERATIONS below N ❑ WC STATU- ❑ OOIRH E.L EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE $ E.L DISEASE - POLICY LIMB $ B GENERAL CONTRACTOR AGL87447 02/22/2010 02/22/2011 1MILLION/1MILLION DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remelts Schedule, IF mime space Is required) GENERAL CONTRACTOR OPERATIONS INSTALLATION AND REPAIR OF A/C ELECTRICAL WORK MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2 AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE MAIKEL WONG -AGENT ALACTICIPANY CE RTIFICATE OF LIABILITY INSURANCE �,(° o °°"'""' THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polies may require an endorsement. A statement on Brie certificate does not confer rights to the certificate holder In Neu of such endorsement(s). PRODUCER Franklin Insurance Group 8672 SW FL 72 Street Phone (305)630 -3923 Fax (305)675-5964 CONTACT MAIKEL WONG PHONE FAX No. Farts ( 630-3923- 1 (A/c. Noll (305) 675 -5964 ` MAIKEL@FIGINSURANCE.NET MD � m e E147972 INSURERS) AFFORDING COVERAGE NAm s INSURED Kadbe Construction, Inc 23654 SW 107 Ct Homestead, FL 33033- INSURER A: LLOYDS UNDERWRITERS INSURER B : ACCIDENT INSURANCE COMPANY INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES ACORD 26 (2009109) QF CERTIFICATE HOLDER CERTIFICATE NUMBER: CANCELLATION REVISION NUMBER: © 1888 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD