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MC-10-1721
Inspection Number: INSP - 151751 Permit Number: MC -9 -10 -1721 Scheduled Inspection Date: October 07, 2010 Inspector: Perez, JanPierre Owner: RODRIGUEZ, LORENZO Job Address: 9212 NE 10 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: OMAR & SON SERVICES Building Department Comments October 06, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060060010 Phone: (305)219 -6495 4 TON CHANGE OUT 14 t 1,D Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 23 of 31 Miami Sh=ores Village Buildin g Department D 17'73/ n 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Z �1 200 Tel: (305) 795.2204 Fax: (305) 756.8972 . �..�-- '- - INSPECTION'S PHONE NUMBER: (305) 762.4949 BY: "..... BUILDING Permit No. (4 C. Q -~ I PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) Lo IJ'Z® Phone # ZIO,— "1 n �O f Owner's Address / 2- 12 AJ f Q M' �/ .s a n City � kk. c3 'G State PC Zip 33/3V Tenant/Lessee Name Phone # Email q7 /7— AJE /D 4' City Miami Shores Village County Miami -Dade Zip 33/3? Job Address (where the work is being done) FOLIO / PARCEL # 1� 320 O / -- I 0 Is Building Historically Designated YES NO D ut©w 0 ,DPA Contractor's Company Name Contractor's Address N !A ss 13 0 73 1 f2 Aft City 0 pck I Od Qualifier Name U 1Mm'1 60M4LZ� State Certificate Registration No. QA-C40 -Cer.Cc 3j Certificate of Competency No. // Contact Phone 205 2 1 6 S E-mail 00 C-�P'nez Q/.< B/S' i' Architect/Engineer's Name (if applica ) 1 % Phone # /v/� • Value of Work For this Permit $ Type of Work: ['Addition 4 Describe Wor : **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** �( _fees ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** _ Submittal Fee $50. Permit Fee $ Pap Notary $ State V ['Alteration ❑New AA -- v ciao e 0`. eatiptence-k- Phone # 705-- - 12 /% Zip 3'3 .0-C / Phone # Square / Linear Footage Of Work: Training /Education Fee $ Scanning $ Radon $ Double Fee $ Pb Structural Review. $ Total Fee Now Due $ Violation date: DPBR $ CCF $ Flood Zone NO Repair/Replace ❑ Demolition C /CC $ Technology Fee $ Bond $ 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: 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 o commencem t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is ssued. the ence of su posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature r O Owner or Agent The foregoing instrument was acknowledged before me this 20 / 0, by C6t t 701yC2 Sign: Print: day of who i • ersonally known o me or who has produced NOT My Commis APPROVED BY As identif (Revised 07 /10 /07)(Revised 06/10/2009) Z 0 1 0 ice 5■otary Public State of Florida 0 . Omar Gomez ar My Commission DD838193 of moo Expires 01/17/2013 * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ation and who did take an oath. LP1ans Examiner Signature ontractor The foregoing in rument was acknowledged before me this 29 , day of 1'/ 20 /0, by ICACI ) • , who is per finally knows to me or who has produced Engineer NOTARY PUBLIC: Sign: Print: My Com as identification and who did take an oath. (407) 348 1 4 N4 6 COMMISSION # DD745952 EXPIRES January 03, 2012 Floridallota ryService. com e ' Zoning Clerk checked UNIT BEING REPLACED DATA NEW UNIT tAA MANUFACTURER A 'k k v, i J' 1"2 -row 4 -/4 AHU or PKG. UNIT MODEL # ree '/PJ! I'Gmc2150 zfr-74z.. COND. UNIT MODEL # A 4 5 te: 10 KW HEAT t 0 Li_ NOM TONS tf AHU L'CU 2. PKG 1) M.C.A AHU CCU 26 PKG AHU 60 CU £' 0 PKG 2) M.O.P AHU 6 000 P'O PKG AHU220CU PKG 3) VOLTS AHU7ze)CU2'PKG PKG UNIT / / PKG UNIT / / g //' EER/SEER 13 /_ YES NO V REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES C NO YES NO V NEW 4 "CONCRETE SLAB YES NO V YES NO iO NEW ROOF STAND YES NO YES NO 1 NEW RETURN PLENUM BOX YES NO I 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. n �� Job Address (where the work is being done): 82_12 -we 10 L City: Miami Shores Village V '. County: Miami Dade ✓ Zip Code: / 3 K 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 fff NO ❑ Contract Attached: YES Pi 1. Minimum Circuit Ampacity (Wire Size): 4 to 2. Maximum Overcurrent Protection (Fuse /Breaker ize): flit- 40 � } 3. Voltage of Circuit (208/240/480): ZO & z4O 4.e) afrutX Owl ctud v -eviAi &AtoskcS3 4. Size Disconnecting Means: Contractor's Company Name: State Certificate o Registration N. Pfik QwcQ 42 y.,J Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Phone: Certificate of Competency N. Signature Date: 1, °° signature only) TH1818 TO CERTIFY THAT THE POLICIES Or INSURANCE LISTED <3ELOW HAW EEEN.ISSUED TO• iNEUREONAMED ASQV6••FOR THE POLICY PERIOD • INDICATED- NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED DR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POI,ICIE$ 'DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S H POLICIES, UM1T8 SHOWN HAVE SEEN REDUCED ET PAID CLAIMS, . era. kL. A TYP E + I a CE OBISMI I.J - F20wAL aunimnren neeimitENTATIyas r _ 1 FOIST N UlhlsiM Q A i r * � I 0 8t.0• `45274 O®1300009 • Dir2012D•b ' Eppd CNOQ: i 1000000 GtNEHAL UAf3lLtI Y MENTCD • ad $ MEC __.___ lCLArms -MADE 71 OCCUR IVIED D T (Any one wean) $ 5000 PERSONAL a ADV INJURY $ 1000000 GENERAL AGGREGATE 2 _ DEN1, AGGREGATE WAIT APPLIES PER 7 POLICY r . I kCTJ 1 1 LOC STS , COWIDP ASS S $ AUT01La811.E UAB.ITY 1IIUEt56t1,$1N[i.E UNIT i • ANY AUYQ • EMILY Nam fie'mat) S ALL OwNeo HIRED AUTOS AU 108 LI AUTOS AUTOS O.OWNED E0SILYINJU c�NEnt) $ �tlf s 8 m _ VN6EELLA UM) WICKES 1dA8 1 OoeuR CLAIfuS - MADE EACH OCCURRENCE S ACCREGATt? $ Deo 1 1 RETENTION S s g =MERE EMPLOYERS' ANY COMPENBA7bR Ann LumouTY y � PROPEISTORIPARTNEFFECECUTIVE I, N I A 181143812 i 012312009 1012312010 1 yy�g TORY L S_ q EL EACH AO©OENT - -- $ 100000 OFFICER/MEMBER EXCLUDED . tm ey M g EN) DE- GR�IPTI4 i OF FO OPERATIONS below E•L.CISEASE- EADERDrM L 100000 _ E. I. MERGE -PO .ICY LIMIT E 500000 DESCRIPTION QP OPERATIONS 1 =ARCM VEHICLES (Aura ACORO itn, ASaltlead Remade; SaMeele R were even fe tsqulreel AIR CONDITIONING CONTRACTOR CITY OF MIAMI SHORES *QUO ANY OF THE ABOVE DESCRIBED ME ERIVIAIMN QATB TIWREQFI NO ACCDRDAlICe Plum TFYa•PCILIOY BE CANCELLED IMFORE DE D MY aunimnren neeimitENTATIyas r FROM : JOSE M. CORREA PHONE NO. : 395 379 7222 Sep. 29 2019 99:08AM P1 AC-CM!) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE 15 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder IS DA ADDITIONAL INSURED, the pollcy(les) must be enden3od. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement a . PRODUCER 1 INDEPENDENT INSURANCE AGENCY $834 SW BO ST SOUTH MIAMI INSURED COVERA 13073 NW 42 AVE OPA LOCKA ACORD 25 (2010105) ft 53143 OMAR & SON SERVICES INC. FL 33054 CERTIFICATE NUMBER: 9iRItnBAIS) AFPORDEN comma INSURER A: AMERICAN FW IRE mum BRIDOEFIELD CASUALTY WNW 6: DIESER to ft E: DEEMRER F: REINSION NUMBER Ira Pin NAIL A 5 ACORD CORPORATION. AS fights ream Tho ACORD name and to era registered of AGORA 09/07/2010 08:25 3055923819 Certificateof Product Ratings AHRI Certified Reference Number; 3938653 Date: 9/7/2010 Product: Split System: Air.Cooled Condensing Unit, Coll with Slower Outdoor Unit Model Number: 4A7A5049E1 indoor Unit Model Number: 4TEE3F48B1 Manufacturer: AMERICAN STANDARD, INC. TradelErand name: ALLEGIANCE 15 Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD, INC. Rated as follows in accordance with AHRI Standard 2iO/249098 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 Capaoly (Stunt: 45000* 13.00 • • . SE J.1„. 18400 ymrskile A 1:11'. " ) ..! I .', 1 ,, 1,1,11 ,•,,[; 1 ; This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17, 2009 and Dec 31, 2010. L, I l:1l lliH di I . dsst I wJdI TH.; .;11! d ;.,. .,:d• ;3 ; " d d ;'d ' ; 1 •I dl "Ai VI. II t 11 r• P '• i; r I ; ; I ;I! 7 ,;11;1111: • Retittga fallo%ves by en uteri Iseleala a volard.wy rrirrits e rovieuely pubasbad dela, allege ascort•ionalatl vett a WAS.1N/Veri Indicates art Involutrtitrtr retitle semonalemmisaltedlINNOIM CERTIFICATE VERIFICATION The Information fur Vie model eked on the serenade can be verified at weivehrldlractfeYetfir click on "Iferify Cortifieste" link end entar the AHRI Certified Reference NI,nher end the date on which the ottraticate was tasted, which Is RAW above, midi,* OsitMuate No, widish is feted Wow. 02010 Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: d ;i4 i:i Ii l'j Ill ll I dl II .:d did id id 11 II!L1I l',,t;s1 ad.1, .1 ,11 1[J, DISCLAIM* AHRI does not endorse the oroductial listed an this Certificate and makes no ropresenredons, wartintIos or guarantees as to and assumes etr rOSPeilfirfillitY for, the produnds) listed teeth's Ceaftenta. AHRI ei(pronly disdains ail ilablilly for damages of any eine arising out elm use at performance of thn iptatingilah untie una uthorized stiendion of dabs listed on Ns cm/Meats, °edified Wino are valid only for modals end configurations USW M the direntoty at aiwerehndllecttinime% TRRIVItt AND ciONLir I IONtit d , fide Certificate and Its etilibirte are propilatuy products of AHRL This Bert %atwitter! Only he used for individual, prone and Minfldental reference purposes. 7110 contents of tkre C'eetifieutemay net, !el ieboie or In part, be reprodulen; cOrtledi disseminated: entered into a computer databases or etharetea trtillbetl, in any town or manna eft* any ineans;excars ter me users Individual, personal and canfidendal reference Aipconattaning, Heating, FIN NM IA and Refrigeration Institute 129203a35232721006 • AIR SYSTEMS PAGE E12/32 305) 688-4949 °F e (305) 2194491 FLORIDA A, DATE r JOB NAME s 5 Y , k , $g JOB LUCit l R• „ : DESCRIPTION r PRICE AMOUNT 1014- I 1 _' 1 (o : 00 t 1 1 1 1 1 1 1 #02 1 WO [4) I 1 1 1 RDA Sitfi tigb•UP4 Lisodli i 1 1 A 1 t > IN firei-L,,— n / " n f "tip.. „pI'" fn.. �N` 'U�IX""" ' i 1 1 I 1 1 1 1 t 1 1 1 1 t in . 1 1 1 305) 688-4949 °F e (305) 2194491 FLORIDA