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MC-11-72Inspection Number: INSP - 154935 Permit Number: MC- 1 -11 -72 Scheduled Inspection Date: January 27, 2011 Inspector: Perez, JanPierre Owner: DAVIES, GWYN Job Address: 156 NE 91 Street Project: <NONE> Contractor: BLUE BREEZE AIR CONDITIONING Building Department Comments REMOVE AND REPLACE 3TON AC qic Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 26, 2011 Miami Shores, FL 33138- 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 1131010190060 Phone: 305 -865 -1220 Page 16 of 29 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ____ Tel: (305) 795.2204 Fax: (305) 756.8972 BYe- - ®- 0000vo� oa INSPECTION'S PHONE NUMBER: (305) 762.4949 pp BUILDING Permit No. M 1 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): q"'") Phone #: 3C S f - YOZ. V Address: I ICs M 1 5a City: Mt cr% Swope. State: FL Zip: °33t 3� Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: 15 Co 1 9 1 City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name:) o..A.> �ax� �z ®we ■sa. Phone #: 3CeS SCS ° 1 Z. Address: G S S 1.1“0.-1 11 3 S'r City: 1"i r t State: FL- Zip: - 6 - S Qualifier Name: rc'1 qT % �T� Cesr-cb r, p Phone#: S -ICS - i 7.,7-0 State Certification or Registration #: . he. 1 3 4 2.1? $ Certificate of Competency #: Contact Phone #: 'US 'RCS 1 Email Address: DESIGNER: Architect/Engineer: Phone#: 5 Value of Work for this Permit: $ Type of Work: ❑Address Description of Work: . e;.ec'co.., C Miami Shores Village I Building Department �l .uw i a 2oto ^t County: lot WAILS INK Square/Linear Footage of Work: ❑New Repa ir/Replace ❑Demolition DAlteration Miami Dade Zip: '33 13g < ) l:/ Flood Zone: + ********* ***+ x****+x ***+x****** ****** ***** p �xa� *,x****** * *�x,x *a�x�a� ***** *** xa�****+s+��x�x+ *** Submittal Fee $ 4 � Permit Fee $ a o It CCF $ CO /CC $ Scanning Fee $ ( Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 \\V\ Bonding Company's Name (if applicable) Bonding Company's i ddress 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 cozzzznencement 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 � osted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absent- of s poste otice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent Con : ctor The foregoing instrument was acknowledged before me this A� The foregoing instrument was acknowledged before me this day of 1 Ad , 20 4l, by , day of 12_ , 20 l4 , by �P , 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. L m NOTARY PUBLIC: Sign: As identification and who did take an oath. Print: tit) Lam. UL A) - ' My Commission Notary Puolrc State of Florida E Van Den Bergh o� My Commission DD778217 T I 0F0 .0 4 % . ' Expires 04/13 /2012 Signature **** * *** * * ** *** * * ** * ** NOTARY PUBLIC: Sign: Print: My Comm .orb ealotary Public State of Florida a ^ E Van Den Bergh X 4 7 My Commission DD778217 �oFco Expires 04/13/2012 If ** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /I0 /07)(Revised 06 /10/2009)(Revised 3/15/09) UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER A 9 t .1 co al" °1L g„d N 4 AHU or PKG. UNIT MODEL # VA 5 ®3r. 4,4-7_.— COND. UNIT MODEL # --lJ n 4 A 60 t'L.g KW HEAT 4,0 .3 NOM TONS : AHU Co CU PKG 1) M.C.A AHU (,.O CU 50 PKG AHU 60 CU 1 PKG 2) M.O.P AHU 60 CU -SS PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / 5. 0 EER/SEER i, t, YES NO REPLACING DUCTS YES (1 YES NO REPLACING THERMOSTAT ES NO YES NO NEW 4 "CONCRETE SLAB YES 10 YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 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): 5 G W City: Miami Shores Village County: Miami Dade Zip Code: 33 & 3 B 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 f ' ARHI Sheet Attached: YES E' NO ❑ Contract Attached: YES Miami Shores Village Building Department 10050 N. E. 2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1. Minimum Circuit Ampacity (Wire Size): 50 AY 2. Maximum Overcurrent Protection (Fuse /Breaker Size): `3 3. Voltage of Circuit (208/240/480): 9..o9//9 4. Size Disconnecting Means: Go ot11... Contractor's Company Name:, /t Phone: State Certificate or Registration N. a e Certificate of Competency N. Signature (Qua1re s si a re only) Date: www.ahiidirectory . org_: Certificate of Product Ratings This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. AHRI Certified Reference Number: 3200465 Date: 1/12/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: C4A836GKD* Indoor Unit Model Number: FVM4X60**** Manufacturer: DAY & NIGHT Trade /Brand name: CONSTANT COMFORT SXT+ R410A AC Manufacturer responsible for the rating of this system combination is DAY & NIGHT 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: * Ratings followed by an asterisk (ry 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) fisted on this Certificate. AHRI expressly disclaims all Debility 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 fisted in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRL 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 forthe model cited on this certificate can be verified atwnwmr.ahridirectory.org, click on "Verify Certificate" Zink 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 Cooling Capacity (Btuh): " 36000 EER Rating (Cooling): 13.50 SEER Rating (Cooling): 18.00 / RAMP Air- Conditioning, Heating, Pan M® t and Refrigeration Institute CERTIFICATE NO.: 1:29393260437205552