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MECHANICAL PERMITMIAMI SHORES VILLAGE BUILDING DEPARTMENT 'f\ /15 305- 795 -2204 O ■.\• Building Inspection Request Type Insp Permit No. Name Address Company Phone # y\C o S Inspection Date Approved Correction Re- Insp'n Fee Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspectio Reques Date Permit No. 'M C c3L — 55 Name ] Address 10 �t_. Company o-- ONOVillICI Phone # Inspection Date 4 5 Approved ❑ / �l� .�,. J�i � , y • j 4 Lj Correction ) Re- Insp'n Fee ❑ BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electri Owner's Address / 20 / E ' 9PZ. Owner's Name (Fee Simple Titleholder) City M t' / State AY A- Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name k(5 C aft 44u ,-Phone # 3D,1 6 O SDO Contractor's Address ca 0�-d City • VV4 Itvel I State �� T� Zip 3 /) Qualifier g4,640-viii 0 Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: Describe Work: a 1K0 - Submittal Fee $ 50 00 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 � t) cal Plumbing 2 C rt Zip 33/34 Phone # County Miami -Dade NO ❑Addition DAlteration ❑New Master Permit No. Fo(wot //3a0fo. Roofing Phone # 3a 15 02./ 47_/ Zi p ..33 e Square Footage Of Work: [r Repair/R plat ❑ Demolition Rote) r o �= L turd Est i vwir * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ CCF $ Q Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Permit No. pew o LJ - 5S Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ 0 , (Continued on opposite side) Bonding Company's Name (if applicable) fBonding Company's Address / City State / Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address J f City State I 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 � to attachment. Also, a certified copy of the recorded notice ld�'1�lil�digyeent must be posted at the job site for the first ' 9 Yll'lho9ccurs seven (7) days after the building permit is,„ I " .dg d ce of such posted notice, the inspection ‘ �ib -4Ve a reinspection fee will be charged. � 0 . •• . Pa puoTo , �76ie • a0� 00\1PaPuogl • % � � i . Signature : ®. 1�t' 4 Signa a • rtr:Ageit e d ll ,, o S'-, : p oi ` Sn� h '� . :�� `l`O •• $4. The foreg(ymg e¢ ackr�twledged before me this The forego% it lrakaclewledged before me this day of 4, day p�` \ a\� e� day of --,/ //,; 1 1/ 1 111 ��\�`y . who is personally ini 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. o ; �� 0e g( 1 'P $ ntratibr NOTARY PUBLIC: . _ NOTARY PUBLIC: Sign: Sign: Print: r � ,� /�1 Print: My Commission Expires: My Commission Expires: �,�,, , (Certificate of Competency Holder) al State Certificate or Registration No. 't t%�J 31 Certificate of Competency No. ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 10/14/03 JOB NAME ( /tn) 7�t Fm m✓ ADDRESS ins 1 ' 9c)._ Different location than above? MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE: EER CONDENSOR MODEL # 0 `/4 CONDENSOR MINIMUM CIRCUITS AMPS q/ MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE: CONDENSOR AIR HANDLER EER /Z,d AMP SIZE S GNATURE OF QUALIFIER qict— EXISTING CONDITIONS ��^^ 1. HOUSE MAIN ELECTRIC SIZE AMPS /5 WIRE SIZE oW 2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZE 4S , & CIR. BKR. AIR HANDLER BRANCH CIRCUIT:WIRE SIZE , & CIR. BKR. 3. SIZE OF EXISTING COMPRESSOR DISCONNECT: AMPS. TYPE: FUSE 52) CIR. BKR. SIZE OF EXISTING AIR HANDLER DISCONNECT: _ AMPS. TYPE: FUSE CIR. BKR. 4. IS DISCONNECT WITHIN SIGNT AND READILY ACCESSIBLE? YES v //- NO 5. EXISTING UNIT TO BE REPLACED OR OR RELOCATED NAME PLATE INFORMATION FROM EXISTING UNIT MAKE ( //14Fi4 - PACKAGE MODEL # CONDENSOR MODEL # am/tow-do/ A.H.U. MODEL # HEAT PUMP TYPE YES NO KW HEAT STRIP SIZE CONDENSOR MINIMUM CIRCUITS AMPS L 9(.1 A.H.U. MINIMUM CIRCUIT A:`.PS /1' ic( CONDENSOR AMP SIZE FUSE � AIR HANDLER AMP SIZE FUSE NAME PLATE INFORMATION FROM NEW UNIT BEING INSTALLED MAKE /M EAVA P L)/ 440 PACKAGE MODEL # /\:( - 10 1 6\ HEAT PUMP TYPE YES NO ✓ KW HEAT STRIP SIZE A.H.U. MODEL # A.H.U. MINIMUM CIRCUIT AMPS AMP SIZE FUSE 4 SIZE FUSE SIZE 6 O SW SIZE FUSE SIZE SW fl HACR CIR. BKR. HACR CIR. BKR. HACR CIR. BKR. FUSE HACR CIR. BKR. 3s CERTIFICATE NUMBER Sec. 5-1.1. Air conditioning regulations. - (a) All individual air conditioning units installed in walls or windows shall be securely anchored to the walls by approved methods. Units Installed over public property, paths of egress or more than ten (10) feet above grade shall be secured to the struc- ture by bolts or screws to resist horizontal wind loads. Such units cantilevering more than flight (8) inches on the exterior of a building shall be supported by steel angle brackets secured by bolting. Bolts to masonry shall be set in lead shields or similarly rot - resistant fastenings. (b) The folt wing special requirements shall apply to the con- trol and regulation of noise nuisance from air conditioning machinery: (1) All equipment. existing or hereafter installed, regardless of location, shall be maintained in good working order. Equipment so located that normal operating noises create a nuisance to adjacent owners or occupants shall be pro- vided with soundproofing, or sound - absorbing bafels, or enclosu.res. as approved to insure maintenance of a rea- sonable noise level. (2) All equipment on outer walls. on roofs, or In other exposed locations. which are unduly noisy, and which causes complaints from adjoining property owners or occupants. may be required to be relocated. redesigned and'or en- closed in noise - retarding materials when. In the opinion of the building official, such enclosure is necessary or would be effective. ,(3) Special consideration shall be given to the planning of all future instkllatlons to minimize the noise nuisance to ad- joining property owners or occupants, and the 'building official shall have authority to reject or require the rede- sign of any system which, in his opinion, would cause such a . noise nuisance. (c) Violation of this section shall be punished as is now or may hereafter be provided by law. (Ord. No. 299, II 1 -3, 2.21.61) I have read the above ordinance and will caply with the `\ 11 ation.s thereof. � L. BUN i , � , � � \\\��� 111111111110 �tsSIONF • . �o�Est1,2p ' ' s oo� I I ') kr - fi e . • #Dl`�r iatvre = 2 • SOS• So 0 ce: o� °�•. . . 16,;.' .; °Y a in- 1nso� ' °Y Itl{111 1 ,,,r, • ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS, CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CEMRAL) e/voNi.y 1 DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 IIP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTCRS OVER 100.H? VIOLATION INDIRECT WASTES- A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER -NEW INST. GENERATORS TRANSFORMERS I hlEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA /„ !L ten) RELAY TELEVISION OUTLETS J� I� Gt r T DRAINFIELD, 4 TILE/RES. VIOLATION ( /✓NuT' & Aj _u PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN. ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER. SET (GAS) GAS PIPING ADDENDUM BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department '�' De artment o oll X- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. (-n(/0it /13gaJot3©i1-o Permit Type (circle): Building Electrical Plumbing Roofing J/� L &l t 7 Phone # 3OS '7 .�(� Owner's Name (Fee Simple Titleholder) � i 7 1✓ Owner's Address / & �C i ; °` Sol r- 4 City in t /ffi)ri 1 State ' - Tenant/Lessee Name A)1 A- Zip 33/3F Job Address (where the work is being done) , yU-_ A O- City Miami Shores Village County Miami -Dade Zip - 3 i3 e Is Building Historically Designated YES NO Phone # Contractor's Company Name LIS/r7f Ni (te — � On'yn. Phone # 3UJ — lP r L ceo tt Contractor's Address of 0c-3 ) )4 (f City • 4t /hel l /& / State Ll� Zip 3 3 ■ 7 �' Qualifier (,e 9-t 41 Pr ' Lt41 Architect/Engineer's Name (if applicable) Phone # _ $ Value of Work For this Permit ZooD- -- Type of Work: ❑Addition DAlteration ['New [Q Repair/R plat ❑ Demolition ,. Describe Work: t-e �,� r 6 C G�� LI re �' ( r -0 Y I) cito Ls 0 (kJ Submittal Fee $ Permit Fee $ CCF $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Bonding Company's Name (if applicable) Bonding Company's Address City Zip p 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 • a to attachment- Also, a certified copy of the recorded notice NWMIlilvent must be posted at the job site f or the first '"� N` .` qg 4/ permit \\` z i e ! d dv)ce of such posted notice, the 4/ph/Recurs seven (7) da y s after the building ermit is + inspection �§b r' a reinspection fee will be charged. `00. • , Pe °: :1 i am • i • ti97 QI� Y� Signa Signatuae ► _ __ �+ 'The foregtine ,, •• .,.••• tcla before me this 'The foregorin neM before me this ---y of . ry J /t/ .. 1 O` who is personally Oiu me or who has produced who is personally known to me or who has produced as identification and who did take an oath. Chc 10/14/03 NOTARY PUBLIC Sign: Print: As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. 0 l 3 Pt(y Certificate of Competency No. ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning JOB NAME 0 / / ' �' ADDRESS _/n , l 90v c rit Different location than above? 1. HOUSE MAIN ELECTRIC SIZE AMPS 2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZECD , & CIR. BKR. SIZE FUSE SIZE45 O SW AIR HANDLER BRANCH CIRCUIT:WIRE SIZE , & CIR. BKR. SIZE FUSE SIZE SW 3. SIZE OF EXISTING COMPRESSOR DISCONNECT: 5"(Z AMPS. TYPE: FUSE ■52) CIR. BKR. SIZE OF EXISTING AIR HANDLER DISCONNECT: AMPS. TYPE: FUSE CIR. BKR. 4. IS DISCONNECT WITHIN SIGNT AND READILY ACCESSIBLE? YES IV NO / 5. EXISTING UNIT TO BE REPLACED v OR RELOCATED NAME PLATE INFORMATION FROM EXISTING UNIT MAKE / PACKAGE MODEL # CONDENSOR MODEL # 2)q v 76 / Y'ce - d A.H.U. MODEL # HEAT PUMP TYPE YES NO KW HEAT STRIP SIZE CONDENSOR MINIMUM CIRCUITS AMPS MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE: CONDENSOR AMP SIZE FUSE AIR HANDLER AMP SIZE FUSE EER /O,0 EXISTING CONDITIONS /S#0 WIRE SIZE o.01 A.H.U. MINIMUMS CIRCUIT A1'PS NAME / PLATE INFORMATION FROM NEW UNIT MAKE 1 441 rm'll/!, /174/9 CONDENSOR MODEL # gn 4"O HEAT PUMP TYPE YES NO ✓ CONDENSOR MINIMUM CIRCUITS AMPSL ?/ PACKAGE MODEL # A.H.U. MODEL # KW HEAT STRIP SIZE Cam' -0 35 1 CERTIFICATE N UMB E R A/AQ HACR CIR. BKR. HACR CIR. BKR. BEING INSTALLED A.H.U. MINIMUM CIRCUIT AMPS MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE: CONDENSOR AMP SIZE FUSE 6U HACR CIR. BKR. AIR HANDLER AMP SIZE FUSE HACR CIR. BKR. EER / GNATURE OF QUALIFIER C Sec. 5-1.1. Alr conditioning regulations. (a) MI individual air conditioning units installed in walls or windows shall be securely anchored to the walls by approved methods. Units installed over public property. paths of egress or more than ten (10) feet above grade shall be secured to the struc- ture by bolts or screws to resist horizontal wind loads. Such units cantilevering more than flight (8) Inches on the exterior of a building shall be supported by steel angle brackets secured by bolting. Bolts to masonry shall be set In lead shields or similarly rot-resistant fastenings. (b) The fo118wing special requirements shall apply to the con- trol and regulation of noise nuisance from air conditioning machinery: (1) All equipment. existing or hereafter Installed, regardless of location, shall be maintained in good working order. Equipment so located that normal operating noises create a nuisance to adjacent owners or occupants shall be pro- vided v--ith soundproofing, or sound - absorbing beliefs, or enclosures. as approved to insure maintenance of a rea- sonable noise level. (2) All equipment on outer walls, on roofs, or in other exposed locations. which are unduly noisy, and which causes valid complaints from adjoining property owners or occupants, may be required to be relocated. redesigned and/or en- closed in noise - retarding materials when. in the opinion of the building official, such enclosure is necessary or would be effective. ,(3) Special consideration shall be given to the planning of all future (rutlsllationt to minimize the noise nuisance to ad- joining prdperty owners or occupants, and the building official shall have authority to reject or require the rede- sign of any system which, 1.n his opinion, would cause such * nuisance. (c) Violation of this section shall be punished as is now or may hereafter be provided by law. (Ord. No. 299, 44 1 -3, 2-21-61) I have read the above ordinance and will omply with the `N }� tions thereof . • \\ \io '-• . o �" c O \ St 1. .y � v� , u, khf fie. • gy p \ \ 9 A • • ;�'} ,;min • X c • e • • f.,,T�,l1 ION ,o •. ,1 1 � / -> . d. d� ?Gbtectqzz- ;llnature Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/29/2004 Applicant: D'AN ZEIFMAN Owner: ZEIFMAN D'AN JOB ADDRESS: 1020 NE 92 ST Parcel # 1132050130020 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2004 -55 Contractor RESIDENTIAL AIR CONDITIONING CORP Contractor's Address: 20250 NE 15 CT Local Phone: 305 - 652 - 6040 Page 1 of 1 Legal Description: PL OF REPPENHAGENS PB 41 -100 LOT 3 LOT SIZE 80 X 117 OR 18948 -2162 12 Fees: Description Amount FEE2004 -4273 Building Fee $106.00 FEE2004 -4274 CCF $1.20 FEE2004 -4275 Training and Education Fee $0.40 FEE2004 -4276 Technology Fee $2.65 Total Fees: $110.25 Total Fees: $110.35 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 10/16/2004 Construction Value: $2,000.00 Work: REPLACE OF EXISTING 4 TON CONDENSING UNIT ‘ Q . --s.--\\k 4r s 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: • Date Job Address I Oa O t‘1 E UST Tax Folio Legal Description Owner / 44marist4 COLA r1 Ze 1 FM A ■l Master Permit # 370/ 7 Owner's Address 10 A 0 t'4 E ga S Phone '7s el - a( a 1 Contracting Coves i d e n \1 C., Pt I P.- AddressaO S o f■) ► CT Qualifier A L 1 s /P` SS# COSc2 6 0 S tat e PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Co 0 K2 i'F.'ipol # S. r- — Competenc a ((% O`S Architect /Engineer, Address Bonding Company Address Mortgagor Address Permit Type(ci cle one): BUILDING ELECTRICAL PL VG MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION R pLce E isrini- cARRUEQ spGr L 1T44 k\EW R ? , 1 ER. SPLi t Cor C o IZ bRO LiS Sg / OWNER'S AF be done i authoriz Signature Date: 4' Square Ft. Estimated Cost(value $ /900 — WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. IT: certify that all the foregoing information is accurate and that all work will ith all applicable laws regulating constructs -anel,zoning. Furthermore, I d contractor to do the work stated. Notary as to Owner and /or Condo President My Commission Expires: `‘9,P, ��NMulilhj� 5,00001014%; ** * * * S *�T.i t�b ST 1, tor-t *s FEES: PERMIT 14` 1� •'' � APPROVED: / /� /� 0VC 1.............. Condo President Zonin Mechanical * C.C.F. Signature of Contractor or owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: * * ��Wo,N L \\ 0011114/4 / ��:• MIS • '•. , O� EY,oO NOTARY ,9 m - • Oe frG38 4336 Q� * Plumbing Engineering Building Carrier Air Condit oiling b v,S'00r �agi G 0 V(/ Ca••••• Corpo •algn .t0 *: t - :C arries Carver Parkway Syracuse. New York 13221 Commercial Air Conditioning RESIDENTIAL AIR CONDITIONING CO. 20250 N.E. 15 COURT NORTH MIAMI BEACH, FLA. 33179 • o Carrier Corporation — 1961 .I I • • Prepared for4OW 41Z' b Ze Address 1 a 4E /A &I-koR Ev,ioubtari)A Salesman Job No D nn E-53 (7-77) 1 1. .....1 ..1 (905 -0