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MC-11-135Inspection Number: INSP - 155287 Scheduled Inspection Date: March 21, 2011 Inspector: Perez, JanPierre Owner: FEE, JAMES Job Address: 295 NE 94 Street Miami Shores, FL Project: <NONE> Contractor: KENDALE AIR CONTRACTING Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 EXACT REPLACEMENT INCLUDING LOCATION OF EQUIPMENT AND DUCT WORK Passed ll� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 18, 2011 For Inspections please call: (305)762 -4949 Permit Number: MC -1 -11 -135 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060133840 Phone: (305)232 -3000 Page 18 of 37 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLCY 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, T THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R LTR TYPE OF INSURANCE ADDLSUBR %MD POLICY NUMBER - POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYM wars A GENERAL UABIUTY COMMERCIAL GENERAL UABLf7Y OCCIAR CPS1326663 1/28/2011 1/28/2012 FAaioccuRRENcE $1000000 X PREMISES(RENTED pn PREMISE8 (Eaartenaal $10, 000 $ CLAIMS•MADE X MED EXP (Any one person) $5, 000 pEssoNAL A ADy thuURy $1, 000, 000 GENERAL AGGREGATE $2000000 GENL — I AGGREGATE UMIT APPLIES PER: FOIJCY Fn JECT n LOC PRODUCTS - =SWOP AGO $2000000 $ B AUTOMOBILELIABIUTY ANY AUTO ALL OWNS AUTO SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS PHPK593093 7/1/2010 7/1/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per pmson) $ — BODILY INJURY aodded) $ PROPERTY DAMAGE r $ X X $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAMWMADE EACH OCCURRENCE $ _ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ c WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PRDPFBETORIPART OFRC EXCLUDSM (Mandatory M NH) II yes, describe under CESCRIPBON OF OPERATIONS CUTME Y /N N r A TRC3271039 1/28/2011 1/28/2012 X WCBTATU 19 V I - 1 TORY LIMITS EL EACH ACCIDENT $1000000 EL DISEASE - EA EMPLOYEE $1000000 babe EL DISEASE - POLCY OMIT $1000000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedude, If more space le required) Miami Shores Village Building Dept 10050 NE 2nd Ave Miami 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 e'' 4 4 a te ...- -. Awful CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS 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 certMcate holder b an ADDITf0NAL INSURED, the poIIcy(les) must be endorsed. 9 SUBROGATION IS WAIVED, subject to the teens and coedffon s of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holler in lieu of such mss). PRODUCER GBP Risk Solutions www.GBPrs.com 2260 E. Brown Rd, Ste 2 East Mesa AZ 85213 INSURED Central Mobile Air of Miami Inc. dba: Kendale Air Conditioning 12091 SW 117 Court Miami FL 33186 CONTACT NAME. Flower NA PHONE 480- 775 -1 811 1 (. Net 480- 668 -1 936 E -ArAIL ADDRESS: teresa @ labors.com C PRODUCER IDs: 10511 INSURERS) AFFORDING COVERAGE INSURER A:Scotts Indemnity Company N URERB:Philadelphia Insurance Company MWURERC :Wesco Insurance Company MEURER D : INSURER E : INSURER F: DATE (ADB!DDlYYYY) 1/28/2011 NAIC R3 18058 25011 COVERAGES CERTIFICATE HOLDER ACORD 25 (2009/09) CERTIFICATE NUMBER: 775 1999-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are neglstered marks of ACORD A \ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 ` BUILDING Permit No. IV C) 1 t ® 0 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): ! 44 661 Phone #: 79t g ? P7 Address: 8 9 s, 9 ✓ gc7 City: /1? /..qs z`w '-, State: Zip: 33/37 Tenant/Lessee Name: Phone #: Email: 9,.5' /f./: 9 Ske A City: Miami Shores County: Miami Dade Zip: 3?/ 37 Folio/Parcel #: / f— 3 ZO C, - 0) 0 3 3 g c/ o Is the Building Historically Designated: Yes NO Flood Zone: A/O / CONTRACTOR: Company Name: � g�"�� 4 o/ At-7 Phone #: .40, r ' 7, 3 7 ° .3 C0 a Address: / / G(.o // 2 (742G, City: ,i1/.+/�/✓,%.+' State: del Zip: 3 3 /1‘ Qualifier Name: , kk ,6�P,e` s. 4 eiv Phone#: .?of 237 - :3 a a State Certification or Registration #: 4 2) i -e Certificate of Competency #: Contact Phone #: 30 • L 3 L' 3 0 0 °e) Email Address: .'v 1 e A 9 dtr L.® i - 1"/ -1 . C 44 ()(" P6 P( Led a t Dt 4 DESIGNER: Architect/Engineer: Phone #: A / A cot& JOB ADDRESS: Miami Shores Village pOIERVISA JAN $ 6 2011 lui Building Department CO Value of Work for this Permit: $ (0 in/ Square/Linear Footage of Work: Type of Work: Address ❑Alteration ❑New 2epair/Rep ace ❑Demolition �ir'e Description of Work: 4,k h� ,%eeru-e•` t/ . i2 4-k4l 1 y ' J gee' 6 !s // fr A i As./2. d)!i'l/ li ****m+ u*******m +x***mm**m+x+x**** FA*** �n�xwa�a�x�+ xmm�ux� +�x��u�x *+x�xx�x�x��x�x�x Submittal Fee $ Permit Fee $ ti CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO/CC $ Bond $ TOTAL FEE N DUE $ IR) 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 AFI WAVIT: 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 b1 apprred and a fee will be charged. Signature* NOTARY PUBLIC: APPROVED BY Owner or Agent The foregoing instrument was acknowledged before me this Of day t a .20 ,by 3 - 4 111 P - TEE, ,g who is personall known to me or who has produced As identification and who did take an oath. Sign: cic LT Print: NOR! new Pn rhess NMI! Commission Expires: 1,;,• =Commissiof #DD865073 ` ••...• ••'' Expires: APR. 13, 2013 BONDED .. THRD ATLANTIC BONDING CO., INC. + t6i4+ 8Z**+ kM+*sh+H¢}*+'Rd.�tg.Y** **..+ a y ;;.: #; : •. s3k+ : % **** * E+£ aa' F *tai} *•"S*Ste *** **** Plads Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Signature Sign: Print: My Commissi Contractor The foregoing instrument was acknowledged before me this . day of ,20 a., by S G",.0� --�1« , who . personally kn wn to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Notary Public - State of Ronda ' y • My Comm. Expires Oct 4, 2018 Commission # 0D 827184 Bendel through Woad Zoning Clerk THIS IS 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADM INSR bU W SF VD POUCY NUMBER — POLICY EFF (MM/DD/YYYY) POUCY EXP (MM/DDIYYYY) OMITS A GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY OCCUR CPP00070473 01/28/10 01/28/11 EACH OCCURRENCE $ 1,000,000 X P $ 100,000 CLAIMS -MADE X MED EXP (My one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 X BLANKET WOS GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 — 1 POLICY PR- LOC $ AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUT OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/N N / A 57510 02/01/10 02/01/11 X WC STATU- OTH- TORY LIMITS ER E. L. EACH ACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYEE $ 500000 below E.L. DISEASE - POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) MIAMI S2 Miami Shores Village Building Dept 10050 NE 2nd Avenue Miami Shores FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE A► b® CERTIFICATE OF LIABILITY INSURANCE OP ID AA THIS CERTIFICATE IS 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 an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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(s). PRODUCER Kahn-Carlin &.Company, Inc. 3350 S. Dixie Highway Miami FL 33133 -9984 Phone:305 -446 -2271 Fax:305- 448 -3127 INSURED Kendale Air Conditioning Central Mobile Air of Mia Inc 12041 SW 117 Court Miami FL 33186 LAM I Al. I NAME: PHONE Est): FAX (A/C, No): ADDRESS: PRODUCER CUSTOMER ID #: K NDA - 1 INSURERS) AFFORDING COVERAGE INSURER A : FCCI Insurance Company INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : DATE (MM/DD/YYYY) 01/12/11 NAIC # 10178 COVERAGES CERTIFICATE HOLDER ACORD 25 (2009/09) CERTIFICATE NUMBER: CANCELLATION REVISION NUMBER: 20 AC I All rights reserved. The ACORD name and logo are registered f ACORD proposal **Alec! bx t Street NEW EQUIPMENT: SYSTEM 1: Rh uctuts e 212. .4 H 2.ya Tarnow T1 it Au: I- atal to 16 .0 SEER O Ton (Model. 14 A.ims o Btutt l _ Heal Sldp• • Maximum KW site allowable on ate eiitaing electrical clrtatit to exiSHng Unit. ❑ 0 ELECTRICAL AND CONTROLS: (W'Five Function healing a cooling thermostat PeCinb.Mf able. (Reconnect existing electrical to new une(s)- geKendale Air Conditioning, Inc. will not provide eny electrical work other than to reconnect the existing electrical service to the new equipmetd. W'tn the event that the Waling electrical service Is inadequate in any way or dies not meet ail electrical codes. the customer will be responsible for at expenses. Including. but not Hotted to permits mid itispectbn fees. and any other costs necessary for any additional electrical wok. 0 0 ❑ . DUCT SYSTEM: ❑ Reconnect to existing duct system O Ai' Handier of metal stand gyAh Cleaner with disposable elemeidsOne i earSuppt ❑ We rtereay propose to Iwmtsp the above. es *WW* torthe sweat 4r t Peymonl terns sal be* ACCEPTANCE OF PROPOSAL: 1 accept FMS proposal and ail the terms and conditions on the face end back 1 understand that the terms. condttlona and warranties : a kmlied to Horse sated in ads proposal. t am the owner et the art have been givers authority by the owner Of and hereby dosobystgnalWO. 1 said property to order ( error The Qpaaty Is The Di f eretue V I C1 t -U atirene PIPING: arikeconnect existing piping 0 New condensate piping 0 New oo densate pump- 0 New liquid tine she ❑ New auction line wth thermal barrier size D Other GENERAL: 11l will be consistent mail existing codes al the time at Installation. (D equipment web be removed from promises. Peecaetconcrete slab provided iF teeded.3‘ X% VAS work to be performed In a neat& atonal manner 6rcloding cleaning up end debris lemavalupon lob crmipletion. (g price below is after rebate P applicable) end is to be paid dtremy to the O WARRANTY: no len Yoga) ma uera warrant/cm compressor & Ten Years) rnantdactu'ere wane* on parrs ®' Two Year(s) materiel and later t Maintenan ee agreement complete systems came with a tree one year rnaintenerve agreement. 0 Renewal maim tithe purc aser Mends et renews Oh mahtenarma agreement within one year el lids agreement, Kendate Aft Conditioning will extend the warranty on all labor, material end Neon for en equal number of Veen ap to tour (4) more years to tun cortawirenUYw with Maintenance Agreement for no extra charge. ❑ Signature: She: contract= • 12041 SW 117th Court • Miami, Florida 3318E .• (305) 232 -3000 {Customer) fate) on day of Gnslattetion. CAC 016540 AC Search Outdoor Unit Indoor Unit http://www.alridirectory.org/ahridirectory/pages/ac/defaultSearchaspx Are you a Manufacturer? 1Sian MI AC Search Horne 0 Modify M Export Double click on a row to view/print AHRI certificate. AHRI certificates are not available for Obsolete AC and HP equipment. Model Status of 'Active' means models are currently in production. 'Discontinued means that the manufacturer has elected to stop producing, yet stock is still available. 'Obsolete' means that the manufacturer is required to stop manufacturing due to a test failure in the AHRI Certification Programs. Cooling 1 I 1 Est I AHRI : • • 1 I National Eligible I Ref # ' 1 for Export '. °Pe daxr tt i codified Model Manufacturer Trade/Brand 1 Manufacturer Model Ma Model nufacturer(Mix- 1 Fumace Capacity EER i SEER Phase AHR1Type i HSVTC Exclusively Annum: F Status Type Name Match) i Model (E3tuh) i . . RHEEM I RHEEM • • • . ' • I I 3412355 Active Systems 14AJM 1 MANUFACTUR RHLL-HM3617+RCSL- NG 14AJM30 1 H*3617 29200 ! 13.00 16.00 1 1 RCU-A-CB 210 Yes SERIES i COMPANY Now displaying records 1 - 1 of 1 total Home Contact Us [Terms and Conditions License AliRlDirectory Data Copyright CO 2010 Air-Conditbning, Heating, and Refrigeration Institute. All rights reserved. 1 of 1 1/12/2011 9:59 AM UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL #12 //C C/ , i.I I COND. UNIT MODEL # /Y,4 J/' 3c) KW HEAT -a.S /LL„ NOM TONS 3 AHU C PKG 1) M.C.A AH PKG HU CU PKG 2) M.O.P U CU PKG AHU CU PKG 3) VOLTS 30 0 /¢ AHU CU PKG PKG UNIT / / PKG UNIT / / tYES) N o n a 1/4 6) C- V ° REPLACING DUCTS i /,t YES NO fE NO REPLACING THERMOSTAT' / YES NO NO NEW 4 "CONCRETE SLAB YES NO ES NO NEW ROOF STAND YES NO ES) NO b 0- Gyx)• GL° tr NEW RETURN PLENUM BOX YES NO 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): (99S "i✓ 9 j / Ga, (2 G1 Ci ty. Miami Shores Village County: Miami Dade Zip Code: 3 / 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 IdNO ❑ Contract Attached: YES C)lvla`\ 1. Minimum Circuit Ampacity (Wire Size): ) b 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3 0 r; 3. Voltage of Circuit (208/240/480): 290 4. Size Disconnecting Means: Contractor's Company Name: ✓® /% 5/ %�.7 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Phone: 3 ,3 - .700 e State Certificate or Registration N. (74(b 4, j V C3 Certificate of Competency N. Signature Date: / /2 // (Qualifier's signature only)