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MC-10-1769Inspection Number: INSP- 152029 Permit Number: MC -10 -10 -1769 Scheduled Inspection Date: October 21, 2010 Inspector: Perez, JanPierre Owner: MERCER, WILLIAM Job Address: 990 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: EDD HELMS ELECTRIC & A/C INC Building Department Comments REPALCE 4 TON SLIPT SYSTEM q-Aq Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Passed Lwl Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments October 20, 2010 For Inspections please call: (305)762 -4949 CL Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060143150 Phone: 305 -653 -2520 Page 13 of 21 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Address 91 0 N Tenant/Lessee Name Email 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 Master Permit No. Owner's Name (Fee Simple Titleholder) c ijl eECei Phone # 3es 75y- 9 o Cit in 114 Pill e5110 Re 5 State PO aide- Zip 3 / 3 d' Phone # Job Address (where the work is being done) WO NE 97 57s7' City Miami Shores Village County Miami -Dade FOLIO / PARCEL # (f — 3Z®4"0iY a/S0 Is Building Historically Designated YES NO Contractor's Company Name £Jd itafry 5 Aikeon06- 6id ;ni Contractor's Address 17dS0 N ,h".. iq tJE'. City /9? t >~I vyt + State K'L Qualifier Name ao r°7 t2® rf 5 State Certificate or Registration No. LAIC /2 '/ /2 e/16, 74/ Contact Phone e3®5e53 625 x 4 Certificate of Competency No. Permit No. C. IC-O'" Zip 33/ .3? Flood Zone Phone #(119.0 S3 - 2f 3 0 �i "rT: - t 1 C Zip 33t &Z. Phone # 3 d S c, 5 3 2.5' 2-6 E -mail 1/14 ac/ ly pw✓idhei ii5 - co Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ , e q. 6 7= ° ° Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑ New ( Repair/Replace El Demolition Describe Work: iQ Pit'e ' iS%t / pp oc iNj t iV ' To Ai �p/ / �ifS ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *F es * * * ** ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** V� J Submittal Fee ��✓ Permit Fee $ ` CCF $ CO /CC $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation dater �j Structural Review. $ Total Fee Now Due $ t .✓ 1 4 1 Technology Fee $ Bond $ See reverse side —> ID OCT 0 6 2010 BY.__ 6 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 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 abser; ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 1 n Owner or Agent The foregoing instrument was acknowledged before me this day of ©G% , 2 0/6 , by J4 `Ifefre e .t, who ispersonally known to me or who has produced / / 2-j1 20 388!/ A s identification and who did take an oath. NOTARY PUBLIC: Sign. u. I':I Print: / ._,. My Commission E a + • *= MY COMMISSION # DD 817400 fun. - ARP, .+4ts Goodell Publle Underwm ItoNotery srs (Revised 07 /10 /07)(Revised 06/10/2009) 1 EXPIRES: October 1, 2012 it .s 1 J� NOTARY PUBLIC: Sign: Print: My Commissi Contractor The foregoing instrument was acknowledged befo me this 6 day of t eCidrfr ,2% , by 4b.1 Ro/e/QT5, who is pers a y known me or who has produced as identification and who did take an oath. i • MY COMMISSION # DD 817400 " EXPIRES: October 1, 2012 •l,�j' o , Bonded Thor Notary Public Undenvdtere .dade4e kkatc�Y�Y�Y 4r�Y�Ydckk�i3:9e�Y #z4�Y�Y �Yatr3cdr k*** 3r3e9:9e�Y9e�Y k ..... Y3: 3:*** . .............................** *............. APPROVED BY ' M' Plans Examiner Zoning Engineer Clerk checked UNIT BEING REPLACED DATA NEW UNIT j 2tq av@. MANUFACTURER 62(.0)d 'Nu 40 (a Cr 4 0 AHU or PKG. UNIT MODEL # 04C. L. /4i' Yd'aaC 2.11R 7.O L(4' COND. UNIT MODEL # ig4p-r Le'4 I 0 KW HEAT 1 0 4 NOM TONS 4' AHU 60 CU PKG 1) M.C.A AHU COCU CPKG AHU $'O CU PKG 2) M.O.P AHU.ro CU.S..r PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER J6 -- YES NO REPLACING DUCTS YES NO c( YES NO REPLACING THERMOSTAT YES ®( NO YES NO NEW 4 "CONCRETE SLAB YES k NO YES NO NEW ROOF STAND YES NO aC YES NO NEW RETURN PLENUM BOX '\YES of NO \\\YES 71 ... _.f,e • ti Signature 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): .)/' O ilk � ' 76T #111IJr1/ r 0 t '5 City: Miami Shores Village County: Miami Dade Zip Code: 3 3 / 3d' 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 3. Voltage of Circuit (2 /24 80): 4. Size Disconnecting Means: State Certificate or Regis fr ion N. (Quallfie s Ignatius only) AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC I. O - 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ i e Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Robert Roberts CMC1249674 Contractor's Company Name: fd d tle Gar S ate Po.v�! 7104 Phone r, 64 ®24 3 Cp Certificate of Competency N. :.;err i� �,•i u� bird (.::to or 1. ''012 . :- ;: •.+erwriters • E/ll/ll'Edd Helms Air Conditioning & Electric Sep 27, 2010 To: William G Mercer 990 NE 97 St Miami Shores, F133138 305- 754 -2190 C A C # 1249674 We hereby propose to furnish labor, materials, and equipment as outlines below: 1) Ruud cube (4) ton 16 SEER system with air handler • R410 -a refrigerant • Condenser Model :14AJM49A01 Air Handler Model: RHIKEHM4821JC • Copper on aluminum condenser coil. 2) 10kw Electric heater. 3) Hurricane clips for condenser. 4) Install new cement pad. 5) Install new Honeywell digital thermostat. 6) Install new cut off switch. 7) Attic horizontal installation 8) Install new aux pan. 9) Reuse: ❖ Existing 7/8" 3/8" refrigerant lines. + Reuse all and wiring. • Existing duct work. • Existing drain line. • Electrical disconnect box. 10) Remove existing equipment from premises. 11) Complete startup and check out. 12) Mechanical city permits with inspections included for unit replacement. 13) No other items included other then work scope listed above. 14) Optional 1 bulb UV light system AIR SCRUBBERS for air handler: additional $650.00. 15) Optional duct cleaned up to 10 grills additional $ 850.00 16) Warranty > Equipment -10 years compressor, 10 years condenser coil, 10 years parts, and 1 year labor. > After it is registered with the manufacturer. 7850 NE 5th Avenue • Miami, FL 33162 • Tel: (305) 653 -2530 • Toll Free: (800) 329 -2530 • Fax: (305) 653 -7933 • www.eddhelms.com EIll'Ill'Edd Helms Air Conditioning & Electric Total for goods and services above: $ 5467.00 FPL Rebate: - $ 780.00 Total $ 4687.00 q — .1 7 - to ,i. 3, - (13 4" CC" r1► pi- 6 - 77/ ON Final total Investment price after all rebates: $4687.00 bUC System approve for tax credit 30% up to $ 1500.00 Cash or Credit Card terms: 50% down payment, balance due on startup of equipment This proposal is dated Sep 27, 2010. It is valid for 15 days. Edd Helms Air Conditioning is authorized to perform the above work and services at the prices and terms specified herein. All payments shall be due in accordance with the terms described above. Customer agrees to pay all court costs and attorneys fees should legal mean be necessary for collection. The HVAC system included in this proposal is designed according to industry standards to provide comfort cooling in occupied areas. This proposal does not include the responsibility by EDD HELMS for any procedures to identify, control, eliminate or remove mold in occupied or unoccupied spaces. If you suspect mold to be a problem, or if you have construction conditions that support the growth of mold, we recommend the CUSTOMER take remedial actions outside of this proposal to eliminate the problem, remove the mold, and insure a mold free environment. Edd Helms Air Conditioning shall not be responsible for drywall repairs, painting, concrete repairs, or code violations outside of the scope of work. All cancellations must be submitted in writing direct to Edd Helms Group, Inc. three business days before verbal schedule installation date. ALBERTO QUJROS Comfort Specialist Customer Signature Cell: 305 218 3134 — ? 7 — -40 /e aquiros@eddhelms.com Date oft 670 p ('/7. :p / ie O� @Oflh/3//c : 23 • 3 f33 17850 NE 5th Avenue • Miami, FL 33162 • Tel: (305) 653 -2530 • Toll Free: (800) 329 -2530 • Fax: (305) 653 -7933 • www.eddhelms.com Certificate of Product Ratings AHRI Certified Reference Number: 3800714 Date: 9/27/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number. 14AJM49 Indoor Unit Model Number: RHKL- HM4821 +RCSL -H *4821 Manufacturer: RUUD AIR CONDITIONING DIVISION Trade/Brand name: RUUD 14AJM SERIES This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17, 2009 and Dec 31, 2010. Manufacturer responsible for the rating of this system combination is RUUD AIR CONDITIONING DIVISION 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: Cooling Capacity (Btuh): 46000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 *Ratings followed by an asterisk (1 indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which Indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the products) listed on ifils Certificate and makes no representatlonm, warranties or guarantees as to, and assumes no responsibility for, the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or pertom►ance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are vabid only for models and configurations listed In the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contends 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 c®' The information for the model cited w on this certificate can be verified at ww.ahrfdlrectoryorg, As. dick on "Verify Certific ate" link and enter the AHRI Certified Reference Number and the date on rill which the certificate was Issued, which Is listed above, and the Certificate No, which Is listed below. Air - Conditioning, Heating, and Refrigeration Institute ©2010 Air- Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129301112961922430 THE POUCIES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR INSRC ADD'L TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE (MM/DD/YY) POUCY EXPIRATION DATE (MM/DD/YY1 LIMITS A X GEN LIABILITY COMMERCIAL GENERAL LIABILITY GL2011926080010 • $0 Deductible 07/01/10 07/01/11 EACH OCCURRENCE $1,000, X PREMISES Ea occurrence) $50,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $5, 000 X XCU /Contractual PERSONAL & ADV INJURY $1,000, X Broad Form PD GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POUCY n ECT n LOC PRODUCTS - COMP /OP AGG $2,000,000 7 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA20011460902 07/01/10 07/01/11 COMBINED SINGLE LIMB (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ — _ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESSIUMBRELLALIABILITY CU200114909 07/01/10 07/01/11 .EACH OCCURRENCE $5,000,000 OCCUR CLAIMS MADE AGGREGATE $5,000,000 DEDUCTIBLE RETENTION $ O $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNE OFFICER/MEMBER EXC UDED? ECUTNE If yes, describe under SPECIAL PROVISIONS below WC200250110 07/01/10 07/01/11 X I ORRY TIMITS I I °FR EL. EACH ACCIDENT $500,000 $500,000 $500,000 EL. DISEASE - EA EMPLOYEE EL. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ACORD. CERTIFICATE OF LIABILITY INSURANCE 7/21/ 2010 PRODUCER Paul H. DeSilva Bateman, Gordon & Sands, Inc. P.O. Box 1270 Pompano Beach, FL 33061 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Edd Helms Group, Inc.;Edd Helms Electric LLC;Edd Helms Air Conditioning Inc 17850 NE 5th Avenue Miami, FL 33162 -1008 INSURER A: Amerisure Insurance Co. 19488 INSURER B: • Amerisure Mutual Insurance Co. 23396 INSURER C: INSURER D: INSURER E CERTIFICATE HOLDER Miami Shores Village 10050 NE 2 Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1(1 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. A RESENTA • ACORD 25 (2001/08) 1 of 2 • #5315070/M310898 CANCELLATION JMR O ACORD CORPORATION 1988