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MC-10-183 3 3 'A'if 3 ,Q fir` . Miami Shores Village;. u F 10050 N.E. 2nd Avenue + Miami Shores, FL 33138 -0000 r Phone: (305)795- 2204 Expiration: 712010 Project Address Parcel Number Applicant 308 99 Street 1132060135590 KRISTINA BURROWS Miami Shores, FL Block: Lot: Owner Information Address Phone Cell KRISTINA BURROWS 308 NE 99 ST. 305858 -9868 MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone Valuation: $ 7, TYCOON FLOW CONTROL (305)828 -6655 Total Sq Feet: 0 Tons: 4 For Inspections please call: Additional Info: A/C SYSTEM REPLACEMENT (305)762 -4949 Classification: Residential Available Inspections: Approved: In Review Inspection Type: Comments: Date Approved:: In Review Final Date Denied: Type of Work: MECHANICAL Fees Due Amount Invoice # Total Amt Paid Amt Due CCF Education Surcharge $ .6U MC-2-10-36972 $ 281.10 $ 231.10 V Permit Fee - Additions✓Alterations $265.30 MG2 - - 36972 $ 281.10 $ 281.10 $ 0.00 Scanning Fee $3.00 Check #: 6486 Technology Fee $6.40 Total: $281.10 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. February 10, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy February 10, 2010 1 Miami Shores e Villa 'MIT g d Building Department ° 10050 N.E.2i1 Avenue, Miami Shores, Florida 33138 Tel: 305 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. �` ®' l� PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder)� "PTioige Owner's Address 3a City y, e �/�rI.YPS State '0 Zip - 13 Tenant/Lessee Name Phone # Email Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO N N Flood Zone Contractor's Company Name ep Phone # �� (f 2( f- � Contractor's Address — oe City 7°r'J% ���Ce/�ii State ��16 Qualifier Name / ® � ® /,p.� Phone # State Certificate or Registration No. 4?4azP/ 9 704y Certificate of Competency No. Contact Phone ®v''�'p��� — �4� ,3 E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ .�� Square / Linear Footage Of Work: Type of Work: (]Addition ` Alteration New .....-jR, Repair/Replace ❑ Demolition Describe Work: z 4r9i3t4e4e4r: R: tkkaY�e4e9t4tk9e4eYdcoY4iYdeBe9ivY4e4nkde4eoY�r4e9ekYat / F r sezY4e4e: tr9ntrkinY�e9e9e9eaksYYvY4eY& �otr4r�& de9e�fedr4ek4ed r &Ydc4r4enYiroYde� Submittal Fee $ Permit Fee $ � QCF $,� CO /CC $ Notary $ Training/Education Fee 0 Technology Fee $, 40 Scanning $ °t/ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ C- ' Y� 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 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 be approved and a reinspection fee will be charged. Signature Signa e �a Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 1 , 20 , by day of 20 /f , by , who is p son ally known to me or who has produced who is personally known to me or who has produc As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: YESENIA P DR b. Co Sign: Sign: ebru troossrst+s Print:' Print: My Commission Expire s ' B My Commission Expires: APPROVED BY Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) ammnmiu Proposal Date f Job i Sears Home improvement Products, Inc. Customer Name P.O. Box 522290 1024 Florida Central Parkway Customers Frome Phone Customers work Phone Home Improvement Products Longwood. FL 32752 -2290 S_ a t 2153 1 Phone (800) 469 -4663 Street Address ESTIMATE AND PROPOSAL contractor License/Registration Number qQ T Coolin FL (Gen.Contc#CGC012538 City State Zip code Heating &C HVAC # CMC1249510) i Is Installation within city limits? Install Address County Cafes ❑ No _ eelblg Patdrees (f diBvnerrt from above) Cry State Zip Code Protect consultant Name & License No. (if nppecabie) Description of the Project and D escrip tion of th ®SigniRcard Materials to be Used and Equipment to be I n3blIed SYSTEM INFORMATION: Equipment Brand: C ymi- RSplit System ❑ Package ❑ Dual Fuel C9 SEER (up to) - I Cooling BTU: MOOG KW: ❑ Straight Cool ❑ Heat Pump ❑ R -22 INSTALLATION TYPE: ❑ New eplacement ❑Conversion RNA • ❑ Gas 11 Oil ❑ LP Gas ❑ Electric C ;emovs and discard old system A AFUE (up to Heating BT EQUIPMENT SPECIFICATIONS: ELECTRICAL: Existing New MODEL # OF NEW COMPONENT I9 TO EXISTING ELECTRICAL 11 EK FURNACE/FAN COIL MLOA b 1i V CQ fA ❑ INSTALL NEW AMP MAIN PANEL ❑ iy CONDENSER UNIT [GY NEW DISCONNECT ❑ FURNACE ❑ CONDENSER ❑ CJ EVAPORATOR COIL _ ❑ NEW GFI OUTLET ❑ ATTIC LIGHT & RECEPTACLE ❑ ❑ PACKAGE UNIT Other: ❑ [Er • � E _ MIA DUCT WORK: ❑ ❑ HUMIDIFIER _ EXISTING DUCT SYSTEM ❑ ❑ AIR CLEANER ❑ INSTALL NEW DUCT SYSTEM WITH # NEW RUNS ❑ ❑ UV LIGHT ❑ REBUILD PLENUM ❑ Supply ❑ Return ❑ ❑ EVAP COOLER ❑ NEW TRUNK LINE(S) ❑ Supply ❑ Ret MISCELLANEOUS: ❑ NEW RETURN GRILLS) X X ❑ 13 LINE SET �' 11 PAD " x ❑ REPLACE REGISTER(S)# ❑ u�b ❑ DRAIN LINE ❑ CONDENSATE PUMP ❑ DUCT CLEANING ❑ ❑ AUXILIARY DRAIN PAN ❑ Ot her Other: CLUE V=NO ANDtOR CHIMNEY: ❑ Use existing vent or chimney ❑ Install new Chimney liner Size: 1t� PVC Vent Pipe for High - Efficiency Furnace ❑ Horizontal ❑ Vertical ❑ Type -B Vent Pipe ❑ Stainless Steel Vent Pipe ❑ 1 Pipe Installation 112 Pipe Installation ❑ Combustion Air ❑ Existing ❑ Modify SPECIAL INSTRUCTIONS: ctm 4wo, . ► 7� �0►- t e.Fi6d , r AN of the above check boxes have been reviewed and explained to me. Customer(s)initials APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately ASIE (Approximate Start Date) and will be substantially completed by approximately ASl D (Approximate Completion Date). These dates are subject to change at the time the tint & i5 accepted by Sears Home Improvement Products, Inc. ( "Sears ") or at any other time by mutual written agreement Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. AS11 ABATEMENT This Estimate and Proposal assumes that there are no asbestos containing materials ( "ACMs ") that would be disturbed in the performance of the installation work If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qual'iaed person prior to the start or continuation of work. If Customer falls to arrange for necessary asbestos abatement within thirty (30) days. Sears may cancel this contract upon written notice to Customer. Custome s Initials PLEASE NOTE that Sears is not responsible for correcting airy existing code violations or pre - existing conditions of any ductwork, piping, electrical Supplies or equipment not being replaced at this time. if additional work is required, it will tie the Customers responsibility. Any additional charges will be quated and approved prior to the start of any additional work Customers initials k EV THE XTRACT PRICE INCLM No A Copy of the terms and conditions of the Masler Protection -Year Master Protection Agreement ❑ Agreement or Repair Protection Agreement (as applicable) have been -Year Repair Protection Agreement ❑ provided to Customer. Customer(s) initials V C4C The TOTAL PRICE including all labor, material, taxes; and any applicable discount is Contract Price State Sales Tax { e / IS Loci Sales Tax { q Customer Payment is due prior to Sears' placement of Special Order for products. FAr Tote Amount Due S The form and method by which the Customer(s) will pay is described in a separate Cash/Cr Ca edit rd Payment Addendum made a pad ofW incorporated into this contract by reference. Customer(s) initials k NOTiICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 85 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED N0710E OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Additional provisions of this contract are slated o n the pages following. Customer(s) initials e81•Fl. Ran 04M cEIRrr- IC,AtE OF UABILITY INSURANCE r DA MgoMvOVY) PkDUCLR SoUth Pacific Profss'siomal Ins. THIS CIrRTfRCATE IS IS•SUCD AS A MATTER OF WADFtMATIoN 500 ICW. 49th Stmt O AND CONFERS NO IYI014TS UPON THE CEIdIVFtCATE HOLI72ERL TIHIS CERTIFICATE DEC M 196tAMENb. EXTENO3 OR f Hialeah, FL 33 112 ALTER THE COVERAt3'E AFFbROE13 BY'tHE P13LUCI#S At-L;U .. —_ Phone (305)a25_153-5 Fax (305)325 -5694 INSURERS ME ORIDINU COVERAGE � NAIC # _ INSIURED TYCOON FLOV#Y CONTROL CORD INSURER A. 1A CENnANT UNDERWRITERS, LL'C 53683 - -M 250 Vd 78 St Bay # s IrnSUItE It C3 - Hlairaah, FL. 33rDl6 INSURER D: jj • INS A UNDERIAPR LLC THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURNO NI MIED ABOVE FOR THE POLICY PERIOD INDICATED. NOfV9ITI1$TAN©ING ANY REQUIREMENT, TERM OR 'CONOTION OFANY CONTRACTOR OTHER 130CUNIENTIVIT ('RESPECT TO 1VIHIOH THIS CERTIFICATE MAYBE WaUI=D Opt 141AY PERTAIN. THE INSURANCE APPORDSD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO FALL THE 'TERMS, EXOLUSION81 AND CONDITIONS OF SUCH POUGIES. AGGREGATE LWTS SHS7+6VN MAY HAVE RE EN REDUCED BY PAID CLA,9A6S• MaR AD[rL T9'PE OF IN SlDRJ1NCE POLICY NUMBER �07JRY EFPEO PT1R POI ICY ®MRRAIMN T4 ���.o _» oul Tetr�Mavr�nrv+r�tl'rnara tnnm ®rrw� LO GEAIEIiAt LIA61110 rY EACH OCCURRENCE T 1 ,000.0 0") �f COM IAERCAL GENERAL LWEIILITY c A , tl - E'T'O RENTED GL [ 100,00@ - 50497 -00 09I23r�SOt19 09t23J201LI PRENAISEB 4t7raM�).. CliINIS MADE IM, OCCUR N,1ED EXP (An one pwon) 'JA _6,QD1y ii4O NAL&ADVIALIUR Y 1,000,000 :GENERALAG13REPATC _ _.. G_E`N'L AGGREGATE U ITT APIF'LIES PtR , P RODUCTS - COMPMP ACoG' 1,01(30,Od0 POLICY F�€1tJEL - 1 ;� LdC — AUTOMOOLE UABIL.ITY C�AhA ®IhFED SUQLE I WIT 1 i ANY AUTl7Ea erd<Ian1) ' LJ ALL OWNED AkIT03 BODILY IG4IJlDI'1Y j 1 1' SCHEDULED AUTOS (Per Pemm�) I .. NIKE(] AUTOS BODILY INJURY - — NON M%WED AUTOS : (Par accident) PROPE'RTY UAMAGG . . _...._. _ . Per ao*eadj _ GARAGE. LIA6SUTY — AUTO ONLY - EA ACCENT L ANYAUTO I OTHER TKKN 6A AC _ I..... —_ AUTO ONLY: — EXCESS I UMBRELLA LaAsiITY' i --- EAC M OC CURRENCE - ❑ OCCUR — I CLAIMSMADE I AGGREQATE D'EDUC RETENTION) $ 4rJ4RKE s COtAPEINSAT10N AN J VtiIC STA� EMPL®'dERTi' LIABILITY YIN I V4IC- 304)474 091231Z0D9 I}9l23 01 d1 D ARY L r A P. vAer J EXCLU D i EXECUTIVE L E ACH ACCIDENT 111<ID,0 EfIC4� ;rJ�U'61�NiSCIa L'•NCL1aE'? � - ' "wndatar} In NMI I E.L. DIS - EA E MPLOYEE ' _ 14'tI) IT+p os, L.: tII am v7er - SPEcrAL PRCV S1 0N1S betm E.L. DISEASE- POLICY I IMUT s00.04�47 1JESCRIOT,1 ®N OF OPPMATIONS t LOCATIONS t VEIM.ICLES I EXCLUSIONS ADDED BY VNIDORSEMENT ! SPECIAL PROVISIONS ' I CERTIFI HOLDER _ C E SHOULD ANY OF THE ABOVE DESCRMIEED POLICES ISE CANCELLED BEFORE THE 1 -_ - 19VIRATION DATE THEREOF, THE ISSU H13 INSURER IIUILL ENDFEAVOR, TO (MAUL MIAMI SHORES VILLAGE DAYS WRMN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 1$'+650 ME 2 AVENUE THE LEFT, BUT FA1LUR SO SIFI+�LI _UIVIPf33E IJO' CDBUGATION OR LIABILNY 11 OF ANY KIN UPON, , E Ilk 1 OR REPRESENT MIAMI SHORES. FL 33138 AUTwO ED R FAX 365. 756 - � J �J C D �5 $7A881�1� 4�F - X188 9 ACOIFt4]• CORGI' 1909. All rights Y1ve D name and logo aft raolsthred migrks of ACORO LA d 0£51 599 009 L << Xvd 50 :tL OL- 20-0602 AC# 4 5002c STME OF FLOP DEPART O�{ SUS" Q TAN SEM L09QS28d'2113 IC 08 28 2089 097008941 26153 r. The BUSINESS ORGANIZATION Named below IS QUALIFY % Under the grovi.aioxi s of Chs ter t Expiration date:.A G 31, 20;11 {THIS IS NOT A LICME TO FRR a 1.T �' T COMPANY TO TAO BUSINESS O NLY IF IT TYCOON FLOW CO1*kOL CORD 1271 WEST 62 STREET, HIALEAH FL 3301'2 CHARLIE CRIST CHARLES. W. DRA w GOVERNOR SECRETARY DISPLAY AS REOURED BY LAW AT 1 3631 X ✓" 7p _ B MBLAATTON t SEQ#10$463.100654 IAT CHUCK DSO BY LAW r i M"01-DADE COUNTY 2009 LOCAL.BUSINESS TAX RECEIPT.;,;: FIRST -CLASS s TAX COLLECTOR MIAMI-DADE COUNTY - STATE OF 140 W. FLAGLER ST. 30,201-0*. U.S. POSTAGE , EXPIRES SEPT ,.: ;" PAID 1st FI MUST BE DISPLAYE A PLACE OF' BUSIlV MIAMI, FL MIAMI, FL 33130 PURSUANT TO COUNTY uOtR CHAPTER 8/� ART. 8i;1_ PERMIT NO. 231 516497 -5 THIS IS NOT A BILL —' DO NOT PAY RENEWAL Bu$IN sP�IAM j Ow CFATROL CORP STATE EA0813706 539870 -6 T 2500 W 78 ST BAY 33016 HIALEAH OWNER TYCOON FLOW CONTROL CORP Sec IV9' SPE�C n MECHANICAL CONTRACTOR WORKE1 /S THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAW$' OP THE DO NOT FORWARD COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMTI OR LICENSE REQUIRED BY LAW. THIS IS TYCOON FLOW CONTROL CORP NOT THE A HOi ER S OUAUFIFICA F E L I P E D S O L E R PRE S TINS' 1271 W 62 ST- PAYMENT RECEIVED HIALEAH FL 33012 WAMPOADE COUNTY TAX COLLECTOR: 08/04/2009 60000000543 000045.00 SEE OTHER SIDE a Inspection Worksheet Miami Shores Village -� 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP 136419 Permit Number: MC -2 -10 -183 Scheduled Inspection Date: March 02 2010 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: BURROWS, KRiSTINA Work Classification: A/C Replacement Job Address: 308 NE 99 Street Miami Shores, FL Phone Number 305/758 -9868 Parcel Number 113206013559 Project: <NONE> Contractor: TYCOON FLOW CONTROL Phone: (305)828 -6655 Building Department Comments REPLACEMENT OF A/C 4 TONS 10KW 3/ z4 l (.J Inspector Comments Passed h Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 01, 2010 For Inspections please call: (305)762 -4949 Page 16 of 27