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MC-10-1921Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Lvr. Inspection Number: INSP- 152772 Permit Number: MC -11 -10 -1921 Scheduled Inspection Date: December 21, 2010 Inspector: Perez, JanPierre Owner: STOBS, MARTHA Job Address: 828 NE 99 Street Project: <NONE> Miami Shores, FL 33138- Contractor: C&R AIR CONDITIONING CO Building Department Comments December 20, 2010 For Inspections please call: (305)762 -4949 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060142440 Phone: 305 -685 -6394 REPLACE 3 TON SPLIT NH AND COND <S7P I 1,0 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 11 of 28 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) 27144 ' 4 p. A I Owner's Address g d`L p N C 9/ 4` .-. City " �Lth'n� �G� State Tenant/Lessee Name Phone # .3 - 7 90' of 9/1 Email Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES City (Ct (44a Qualifier Name J' (') b-p t 3 C Inv 7 s l State Certificate or Registration No. C. A L 0 V.6 4 ('-i Contact Phone 3 d S 6 O S 6 -1 (-•( Value of Work For this Permit $ Type of Work: Describe Work: Notary $ Scanning $ Double Fee $ Structural Review. $ 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 6073 N+J 167 4T C. - Addition Training /Education Fee $ 82cNt 99' County Miami -Dade NO State F , Violation date: Alteration A Jtirej /H t� Certificate of Competency No. 0 L - 80 2 • Master Permit No. Phone # os' /"J ®• at-17i Zip Phone # Radon $ DPBR $ Bond $ Technology Fee $ NOV 0 1 2010 BY: Submittal Fee $ D ' CO Permit Fee $ ' ,2— Total Fee Now Due $ See Reverse side IP 2 Permit No.O i MO MI Zip Zip Flood Zone Contractor's Company Name C_ + g A . r CO vt d C ®. Phone # Contractor's Address E -mail C Q hck R A G Ory, r 0 4 n y A O L. C 014-1 Architect /Engineer's Name (if applicable) Phone # sloe Square / Linear Foota a Of Work: ❑New Repair /Replace ❑ Demolition CCF $ CO /CC $ 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 reins* tion fee will be charged. Signature L 1__ ' A ` �,`j Signature Owner or Agent The foregoing instrument was acknowledged before me this I day of NOV , 20 i 0 , by who n to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: KUtttK 1 J. CNRYST My Commission Expire :; r•� ' = Commission # DD 955419 "-Ai Expires May 24, 2014 Bonded TMu Troy Fein Narance 100.XWM% APPROVED BY a (Revised 07 /10 /07)(Revised 06/10/2009) laps Examiner Engineer The foregoing instrument was acknowledged before me this day of 00d, d. ,201 by who as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ******* *** * * * * *** *** ** *k* * * * ** * * * * **** *** *************************** 1✓ kr Contractor o me or who has produced My Commission Expires: JANET KRANZ ,7 '! Commission DD 621880 • iri ,,,,. m y xwuaenceecoeeeme Zoning Clerk checked UNIT BEING REPLACED DATA NEW UN T C.cAP r i f a MANUFACTURER FO4A/U FO-i2 AHU or PKG. UNIT MODEL# _ .: H LL k -r U A 0 2 C COND. UNIT MODEL # o A "f 19 AI' M - 7 0 5 KW HEAT °] . • 3 NOM TONS 3 AHU CU PKG 1) M.C.A — > AHU 4O CU ,IS - PKG AHU 40 CULO PKG AHU CCU 55 PKG 2) M.O.P a AHU CU PKG 3) VOLTS 2.3b 1 P H AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER ` , * 1 YES NO REPLACING DUCTS YES YES NO . REPLACING THERMOSTAT NO YES NO NEW 4'CONCRETE SLAB NO YES NO NEW ROOF STAND S YES NO NEW RETURN PLENUM BOX Mt NO 1 . It Minimum Circuit Ampacity (Wire Size): 6 K 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 4 D Size Disconnecting Means: H O Contractor's Company Name: C_ -} r ` r Co . C ® State CertificatirRegistration N. C A C Oa C. 4 I Certificate of Competency N. 0 t a e02. , -1 AIR CONDITIONING REPLACEMENT DATA Signature r�j�k Ill 1•, signature only) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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): gag {V E 9 9 * City: Miami Shores Village County: Miami Dade Zip Code: -3 3 1 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 ❑ NO ❑ Contract Attached: YES ❑ 3. Voltage of Circuit (208 i , 80): 4. Phone: 3©1"' CtS6 0 9 " Date: IO.28- / 13.0 GUSTO E j PHONE HOME DATE 1 1 ' a , AD RESS ea i N E 9 9 St WORK ❑UNDER CONSTRUCTION 0 P ■ CELL 3o s ''i C 0 2c-11 1 I2KXISTING STRUCTURE We hereby propose to: Fufnish, install and service the equipment and materials listed below with the conditions and specifications detailed below. NEW EQUIPMENT System #1 $ 186) I : System #2 $ System #3 $ P ®� b Rebate/s - - _ �®° ^fasx O .. i c do. 0O B Your Investment 3 6 et S-- ® __ Manufacturer R V L)tl ]] Condensing Unit Model # 14 AZ N1 36 Air Handler Model # RHLL1-tM3a leek - # Re RI-110 Heating KW 1 • Btuh 37,660 S.E.E.R. 1 Ip . 1 '3 .® £ E R Warranties Labor 1 Yr. Parts 10 Yr. Labor Yr. Parts Yr. Labor Yr. Parts Yr. Compressor ) h Yrs. Compressor Yrs. Compressor Yrs. MISCELLANEOUS ❑ Condensing Unit Stand ❑ Air Handler Stand 0 Float Switch ❑ Ref. Line cover ❑ Condensate Line [] Concrete Slab ['Thermostat S 0 PD Auxiliary Drain Pan [Ref. lines ❑ Fire Dampers ❑ Other DUCT SYSTEM ELECTRIC SYSTEM ❑ ackage Unit Changeout Existing Reconnection [R eco t to Existing stem ❑ New Electric d G � �.t J 1 , W / d M ^Y mt TOTAL INVESTMENT FPL%DEALER REBATE YOUR INVESTMENT PERMIT FEE NOT INCLUDED PURCHAS C &R Air Conditioning Co. 6073 NW 167'" Street Suite C -4 Miami Gardens, FL 33015 -4330 DADS: 30 5 - 685 - 6394 BR WARD: 954 -680 -4494 A qualified air conditioning expert will start and test the system and explain its operation. This proposal is good for a two week period from date of proposal and at that time is subject to review. Title to the system shall remain in us until all sums due us have been fully paid. In the event the purchaser fails to comply with any of the requirements of this contract and such default results in litigation, the Purchaser agrees to pay reasonable attorneys fees and all court costs and expenses incident to such litigation. Delinquent payments shall bear 1.5% per month interest from due date until paid. All work is to be performed during our regular work hours unless otherwise specified. This contract contains all agreements. Neither party shall be bound by any representation, warranties nor agreements, oral nor written not herein contained. This proposal shall become a contract when accepted by you and approved in writing by our duly authorized corporate officer. We agree to furnish and install the above described labor and materials on the terms indicated below for System # R CAir1b2 DATE / %iJ I a REPRESENTATIVE V OR 2 WEEKS 50% DEPOSIT $ d 660, 50% DUE WHEN READY TO OPERATE $