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MC-10-1926Inspection Number: INSP- 153492 Permit Number: MC -11 -10 -1926 Scheduled Inspection Date: November 23, 2010 Inspector: Perez, JanPierre Owner: TOTH, CHRISTOPHER Job Address: 95 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARVINS AIR CONDITIONING CORP Building Department Comments AC CHANGE OUT 4 TON Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 152791. need to seal plemun with mastic jpp November 22, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 VV Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060131170 Phone: (305)541 -8408 I Page 22 of 31 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Address 4 :t s Tenant/Lessee Name Email , Zyr +<:.! '<:.! + 1- City Qualifier Name 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 Job Address (where the work is being done) 96 9 P sr City Miami Shores Village County Miami -Dade FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name /14,4007/. /¢ /G t ©>t=p Contractor's Address /.6 / — W. I/ - T "Eee •q-GE / u 41'-/f State / - • . 2T Nf t 64 Permit No. Master Permit No. Owner's Name (Fee Simple Titleholder) CI-) 1 I H / Phone # 3 (3 - G 3 2 — L i ti; IF4��� �o�C tc1�T 4-- }� City % e SVA G ft.e' S State -L Zip 5 3 P Phone # Phone # @O 6N/- 8yo 8 Zip 33/35" Phone # Flood Zone I NOV 0 12010 Zip Zip State Certificate or Registration No. C/3 C / / 6 a /hi Certificate of Competency No. Contact PhoneX3QS') 2 // _ J' E -mail Ali/ .4jj/,' Y # / a Apt „ c o " ( Architect /Engineer's Name (if applicable) Value of Work For this Permit $ Structural Review. $ (p ',Li Phone # Square / Linear Footage Of Work: Type of Work: Addition ❑Alteration ❑New Z1, Repair/Replace t& t Describe Work: Ai •' vt - U o lac -t, - 5 , ❑ Demolition J WI i Submittal Fee $ ' Permit Fee $ 1,4 vot+ CCF $ Notary $ Training /Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Total Fee Now Due $ C O /CC $ Technology Fee $ Bond $ 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. Signatu wner or Agent The foregoing instrument was acknowledged before me this Pr day of 44(,/,. , 20 to , by isrofAer Tm who is personally known to me or who has produced —r,cj —1) O —6'7— hl 3 —DAs identification and who did take an oath. NOTARY PUBLIC: Sign: Print: APPROVED BY (Revised 07 /10 /07)(Revised 06110/2009) ERICKA A FLETES •*c MY COMMISSION # 00996538 My Commission Expires: (407) 398 -0153 = +•�� I 4 glans Examiner Engineer Signature Sign: Print: Contrac "or The foregoing instrument was acknowledged before me this /= day of NO?. , 20 10 by IAN .onto , who is personally known to me or who has produced NOTARY PUBLIC: as identification and who did take an oath. ERICKA A FLETES IRES May 31, 2014 38 FloridallotaryService.com 407 39&0153 My Commission Exp �� ik Zoning Clerk checked UNIT BEING REPLACED DATA NEW UNIT LEAS/ ®X' MANUFACTURER d of AVA AHU or PKG. UNIT MODEL # gf111.404 #jRR1 T 4 N A COND. UNIT MODEL # RAP14n411yEz 11 HP KW HEAT '1.6 K) 1 / trWc. NOM TONS ij T' ®,y C' AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT I I EER/SEER / 3 / /6 YES NO *' REPLACING DUCTS YES NO I/ YES NO V REPLACING THERMOSTAT YES V NO YES NO V/ NEW 4 "CONCRETE SLAB YES ✓ NO YES NO V NEW ROOF STAND YES NO YES NO ✓ NEW RETURN PLENUM BOX YES i/ NO Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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): 1 City: Miami Shores Village County: Miami Dade Zip Code: " I g 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 1. Minimum Circuit Ampacity (Wire Size): '/6 A e /#' 2. Maximum Overcurrent Protection (Fuse /Breaker Size): y AMR 3. Voltage of Circuit (208/240/480): G"'O 4. Size Disconnecting Means: 4°5 Age Contractor's Company Name: / 1A/z1/ »nr 4 ,4/C 2's P Phone: 0306) 6 44#0 ' State Certificate or Registration N. CAC fg /(®.9 11 Certificate of Competency N. Signature �--- Date: 1/ — / / ( ualifler's si only) AHRI Certified Reference Number: 3410807 Cooling Capacity (Btuh): 47500 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 Certificate of Product Ratin • S This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. Date: 11/1/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number. RAPM-048JEZ Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 Manufacturer: RHEEM MANUFACTURING COMPANY Trade/Brand name: RHEEM RAPM SERIES Manufacturer responsible for the rating of this system combination is RHEEM MANUFACTURING COMPANY 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: by MI as ('j indisale a nabatary reaa a of tea, unless ananacanied nib a MS. eaI i " as imbuing nee. DISCLAIMER AIM does not endorse the fisted on this Cerfincate and makes no represeistudons,vaanaties or guarantees astir, and assumes no tanfaraddlav fur the pmdu s)i5eedcothis Confide. ma rooms* disdain' ai Rank for damages ofors Wad wising out albs UM or perfoonanceofthe paoduegsg, adtssagen of data fisted =Ws Oneficate.Oatified taringsare valid only for models and conligwations BMW in the direlwgat WWW.a h1dbectou r.org. TERNS AND CONDITIONS Ibis Certificate and its contents are groprietary products of AIM. Ibis Certificate stela*tressedf r personal and confidential reference purposes. Tbe conindsof this C may net in whole or In pad, be nwardocut caplet inlo a amenderrbiabasw or ofirendse rented, in any bran or manner or byany means, exceptforffiarisen iniewhinat, personal and confidential rebsence. CERTIFICATE VERIFICATION The infonnaffiun foram modd cited anger cedfficate can be verified aat w.ahridirectonr.org, dick Oil "Verity Cer ®ficaie" fink and enterthe ARM Certified Reference leumber and the daimon which the caditicate was issued, which is fisted above, andthe Certificate lroywhich is fished below 02010 Air - Conditioning, Heating, and Refrigeration institute CERTIFICATE NO.: 129331004691006521 Air - Conditioning, Heating, El and Refrigeration Institute THE•POLIGIESOF INSURANCE LISTED BELOW/MME ANY RECUMBENT. TERM OR. CONDITIIM MEAT PERTAK THE insunAgeEAFFORDEaD.BY �EGATEUMITSSHOMMMATHAVEBEENR SHOULD ANY OF TtEABOvE OESCRIBED POLICIES BE CANCELLED BEFORE TES INPIRATION DATE THEREOF. TIE Ism INSURER WLL ENDEAVOR TO MAIL 30 DAYS WRITTEN Miami Shores Village Building Department 10050 N. E. rd Avenue Miami Shores, Fl. 33138 Fax: (305) 756- 8972 NOTICE TO THE CERTIFICATE MOLDER RAVED TOm LEFT. BUT FAILURE TDDOSOSHALL noose NO osuoatON OR Lukaany OF ANY we EPoN TES INSURER. Rs Amass OR REPRESENTATIVES. AUNCREED •_________ THE•POLIGIESOF INSURANCE LISTED BELOW/MME ANY RECUMBENT. TERM OR. CONDITIIM MEAT PERTAK THE insunAgeEAFFORDEaD.BY �EGATEUMITSSHOMMMATHAVEBEENR BEM 1SSJED TOME INSIJRED NAMED ABOVEFOR• 7, P. OUCYPERIODINDICATED .Na1wuHSTANDrwG MARY COW'VRACT OR OTHER u itsi mi'l EGT TO WifIcH.THISMERTIPIcATE MAY BE ISSUED OR THE POLICIES DESCRIBED HEREIN IS SUBJECTT•O.AU. THEMES. EICCLUS!CNSAND CONOIUON5 OF SUCH ETIBYPARICCAIMR. m it MI. A uu m t� ' SAL r OF _...�,.•_ LIABILITY CONSAINEIALGENERAL LIABILITY POLECYnumnisi ' 9AL061135 - , . O I % "�fI x � o • • 'l 1 .. . A T,�'i 07/22/11 LIMITS EACH OCCURRENCE $ 300,000 07/22/10 0 T EA ci t S 50, 000 a.AIM S oco SM� LLt NE DEXP/Amon/seisortl $ 5,000 II Pam mumcomnirtr $ 300,000 III GEHL GENERAL AGGREGATE $ 600,000 AGGREGATE LIMIT APPLTESPER: E FM 1 LOC PRODUCTS - COW.WIOPAGO S 300,000 ALIT MOBILEUABRRY ANY AUTO ALLOWNEDAUTOS AUTOS RIMED AUTOS r wNiTEDAU TOS LIMIT (Eaea:WMdl $ II 000LYINJURY OF PI BODILY INJURY I ffi ■ PROPERTY lP aPMAGE $ GARAGE LIABILITY AIWA= AUTOORLY- IAACCIDErT S OTHE THIEN FA ACC S AUTO ONLY. AEG IS EXCESS/UMBRELLALIABLITY OcO.R ■ CLMIMSMACE EACH OCCURRENCE $ ■ AGGREGATE $ DEDUCTIBLE S ■ WOFEERSCONPINSATIONAND 'EMPLOYERS immure OR C tout O u ItvE OPFQ PRO WmN 17Q YLUb.rss I rev EL EACH ACCIDENT $ EL - EA EMPLOYEE S EL DISEASE - POLTCY LIMIT , $ ODER DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / EXCLUSIONS ADDEDBYESDORSEANT SPECIAL PROVISOS ACORD. CERTIFICATE OF LIABILITY INSURANCE THIS CERTIRCATE-IS ISSUED AS A MATTER OF INFORMATION ONLY AND .I:ONEERS NO. RIGHTS. UPON THE -CERTIFICATE HOLDER. THIS. CERTI DOES NOT AMEND, EXTEND OR. ALTER THE. COVERAGE AFFORDED BY THE POLICIES .BELOW_ i1!tSURERS AFFORDING COVERAGE I SURER : NOVA • XNSURANCB CO tR NsurIEN C miser Oc HNC# PRODUCER BEACON INSURANCE GROUP, INC 8567 CORAL WAY, #301 MIAMI, FL 33155 305-266-9706 MSURED MARVINS A C CORP COVERAGES 1761 SW 11TE TER MIAMI, FL 33135 ACORD25(2DOIm8) �c �rNr'T •d 9SB T I •SSOE 7/27/2010 Mc- 1I -10-• ►9ac GACORB CORPORATION 1988 Std s,NIANUW dES =TO OT TO AoN