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MC-10-2015EXACT CHANGE AOUT OF 3.5 TONS NC SPLIT SYSTEM (NH AND COND UNIT) 11 1 7' 4 Passed Inspector Comments CREATED AS REINSPECTION FOR INSP- 153280. r Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until I nspection Number: INSP - 155157 Permit Number: MC -11 -10 -2015 Inspection Date: February 02, 2011 Inspector: Perez, JanPierre Owner: RALPH, MARGARET Job Address: 1510 NE 105 Street 7 -C Project: <NONE> February 01, 2011 Miami Shores, FL Contractor: REA AIR CONDITIONING INC Budding Department Comments 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 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)793 -7864 Parcel Number 1122300530310 Phone: 305 - 266 -6627 Page 1 of 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) e r �� Phone # Owner's Address _ M LQ _ 1(2 � 7 ' City c State F1 — Tenant /Lessee Name E -MAIL: Job Address (where the work is being done) SAV11\e__, City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 11- Is Building Historically Designated YES NO Architect /Engineer's Name (if applicable) Type of Work: ❑Addition Describe Work: e p LL kAD Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. ti0..- 015 Master Permit No. Zip Phone # Contractor's Company Name A . AL)r (c r' - f 17 Y) Contractor's Address 77j� CIL( City__/ ALc�WI,\ � State CV__ Qualifier Name \C�I/�+�:VI[ 8 - A ( Phone # brfp - a {c9( 4 , (D(o ) State Certificate or Registration No. Certificate of Competency No. tan l r E -MAIL: Value of Work For this Permit $ Square / Linear Footage Of Work: ❑Alteration Phone #�^ Phone # I❑- Repair /Replace ❑ Demolition * *xxrxx * * * *xxxx xxx xxxx.....*...xxxxxxxxF do ** **ie***** *at****a:ic******** *** Submittal Fee $ SD . 00 Permit Fee $ � �(` 'k' tsv CCF$ Technology Fee $ CIVMS NOV 1 2 2O1 o BY:...,.....,. Zip CO /CC Notary $ Training /Education Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 05 - :1, 1 A See Reverse side -> *117 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: 1 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this l a. day of C'rtDCJ , 20 l l'7, by ffe-Ir 1 ,N\pkel who is personally known to me or who has produced Novu t i sitifitikifrAtitteitloydndid take an oath. Susan B. Lata NOTARY PUSS: '_ Commission #DD785901 , '' Expires: " 05, 2$ 2 Sign: Print: BONDED TIIRU - C IBM ■174 y 41•711/ APPLICATION APPROVED BY: (Revised-02 /08/06) 46,-/ Signature Contractor The foregoing instrument was acknowledged before me this Ja day of not) , 2010, by who is personally known to me or who has produced NoT mukygificgikiEwAtthejkid take an oath. " usan B. Lata NOTARl�, I mission #DD785901 ,;,,..S Expires: MAY 05, Sign: Print: = 0 ' ' ED THRU ATLANTIC BONDING CO Lr k My Commission Expires: My Commission Expires: ic*xxx******** aea4****uux aYxaY9:****xxxx*x &xx****xxxxx xx *rxxxnYxxrxxxx,kfrxx *4exxxxxxxxx xxx ,Yxxxxdexx&x*****xx'xxie**** Plans Examiner Engineer Zoning UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER y/64 di/f 77ZJ 1A- T. 7-c." g AHU or PKG. UNIT MODEL # 'e6 -,,e-b fl 77 6 COND. UNIT MODEL # 1,6 1`P 6 y KW HEAT / 0 3, S NOM TONS 3-. 5 AHI.5'rs CU3 PKG 1) M.C.A AHCU PKG AHU5L, CU j PKG 2) M.O.P AH a CU >bPKG AHM CIX36 PKG 3) VOLTS A PKG UNIT / / PKG UNIT / / EER/SEER ) (9 YES NO REPLACING DUCTS YES YES ' • ; REPLACING THERMOSTAT YES � YES + • NEW 4 °CONCRETE SLAB YES 5; YES < NEW ROOF STAND YES �iC•� YES NEW RETURN PLENUM BOX YES 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): 151 D G - 7 C- City: Miami Shores Village 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 (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Registration Signature (Qualm 1 a may) County: Miami Dade Zip Code: 3138 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ARHI Sheet Attached: YES /, NO ❑ Contract Attached: YES ❑ 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): ,ms Phone: S Certificate of Competency N. Date: 4 )1 UICIP antii CERTIFIE www.atti direc,tory.or.g Certificate of Product Ratincis AHRI Certified Reference Number: 3435474 Date: 11/11/2010 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTR5042E1 Indoor Unit Model Number: 4TEE3F40B1 Manufacturer: TRANE Trade/Brand name: XR15 Manufacturer responsible for the rating of this system combination is TRANS 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): 40000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. *Reims followed by an asterisk () indicate a vc!mtay mate of prevlardy published data, unless wed with a WAS, which indicates an involuntary mate. DISCLAIMER AHRI does not endorse the product(s) Bled on this Cettlicate and makes no representations, stananties or guarantees as to and assumes no Reponsibility fa% the product(s) listed on this Cedifiatte AHRI expressly disdains ail fiabiigy for damages of any kind arising out tithe use erperformance of Om products), or untaithmrdaed awn of data fisted on this CertMcate. Certified ratings are valid only torte and configurations fisted In the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contends are proprietary (=thuds of A H R I . This Cerfiflcate shall a d y be used for individual, personal and c o n f i d e d ne a proposes The contents of this Certificate may not In whale or in part, be reproduced; copied: disseminated; entered hmu a comma database or othmuise utlfised, in any tbrm censor by any means, except far the user's Individual, personal and confidential rye CERTIFICATE VERIFICATION LIEN The information forth° model dted on this certificate can be verified at w caw- ahridirectory org, Air Conditioning, Heating, dick on "Verity Certificate" fink and enter theAHRICet Med Reference Number and the date on inn em isji and Refrigeration Institute which the certificatewas tamed, which In listed above, and the Certificate No, which is listed betorrr. ©2010 Air- Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: AIR CONDITIONING AT ITS BEST REA 7351 N.W. 7th STREET SUITE °R° AIR CONDITIONING MIAMI, FLORIDA 33126 ` PHONE (305) 266 -6627 Ralph ResidenccA CO22414 FAX (305) 2 8 99 -2853 11/11/10 PROPOSAL SUBMITTED TO 1510 NE 105 treet PHONE Air re. p lsweement DATE — STREET Miami Shores,FL JOB NAME CITY, STATE AND ZIP CODE JOB LOCATION JOB PHONE We hereby submit specifications and estimates for: 1. Removal of existing central A/C 2. Installation of a new 3.5 ton Trane central A/C system Model # 4TEE3F4OB for the air handler, matched with model # 4TTR5042 for the condensing unit. S.E.E.R.16.0. 3. Installation to include the following: Reconnection to lines permit, existing and electric, crane service, thermostat, and labor. 4. Warranty: 10 years on compressor, 10 years on all Trane parts, 1 year on workmanship. 5. Price: $6,700.00 tax included. Subtract $685.00 for F.P.L., actual cost is $6,015.00. SiMO113a1111 Seven hundred an drn0Il4bor- complete in accordance with above specifications, for the sum of: 6,700.00 dollars ($ 1 Payment to be made as follov2000.00 down, balance upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifica- tions involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance.. Authorized ' Signature ote: This •roposal withdrawn by us if . •t aces ed • -y b with;` days / a coopiance of 9 -The above prices, specifications and con- ditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance' di e Signature / v / Signature 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'L I NSR LTR ADD INSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) - POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS A GENERAL UABIUTY COMMERCIAL GENERAL LIABILrrY 77PR869903 -0001 07/01/10 07/01/11 EACH OCCURRENCE $ 1,000,000 X PRISES(Ea $ 100,000 CLAIMS MADE X OCCUR . MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n jECOT- n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 n B AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAPC5904074286 07/01/10 07/01/11 COMB SINGLE LIMIT (Ea CO cident) $ 1 000 000 , r X BODILY INJURY (Per person) X BODILY INJURY (Per accident) X PROPERTY DAMAGE (Per accident) $ GARAGE UABIUTY ANY AUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ n OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY Y / N ANYPROPRIETOR /PARTNER/EXECUTIVEn OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below 83042442 07/01/10 07/01/11 WC STATU- OM- TORY LIMITS • X ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE- POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS • Air Conditioning Contractor. *10 days non -pay. coRV® CERTIFICATE OF LIABILITY INSURANCE ODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FILER INSURANCE, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9440 S.W. 77 Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. F 9 Miami, FL 33156 Phone : 305-270-2100 Fax:305- 270 -2195 INSURED REA Air Conditioning, Inc. 7351 N.W. 7th Street Miami FL 33169 OP ID CP REAAI01 INSURERS. AFFORDING COVERAGE INSURER A: Nationwide Mutual Insurance Co INSURER B: Allied P &C Insurance Co • INSURER C: Bridgefield Employers Inc. Co. INSURER D: INSURER E: DATE(MM/DD/YYYY) 06/30/10 NAIC # 42579 10701 COVERAGES CERTIFICATE HOLDER ACORD 25 (2009/01) City of Miami Shores Fax #305 - 756 -8972 10050 NE 2 Avenue Miami Shores FL 33138 CITYO56 CANCELLATION AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.