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MC-10-2054Scheduled Inspection Date: May 11, 2011 Inspector: Bruhn, Norman Owner: SPONDER, SUZANNE Job Address: 160 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: BEST SERVICE AIR CONDITIONING CO INC Building Department Comments May 10, 2011 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 Inspection Number: INSP- 153447 Permit Number: MC -11 -10 -2054 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)539 -3099 Parcel Number 1132060131860 Phone: (305)255 -8670 EXACT REPLACEMNT 2 TON 10 KW HEAT AC SYSTEM �054�8 q0. c-12- ?DS 5‘i 3011 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments GNU 1)4-- 6‘1- C(11) Page 3 of 25 Inspection Number: I NSP- 153447 Scheduled Inspection Date: May 11, 2011 Inspector: Bruhn, Norman Owner: SPONDER, SUZANNE Job Address: 160 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Building: Department Comments EXACT REPLACErail vii' 10 KW HEAT AC SYSTEM May 1A 2A11 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: BEST SERVICE AIR CONDITIONING CO INC For Inspections please call: (305)762 -4949 Permit Number: MC -11 -10 -2054 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)539 -3099 Parcel Number 1132060131860 Phone: (305)255 -8670 0.5 4.5 q0`t ci2J 3a5 5p( 304'11 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments G nu ov\- Ciotti D...... ...s ec ‘1\k` BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL p OWNER: Name (Fee Simple Titleholder): S (4Z ' N C S 1 0 M 1L1 eft- Phone#: Address: 1 6 0 E / 0 Z S T City: M l An" 1 5 ✓' e.S State: P Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: / 6 6 /4 E (d ti S f City: Miami Shores County: Miami Dade Zip: 3 3 f 3 Folio/Parcel #: / ( 3 0 6 - 0 /3 ^ / g"6 0 Is the Building Historically Designated: Yes NO Flood Zone: 1 CONTRACTOR: Company Name: esi- Sc1L 4-c_ co — A,.. L Address: / 1 0 33 5 (Pr - C City: /Y\ La's 1 State: P Qualifier Name: 12 U'''t t. a .) State Certification or Registration #: Ca (D 1 if 6 E, Certificate of Competency #: eSI - Serve c c. l -h•-,e Contact Phone#: 2 0 8 2-S f r/ O Email Address: Value of Work for this Permit: / ( f 3 0 0 Type of Work: °Address °Alteration Description of Work: 'C -�'nA .4 re, P Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. Master Permit No. $ Square/Linear Footage of Work: °New I tepair/Replace 1 /vrcA...) NOV 1 7 200 Zip: . ?3/3 $' /sf 1 t-t l 1 c r" i"c Lo —.,," V' Phone#: 3 0 z.s C-1 9 Zip: 2 / 6 Phone#: 3 of- L- f 5' q .- --o DESIGNER: Architect/Engineer: Phone#• °Demolition Submittal Fee $ ' Permit Fee $ 24 i 00CCF $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 . (0 -'...112 A a Y CO /CC $ DBPR $ Bond $ Technology Fee $ 1- 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 re• ection fee will be charged. Owner or Agent The foregoing instrument was ac . g: before me this 2 +. The foregoing instrument was acknow day of SP , 20 10 day of $ , 20 10 , who is personally known to me or as produced who is personally known to me or who h NOTARY PUBLIC: Sign: Print: My Commission Exp/r „,,,, xp'' e�: NIAR. 06, 2011 BONuLi, RIAU 'SIANTIC BONDING CO, INC. ********* *** * * * * * ** * *** * * * * * ** * * * * * * * *** ** * ****** ***********************************b1:************** ** APPROVED BY As identification and who did take an oath. as identification and who did take an oath. S we tame- STATE OF FLuDIA Shen; Steele Structural Review (Revised 07i10/07)(Revised 06 /10/2009)(Revised 3/15109) ans Examiner NOTARY PUBLIC: Sign: Print Wit Steele ^ a - vri ;11.06, 2011 My Comm &sp : ..dale BONDING Ca, rte. Zoning Clerk AHRI Certified Reference Number: 3763876 Date: 11/17/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: UASL- 024JEC Indoor Unit Model Number. RHPN- HM2421 +RCSN -H *2421 Manufacturer: RUUD AIR CONDITIONING DIVISION Trade/Brand name: RUUD UASL SERIES Cooling Capacity (Btuh): 24600 EER Rating (Cooling): 1430 SEER Rating (Cooling): 18.50 ©2010 Air - Conditioning, Heating, and Refrigeration Institute This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. Ratings followed by an asterisk (') Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. 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: DISCLAIMER AHRI does not endorse the product(s) fisted on this Certificate and makes no moons, warrantles or guarantees as to, and assumes no responsibility for the product(s) listed on this Certificate. AHRI expressly disctakns all liability for damages of any kind arising out of the use or performance of the prodwx(s), or the unauthorized alteration of data fisted on this Certificate. Certified ratings are valid only for models and configurations listed In the directory at wE a h ri TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRL This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of thls Certificate may not, In whole or in part, be reproduced; copied; d nl rated; entered into a computer database; or othemise utilized, in any fomn or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The intonation for the model cited on this cite can be verified at _ ;;, : _ .y, ; itiO is , ` . r eating, click on "':." ° fink and enter the AHRI Certified Reference Number and the date on aldch the certificate wag Issued, which is Iced above, and the Certificate No., which Is meted below and € e i c %a ,'_ r t . ? r P s'a� CERTIFICATE NO.: 129344793473742548 • RIVER. LICENSE CLASS SW112S 1, PL 33178442a COO.1 37' six TV1: 1h4110 -201 t1 +;fix ate: �i »�ran•a •, p ico:11.1 Ga2tlGA ,• • Q'•i.e U•li:.crr 144-: ■t.Yit 1'rr.'NI r;olutivlet'l ia lkq h»;r ?,•5 • wen: non xi` 1s - ..'.2r A 0 • TYPE OFINSURANCE QENERAL UABriftY POLICY NUMBER POLICY EFFEcTorE pATEBN0norrern Pout EIRRATioN massatmonrro LIMITS GL- 0521015923 -00 03111/2010 03111/20 EACH OCCURRENCE $1,000,000 CON[4EROAI. GENERAL LIABUTY DAMAGE TO RENTED 0emmeloe) $100,000 MED EXP (Anyone pew) $5,000 013 tMADE '"1 OCCUR ga PD: 0ed: 1250 PERSONAL a ADV INJURY $1,050,000 ® GENERAL AGGREGATE $2,x,050 GEM. AGGREGATE LIMIT APPLIES PER: PROWL—TS -COMP/OP ACID $2,000.000 J POLICY ® PROJECT ❑ LCD 1 AUTO LIABILITY ® ANY Auro ® AU. OWNED AUTOS (DINNED SINGLE LBW (E a :' - " BODILY INJURY ( ) ■ • SCHEDULED AUTOS ® HIRED AUTOS ;0 NON OWNED AUTOS BODY INJURY (Per PROPERTY DAMAGE ;CI GARAGE UABIUIY • ANY AUTO f AUTO ONLY - EAACCIDENT OTHER THAN EA ACC AUTO ONLY: AGO ; EXCESS! UT BPELLA LIABILITY ;C OCCUR 0 CLAIMS MADE • DEDUCTIBLE j0 RETENTION $ iI /P EACH OCCURRENCE AGGREGATE " ViORKERS COMPENSATION AND EMPLOYERS' UABILITY Y/N B . ANY PROPRIETOR / PARTNER / EXECUTIVE I OFFICER / MEMBER EXCLUDED? Y MA I SPECIAL describe under WSAUIEC- 12071902 09!25/2010 09/25/2011 © TPLr�A s • 2414 EL EACH ACCE ENT $100,000 EL DISEASE - EA BAPLOYEE $100,0 $500.0001 EL DBE- POLICY LW IT ; OTHER DESORPTION OF ONN IO/LOCATIONS / VEHICLES / EXCLUSIONS ADS BY ,BAECIAI. PROVE 09/30/10 THU 02:22 FAX 7862067066 PRODUCER Galloway Insurance 17354 South DIxIe Highway Miami, FL 33157 Phone (305)255 -1661 INSURED Best Service Air Conditioning Co., Inc. 12033 SW 117th Court Miami. Florida 33186 Fax (7 -7068 COVERAGES 4- CERTIFICATE HOLDER GALLOWAY INSURANCE CERTIFICATE OF LIABILITY INSURANCE DATE (IIWDDNY) THIS CERTWICATE IS ISSUED AS A SUTTER OF INFMAATIIN4 ONLY AND CORMS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORIRNG AFFORDING COQ NAIC 6 BNURER A American Vehicle Ire Company INSURER B: SUA Insurance VISURER C: OSURER D: INSURER E — THE POLICIES OF INSURANCE LISTED NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORME POLICY PERIOD RATED. NOTWITHSTANDING ANY REQUIREMENT, TER! OR CONDmr N OF ANY CONTRACT OR OTER DOCXIMENT WITH : rTO WHICH THIS CERTIFICATE MAY BE DIED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS S AND CONDITIONS OF SUCH POLICIES. AGGREGATE UM1TS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. "Please trots that any changes to this poticy must be submitted to the Insurance Company for approver'... CANCELLATION Iii 001 UNIT BEING REPLACED DATA NEW UNIT C'-o o�-... 0. MANUFACTURER CAA d d— el, is r• a"— 2. le y AHU or PKG. UNIT MODEL # it t4 Apr -114 r Z , a-ii - c- ,-, a r -- e- (- es.7:5 COND. UNIT MODEL # tit 4-,S' L p °L `F Je- C KW HEAT 1 0 NOM TONS 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 / / /0 EER/SEER i e a J� YES NO REPLACING DUCTS Y SI, YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YE NO YES NO NEW ROOF STAND 0 NO YES NO NEW RETURN PLENUM BOX YES IVO) 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): / (' D /J o City: Miami Shores Village County: Miami Dade Zip Code: 33 1 J Change Disconnecting means: YES ❑ NO'% ARHI Sheet Attached: YES NO ❑ Contract Attached: YES ❑ 1. Minimum Circuit Ampacity (Wire Size): / 0 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: 2 V Contractor's Company Name: r? eS fr C a f r (d-ail h Phone: 2 - 2 - rJ '-q Certificate of Competency State Certificate or Registration N CACO / 9 5G 6 Signature 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 SUBMITTALS ARI (AHRI) DATA SHEET REQUIRED I S"a (Qualifier's signature only) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 C_ Date: i ( ! �' f( d Best Service Air Conditioning P.O. BOX 162069 Miami, FL 33116 (305) 255-9870 255 -9871 Bill To Sponder 160 NE 102 Street Miami Shores, F133138 Page 2 Invoice Date 10/4/2010 Invoice # 313 P.O. No. Terms Project Quantity Description Rate Amount THE ABOVE AC SYSTEM WILL CARRY A 10 YEAR ALL PARTS, 10 YEAR CONDENSING UNIT REPLACEMENT FOR COMPRESSOR FAILURE, WHEN UNIT IS REGISTER WITH RUDD MANUFACTURER THE ABOVE AC SYSTEM WILL QUALIFY FOR THE 2010 TAX REBATE OF 30% OF TOTAL COST UP TO $1500.00 YOUR COST $6396.50 X 30 % = $1918.95 = YOUR REBATE $1500.00 THE COST OF YOUR UNIT WITH ALL REBATES AND CREDITS WILL BE $3311.50 THE REMAINING BALANCE WILL BE DUE UPON START UP OF AC EQUIPMENT AND COMPLETION OF INSTALLATION Total $5 ,961.50 Best Service Air Conditioning P.O. BOX 162069 Miami, FL 33116 (305) 255-9870 255 -9871 Bill To Sponder 160 NE 102 Street Miami Shores, F133138 Page 2 Invoice Date 10/4/2010 Invoice # 313