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MC-10-2184Inspection Number: INSP- 154171 Permit Number: MC -12 -10 -2184 Scheduled Inspection Date: December 21, 2010 Inspector: Perez, JanPierre Owner: VILLAR, ALBERTO Job Address: 195 NW 103 Street Miami Shores, FL 33150 -1235 Project: <NONE> Contractor: JOSE C YANE AIR CONDITIONING & APPLIANCES SERV INC Building Department Comments 4 TON SYSTEM CHANGE OUT, AND 2 TON SYSTEM CHANGE OUT, SPLIT SYSTEM c (4'2Lij(o Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments December 20, 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 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)758 -0971 Parcel Number 1121360131510 Page 23 of 28 BUILDING Permit No. PERMIT APPLICATION FBC 20 1 et • Phone # ( 758 62.9 q / Permit Type: MECHANICAL Owner's Name (Fee SimpleTitleholder) t--- 1 .0r Owner's Address ( j J Vi) 4) LCI: '3 - Cit H G /4672 Es State i- b.. Zip .3 3 I 3 e Tenant/Lessee Name Phone # Email /Is/(J / 7 ,; c Sr City Miami Shores Village County Miami-Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name ir) E t on‘e Phone # Contractor's Address /02 / /1/. City /1/ 4 9 /9 State r zip / Qualifier Name 4 6 y /1/.c Phone # 7424--‘ A- 93 std State Certificate or Registration No. (3 14e- / j I/ Certificate of Competency No. Contact Phoner E-mail Job Address (where the work is being done) Miami Shores Village il a A , , I d L- a Of,))() 21 N„ Shores, HorliThci u) 79:).1204 (j(b) 7: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work LAddition EAlteration 111New El] Repair/Replace 11] Demolition Describe Work: I 7 16f- , / ren ***************************************F s ************ Submittal Fee $ Permit Fee $ . 1 1 —.) CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Structural Review. $ Total Fee Now Due $ See Reyerse side -5 Code Enforcement $ Double Fee $ Master Permit No. DEC 1 3 2010 Bonding C ''s Narne l / t d &.gsag'' y_ lLl,., 1 J:ttne Mortgage Lender's .Address City State Lip 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 hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap oved and a reinspect* fee will be charged. ti Signature Sign: Print: The foregoing instrument was acknowledged before me this day of_ f' (, ,20 /A, by ' who is personally known to me or who has produced As identification and who did take an oath. NOTARY PURIAC SARA MONTERO " i° MY COMMISSION # EE022532 EXPIRES Sept^ nb'er J i , 2014 v :.r Florid a; My Commission Ekpires: * * * * * * * * * * * * * * *F* ilpD dJ Ow er or Agent APPLICATION AO'VEIT'Y"" (Revised 07/10/07) Ink Engineer Signature The foregoing"instrument was acknowledged before me this a day of 20 Al, by 10-- "i (� 1 1 Li Y, C who is personally known to me or who has produced as identification and who did take an oath. NOTARY PURI C'a Sign: • SARA MONTERO My COilliii 4 SSEO R ,2 •.: MY COMMISS! < i# EE022532 '. r ief , EXPIRES S° :'::er 01, 2014 (407)398 -0153 Fbr:f ::roice.com Print. -C ***** " * / * * * ** ** ****** *** * * * * ** * * * * * * * * * * * * * * * * * * * *** ** Plans E nhin Zoning Clerk checked WORK TO BE PERFORMED AT DATE NAME E i . A r ADDRESS �®� � iv iv lea a S ? ADDRESS " ,i W 0 3 CITY, STATE CITY.STATE /(1 DATE OF PLANS PHONE NO. ARCHITECT We hereby propose to furnish the materials , nd perform the labor > . • ry for the completion of A -� j isf1C ' A z- A'' i.." .1;4. , - Vic 72"k /Si • All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and s • =.._ ifications submitted for above work and completed in a substantial workmanlike manner for the sum of: ' — Dollars ( a v I d i I trl 0 kr - ` _ ,. _ with payments to be as follows sail be " «+a «ser. become Respectfully submitted cent and above Pe estimate. N agreements cordagara nyna strikes. accidents. t delays beyond OUT Manna Per be withdrawn by us if not accepted within days Note - This proposal may 0 ACCEPTANCE OF PROPOSAL CJ ACCEPTANCE OF CO RACT motions and conditions are satisfactory and are hereby accepted. Y e • , 'e • ` ' " ' : • • Payments will The above prices, � - ° be made as outlined above. . , 1 sIGNATUR DATE SIQN JOSE C. YANES AIR CONDITIONING & APPLIANCES SERVICES, INC. 1021 NE 132nd STREET, NORTH MIAMI, FL 33161 LICENSED & INSURED CELL: 786.683.9345 FAX: 305.895.3565 CONTRACT ir PROPOSAL 0 Dec. 11 2010 4:24PM TORRES INSURANCE AGENCY DATE @IMIIDDmrrY; ACO_!Q. CERTIFICATE OF LIABILITY INSURANCE _ 12713/2010 PIIoDUO R (305) 512 -5880 x210 ?AX: (305) 512 -5881 THIS CERTIFICATE IS ISSUED A$ A MATTER OF INFORMATION Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Torres Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6135 NW 167 STREET # E25 ALTER THE COVERAGE AFFORDED = THE POLICIES DEL !W- Miami Lakes FL 33015 INSURED Jose C Yares Aix Conditioning s Applicancea 1021 NE 132 Street GENERAL LIABILITY X SGMMeRC■AL. GENERA,I ,BILITY CLAIMS MADE X OCCUR X $500 ED Ded GEM- AGGREGATE LIMIT APPLIES PER: POLICY [I'm .. _ 1 LO LIABILITY ANY AUTO ALL DINNED AUTOS X SCHEDULED AUTOS H AUTOS YAP.. NON -ONN F.0 AUTOS X ATP $1OK/$i Dad x aiX- RBaBcTED ,^ GARAGE LIABILITY AhW AUTO OTHER Exces$ VOIBRELLA LIABILITY OCCUR 1 ..�-- I CLAIMS MO! DEDUCTIBLE RETENTION ! WORKER/ coresN9ATFON AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEKECUTIVE OFFICER/MEMBER EXCLUDED? It yes, &WCWDe antler gPF� _%IA�PROVISIONS�I� - °®e C RTIFICATE HOL (305)756 -8972 Miami Shores Village 10050 NE 2 Ave Miami Shores, FL 33138 ACORD 25(2001,0s) INS025 moo . Dea 06256722 -1 O1 i. 0002704 01 3/7/2010 INSURERS AFFORDING COVERAGE INsuRER A: National. Group Insurar+o13 NSUa R e: Q1tOGRES8IVE w ^R C: IPiSUR!R 0: INSURER e: North Miami n 33161 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. P3 OF INSURANC 1,000,000 y 100,000 1,000 000 S 2,000,000 $ 1,007,000 POUOY NUMBER 3/7/2011 7/17/2011 F13 IrINAI AAOV INJURY GENERAL AGGIRPXrlAYF PRODUCT$ - COMP, AGri COMBINED I:ENGLE LIMIT (Ea Eo aant) , BODILY INJukY Post ;Prowl BODILY INJURY (Per accMent) PROPERTY DAMAGE (per ®oX®ent) OTKER THAN EA ACC' AUTO ONLY: T IAMII'.0 I 10,000 20,000 10,000 2 1 E E.. •, aMP E. DI P POLICY EFFECTIVE 7/17/2010 D ESCRIPTION OP OPERATIONSILOCATWNBNEN CLE5/ XCLUSIONB ADDED eY ENDORSEMENTISPBCIAL PROVISION Air Conditioning. a) Yo Comprehensive mind Co11ie.or► coverage Shah; 1591 Lord F1SO Vine 3.eTE3X1713V/002588; 1993 Hord EaonolAne 3250 Vine 1FTPE242714 70518; 2002 Ford 3conolit►e 3250 Viu# 3,VERE242X211A5L198 CANCEIJ A11ON v EqXPI TOOK LIMBS NJ1 •. Art SHOULD ANY 00 THE ABOVE DESCRtD D[i POLICIES ea CANCELLED =FORE THE EXPIRATION DATE THEREOF, THE ISSUING INBUR3R WILL ENDEAVOR 'TO NAIL 10 PAYS WRITTEN NOTICE TO THB CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 30 SHALL IMPOSE NO OeiteAT10N OR VABILITI OF ANY KIND UPON THE INSURER, ITS AQRNTS OR REPRESENTATIVES AUTHORIZED REPRC8ENTATIW No. 1814 P. 1,'2 NAIC 0 ACORD CORPORATION 1953 Paopie2 Certificate of Product Ratings AHRI Certified Reference Number: 3080583 Date: 12/10/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX130241B* Indoor Unit Model Number: AR *F182416B* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade /Brand name: GOODMAN, JANITROL, AMANA DISTINCTIONS, EVERREST, ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 23000 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 ' Ratings followed by an asterisk i') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations fisted in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The infomtation for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link an'i enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2010 Air - Conditioning, Heating, and Refrigeration Institute Air - Conditioning, Heating, and Refrigeration institute CERTIFICATE NO.: 129364865909831587 UNIT BEING REPLACED DATA NEW UNIT 'CY2M . -- MANUFACTURER 6 2D /V AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT .5 kW' " NOM TONS AHU CU PKG 1) M.C.A (A) ) PKG AHU CU PKG 2) M.O.P ' AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER /7/6 - <,--3 , 410 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT d YES NO NEW 4 "CONCRETE SLAB E NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX NO AIR CONDITIONING REPLACEMENT DATA 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): /96— L.a City: Miami Shores Village County: Miami Dade Zip Code: / , 3cf 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 t 1. Minimum Circuit Ampacity (Wire Size): / e 2. Maximum Overcurrent Protection (Fuse /Breaker Size): -2_u 3. Voltage of Circuit (208/240/480): 2..-y ° 4. Size Disconnecting Means: Contractor's Company Name : C 7..9i J' /L /h !iG'7 /& - Phone: 7,( - «C State Certificate or Registration N.e - -R -L- J 'i / 7g Certificate of Competency N. Date: /)-/j3/ / UNIT BEING REPLACED DATA NEW UNIT j-7 iLa._ . MANUFACTURER 6- "e-2D '4- AHU or PKG. UNIT MODEL # COND. UNIT MODEL # 4 4 0 9',f' / - KW HEAT / W NOM TONS 9"7-Vi- AHU CU PKG 1) M.C.A tom'' PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER fi . 2. 0 R° / P el YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT NO YES NO NEW 4 °CONCRETE SLAB ,�„ NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX NO NO AIR CONDITIONING REPLACEMENT DATA 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): / /Vi l ®,3 S City: Miami Shores Village County: Miami Dade Zip Code: t 33 4.4 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 Ei NO ❑ Contract Attached: YES 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name. . r. Signature/ r k 'al er's'. ignature on 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 Date: f1�7/3 `/ 11 Phone:-7(t'/6-‘' ef ? " ¶- 1 State Certificate or Registration N. C - / 7it Certificate of Competency N. r a Certificate of Product Ratings AHRI Certified Reference Number: 3513758 Date: 12/10/2010 Product: Split System: Air - Cooled Condensing Unit, CoII with Blower Outdoor Unit Model Number: GSX130481 B* Indoor Unit Model Number: AR *F486016B* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade /Brand name: GOODMAN, JANITROL, AMANA DISTINCTIONS, EVERREST, ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 46000 EER Rating (Cooling): 11.20 SEER Rating (Cooling): 13.00 * Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the products), or the unauthorized alteration of data Listed on this Certificate. Certified ratings are valid only for models and configurations fisted in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilize!, in any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which Is listed below. ©2010 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129364864684026802 !AD' Air - Conditioning, Heating, �� IL' and Refrigeration Institute