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MC-09-936Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 116116 Scheduled Inspection Date: August 13, 2009 Inspector: Perez, JanPierre Owner: PEINADO, ULISES Job Address: 1048 NE 99 Street Miami Shores, FL 33138- Permit Number: MC -6 -09 -936 Project: <NONE> Contractor: EDD HELMS ELECTRIC & NC INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)498 -0577 Parcel Number 1132050180180 Phone: 305 - 653 -2520 Building Department Comments REPLACE EXISTING (4 TONS) CONDENSER UNIT AND AIR HANDLER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Amin.* 19 9nna For Inspections please call: (305)762 -4949 PanoRnf14 (e14!.:0)ti Yf' Miami Shores Village Buildin g Department artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) 2}/J Owner's Address /t9 I2 ,(J 9, ,5 d City / if.4.v& i°� State r-l— Zip 33)3 Tenant/Lessee Name Phone # 365- 75- 7— k ,k' 7 E -MAIL: lagMEWM All JUN 0 4 1009 Permit No. C �d Master Permit No. Kr'& 1Phone # Job Address (where the work is being done) /6 4r X/6. $' ,Si/7,e-14 ' 024' City Miami Shores Village County Miami -Dade Zip .33/ 3 FOLIO / PARCEL # /f -77-667- ®%f fib Is Building Historically Designated YES NO X Contractor's Company Name &'D /-6. .5 4 (fir Phone # S =%'. 7— 2.5-30 Contractor's Address /-7g- .b r�.A�.e� 24i, 1 City iqiii-4.l State i4C- Zip 33i b� Phone # Qualifier Name /6le, -/ 4hed -i State Certificate or Regi tration No. C.- Aie1Z' 9 7 Certificate of Competency No. E -MAIL: /nhet /ieY Architect/Engineer's Name (if applicable ) ot �� , � ` Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Addition El Alteration ❑N esk Describe Work: repq ee a ,q(/L I-44"d ie/ Repair /Replace ❑ Demolition !'(} cxxxxxxxxxxxxxxxxxxrxrxxxxxxxxxxxxrxx a xxxxxrrrxxxxxrxxxxxxxxr ,xxxrxrxxxr. r. x`xxxrxrxr, Submittal Fee $ Y Permit Fee $ grO CCF $ CO /CC Notary $' Training /Education Fee $ j l�_�'� Technology Fee $ ,S„ Scanning $ Bond $ Structural Review. $ Radon $ DPBR $ Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 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. l 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abence of such posted notice, the inspection wil not proved and a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this 3 day of ' J LJ vi e , 20 cfl , by K r S . + a VS @- who is personally known to me or who has produced L As identification and who did take an oath. NOTARY PUBLIC: Signature Contractor The foregoing instrument was acknowledged before me this 3 day of 31.4.11.e_ , 200 , by ao ri -- Jc r+5 who i esonally known t me or who has produced as identification and who did take an oath. Sign: Print: My Commission Expires: w xxr. xx *x w** '* EXPIRES: October 1, 2012 ova\' r - Bonded Thru Notary Pali,: Underwriters APPLICATION APPROVED BY: (Revised 02 /08/06) NOTARY PUBLIC: Sign: Print: My Commission Ex 4 ' f. EXPIRES: October 1, 2012 Bonded Thru Notary Public Underwriters Plans Examiner Engineer Zoning /rip s NOVICE OF COMMENCEMENT A RECORDED COPY'MtJST BE POSTED ON THE 3OB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO.//-3alL ©J Df STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 11111111111111111111111111111111111111111E c:F11 2009R0402343 OR Bk 26889 Ps 07814 (fps) RECORDED 06/03/2009 16:03:22 HARVEY ROVINp CLERK OF COURT MIAMI -DADE COUHTYr FLORIDA LAST PAGE Space above reserved for use of recording office 1. Legal description of propeirty and [street//address: /MAR; �y1rYYS .ii°.t -$, 43 1/ 9 /eks7? 04' N2 £`G „s,1-r.0 - "pt., k - s yfiT. .3/ 3 F 2. Description of improvement he 1014-e.6- coe 5h' 'l $ c °} ( `f n n 3. Owner(s) name and address: KM (R..i lei- (- Interest in property: 6 w yz -e A nrs� C'4 S'/v€ f� -/ L 14,14 /Me 4-1—_ . /.3P Name and address of fee simple titleholder: / 4. Contractor's name, address and phone number: )b h1 ( 2J 30S dv -s-2- 2 s"W /7''rrSd ,G es i% /: a'r 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provled by STF=`E OF FLORIDA, COUNT;' OF DADE Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: J c:�t ;; =Y ,hat!hrLl IS ,,' a ^yortns n"i�� rat � -!i" ihl: 01(ii.� �if1 � � 8. In addition to himself, Owners designates the following person(s) to r- `..- -t.: of he' Name, address and phone number. 141,';;7 j 1774! if: 67E" 8 ' 713.13(1)(b), Florida Statutes. By t 1' e c,ecc \C. prO ad / 'Y• , GOD ,Yt 111U2,1,4 ..4 ction 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAD I ER 713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND GAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF .• . INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR ' OrDING YO ' NO CE OF COMMENCEMENT. j (s) offer s) or Owner(s)' Authorized Officer /Director/Partner/Manager i ame , s sr.e.v Title /Off=ice e STATE OF FLORIDA COUNTY OF MIAMI -DADE The foregoing instrument was acknowledged before me this _3 day of By <<- (5 4,7 •?• e se— ❑ Individually, or ❑'as Occs v1 e �- ❑ Personally known, or ❑ produced the following type -f ide By Print Name Title /Office Signature of Notary Pu Print Nam (S ) O d '91i15-11— /7 "0 Al ,4e_ saPP,:Fc 33/ Z ,/v o7 for VERIFICATION PU T TO SECTION 92.525 FLORIDA ST Under •enalties of •erju ;, I declare that I have read the foregoing -d th are true, to the best of my knowledge and belief. wner(s)'s Authorized Officer /Director /Partner /Manager who signed above: By Customer 4 ahris-tin 1-0-V vi Address /b VI /VT 9V c5 . City /State/Zip .7)'i <, 1 &sj /Z, '/ P Home Phone 30S-- 7- 12-,,a 7 Work Phone/di- ic 6 -rte This Proposal Dated 3 62e e? is valid for 10 days. 32j... 144 De cription of th Work and Services proposed: �! bc- /ff-/g/ lll�lll� Edd Helms Air Conditioning & Electric CAC 009327 & EC0000339 17850 NE 5 Avenue, Miami, FL 33162 -1008 Phone: 305 -653 -2530 Toll Free: 1-800-329-2530 Fax: 305- 653 -7933 - _ ... maw.► 4cs 4 ii System Option Price bef_ re Reba SEER: /dic Rebat Price after Rebate CONDENSING RIIT l fl, 1,7 I Manufacturer: vv.) Model: O jqNLo49 oEL Tons: L{ Comp. Warr (yrs)10___ System Option B Price before Rebate SEER: Rebate Price after Rebate CONDENSING UNIT Manufacturer: Model: Tons: Comp. Warr (yrs) AIR HANDLER OR PKG UNIT Manufacturer: R Model: Ni-11).04-01, KW: 76-' Config• Vtier AIR HANDLER OR PKG UNIT Manufacturer Model. KW: Config System Acce,ssori s Thermostat: I fl Electronic Air Cleaner Ceiling insulation: DUCTWORK INFORMATION Number of New Drops: Smoke Detector Reqd? Existing Insulation R- Value. PERMIT INFORMATION Folio #: Mechanical Reqd9 Me/ ec,) Electrical Reqd? Warranty Warranty Price for Service Option # / Option System Option A System Option B Electrical Electrical Price for Service Option # Option System Option A / System Option B Option #1 One Year, Next Day Service- Monday- Friday, 8AM till 3PM. Option #2 One Year, Same Day Service- Monday- Friday, 8AM till 3PM. O• • • = One Year, Same Day Service- Monday-Friday, 8AM fill 8PM. • • '... • • .. / -i' G C�9v'C/f�' 1r 0' /Y. i - bw z .716 S O•t'. Reconnect to existing electric, no changes included. Option #2 Reconnect to existing electric, separate high /low voltage only. Option #3 Install wiring from existing panel to air handler & condensor. Option #4 Service upgrade to 200 Amps including Option #3 above. Total Amount due for the work and services selected above: Submitted by: Coe To yfon n = 97o --47// Sales Representative Proposal Ref # Acce • ted b Ed • H ditioning, Inc. rilopw Authorized Man:. - s. A deposit payment in the amount of L must be made when the gistiomer accepts this proposal. Payment fo the remaining balance of le 4 3) 7Z .00 will ho made with a credit ?Li or by: card # COD - Payment upon Completion vn rlatc Financing applied for with (Proposal Subject to credit approval) Edd Helms Air Conditioning is authorized to perform the above work and services at the prices and terms specified herein. Customer agrees to pay all legal fees, court costs, or other collection expenses should legal action be taken for nonpayment. It is agreed that all equipment and materials required to complete the work or services described above shall remain the property of dd Helms A Cond' Toning until full pae, of total ®ount due is �a // AukhO L & Acce . ted By: ure, Title & Date Customers Signature & Date of Acceptance NOTE - ANY EXISTING BUILDING CODE VIOLATIONS ARE NOT THE RESPONSIBILITY OF EDD HELMS.