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MC-11-1079Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 160929 Permit Number: MC -6 -11 -1079 Scheduled Inspection Date: June 28, 2011 Inspector: Perez, JanPierre Owner: STEIN, JAY Job Address: 1700 NE 105 Street 402 Miami Shores, FL Project: <NONE> Contractor: PENGUIN AIR CONDITIONING CORP Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1122300500590 Phone: (305)893 -3055 Building Department Comments REPLACE EXISTING 1 1/2 TON PACKAGE UNIT (WATER COOLED) l I Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 27, 2011 For Inspections please call: (305)762 -4949 Page 13 of 15 06/14/2011 10:20 3057516148 JAY STEIN MD PA JAN 27• -1900 08 ;10 • i=aoa N,e, men. meter L Im a :•Ma om omMut. t LO st14. t Jima 14, 2011 JAY O. STEIN, lu{_D., PA yr mare. mM1EWUa moms op otetwoPAED+e stmama C - 1 079 PAGE 02/02 P.01 111.12r!toivE MOM P41.24s0 To Whom It May Concern: I Jay Stehi MD, give Penguin Mr permission to install AC unit in our apartment amber 402 at The Shores Co ium located at 1700Northeast 105th Street in Miami Shams. We also have the signature of the Association from the apartment allowing Penguin Air to go into building to do the change. Lucretia Payton Condo Association TOTAL P.01 4 ,10( 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 Permit No. N/r,,, 1)- 10-9 Master Permit No. 'BUILDING PERMIT APPLCATION IBC 20 Permit Type: MECHANICAL JUN )II 1 Owner's Name ( Fee Simple Titleholder � Phone # '%� 5' 75 1 ° ;RTC owner's Address d 7 G k I. City 1 &j'Y d sy) 6'`e State Zip :' ',`Tenant/Lessee Name Phone # Email Job Address (where the work is being done) City Miami Shores Village OLIO / PARCEL # s Building Historically Designated YES NO Flood Zone 1 00 NF, 1 o5 County Miami -Dade Zip Contractor's Company Name J t I 1 ,:)y , I; / I ?i u `, Phone # , �. 0 S- Contr�actlor's Address 197,3 kit I LI 7'' �/ fit ` - ∎∎ ,b I State (Qualifier Name j Zip 3 S' i Phone # (State Certificate or Registration No. Contact Phone C1- `,t) - 4 0s-6- E -mail Certificate of Competency '(3 Ibkrchitect/Engineer's Name (if applicable) Phone # 409 6) Value of Work For this Permi $ g / Square / Linear Footage Of Work: Type of Work: ❑Addition ['Alteration / New Repair/Replace ❑Demolition Describe Work: o ? � � tip 117_ 2 � ! :i� - - L i � d (L( + ' I ; 'L * * * * * * * * * * * * ** Submittal Fee $ Notary $ Scanning $ Double Fee $ * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ Training/Education Fee $ CCF $ CO /CC $ Technology Fee $ adon $ DPBR $ Bond $ Structural Review. $ Violation date: Total Fee Now Due $ See Reverse side 4 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first in ection which, ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wil of be approv 'd /and a reinspection fee will be charged. Signature The for omg instrument was acknowledged before m e this / i day oft) ,20 /(,byJ 5 W wner or Agent -227,3 Oignature ,R Contractor The foregoing instrument was acknowledged before me this day of aUN , 20 ®t , by 6-4l /.f c who is personally known to me or who has produced who is personally known to m ■s mm Y III YYYYYYYIIaIYYUYYn ;;7 /21�j4 _ C rp As identification ark wYio B': ' f$£FtAN f /(=- "4 /" as identi NOTARY PUBLIC: ; v i`"�'°�•f Comm# DD0793013 `:° i " Expires 6/8/2012 piOTARY PUBLIC: p4,,4` Florida Notary Assn Inc Sign. Print My Commission Expires: (0 — 2-®(Z or ryas producet1 o4pay °oa'o, PAUL JOHN SMAILIS Sttttiof Florida use? My Comm. Expires Jan 5, 2014 ?� °� Commission # DD 950222 An" Sign: �✓ Print: �v� ' / (_f My Commission Expires: /— — / y *** * * * ** * * * * * * * * ** * * * * * * * * * * * * * ** lk * * * ** ************************************ :* ** * * * * * * * * * * * * * * * * * * * * * * * * * ** 615* 1l APPROVED BY Plans Examiner Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Clerk checked 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): 17 GC) Aid-,_ d 05 4:-h Si City: Miami Shores Village County: Miami Dade Zip Code: 5;31 5? 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. [0 UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER PIP AHU °M . UNIT MODEL # t(2, 0 ' S COND. UNIT MODEL # KW HEAT 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 / I EER/SEER _" _ YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YES O) YES NO NEW 4 °CONCRETE SLAB YES Oe YES NO NEW ROOF STAND YES r YES NO NEW RETURN PLENUM BOX YES L9. 1. Minimum Circuit Ampacity (Wire Size): 1 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Mean Contractor's Company Name rk , p,1,iri R.. Hrkii4 I 0vi1: j / (O/2 -z-) Phone: J ©S -5 `l3 —90 5-6-- 0 a� _ State Certificate or Registration N. ��� Certificate of Competency N.� C.G�1�1�1� �.i C�� -� � � �� Date: ' 'l (�i t � Signatures (Quail er's signature only) SPECIFICATION DATA SHEET ECM 8 PACKAGED UNITS L tri 'Ilarsi7r4k2Ow-T-- ELECTRICAL SPECIFICATIONS Electrical Elect. Compressor trt#Tt: swrglkt-,0 Blower MECHANICAL SPECIFICATIONS Loop Pump 1 Min. I Max, Circuit Fusel BLOWER PERFORMANCE Available External Static Pressure (Inches of Water, Gauge. Wet Ca and Filter included) 1 Speed 5,9 2.5 3.0 8.2 3.5 , .,v:, ^ , •,- ,1W. W{A F.W.,,T4‘,1, W8/230- -60 - 5.4 48.0 1.8 14 - • 12. 20 265-1-60 r -2 7.1 44.0 1.6 114 • - 10.5 15 570 630 515 • - - .. - - Lo L___ll - 510 - - - - .., . - - -1-D=E_I-- BLOWER PERFORMANCE Available External Static Pressure (Inches of Water, Gauge. Wet Ca and Filter included) 1 Speed 5,9 2.5 3.0 8.2 3.5 4.0 13,7 5.9 4.5 DAY 17.0 Zu.o 7.3 6.9 14.49 High 770 700 680 650 610 570 530 515 • - - M adiUM 670 650 615 570 630 515 • - - .. - - Lo 560 520 510 - - - - .., . - - ISO 13256-1 CERTIFIED PERFORMANCE DATA Rated at 650 CFM and 5.0 GPM Water Loop Ground Water Cooling Heating Cooling Heatin. Cooling Heatin CaDaoltvi EER Capacityl COP Caoacitvl EER , -neat( COP EER Cape COP 10,VOU ,U 24ipu 4,4 .t,4tfu t 19.0 i 143,t,F00 1 3.8 19,800 1 14.1 1 13,400 1 3.3 I Ane..o5; ,nnog.• c:011F1 ewe= n r Refrigerant: R-410A Air Coil Feet Deep O.D. Inch Water Coil Coaxial 450 psig Blower Size 9x7 DD Net Weight Compr Type Reclproc:ating Ship Weight FLUID PRESSURE DROP Ground Loop (Ext. Range Required) CAPACITY DATA All performance at 650 CFM and 5.0 GPM COOLING EFT Rwige (StItUlard) err PtRrig9 It8nge Q") detr to 100eF 45* to 11frf Fluid Temp. (°F) 50° 70° 85° Air Total Sensible to Power Temp. Capacity Capacity Total Input (°F) (MBtuH) (MBtuH) Ratio (kW) 18.96 12.35 0.65 1,06 # MIS 61*wb 100° ;no 80° 75t1b 70° 63°wb 85° 100° Vr.t,iki t 14.11 17,21 11.44 0.66 of Reject (MBtuH) EER .58 17.9 1.29 21.61 13.3 15.90 10.85 14.59 911 19 19.38 18.45 10,30 i3 77 14.21 13.70 17.05 12.99 0.68 1.46 0.71 1.63 fl 7'l fri 0.73 1.18 0.74 1,30 0.78 1.47 20.89 10.9 20.17 8.9 7Q 'ion 23.42 16.4 22.88 14.2 22.06 11,6 15.84 12.34 0.79 1.64 21,25 9.5 60° 70° 85° 100° 60° 700 700 85° 80°4h 67°wb 21.28 15.70 20.26 15.13 18.72 14.35 17.18 13,63 ,40 ii,jb 0.74 1.19 25.35 17,9 0.75 1.31 24,72 15.5 0.77 1.48 23.78 12.6 0.79 1.66 22.83 10.4 0.14 1.0 85°db 23.18 17.20 0.74 1.20 27.28 19.3 71°wb 22.06 16.58 0.75 1.32 28.56 16.7' 20.39 15,73 0.77 1.49 25.49 13.7 Aftr, 40 70 44 CIA A 011 4 0, rss Art 4.1 51 erg n fAete Pftga containing omen:wear. reverdno meaty tee tnetenna devise, end hest exchenews. Alto inclurkwi are Way controls: Melted oretection for =torn. NO end law retterent memo mediae end e ittelt-etit wait. Seteneed range option hviodeF vdmmian onlvo anderffig dFlAca, In:N*11d *TOR adi and laNd 0a12 lack.mut csediplt Portennanco based ea ARVISO woof owe Auld tow and voltage. F41'011,1100 other than ratod coneult the MP RAP ezinsitnn nnavinon fl.a En v.14.16nota I. :ow...4.n .4.1.1..Ida. aaa -.L- AI 21000 000r00E00 (Mere, and dowdeomont seeodoedene ere edged to change without mita MOMS Rov. 014F HEATING EsPjFittnevatmtard) Fluid Temp. (°F) 50° okr Air Temp. (°F) 70° 80° 50° ann 70° 80° 50° 60° Jo 60° Flu Flow Pressure Drop 2.5 5,9 2.5 3.0 8.2 3.5 4.0 13,7 5.9 4.5 DAY 17.0 Zu.o 7.3 6.9 EFT Refer feat Ranee OPt4an) 25* tel Total Power Capacity Input (MBtuH) (kW) 19,75 1.44 25.75 .66 of Abe. (MBIUH) COP 14.84 4.0 20.08 4.5 28.75 1.77 22.70 4.8 18.67 1,46 13.68 3.7 oi 41 1 Fet 1Ft 11 A ti 24.34 1.69 18.58 4.2 27.18 1.80 21.02 4.4 17.42 1.49 12.32 3.4 20.06 1,61 14.56 3,6 25.33 1.84 19.05 4.0 LOW TEMP HEATING ,30‘ 40° 25° 30° 700 12 01 13.46 16.42 11.36 12.75 extended Range Owen Required Antifreeze Required 1 16 1 05 :rn 1.21 9.33 3.3 1,a3 1.18 1.24 11.89 7,34 8.53 3.6 2.8 3.0 25° 80° 10.60 1.20 6.49 2.8 30° 11.90 1.26 7.59 2.8 40° 14.49 1.38 9.76 3.1 FHP MANUFACTURING COMPANY OV1 N.W. taDtrt tarattU - OR L-aucieruale, L Phone: (954) 775-5471 - Fax: (800) 776-5529 http://www.fhp-mfg.com STATE CC #CA- CO25435 COUNTY CC #11051 COOLING - HEATING ENERGY / SPECIALIST IPen9uin Air Conditioning, Inc. Irop0$0.L & ZtCCepta me 305 - 893 -9055 14230 West Dixie Highway North Miami, FL 33161 Fax: 305 - 893 -9058 PJ.I•GHASER �� � - DATE DATE START -UP ARCHITEC P.O. # STREET 110C.) iiuE 166 40- 1 01,--ffi PHO E a s-0 BILLING OR TENANT INFORMATION WORK PHONE CELL FAX - 00 -Sa- Curb CITY, STATE AND ZIP ODE i'lsliCki0?s, FA .i3 AIR CONDITIONING AND HEATING EQUIPMENT: ❑ New Installation ❑ Replacement ❑ Repairs EQUIPMENT QTY. TONS SEASONAL S.E.E.R. MAKE MODEL # SERIAL # PACKAGE UNIT 1 1 a i ':' 0 ���������� -�/�p 'elsvig —� tl,-vJ- CONDENSING UNITS AIR HANDLER HEATERS K.W. Installation of equipment Drain System Refrigerant piping 5 minute lime Delay Relay Install ducts outlets and returns Structural supports for equipment Auxiliary drain pan Crane Service Copper coils Other Other COMMENTS THIS PROPOSAL INCLUDES YES ❑ 0 0 ❑ 0 0 0 0 ❑ YES Thermostat wiring I� Power wiring from panel to equipment ❑ Thermostat installation ❑ Cool 0 Heat ❑ Cutting patching holes for pipes, ducts, etc ❑ Duct transition ❑ Connections to existing system Pitch pans end or roof supports - ❑ Start up and balancing equipment Slab or lintels ❑ 1 yr. Guaranty on Parts & Labor ❑ 0 yr. Manufacturer's Warranty on Compressor PAY NT TO BE MADE AS FOLLOWS: /� py/. 1.l Upon Acceptance $ c( �V V 2. ❑ Delivery of Equipment 3. ❑ Other $ 4. ❑ Upon Completion $ $ TOTAL $ All material is guaranteed to be as specified. All work Is to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications 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 Worker's Compensation insurance. Standard Service Hours: 9:00 A.M. to 5:00 P.M. Monday through Friday. Authorized Signature Date (D Note: This proposal may be withdrawn by us if not accepted within I days. cAtceptante of Propo9at - The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: Please sign and return top copy with check. Any changes from above agreement, resulting in additional labor or material, will result in and additional charge agreed upon by both parties. Signature Client#: 10606 PENAI ACORD. CERTIFICATE OF LIABILITY INSURANCE " Q �;;YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. t CONFERS NO RIGHTS UPON THE CERTIFICATE OR ALTER THE COVERAGE AFFORDED BY THE CONTRACT BETWEEN THE ISSUING INSURER(S), must be endorsed. If SUBROGATION IS WAIVED, A statement on this certificate does not HOLDER. THIS POLICIES AUTHORIZED subject to . confer rights to the IMPORTANT: in he certl i ate holder Is an ADDITIONAL INSURED, the policy(ies) the terms and conditions of the policy, certain policies may require an endorsement. certificate holder In lieu of such endorsement(s). ., PRODUCER Advanced Insurance Underwriters 3250 N. 29th Ave Hollywood, FL 33020 - CONTACT PHON' ): (A/ , No): E AIIto, ADDUCE' PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Penguin Air Conditioning Corp. 14230 West Dixie Highway North Miami, FL 33161 nnaacfAi.re` -- --•-- - - - - - -- INSURER A: Granada Insurance Company INSURER e , Florida Citrus Business & Ind. 01/08/2011 Phoenix insurance Company INSURER C : R Y EACH OCCURRENCE INSURER D : INSURER E : AMAGE TO PREMISES (EaEoccurrence) INSURER F : CLAIMS -MADE • THIS INDICATED. CERTIFICATE EXCLUSIONS )NSR - - - --- - ra& V 101VI11 IYVIYlocIs; IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCR BED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR A 1 TYPE OF INSURANCE ADDL. INSR BUBR INVD POLICY NUMBER POLICY EFF (MM!DD!YYYY) POLICY EXP (MM/DD/YYYYI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 0185FL000056 01/08/2011 01/08/2012 EACH OCCURRENCE $1,000,000 $50,000 X AMAGE TO PREMISES (EaEoccurrence) CLAIMS -MADE X OCCUR MED EXP (Any one person) $1,000 X PD Ded:500 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 O- POLICY JET LOC C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car BA2002N83811 SEL 02/17/2011 02/17/2012 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 $ ` X BODILY INJURY (Per person) BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X $ X $ UMBRELLA UAB EXCESS LIAB I OCCUR CLAIMS -MADE EACH OCCURRENCE $ I JI AGGREGATE $ DEDUCTIBLE RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS YIN N/A 10636517 04/01 /2011 04/01 /2012 X WC STATU- I I GM - TORY LIMITS ER ER EL EACH ACCIDENT $1 00,000 below E.L. DISEASE - EA EMPLOYEE $100,000 E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS! LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CANCELLATION Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR/ZED REPRESENTATIVE 01988 -2009 AC ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S741279/M734672 RD CORPORATION. All rights reserved. JOM