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MC-11-830Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 160468 Scheduled Inspection Date: June 06, 2011 Inspector: Perez, JanPierre Owner: JOHNSON, MICHAEL Job Address: 445 NE 94 Street Miami Shores, FL Project <NONE> Contractor: 24 HR AIR SERVICE INC Permit Number: MC -5 -11 -830 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060140520 Phone: (305)653 -5858 Building Department Comments REPLACE 4 TON AC UNIT `l Passed Q Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 159507. no one home 3.30 jpp June 03, 2011 For Inspections please call: (305)762 -4949 Page 20 of 26 Miami Shores Village Building Department /0050 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) Permit No. Master Permit No. Owner's A dress �� City l .eA State Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) 4-4/S---- M ff 94 2: l City Miami Shores Village County Miami -Dade Zip -3 3/3 FOLIO /PARCEL# //— 3y®6 —0/V--®5z0 Is Building Historically Designated YES NO Contractor's Company Name ®?(.( Contractor's ddress _ - 0 6- City Qualifier Name State Certif, ate o Registration No. E -MAIL: � (''gt-c r AV Agernlyr Phone # 3 of Zip X17 9° Architect/Engineer's Name (if applicably / Value of Work For this Permit $ Phone 61j-3 -j g ertificate of Competency No. Phone # Square / Linear Footage Of Work: Type of Work: ❑ ddition ['Alteration ❑New Describe Work: �p � 17 / Repair/Replace L] Demolition ****** * * * * * * * * * * * *k* * * * * * * * * * * * * * * * ** *F, Ms*f **+'t****** ***� *** �4 *** *o4�k*** *** *�ir9r�k**1****** Submittal Fee $ rJV Permit Fee $ �/� CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Q _ Structural Review. $ Total Fee Now Due $ Zoning $ 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. 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 donee 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 O TAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2.00, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be livered to the person whose property is subject to attachment. Also, a cert ified copy of the recorded notice of commencement must b posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of s ch posted notice, the inspection will not be approved and a reinspection fee will be charged Owner or Agent The foregoing instrument was acknowledged before me this 9, day off - t4rui) , 20 A, by J\- 6-tiarwOU C.�L ► t ,L who is personally known to me or who has produced —{ j) As identification and v�tkglddid,�n oath. NOTARY PUBLIC: ���\ NOI N ® %���' %� / I G!rfs9lpy G/ Sign: _ IiI d —s Print: J m CO . d0cv90 ,','4'. . My Commission Expires: '�, is :...X3 0 ,•. itlll111111111\% APPLICATION APPROVED BY: (Revised 02/08/06) Signature Contractor The foregoing instrument was acknowled day of who perso -, kno % to s - o w before me this 20/1 , by fh1/CP( /d / NOTARY PUBLIC: Sign: Print: My Commission Expires:...)U,V Plans Examiner Engineer Zoning 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. ,� / Q Job Address (where the work is being done): 41/5 Jc 15-- City: Miami Shores Village County: Miami Dade Zip Code: 5/3 8 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 n NO ❑ ARHI Sheet Attached: YES n NO ❑ Contract Attached: YES ❑ UNIT REIN REPLACED DATA NEW U IT MANUFACTURER "J // .8 - ,7 LIT' //Z AHU or PKG. UNIT MODEL # i A. . m 1B25J74 /e, KW HEAT NOM TONS fU AHU CU PKG 1) M.C.A AHU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EERISEER /6 YES NO ✓ REPLACING DUCTS YES NO ✓ YES NO ;% REPLACING THERMOSTAT YES NO YES ✓ NO c NEW 4 "CONCRETE SLAB YES ✓ NO YES NO✓r- YES NO -✓/ NEW ROOF STAND YES NO �✓ NEW RETURN PLENUM BOX YES NO 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: 40 A..e/ Phone: O— State Certificate or Registration N. Cj (t9/0 37 Certificate of Competency N. Signature J1444--) Date: % (Qualifier's signature only) This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. Certifi:ate AHRI Certified Reference Number: 3799429 Date: 5/9/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 Manufacturer: RHEEM MANUFACTURING COMPANY Trade /Brand name: RHEEM 14AJM SERIES Manufacturer responsible for the rating of this system combination is RHEEM MANUFACTURING COMPANY Rated as follows in accordance with AHRI Standard 210/240 -2008 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): 13.00 SEER Rating (Cooling): 16.00 • Ratings followed by an asterisk (•) indicate a voluntary rerate of pre tously 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 product(s) listed on this Certificate. AHRI expressly disclaims an 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 listed in the directory at wwwahridirectory.org. TERMS AND CONDITIONS This Certfcate and its contents are proprietary products ofAHRL 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 Information for the model cited on this certificate can be verified at wwwahridirectory arg, 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 Cer iflcate No., which is listed below. Air - Conditioning, Heating, and Refrigeration Institute ©2011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129494361057682040 1 05/09/2011 13:32 ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER Mat ITIOUTBrne Agency, Inc 1216 E. Atlantic Blvd., Suite 2 Pompano Beach, FL 33060 Tel 354 (954) 830.0376 NEAIRED 24 HR AIR SERVICE INC. 20725 NE 16TH AVE, SUITE A21 MIAMI, FL 33179 3054534858 COVERAGES 16385 P.001/001 osfeerani THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS (NOON THE CERTIFCATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE HIS[R ERR CAPACITY INS. CO: Hamm Et BUSINESS FIRST DURANCE CO. INSURER C: NAIC 0 11,NsLITIER 0: 1 INSURER E THE POLICIES OF INSURANCE USrE3 BELOW HAVE BEEN ISM TO THE INSURED NAMED ABOVE FOR THE INDUCT FFRtOD RNDICATED. NOTWITH rAN ANY REQUIREMENT. TERM OR CON MONN OF ANY CONTRACT OR OTHER DOCUMOsrr WITH RESPECT' TO WHICH Ttus ATE MAY BE ISSiB OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES GI BED HERON 18 SUBJECT TO ALL THE TERMS. ECLuSIONS AND CONDMONS OF SUCH POLOAGGREGATE LIMTS SHOWN MAY HAVE BEEN stmecEn BYPAID (9.AIs UISTS ORALLUeurY POLICYNtRIBER POUCY CIATF DA W V M � EACH Col AL GENERAL pARIUTy CL9101001282A 04114/2011 04/14/2012 Daa meErd s 1000,440 100,000 CLANS max X J LUDEXP caw anepmt SS, Gm-AGGREGATE LIMITAPRA& PER: X POLICY ri PAS ri LOC AUTOMOBILE MISERY ANY AUTO ALL OWNED AUnDS SCHEDULED AUTOS HIRED AUTTOS NON wNED ALTTOS CAWS LIABILITY ANY AUTO LYABILN Y OCCUR 3 _ ! CLAD MADE DELIUCTIELE RETHfnON 3 COMPBSSA'ODR Aew t3IFLOMM. UABtUTY ANY PROP RIETOR/PARTTNERtpECUTIVE MIAttUtrilse groper PRO/MONS Woe, MI ER PERSONAL SADV IN.RJRV S170001000 OSNERAL AGGREGATE $ 21000.000 FRac I rs- cos/+Asa $ 1,000,000 CONEUNE0 UNCLE MIT S SUDSY HUM (Per man) a BODILY INJURY wersetidot $ FROPiMDAMAGE E AUTO ONLY- EA ACCIDENT S OTHER THAN AUTO ONLY EA ACC S ACC S EACH occuRRENCE s $ 521-03217 07/20120/0 07011 OPEiAT rLOCAT rVE / EuXtemossAnsetonyBmorspEDIALmssesces INSTALLS AIR CONDITIONERS CERTIFICATE HOLDER rirava143- $ $ t:AGnACc Dr3ir s'E 000,040 EL DisEA$E -EA E+I PLOYS s 1,000,000 F-Lol -PousY war s 1,000,000 CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPT FAX: 305 -756 -8972 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 25 (2 001188) sHOULDANYOFTHEARDYEESSECRMEopmemBECANCELLEDespoRETNEIDIRRADas DATE THEREOF, WE MOO INSURER WILL i R TO Me. 30 Am wrantu UCTI ETOTHE CErtivstscig I NumTDTHE LEFT. WMFAILUREmsDOSOSwat MPG= NO OUUGAIESU on Ltaa riY OF ANY Km PPM -�= EIS A Dris OR OACORD CORPORATION 1988 24 HR AIR SERVICE INC. LIC # CAC1814637 Finail:24hrairsvc @bellsouth.net Website:24HourAirService.com Dade/Broward: 305 - 653 - 5858/754 -422 -2036 Stuart/Port St. Lucie: 772 - 336 -6090 Orlando 407 - 240 -3300 Toll Free: 877 - 753 -5858 Fax: 305 - 653 -5857 Toll Free: 877 - 753 -5858 Fax: 305 -653 -5857 Toll Free: 877 - 753 -5858 Fax: 407 - 240 -3990 197 Drennen Rd, Ste. 417, Orlando, FL. 32806 20725 NE 16th Ave., Ste. A21, Miami FL. 33179 660 NE Ocean Blvd, Stuart, FL. 34996 Quotation Date Estimate # P.O. No. 5/8/2011 11436 Name / Address Project Darren Ockert /Aary+ kg) b 0 Ott 1I 445 N.E. 94trh Street Miami Shores, FL. 33138 445 N.E. 94trh Street 4 Miami Shores, FL. 33138 Description Qty Cost Total WE ARE PLEASED TO PROVIDE THIS AND APPROVAL ON THE FOLLOWING: TO SUPPLY AND INSTALL (1) 4 TON EFFICIENCY SPLIT AIR HANDLER #14AJM49A01 & RHLLHM4821JA, FREE THERMOSTAT, R410A REFRIGERANT, CONCRETE SLAB, PERMIT FEE, MATERIALS, EXISTING DUCTWORK AND CONNECTIONS, ELECTRICAL, FLUSH REFRIGERANT REMOVAL OF EXISTING UNIT, START ( ** *THIS UNIT QUALIFIES FOR $300.00 RHEEM 4 TON - 16 S.E.E.R - FPL REBATE PAID TO 24 HR AIR SERVICE TOTAL PAID BY CUSTOMER - WARRANTY INCLUDES: 10 YEARS YEAR LABOR TERMS & CONDITIONS: 75% Deposit upon completion of Installation includes what is described & specified Date of Submittal. 24 Hr. Air Service is Repairs and/or any Existing Code Violations. OSIOi ) -lot ESTIMATE FOR YOUR REVIEW (16) S.E.E.R, RHEEM HIGH AND CONDENSING UNIT, MODEL DIGITAL PROGRAMMABLE (2) FLOAT SWITCHES, NEW LABOR, RECONNECT TO RECONNECT TO EXISTING LINES AND DRAIN LINES, UP AND TEST SYSTEMS. FEDERAL TAX CREDIT * * *) $4,846.34 ($ 780.00) $4,066.34 COMPRESSOR, 10 YEAR PARTS, 1 and 25% Due after Inspection, above. Proposal is valid 30 days from the not responsible for: any Ceiling or other 4,066.34 4,066.34 Date Acce to By C1 Authorized Signature Our superior service is unmatched, thanks to our dedication! Total $4,066.34