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MC-11-761Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 161103 Scheduled Inspection Date: June 20, 2011 Inspector: Perez, JanPierre Owner: SANCHEZ, LESLIE Job Address: 480 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ACV2 AIR CONDITIONING CORP Permit Number: MC -5 -11 -761 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060190020 Phone: (305)557 -9041 Building Department Comments REPLACE DUCT AND REPLACE NC SPLIT SYSTEM ‘24 Passed 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- 158973. need 35 amp time delay fuses, seal collars with mastic jpp June 17, 2011 For Inspections please call: (305)762 -4949 Page 22 of 30 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. PC--) 11 k'oJ Master Permit No. BUILDING PERMIT APPLICATION FBC 20 a Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) LEA LF GAN Phone # Owner's Address °itF1' I/ 11 City MIAMI shnar,G state Tenant/Lessee Name Email So 1 1.►/A olel,rn�r�- �,hisv+ (a�Meii 1Csv✓V, Job Address (where the work is being done) mac% Zip '3 I ?afb Phone # City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name M !') 2 A £ d94 r) ibiaid '� Contractor's Address (9O/ Av a) /3z f' City /4`t ./t /P c Qualifier Name ,D <S,02- e Phone # :3 OS- Flood Zone 5-0 -ifc/3 State Zip / Sr C Phone # State Certificate or , egistration No. C . /431-5"05,5— Certificate of Competency No. Contact Phone me .S5 /l Y E -mail /P.I' oc?' ate Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ G—, S 0 0 Type of Work: ❑ Additionn ❑Alteration Describe Work: > / /mac Square / Linear Footage Of Work: DNew 1 Repair/Replace ❑ Demolition 3 -row ********** ******* ************* **** * * ** *F:/_ x�**** *** * * *�x�x� * *** * * * **** *** * * *** *** *� *** Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side 5 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City f 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 abs• >nce o such posted notice, the inspection will not be approved and a reinspection fee will be charged. ' / Signature\ Owner or Agent The foregoing instrument was acknowledged before me this day of '7? , 20 // , by who NOTARY PUBLIC: me or who has produced s identification and who did take an oath. My Commission Expires: ************* ***** **** ***** ******* ********** * APPLICATION APPROVED BY (Revised 07/10/07) Contractor e foregoing ins 1 . ment was acknowledged before me this day of ,2"7 ,20 / /,byJ r 2 , who is p sonally kno me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: 'A Print: iF My Commission Ex ° 1a Notary Public State of Florida T; Yinet Marrero c` My Commission DD700719 f ddt Expires 07/31/2011 ?k * * ** .................................................... $ i s Examiner Engineer Zoning 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): 49,0 Nf," City: _Miami Shores Village County: Miami Dade Zip Code: S S' 2 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 ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT , .7 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 / / EER/SEER , YES NO REPLACING DUCTS (YES NO YES NO REPLACING THERMOSTAT S NO YES NO NEW 4 "CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. *y° 3. Voltage of Circuit (208/240/480): 2 SC vok l 4. Size Disconnecting Means: ,4144 Contractor's Company Name: t/g- ✓ "iiL o of i. /1`7%x, State Certificate or Registration N tfs / 0/3' S—Certificate of Competency N. ,�`iri° Maximum Overcurrent Protection (Fuse /Breaker Size): oy0 Signatur nature only) Phone: ss-Se rr�� ALEX SINK CHIEF FINANCIAL OPPICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COIWISSATION LAW * 4r CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE 07/23/2010 EXPIRATION DATE: 07/2212012 PERSON: ACEVEDO JORGE L FEIN: 204328933 BUSINESS NAME AND ADDRESS: ACV2 AIR CONDITZONINO CORP 001 NV 132 PLACE MIAMI FL 33182 SCOPES OF BUS INESS OR TRADE: 1- CERTIFIED AC CONTRACTOR IMPORTANT: Pornt to Chapter 440 . 05414}, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of eleetioa under thIs section may not recover benefits or compensation ander this chapter. Pursuant to tempter 440.06(12), F.S.. Certificates of etection to be exempt.. apply only within the ape of the business or trade listed an the entice of election to be exempt Pursuant to Chapter 440.05 (13), F.S. , Notices of election to he exempt and cert0iates at election to be exempt shall be subject to revoeaton I1 at any time after the tiling of to aota er the fssance at the certificate, the person named on the nonce or certificate no longer meets the requirements of this section for isn ot* of a certificate. Tie department shall revoke a certificate at any time for failure of the person named an the certificate to meet the requirements of this section. QUESTIONS? 0850) 418 -1009 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 ACV 2 Air Conditioning MO I) k' 1 901 NW 132 Pl. Miami, Florida 33182 Phone & Fax: 305 -557 -9041 Cell: 305-586-1143 CAC1815085 sut)nnil ect .t.0 PROPOSAL Job Info: Residential Commercial - Indastrial- 1M Al MAY P 2111 Date: 05 -04 -2011 Name Acv -2 Air Conditioning Nante Leslie Sanchez Street Address 941 NW 132 PL Street Address 480 NE 91 ST City, State, Zip Miami, FL 33182 City, State, Zip Miami Shore, FL Phone No. 305 586 -1 143 Phone No. - We hereby submit specifications and estimates for: Includes: 1- Replacement of 1 Rheem 3 ton 14 seer A/C unit 2- Repair/Replace duct work Note: No electrical work, no braking, no panting, no patching and What is not read or write in this proposal is not including in this price. We propose hereby to furnish material and labor — complete in accordance with above specifications, for the sum o£ ($ 3,000 ) Payment to be made as follows: 50% at sign contract, and 50% upon job completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra cots will be executed only upon written orders, and will become an extra charge overall(' 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 Workmen's c`ns—oa Insurance. Authorized Signature 'V'V Note: This proposal may be withdrawn by us if not accepted within 30 days. Acceptance of Proposal — 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. - Date of Acceptance: cis • D • 2011 Signature Nov.30. 2010 4:I /PM No. 9351 1'. 1/1 CERTIFICATE OF LIABILITY INSURANCE I `n`+ 10 THIS CI ICATE E SAS A MATTER OF GPORDIATIONINCY A1D3 COWERS WI PRINTS tWOPl TM CERTMATE MAR. MS CERTIFICATE DOES tor A IAT1V8X MIKVATWELY AK wee R ALTER THE CIWERAOS AFFORDED WIVE POLICIES RELO . THE CERTWICATE OP SISURANCE DOES IQT C TmITE AC NTICACT PETWEIN TIE BUM stumeate, AUDICOSZED REPRESENTATIVE OR P1W011019t, Ns,TIE CERTGIVIATE Imo. IMPORTANT: If the catitIcate Na is an MRATIONAL RASUIMM, the policyPeo) must be endorsed. If MISROOMMMI ISWAWA sotto Cheterm? and ons Mike policy, cadoM poUcles may A antenna onto tenniente does ma confer I tote ceiBiceue Wider in goo ofs Poommist E* Ua 1nsu anq►#12D 2032 NW 17th Avenue Mland, FL 33142 Pholte (3R5j391.1155 fiiSURED ACV -2 AIR CONpIONING CORP 412 SW 122 MIAMI FL 33184 Fax UVICT ESTREW4 U4URANSE vuene (3y 32S1155- offortilOw toes =MEM MOMS =WOE imam A: SEPJ HMARK INSURANCE CONFANY fie: tee: Mum 11: MOOR F COVERAGES CERTIFICATE DO 15 TOMMY THAT THE moms ctit niaMANce LIMED BMW Mt Ent ISSUM TO THE MUM) ) WASOAROVE FOR DE POLCY PERIOD I N D O A T E O . NOTINTRISTANINNO A N Y RalUIRENENT, m N GooNATION OfANYCoprr CT OROTiItoO z /41110N REOPECT TO WHIM MS CERTMATE MAY /E 3UtAYPIRTA#I,TIERatIRANCE MOWED STINE POISSES INISCRIBED MENG SURGCT To AU. TlETEEM, EXCLUSIONS Ate COMM= ay alai MU teeTS MOM PAYNAVE OM ►9Y PRO 1111"-- Ma ORSURPOICO OBVIERAL Uskaa. Y RI COMM& Ca LY ElOcinwsninzpoccun ❑ A GiNt /101361MINE U W APPLES PEW ❑ paimf ❑ O LL Amounts! ifikOVIM ❑ ANYAUVO ❑ ALL MOM *MS 0 smaanze ems ❑ mom= ❑ nouowevm,emes ❑ weiminAuRs ❑ 0 men Ms ❑ CUOOSMAte ❑ MEM= s AND MIPLOTERS LAST ANY panOThigyin a OF OPEROCNO Tr Kt X10 09107/2011 OESCRUITV2N OF opERATIONotuiCiMa PO IMO numb MEOW Vemorespase is r CERwICATO HOWER Miami Shores Village Building Department _1.0050 N.E 2nd Avenue Miami Shores, Florida 33138 1 ACORD 25 Cr CA(ITTON tams OMB MY OFIMAMS DESCRIMOI POLICIES BE MORE EXPERAZON DRTEDSION, MUMWU. BE oEuvimen is rtt MIS POLICY AMORIZED ACM '" Ali *Oft mania. Ttm ACORD mine and logo are narks of ACORD • • • 10 1.1t) 6 AO 10, lutt 4 100 frsL1, A/ coors 1-e) f56 fe.arteev-iac), WNW elq Sni■Je . 4 :10 ---rang x4 ,005 • 77,1 ,11,W)A tglAy 10 6 2011 Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL TN:rx 'D LES AND REGULATIONS Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Job Name Date MECHANICAL CRITIQUE SHEET ) vu2,27fL