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MC-11-1329Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 162398 Permit Number: MC -7 -11 -1329 Scheduled Inspection Date: August 03, 2011 Inspector: Perez, JanPierre Owner: WALTER, TERRELL Job Address: 125 NE 107 Street Miami Shores, FL Project: <NONE> Contractor: RESIDENTIAL AIR CONDITIONING CORP Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1121360070270 Phone: 305 -652 -6040 Building Department Comments REPLACE EXISTING 3 TON AC UNIT 4.5 KW Q-B Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 02, 2011 For Inspections please call: (305)762 -4949 Page 36 of 47 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number APPROV Expiration: 0122/2012 Applicant 125 NE 107 Street Miami Shores, FL 1121360070270 Block: Lot: TERRELL WALTER Owner information Address Phone Cell TERRELL WALTER 125 NE 107 ST MIAMI SHORES FL 33161 -7031 Contractor(s) Phone Cell Phone RESIDENTIAL AIR CONDITIONING CO 305 - 652 -6040 (954)764 -0489 Valuation: Total Sq Feet: $ 4,187.00 0 1 Tons: 3 Additional Info: A/H & COND UNIT REPLACEMENT Classification: Residential Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: MECHANICAL Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.20 $2.20 $1.00 $146.55 83.00 $4.00 $161.95 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -7 -11 -41536 07/27/2011 Check #: 9538 $ 111.95 $ 50.00 07/22/2011 Check #: 9534 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 1 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. July 27, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date July 27, 2011 1 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) O is Address / .i� )i 6 City/4 // /t`1/' V/6"Lar State Tenant/Lessee Nam Email JUL 2 2 2011 -at) Permit No. t'C, - 11-132-9. Master Permit No. - Lt FL,- �O', : ", one # it'J `7 -�vi�i /0d�° 2 � Zip 3 3/0/ Name Phone # Job Address (where the work is being done) City Miami Shores Village County Mituni -Dade Zip •? 3/4 i FOLIO / PARCEL # // a/ 3 ®e 'BOA 2e7 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name ,I CS it /,4- . /ye e0/44 Phone # Jers" -60 4'e' Contractor's. Address e y' jig da /.fit City Qualifier Name ` 1Utf/ State 1-411 to -i4/13 /� • �� A/M°t Zip 2)' Phone # 3e rot —60 Sly State Certificate or Registration No. Contact Phone Architect/Engineer's Name (if applicable) E -mail x/fr Value of Work For this Permit $ 1 / ! ° C C) Certificate of Competency No. Phone # Square / Linear Footage Of Work: Type of Work: ['Addition ['Alteration ['New Describe Work: /t /Li-(' �� �i 41 C ❑ Repair/Replace ❑ Demolition ***** * * * * * * * * * * * * * * * * * * * * * * * * *''j *'� *,l * * *F Fee $ Permit Fee \y Submittal Fe $ s tk Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ CCF $ CO /CC $ Technology Fee $ Bond $ Total Fee Now Due $ 11 Pis - See Reverse side lii Bonding Company's Name (if applicable) Bonding Company's Address �/ ilJ` :r City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip pi/4- 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 COMMVl ENCEMENT 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. \igna wner or Agent The foregoing instrument was acknowledged before me this 12- day of �y , 20 / l , by who is personally known to me or who has produced As identification and who d2d take an oath. Sig Print: "4) 1.9.�.' =* • ►•• e My Cons4ion fails : o APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this 42 day of file-y{ , 20 i / , by who is personally known to me or who has produced as id NOTARe ' ►' • Sign: Print: My Co cation a who did take an d. th. • �`1C, S1''f„ 0�� * * ********************************************************** lans Examiner (Revised 07 /10 /07)(Revised 06/10/2009) 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): /a? h £ /01/ City: Miami Shores Village County: Miami Dade Zip Code: 33 %/ 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 0,160 Contract Attached: YES EY UNIT BEING REPLACED DATA NEW UNIT -AA_ ._ r e-, MANUFACTURER .e ccA., �U e3-0 4,, AHU or PKG. UNIT MODEL # �� � iy __{__/_ "e-As..1,9 ' I- J,s' 44',8 ® . , COND. UNIT MODEL # ° . ,.5-...-%.1 KW HEAT NOM TONS Ng AHU Ve3 CU2 T PKG 1) M.C.A AHU*) CU 9`PKG AH ; p CU.,y , PKG 2' M.O.P AHU 0 CUB-PKG AHU CU PKG 3' VOLTS cvlo.y - c .Se r/ AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER lie YES NO REPLACING DUCTS YES VO YES NO REPLACING THERMOSTAT E YES NO NEW 4"CONCRETE SLAB �; NO YES NO NEW ROOF STAND Y S `^NO YES NO NEW RETURN PLENUM BOX YES NOJ 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: APi, ti>m17 d-1— Bp_ loi /P Phone: 3 -er- 6T -6 t" State Certificate or Registratio N. CO-e0 i .c(Pyi Certificate of Competency N. Signature Date: 7/1.,2/0 J (Qualifier's signature only) ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS • DISHWASHER LIGHT OUTLETS CENTRAL HEATING �5-• NC (WIND) ,A ) DISPOSAL RECEPTACLES FLOOR DRAIN 'SERVICE TEMPORARY NC (CENTRAL / 44 GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK , INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER j WATER HEATER U.F. PRESSURE VESSELS SINK. POT/3 COMP. ; MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. a MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS/ESCALATORS. WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS , INDIRECT WASTES MOTORS` OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION NC UNIT • NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER —NEW INST. STRIP HEATER HEATER— REPLACE GENERATORS TRANSFORMERS _,___.....___1 LAWN SPRINKLER —WELL GENERATORS TRANSFORMERS SWIMMING POOL _. GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE OUTLETS COMMERCIAL A % ' SEWER CONNECTIONS UTILITY —SEWER SIGN TUBES SIGN TRANSFORMERS , 4 _ , g- sit grg J , ,_' UTILITY —WATER SEPTIC TANK SIGN TIME CLOCK _ 1 RELAY FIXTURES FAINFIELD, 4" TILE/RES. r ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION - CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING www.ahridirectory.org TMs combination qualities for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17, 2009 and Dec 31, 2011. Certificate of Product Ratings AHRI Certified Reference Number: 3805982 Date: 7/22/2011 Product: Split System: Air- Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM36 Indoor Unit Model Number: RHKL- HM3821 +RCSL- H*3821 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 verlficatlon of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 37800 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 • 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 products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certiflcate. AHRI expressly dlsclaims 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 Hated 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 content's 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 www.ahrldirectory.org, click on "Verify Certiflcate" Bnk 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. ©2011 Air - Conditioning, Heating, and Refrigeration Institute IMO 1111M Air- Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129558291807865069 OP ID: E2 '`,`. __ CERTIFICATE OF LIABILITY INSURANCE °ATE(MM/O °""'"' 03/29/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 954-776-2222 Brown & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 954476-4446 P.O. Box 8727 Ft. Lauderdale, FL 33310 -5727 Shawn A. Burton, CIC CONTACT NAME IAICO. Extr I FAX No): E-MAIL L PRODUCER RESID -1 CUSTOMER ID A: INSURER(S) AFFORDING COVERAGE NAIC d INSURED Residential Air Conditioning, Corp. 20250 N.E. 15th Court N. Miami Beach, FL 33179 INSURER A :`FFVA Mutual Insurance Co.+ 10385 INSURER a :'Harleysville Insurance Co.+ 23582 INSURER c : 11/10/10 INSURER D EACH OCCURRENCE INSURER E : X INSURER F : $ 100,000 COVERAGES REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS IN _ t- IS TO CERTIFY THAT THE POLICIES OF INSURANCE NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH POLICIES. USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL , . SUER p POLICY NUMBER POLICYEFP MID, 1 POUCY EXI+ 1.. r• . • Bill LIMITS B GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY OCCUR GL82251H 11/10/10 11/10/11 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES IEa occurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT POLICY n IF a APPLIES PER PRODUCTS - COMPIOP AGG $ 2,000,000 7 I— LOC $ B AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA82252H 11/10/10 11110/11 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $L $ $ A WORKERS COMPENSATION AND EMPLOYERS' LUU3ILITY ANY PROPRIETORIPARTNER!EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) H yyeese deavibe under D$$GRIPTION OF OPERATIONS YIN N / A WC84000259042011 A 03/23/11 03/23/12 X I TORY LIMRB I X I W- E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H Men apace 1e required) Air Conditioning Contractor CANCELLATION MIAM Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2009 ACORD CORPORATION. All riphb reserved. It TAk.;COLLECTOR • MiAMI,O.AtIE,GOkINTY. 1,40.11c&F,M0t.t.*14,11;. ;:. Pt.Goct, " 0.6S9:60 - • ausmigg•WAI6 ° .11101 •• olnimed_ t4 attlitNit stitAiiiit.0410" . 196:: pktw, geA gat. VO.P1 gaiIiitwero "gar.- gfftilt' Aga. gon, over ma in lit 0f1i ittigibi*I'1471 cectrimeniloicim 1HE mothors onAurick, tAX tidron, Wilt-4474nrgOri- count° '09/1412#0-' 011010.094Mt, SEE OTHER OIDE , • • T CLASS 2010 LOCAL 009119E3131AX FIEIPT. , miAtu-DADe cOuNyy. Watt #:leOPIttik:• .,„ MOIRES deqt00,•,, • •-:"P UT de 018pait0tAltpliAce,, 144ratiANt TO COLVTY ■,tiNiF4WAPSI .:w.r,:.1.6.-7,,.. ,.,.. ,. .. . , . .., ... . . • FIRS _ U.S. POSTAGE PAID MIAMI, FL Pttwirt No. 2-1 • THS IS NOT A BILL - ot, NOT PAW 4.. .., RERtWAL I ,, •SECAPT NO: '.'' 063960-0 -ONittriONf Nd CORP :SOTtt '4At03-540 .,, 04TY tlIONIN6 COR. 10 : CoNTRAcTOR • 1 0. a DO NOT FORWARD RESIDENTIAL AIR CONDITIONING CORP RICHARD M VANNI 20250 NE 15 CT MIAMI FL 33179 DETACH HERE „ -','-----T.! virizmit 1 ))T-Nrig-Tvip—'4,v WAwriP$WM-i.FA-4, e c A ; , "ViliTltIr 1 et‘r-'4 -43r, :444f: 4440,:h.' A 0.310 f op --- LM 1 F -- 0314 i GO 1 ni NVIcli r s 1'RP-0P '',.V 31,,,,Itt,. ii I-_,---, ).94};:-.4,. • 1 _4 '':) PREP** ..„..._ :,__.,„ .,.... „...„ - .•: ,.6,...„ pi,......r. Residential Air Conditioning Corp. 20250 NE 15 Court Miami, Florida 33179 305- 652 -6040 * 954- 764 - 0489 * Fax: 305 - 651 -4992 State Licensed and Insured CAC035484 A+ Rating Member BBB July 22, 2011 Terrell Walter 125 NE 107 Street Miami Shores, Florida 33161 Residential Air Conditioning will furnish and install the following: Rheem 3 Ton Saner High Efficiency Split Cooline System —16 SEER Condenser will be installed and secured on a new Dade County approved pre cast slab. Air Handler will be installed on a new metal stand. Installation includes the following all new: Condenser model I4AJM36 Variable speed air handler model RHKLHM3821 Digital Thermostat Heater Connections to existing refrigeration lines, electric and ductwork. Remove and dispose of existing equipment. RX- 11 Flush Float switch Start up system and check for proper operations. All labor and materials for a complete and professional installation. Ten year manufactures warranty on parts, one year warranty labor. Permit fee is additional to price below. Payment terms are 50% deposit and balance due on installation. This unit qualifies for the 2011 Energy tax credit Total Price $4187.00 - $585.00 FPL Rebate = 53602.00 Respectfully, Richard Vanni Residential Air Conditioning Corp. Approved b Account # 21335 -84918