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MC-11-1542
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163626 Permit Number: MC -8 -11 -1542 Scheduled Inspection Date: September 21, 2011 Inspector: Perez, JanPierre Owner: HOWELL, COURTNEY Job Address: 1110 NE 104 Street Miami Shores, FL 33138 -2658 Project: <NONE> Contractor: ALL SERVICES NC IN Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1122320290170 Building Department Comments 5 TON A/C CHANGE OUT z� Inspector Comments Passed W� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 20, 2011 For Inspections please call: (305)762 -4949 Page 14 of 34 31215)//` BUILDING PERMIT APPLICATION Fsc zo Miami Shores Village. Building Department 'v 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 -j AUG Pi 21i Permit No.W 1 I 1 4'_ Master Permit No. Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): c cP Ile' eL � a Phone #: 694"5----* ‘5-76.— 5'3 Address: / / ® 4E / r- S� City: %,, ; 5' State: ��� Zip: ?7/ Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: // /0 /1// /0 `? _- City: Miami Shores County: Miami Dade Zip: 3 ? / Folio/Parcel #:' Is the Building Historically Designated: Yes NO Flood Zone: ecu, 95-Y- 6/T 7FTr. CONTRACTOR: Company Name: C [ Ye �°" l/i e tr'C mfr- Cov.o, f Phone #: 9 S 7- 7 5` rt'-O Address: Cg/C.,®' /7 £ 7 ,v °tom City: 1- At!• a State: Fe Zip: 7,3 ? Qualifier Name:/77 /2f e Ate d7 Phone #: r ea, - 6/ State Certification or Registration #: /1 G G 571f IS' Certificate of Competency #: Contact Phone #: 9g°'' 74i 7~ 0 Tr C90 Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 7 ? r Square/Linear Footage of Work: Type of Work: DAddress DAlteration ONew /Replace Description of Work: f 71/4,° :/c .,4.7 C, Cel-- ?ae) ODemolition ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *, * *; * C * * *+ **+r+ *** ***************m**** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ ° CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 AlH'r'IWAVIT: 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Own 1r or Agent The for going i strument was acknowledged before me this day of '� , 20 AL, by who° is per ly known o me or who has produceF1 I� C identification and who did take an oath. Signatu The fore g i day of Contractor ment was acknowl ,20,L,b ly known to me or who has produced 14ntification and who did take an oath. OTAR PUBLIC: Sign: Print: My Co 1112 * * * * * * * *:/* * * * * * * ** APPROVED BY OT Y PUBLIC: sign: _ oi Print: ' My Commission Expires: %� rr jg�g; SEP. 23,2311 aoaniir * *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** PlaiYs Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk 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. Jo ddress (where the work is being done): } / / e, / /c) e f iami Shores Village County: Miami Dade Zip Code: 3 3 f 3' SJ` 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 SUBMMIT�4LS ARI (AHRI) DATA SHE REQUIRED dam"°° Change Disconnecting means: YES ❑ NO (ARHI Sheet Attached: YES Contract Attached: YES 1. 2. 3. Voltage of Circu 480): 4. Size Disconnecting Means: 04S /j 5- Contractor's Company Name: nL C S" & t// eS /9J2-640.07.0/07-.0.-- - Phone: ?S7( -° c(9- c9FIcr)c' etc- Ct SYr- !"/'�' °7p7y—' State Certificate or Registration N./ ,4Ca / I ? Certificate of Competency N. UNIT BEING REPLACED DATA NEW UNIT X‘ ye ex---t— /3 /1- t MANUFACTURER /s /.I e e A ,4 -2-4 j ' f r S e ? AHU or NIT MODEL # X / / 002 57/14- #7 olfr/t9 o ® J , COND. UNIT MODEL # A- 1-- !� :_ R/5W Lc IC) w KW HEAT • "0 '®�.. NOM TONS 51-°re.4,,. AHU(( U Pr Igoe 1) M.C.A AHU CU PKG AHU &®CU 2) M.O.P AHU CU PKG AHU2c CIt0 • %: • 202 A 30 3) VOLTS 2 ®e-A ?r AHU CU PKG ,: --: =r = -' IT / / PKG UNIT / / EER/SEER / ? S fZ_ YES NO REPLACING DUCTS YES NO }C. YES NO REPLACING THERMOSTAT YES V NO YES NO NEW 4 °CONCRETE SLAB YES L-' NO YES NO NEW ROOF STAND YES NO > YES NO NEW RETURN PLENUM BOX YES NO x, Minimum Circuit Ampacity (Wire Size): eff ezity Maximum Overcurrent Protectio Breaker Size): ,e2 e, -"771195 Signatur (Qu : Ma's signature only) Date: V2 ,//ir .4 Peer, TO: C. A.11 services air antirational ao (954) 749 MOO atmet_t 6u.:(211 tO NE- 1c4 gT simwx(24 • AR , INVC)1',L. 1F "305. 751.7)41 Pl4WIE 3t6.15)-. 2(00 DATE 10.0 64/ - 9/2/20iO ORDER TAKEN BY M4R.11211 e COSTUMER ORDERNo. JOG MANE JOB LOCATION JOB PHONE DESCRIPTION N Di WORK "TO 13K 1.,,C.)NE-EXTE.rtif:)R REPLACEMENT OF CONDENCER UNIT 5 4pj•. C.0.7Y+144 Mat Oki CL- 11WIPM2-% cd.-erdot DrScRiP riOtv OF WORK TO BE DONE 11,11F.F40I2 . REP LACEMNET OF AIR HANDLER 2 WITH 10 KW HEATER NOTE: WARRANTY OF YEARS IN ALL PARTS CO COMPRESSOR & YEARS LABOR Sa-6- CE WITH ABOVE SPECIFICATIO WE PROPOSE HEREBY ro FURNISH MATERIAL AND LASOR—COMPLETE *t Ar.-CORDANN FOR THE SUM OF S, DOLLARS &Si PAYMENT TO BE MADE AS FOLLOWS (...PERMIT EXTRA OUR COST. Ail Material is guaranteed to be as specified . All work to be tompleteid in a wortmanie manner according ;o zitandard practices, Any alteration of deviation from above specifications involving extra costs will be ex,2a-uto Dilly upon writers orders, and will :worm an extra charger over and above estimate. All agreements contingent upon StrliceS. accidents or delays beyond our contra. Owner to carry fire. tornado and otniic necessary Insurance.. ACEPTANCE OF PROPORSAL THE ABOVE PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTEP 01.1 ARE AUTHORIZED TO DO THE WORK AS SPECIFIED PAYMENT WILL BE MADE AS OUTLINED ABOVE AUTHORIZED SIGNATURE 11114.0", ..11411 DATE DATE •*"......14.0*I.N.e.■•••••••■•■■■••••••••■• AC Search '5,0„•"70, 09.0.0,0// ,/ • ' "ffl- ///7 ip•,,ifsfAfr , "' d" Page 1 of 2 A tows C'tRTIFED "..."'<Z1fiatar Are you a Manufacturer? I Sian In, ...................... AC Search -•••••- • Home Of Modtfy ha Export Double click on a row to vlevdprInt AHRI certificate. AHR1 certificates are not available for Obsolete AC and HP equipment Model Status of 'Active means models are currently In production. Discontinued' means that the manufacturer has elected to stop producing, yet stock Is still available. 'Obsolete' means that the manufacturer Is required to stop manufacturing due to e test failure In the AHRI Certification Programs. • • • • 1 ARRI 1 C model manufacturer I Tmda/Brand 1 manufacturer I M ertified 1 1 Ref # status Type Name .• 1.: 1 3115839 1 Active Systems • Outdoor Unit Indoor Unit • Cooling I i ' Est I I I 1 : National I Eligible 1 1 manmxuractu.matchrT I 1 Model 1 ' agecie 1 cailtjhadllY 1 EER 1 SEER 1 Phase AHR1 I HSVTO 1 Vgsoi;ieiortY Ark:1Bu'al i Fermat I 1 1 c , . I i t - 1 Type i Operating 1 Tax 1 1 • . • 1 i • 1 RCU I: • Cost ($) 1 Cooling ; Credit 1 1 , 1 I • RHEEM 1 RHEEM 1 c,,,,, ; r :•••• 497 11 RANL 1 MANUFACTURING 1 '"'''''''. 1 2 5 +R BRHCP1-11 1 . . • , , • . 1 55500 1 10.75 1 13.00 I 1 ; -A- : • 1 SERIES 1 COMPANY 1 csliAz " ; 430A1 1 . • , , ; I • . .• , • 1 CB Now displaying records 1 - 1 of 1 total . , i• • ;ion; I Contact Us rem* and Conditions I OCBtiSe AHRI Directory Date Copyright © 2011 Alr-Conditioning, Heating, and Refrigeration Institute. All lights reserved. http://www.ahridirectory.org/ahridirectory/pages/ac/defaultSearch.aspx 8/22/2011 08/22/2011 08:25 p T0: +1 (305) 7568972 FROM:8778240964 Page: 2 A ° CERTIFICATE OF LIABILITY INSURANCE $A22� o;;"Y) 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(ies) 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 The Fairway Insurance Group, LLC 5461 North Federal Highway Fort Lauderdale FL 33308 CONTACT Annette Griffin NAME: P�NrC°.NNo Extr (954)772 -9819 I (FA/C.No: (954)772 -9564 n DBEs :annetteg @tfigins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Old Dominion Insurance Co. GENERAL X INSURED All Services Air Conditioning, Inc. 6805 W. Commercial Blvd. #219 Lauderhill FL 33319 INSURER B : $ 500,000 INSURER C : ( CLAIMS -MADE INSURERD: OCCUR INSURER E : $ 10,000 INSURERF: CERTIFICATE NUMBER CLl THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT. OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL. INSR SUBR WVD POLICY NUMBER NBG7122A POLICY EFF (MMIDD/YYYY) 7/13/2011 POLICY EXP (MM/DD/YYYY) 7/13/2012 LIMITS EACH OCCURRENCE $ 300,000 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY DAMAGE l0 RENTED PREMISES (Ea occurrence) $ 500,000 ( CLAIMS -MADE N OCCUR MEO � (Any one person) $ 10,000 PERSONAL &ADVINJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEM. AGGREGATE LIMIT APPLIES PER: 7 POLICY n ,a . n LOC PRODUCTS - COMP/OP AGG $ 600,000 $ AUTOMOBILE — _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — _ SCHEDULED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA MB EXCESS UAB _ OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ • DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y f N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) DESCRIPTION OF OPERATIONS below N / A ( I TORY LIMY- I I T EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Certificate is Subject to Policy Forms & Endorsements. reorrrirerr •_t mr.. CANCELLATION (305)756 -8972 Miami. Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 -2382 ACORD 25 (2010/05) INS075 rmvnn/'t 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 Edward Brown /AG © 1988 -2010 ACORD CORPORATION. All rights reserved. THe AP(Ie l name a■,l Ir,rrn are eardofererl martin of Arr Ipn