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MC-11-1659Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164284 Scheduled Inspection Date: September 14, 2011 Inspector: Perez, JanPierre Permit Number: MC -9 -11 -1659 Owner: DEVELOPMENT GROUP, REALTY Job Address: 68 NW 100 Street Miami Shores, FL 33150- Project: <NONE> Contractor: BLUE BREEZE AIR CONDITIONING Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1131010180460 1,P6 Phone: 305 -865 -1220 Building Department Comments REPLACE EXACT A/C UNIT (2) 3 TON SPLIT SYSTEM q---g l) Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 13, 2011 For Inspections please call: (305)762 -4949 Page 14 of 30 Miami Shores Village Building Department IzasoYEI sEp 70'0 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 Permit No. N4CJ )11(o$9 Master Permit No. Owner's Name (Fee Simple Titleholder) r V>1Ny`�` 1/1 C o� \/ Phone # (SCE 5 "Q /02 Owner's Address (o N W /00"x'4 z4 , City %IOiw\l 5k6re.5 State 1- t Zip '3315 0 Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 6,8 . %I ) 1 O6-1'% City Miami Shores Village County Miami -D de Zip 33 '150 FOLIO / PARCEL # Is Building Historically Designated YES NO )' Flood Zone Contractor's Company Name ve__ 0 WA_ ( Phone # '1 05 5 - y1-9S) Contractor's Address C:)S nut) 4.1 te g1 City KehA , t State Zip 31.._643 • Qualifier Name 1 e'[l®U1 a L A Phone # ° 0.6.— 2-,e.2...-C. -5 Sg. State Certificate or Registration No. CA L 32..E € Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if a 1�. ` /% ,/�, Phone # Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: Square / Linear Footage Of Work: ['Alteration ['New AT Repair/Replace ❑ Demolition eW Cat C2 l 3 i- ,Sp4er. * * * * * * * * * *, * * * ** **** * * * * * * * * * * *** ** ee n * * ** ***** * * * * * * * * * * * * * * * * * * * * *,� * * * * * *** Submittal Fee $ Permit Fee $' 1G/ t CCF $ Notary $ Scanning $ Double Fee $ Training/Education Fee $ Radon $ DPBR $ Violation date: CO /CC $ Technology Fee $ Bond $ Structural Review. $ Total Fee Now Due $ 2 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 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 absent of su +; sstee notice, the inspection will not , e approved and a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this day of ar,v, , 20 kl , by McDev4-tt ' who is personally known to me or who has produced ' f' t p4- As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commiss 61/4 ,sry ., .- on.a 68:E tan Den Bergh zr My Cornrnission DD7i '217 • Expires 04/1312012 Signature Contr ctor The foregoing instrument was acknowledged before me this I- day of Arrr , 20 1( , by ), who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co •0 'e Notary Public State of Florida plirn Den Bergh op My Commission DD778217 1•0 0,4` Expires 04113 /2012 * * * * * * * ** , * * * ** *k * *x * * * * *,r *x * * * * * * * * * ** . * * * ** * * **. * * * * * ** * * * *x,r * * *.. ** APPROVED BY \\ r r Plans Examiner Zoning Engineer (Revised 07 /10 /07XRevised 06/10/2009) Clerk checked 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 O 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 DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRALk2_1 01 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 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. 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 26-100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT • NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER WELL - GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE. SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4° TILE/RES. 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 . . 0 L AIR CON ►: T =ING & HEATING® Always On lime—Or You Don't Pay A Dimel® One Hour Air Conditioning & Heating #156 655 NW 118th Street Miami, FL 33168 305- 865 -1220, Fax: 305- 865 -7779 Air Conditioning Repair, Replacement, Service Agreements Licensed and Insured CAC 1813298 www.onehouraiuuiami.com Proposal submitted to: Arthur McDevitt 68 NW 100th Street Miami Shores, FL, 33150 Job type: Replace A/C system Date: September 8, 2011 WE PROPOSE TO FURNISH AND INSTALL THE FOLLOWING: • A/C system with electric heat. • New AH Stand R/A metal EZ change 1" filter. • Float switch to help prevent water leaks. • New Environmental refrigerant R -410. • New Digital Thermostat • Start -up and check operation. JOB QUOTE Comfort System Package for (2) AC Units Premier Equipment XL20i by Trane Variable Capacity Control 2 Compressor Variable Speed Air Handler Yes SEER (Efficiency) 18.5 S .5: 5 y $� 12 \V a t s xY 10 Indoor Air Quality Micro Power Guard 1" electronic air cleaner (Air Purifier System & Germicidal) Safety One Package: new slab, auxiliary drain pan, low voltage, sound package, hurricane tie downs, mechanical attachments, and more Yes Dehumidification Best FPL Rebate q:7 i -1760 OHAC Factory ` i - 00 $4,998 Total Net after rebates Investment 1,' Accepted for purchaser (Principle /O gnature) Print Name/Title Matias Torroija/C .Advisor September 8, 2011 OL Date 0 Accepted ne ' o Air a nditioning Print Name /Title Date ©2010 One Hour Air Conditioning CERTIFI www.ahridirectory,or This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 201t Certificate of Product Ratings AHRI Certified Reference Number: 3220642 Date: 9/7/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTZ0036A1 Indoor Unit Model Number: 4TEE3C04A1 Manufacturer: TRANE Trade /Brand name: XL20I Manufacturer responsible for the rating of this system combination is TRANE 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): 36800 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 18.50 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 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 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. Certffied ratings are valid only for models and configurations listed 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 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 www.ahridirectory.org, Air- Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on MN am and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129599018982484283 Miami Shores Village AIR CONDITIONING EQUIPMENT EXACT CHANGE OUT AFFIDAVIT FORM ALL INFORMATION MUST BE FILLED IN ACCURATELY. THE FOLLOWING INFO TION REPRESENTS THE EXISTING CONDMONS: ADDRESS: a Disconnect Mounting Location information: AHU circuit Size e�c Mounted on AHU unit? Yes No Branch Cir AMP Sze Above Base Flood Level? Yes Na #�r Go Clear workspace Breaker 30" wide & 36" front? Yes X No AMP Gosize map size Mr Ham tfilltanned Bninch Omit Breaker VA Size Br Crean #_ ckeult Breaker Panel ANP Size comer Unit Dammed Mounted on C/U unit? Yes No X Above Base Flood Level? Yes ir; No Clear workspace 30" wide & 36" front? Yes ir No Low voltage thermostat wiring is installed in a separate raceway from the power wiring? Yes 2L,Ne THE FOLLOWING REPRESENTS THE NEW EQUIPMENT: NAME PLATE NM AT1ON: ANEW MR HANDLER UNIT — 1;EW CONDENSER UNIT MINIMUM CIRCUIT AMMO-FY? 2. (. MINIMUM CIRCUIT AMPA -CITY? °L I, • MA IvlLIM OVER Cl.Fidem ' size 40. mAnabil ova etigtERT sm? Q. FT.F.CTRIC BEATER KW SIZE? '-0 i as qualifying agent for the air conditioning equipment installation at the above address location hereby attest: The above information provided for the existing electrical conditions and the nameplate information provided for the new equipment is accurate and truthful. Company Name Qualifier Name Qualifier JA kJ L1L Notary Required Miami Shores ViIiage AIR CONDITIONING EQUIPMENT EXACT CHANGE OUT AFFIDAVIT FORM ALL INFORMATION MUST BE FILLED IN ACCURATELY. THE FOLLOWING INFORMATION REPRESENTS THE EXISTING CONDITIONS: G (90 0' APO S 1 ADDRESS: AM circuit # 6(S AMP Size cu Circa PSreak er ## 7 AZ IV) Circuit Breaker Panel Brandt circuit wire Size X c2 AMP Size Par Handler Disconnect Branch Omit Wire size Condenser Heft Disconnect Disconnect Mounting Location information: Mounted on AHU unit? Yes 3( No Above Base Flood Level? Yes '( No Clear workspace 30" wide & 36" front? Yes X No Mounted on C/U unit? Yes No X Above Base Flood Level? Yes .( No Clear workspace 30" wide & 36" front? Yes < No Low voltage thermostat wiring is installed in a separate raceway from the power Wiring? Yes .2L No THE FOLLOWING REPRESENTS THE NEW EQU PMENT: NAME PLATE INFO ATION: = NEW AIR HANDLER UNIT — - - - - - -- - - -. - - NEW CONDENSER UNIT MINIMUM CIRCUIT AMPAC1TY? 2. 49 MINIMUM CIRCUIT AMPACITY? 9._ ,, . NfAxIMUIvf OVER C'f3kRENT SIDE? 40. MAnWlvi OVi~R d -141` SiEE? FT RCTRIC HEATER KW SIDE? 4.0 i as qualifying agent for the air conditioning equipment installation at the above address location hereby attest: The above information provided for the existing electrical conditions and the nameplate information provided for the new equipment is accurate and truthful. Company Name Qualifier Name Qualifier 1 .y: ' ` 11 Notary Required