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MC-11-1671
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 1 Inspection Number: INSP - 164327 Permit Number: MC -9 -11 -1671 Scheduled Inspection Date: September 19, 2011 Inspector: Perez, JanPierre Owner: ROJAS, ANA Job Address: 1086 NE 96 Street Miami Shores, FL Project: <NONE> Contractor: OMAR AND SON SERVICES Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060143480 Phone: (305)219 -6495 Building Department Comments 4 TON CHANGE OUT Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments September 16, 2011 For Inspections please call: (305)762 -4949 Page 32 of 48 03am-rya] Miami Shores Village CEP 1 2 2O" 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 No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): ,1M4 ` ' g if3 Phone#: 3 ®"S— 7S$'' —63/2 Address:_ City: et o iek Lmt c , J7 (ed State: Q� L Zip: .134 e Tenant/Lessee Name: Phone#: Y:.. MU-11451i Email: Mt/ 22.39 Q ito14Ntfri JOB ADDRESS: a ( Ate- q ( .5 . City: Miami Shores p County: )� Folio/Parcel#: 1 1 3 2 0 0 L2/ c-/?j Y4 0 Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: Wei a44.4 "'m"" f Miami Dade zip: 33/ 3 3 Flood Zone: Address: 130 7 3 /t/& 411- ailef City: 0 poall0 Gtc p_ State: PC— 0 Qualifier Name: 0 66*e� State Certification or Registration #: 1,+6.0 g 53 Contact Phone#: 3 0 2. Phone# 305— 219- 4995 Zip: 33O Sf, Phone#: 305- 2./ 9°' �O qqr Certificate of Competency #. �''C� 7 �/ s Email Address: c® 60144 e Ad- DESIGNER: Architect/Engineer. Alfrt Value of Work for this Permit: $ 1(P Li Squar Footage of Work: Phone#: Type of Work: DAddress ■ Alteration DNew Description of Work: /Replace ❑Demolition ***** * * * *** * * * * * * *** *** * * **Y * *** * * ** Submittal Fee $ �, wc) Permit F = CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ar l . T U q1 FIRST -CLASS US. POSTAGE "PAID MtANII, FL PERMIT NO. 231 453261-1 BUSINESS NAME / LOCATION OMAR & SONS SERVICES NW 42 AVE 33054 OPA L.00KA THIS IS NOT A BILL— DO NOT PAY REi EWAL ES INC RECEIPT NO.'7 STATE �CAC05$f.53 OWNER OMAR & SONS SERVICES INC Sec. Type of Business 196 SPEC MECHANICAL CONTRACTOR THIS IS ONLY. A LOCAL .,.:. BUSINESS TAX RECEIPT. IT DOES NOT PERMIT. THE HOLDER TO3 VIOLATE .: ANY EXISTING REGULATORY OR ZONING :'LAWS OF THE COUNTY OR ` CITIES. NOR DOES IT - EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. mis is NOT .A CERTIFICATION OF THE HOLDER'S-QUALIFICA- TIONS. WORKERIS 5 PAYMENT RECEIVED MIAMI-DADE COUNTY TAX COLLECTORi :. 08/10/2011 60020000135, 000045.00 SEE OTHER SIDE DO NOT FORWARD OMAR & SONS SERVICES INC JOSE 0 GOMEZ PRES 13073 NW 42 AVE OPA LOCKA FL 33054 72 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. Certificate of Product aims AHRI Certified Reference Number: 4151118 Date: 9/6/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4A7A5049E1 Indoor Unit Model Number: GAM5A0C42M31 Manufacturer: AMERICAN STANDARD, INC. Trade /Brand name: ALLEGIANCE 15 Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD, INC. 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): 45500 EER Rating (Cooling): 13.50 SEER Rating (Cooling): 16.50 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. Certified ratings are valid only for models and configurations listed In the directory at www.ahrtdlrectory.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 confidante! reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectoryorg, Air- Condltloning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on 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.: 129598075818472531 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GOMEZ , OMAR OMAR & SON SERVICES INC 13073 N . W . 42ND AVENUE OPA - LOMA FL 33054 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our::prOfeSSionals,Snd"b`uSineSSeS•rahbe from architects to yacht brokers, from boxers Oiirbeque,restaorapts,,,,nd they keep Florida!s-economy,stro99 , k' 1. very :E to improve the way_ we do business in order to serve you better 4itliehiieeSI.0141asii166 There 9d0#an find more information Abat kilikiiviii&Wd the regulations, that impettyod; subscribe 16 deptiri-leitit 'newsletters and Iearn more •about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We - constantly strive to serve you better so that yOu can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! 00.P.vAi; DM4R. Ol'AAR ..:101T 7 DETACH HERE (850) 487-1395 DATE BiaCKNUMWM.; Bonding Company's Name (if applicable) Bonding Company's Address City State j Zip 44 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 be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In t ' , abs ' of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing • + : trnment was acknowledged before me this CI day of .. , 20 1 I. by who is : , known to me or who has produced As identification and who did take an oath. NOTARY P Sign: Print E P My Co *Miry Public State of Florida Omar Gomez �< My Commission DD838193 04 Expires 01/17/2013 or Qj The foregoin instrument was acknowledged before me this _® day of J= , 20 l , by who is personally knower to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: / Sign: * * * * * * * *** * * * * * * * * ** APPROVED BY f :a: • ,,�a; 153 rc `rHeit 1u14i M' .r. • r,, Jr 11 00745952 EXPIRES January 03, 2012 FloridallotaryService.com * * * * * * * * * ** Plans Examiner Zoning Structural Review Clerk (Revised 07 /10/07)(Revised 06/1012009)(Revised 3/15/09) 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. , 4�, Job Address (where the work is being done): 0 g `P q ( City: Miami Shores Village County: Miami Dade Zip Code: 3313 k 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 Lei' NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT cii mote) MANUFACTURER C— /61 l t et A 4. P g AHU or PKG. UNIT MODEL # &Ael FA OC, OsoPSV; K 4-t— i COND. UNIT MODEL # 1147A Vog9 e C ( nZ KW HEAT ®� 4,--01(69'§W NOM TONS q irn AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU ca, CU Vie PKG 3) VOLTS AHU 2 's CU ale PKG PKG UNIT / I PKG UNIT / / 11 0 Wee- EER/SEER r L Sera YES NO REPLACING DUCTS YES ■ • r YES NO REPLACING THERMOSTAT YES •` ►� YES NO NEW 4°CONCRETE SLAB YES 1 • V YES NO NEW ROOF STAND YES • YES NO NEW RETURN PLENUM BOX YES < !` 1. Minimum Circuit Ampacity (Wire Size): 70 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (2081240/480): 7, f® V 4. Size Disconnecting Means: Contractor's Company Name: State Certificate or Reg -' :II , N Signatur;lI/l %o' 4, 4-6- %- v 40 �,r -0 -a pl46e7 sien %� Phone: 305 2 /1-- 601/5 C45 593 C45e5c3 Cerllficate of Competency N. Date: q/4/4°// -f` CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/13/10 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 Tammy Insurance Agency 9821 S.W. 40th Street Miami, FL 33165 Phone (305)485-3999 Fax (305)485-3944 ( } ( � CONTACT NAME: Jessica Hechavarria PHONE (305) 485 -3999- FAX (305) 485 -3944 C. No. Ext): ( (A/C. NM: A p E S. Tammylnsurance@yahoo.com PRODUCER CUSTOMER ID #. INSURER(S) AFFORDING COVERAGE NAIC # INSURED Omar and Sons Services Inc 13073 NW 42 Ave Opa Locka, FL 33054- 305 - 688 -4949 INSURER A : Mount Vemon Flre Insurance Company 986758 -1 INSURER B : CastlePoint Insurance Company 12/13/2011 INSURER C : $ 1,000,000 INSURER D : DAMAGE EEMIESO(Ea RENTED INSURER E: MED EXP (Any one person) INSURER F : PERSONAL & ADV INJURY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 ADDCSUBR INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYYI POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL LIABILITY 986758 -1 12/13/2010 12/13/2011 EACH OCCURRENCE $ 1,000,000 V COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE V OCCUR ❑ DAMAGE EEMIESO(Ea RENTED $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PRO- JECT ❑ LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ❑(Ea ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS ❑ COMBINED SINGLE LIMIT accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DEDUCTIBLE ❑ RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER PROPRIETOR/PARTNER/EXECUTIVE ECUTIVE YYN N I A WCP760662000 10/23/2010 10/23/2011 ❑ TORY L MITS ❑ OT E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 500,000 (Mandatory In NH) If yes, describe under DESRIPTION OF OPERATIONS below E.L. DISEASE - POLICY UMIT $ 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Air Conditioning CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2 Ave Miami Shores, FL 33138 1Fax:305- 756 -8972 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 REPRESENTATi Jessica Hechavarria ACORD 25 (2009 /09) QF 41 1 8 -2009 ACO - I CORPORATION. All rights reserved. Tllle ACbRD name and logo are registered marks of ACORD /(4