Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
MC-10-1774
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 152034 Scheduled Inspection Date: October 05, 2011 Inspector: Perez, JanPierre Permit Number: MC -10 -10 -1774 Owner: MALMSTEEN, YNGWIE & APRIL Job Address: 1009 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ALL YEAR COOLING AND HEATING Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132050150011 Phone: (954)566 -4644 Building Department Comments REPLACE CENTRAL AC 4 TON t)o(5/ Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments October 04, 2011 For Inspections please call: (305)762 -4949 Page 1 of 49 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 0 tti til4-` 4 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical 027 0 4. 2011 Permit No. Master Permit No. Imo( C 10 P VirAtAile R telf\fee / - Owner's Name (Fee Simple Titleholder) _ Phone # P51-1 .. y-4S- (6 `30.1. Owner's Address ) 130 g P C' `T ST ° City –U ellY1 L S In(1) 1"<,..S State Zip SS 3 Tenant/Lessee Name fl S Phone # E -MAIL: Job Address (where the work is being done) 10O. /De c/q s . City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO — Contractor's Company Name ALL YEAR COOLING & HEATING Phone # 954 -566 -4644 Contractor's Address 6781 W. SUNRISE BLVD City PLANTATION state FL Zip 33313 Qualifier Name GRETA B. SMITH Phone # 954 - 5664644 State Certificate or Registration No. CAC058160 Certificate of Competency No. CMC511 E -MAIL: Permits @aycair.com Architect/Engineer's Name (if applicable) NSA Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Addition ['Alteration ['New Describe rk: REPLACE CENTRAL NC ❑ Repair/Replace ❑ Demolition ** * * ** ** ***** ** * *,r**** * ** ** ** * *** * *** Fees ** *, * * ** *, * * *** *, * **, *** ** * * *** * * ** ** *,t**** Submittal Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ ' ( Permit Fee $ CCF $ CO /CC Technology Fee $ DPBR $ Zoning $ See Reverse side –* Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N/A 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 issue.; In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or ►' nt The foregoing instrument was ac . owledged before me this The foregoing instrument was acknowledged before me thi day of ��7 20 /(, by ev/ / /7/S7 64( day of airi , 20 t , by , who is j ersonally known o e or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Signature Contractor NOTARY PUBLIC: Sign: Print: ,ate /t'. A4,€( ...s/ae/¢ My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * ** **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** •.•• "', , RUTH A. RODRIGUEZ Notary Public -State of Florida • +� •; My Comm. Expires Mar 25. 2014 "9 -%..� Ai •Commission # DD 970816 •° rAtl' Bonded Through National Notary Assn (Revised r' /0:/06 �I NOTARY PUBLIC: Sign: Print: My , orplpt49n xpiresiNGRYS FARIAS * :. `ay* ,Q 4I< Iic * *Rta f Florida My Comm. Expires Sep W `,'% 97 Commission # DD 924860 , ,; <<'° Bonded Through National Notary Assn. ) er Engineer Zoning 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): loG0t U e. q sr City: Miami Shores Village County: Miami Dade Zip Code: 3-3 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 n UNIT BEING REPLACED DATA NEW UNIT 1 MANUFACTURER - - Airs '-- -g AHU or PKG. UNIT MODEL # I .. a ` R. C. f4L_ — 2„1 COND. UNIT MODEL # r KW HEAT O K-4., • NOM TONS AHU • CU CPKG 1 M.C.A AHU © CU 3SPKG AHU 6,0 CU i PKG 2 M.O.P AHU cj CU a PKG AHU , 30 cu 2 PKG 3 VOLTS AHU` 'CU ,2:0 PKG PKG UNIT I 1 PKG UNIT 1 / g S EER /SEER iG YES NO ✓ REPLACING DUCTS YES NO V YES .-- NO REPLACING THERMOSTAT YES i'' NO YES NO — NEW 4 "CONCRETE SLAB YES NO ✓ YES NO ✓ NEW ROOF STAND YES NO YES NO �" NEW RETURN PLENUM BOX YES NO V- 1. Minimum Circuit Ampacity (Wire Size): V6 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480):, 20 4. Size Disconnecting Means: (7 Pc-K-4 ? S Contractor's Company Name: V a . C CC J-- ( K) 61 Phone: State Certificate or Regr.tration N. C F C. 0C--g (6S Certificate of Competency N. C- L C 5 ( ( Signature L./' (Qualifier's signature only) Date: f/30/96// Ce This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. ifficate of r AHRI Certified Reference Number: 3799429 Date: 9/30/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 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 verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 46000 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 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.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, " A click on "Verify Certificate" link 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 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129618686863974315 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): 100C( U c 614 sr City: Miami Shores Village County: Miami Dade Zip Code: 3. 1 3e 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 ARHI Sheet Attached: YES ErNO ❑ Contract Attached: YES ®%' Change Disconnecting means: YES ❑ NO 111 UNIT BEING REPLACED DATA NEW UNIT 1 e_x .I MANUFACTURER' .' `g ■ AHU or PKG. UNIT MODEL # r ;t COND. UNIT MODEL # �t.. KW HEAT ®` • NOM TONS AHU , CU PKG 1 M.C.A AHU " ,4 CU 3S PKG AHU y,, CU ' ,• PKG 2 M.O.P AHU; PKG AHU 2,', CU 2 PKG 3 VOLTS AHU CCU; : 0 PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO ✓ REPLACING DUCTS YES NO YES r NO REPLACING THERMOSTAT YES ✓ NO YES NO ✓ NEW 4 "CONCRETE SLAB YES NO tr YES NO .r NEW ROOF STAND YES NO k.o YES NO ✓ NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): C, 2. Maximum Overcurrent Protection (Fuse /Breaker Size): C,n lortuT 3. Voltage of Circuit (208/240/480): 30 4. Size Disconnecting Means: G0 pou' Contractor's Company Name: Li Phone: State Certificate or Re • is tion N. p 2 (62t2 Certificate of Competency N. C L( C—, 5 f Signature (Qualifier's signature only) Date: 9130/913.( This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. uct "atin.s AHRI Certified Reference Number: 3799429 Date: 9/30/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 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 verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 46000 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 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.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, click on "Verify Certificate" link 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 LE © Air- Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129618686863974315 AffloweaskeL.AtThrimentltfa, CONTRACT We hereby submit specification for Equipment installation Indoor Air Quality 0 Other Millar will furnish all parts, labor a dpunait necessary to faclEtale the service checked above in accordance wilh the candid= and specifications listed ki Ills contact. Does not hIchide electrical pagoda unless stated. CONTRACT 6781 W. Sunrise Boulevard, Plantation, Florida 33313 Phone: (954) 566-4644 • Fax (954) 667-1290 www.ayeakcom Est. 1973 with over 150,000 Installations PURCHASER NAME ADDRESS CITY/STATE/DP E-MAIL HOME PHONE If LAI s IWO+) loci Ale qq,q -57-. /AM / (I oilg.S, ft 3 31r8.:.; Al 51E61 Al e /1-0..f,•-co•si 305-54'l'2.157 CELL PHONE 0 Duct Cleaning & Sanitizing e, Vents If 0 UV Light 11 Modify/New Supply Duct(s) o Modify/New Return Duct(s) Size : _ x Qty 0 New Return Air INDOOR AIR IMPROVEMENT of Duct ' - ems Cl High Quality Air Filter Location 0 High Quality Air Cleaner Weston RETURN & SUPPLY DISTRIBUTION ID New Supply Grill, Size: _...... QtY. _ 0 Seal Up Leaks In Ducts 0 Modifications of: ti Supply Pleriui*t 0 Return Air Plenum Spilt System • Package Unit ritHeat Pump Straight Cool Horizontal Application • ID Other SAKE 1 PA ctri 11 ftki Electric Heat / W.f. • eat Recovery Unit Of Systems • Vertical Application • , MODEL A thil61/01 Velf 1(1410,1M SEER 3 prAir Handler Breaker Wire Size 0 Use Existing XReplace 7iNew Breaker S'a Brand .;E. /961/6J6014.„ wfice 'Condenser Breaker Wire Size Use Existing 0 Replace New Breaker Brand .11,4 tat/ 66 it 7.71/ Electrical Disconi— Box in-nrie Float Switch P.:I ;Type of Thermostat - OWeather Resistant Vibration, isolaltDri Pads pit,11A-tirl n'rs FA 1 Year 1 Visit Maintenance Agreement 0 5 Year Extended Warranty 0 10 Year Extended Warranty CONDENSATION & COPPER PIPING Refrigerant Copper Suction Linewittiinsulation, Size: 0 Length of Run 0 New or Existing Copper 0.116frigerant Line Cover • • • Condensate Drain Hook-Up Primary • Secondary • New Condensate Pump 0 Auxiliary Drain Pan 0 Refrigerant Copper Liquid Line, Size: Liability and Workmen's Comp for Our Work Performed with Existing Codes 0 minting Hardware of Stand for Air Handler Hurricane Code Strapping 1 Year Warranty by All Year Cooling on work performed, and manufacturer's warranty on equipment unless otherwise stated below Labor provided by seller in this period Is Monday through Sunday. OTHER • Smoke Detector-Existing/New ' 0 Straps 0 Grails / Genie Lift ID Extend Slab 0 New Slab 0 Labor Needed Subtotal Permit Utility Rebate Man. Rebate Misc Credits INVESTMENT BREAKDOWN Ulilti cq $-,-76 0 $ I 5 $ /SZ° Total Investment $ 224° METE UNITS Balance D 356 ue $ . • $ $ • 1EBMS:any financing must be arranged paler to starting any work. Balance Cue to TecIulclan Span Corn At Year Cooling Rap. License *CAQb5S1BW94CME15Q6X, U16711, 08E000413, ER0012903 Manufacturer's Warranties Compressor Years ID'Condenser LS,LL. Years vaD. Coil r Years /0 Years Years DETAILS OF WORK PERFORMED - Rim 0 a no) wil.'..) - A/(^) Ak /0 V. cfer"t- wftiffAA 4 11. ,A/CC/ Date Customer Soave Oats SEERS FOR TERMS AND coNernorm BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000 VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012 DBA: Business Name: ALL YEAR COOLING /HEATING INC Owner Name: GRETA B SMITH Business Location: 6781 W SUNRISE BLVD PLANTATION Business Phone: 954-56674644 Rooms Seats Employees 10 Receipt #:183 -650 Business 7ype:HEATING /AIRCONDITION CONTR 2TR (AIR CONDITIONING & HEATINCD Business Opened:10 /03/1996 State /County /CertlReg : Exemption Code: NONEXEMPT Machines Professionals THIS RECEIPT MUST BE THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: GRETA B SMITH 6781 H SUNRISE BLVD PLANTATION, FL 33313 POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2011 - 2012 Receipt #03A -10- 00011520 Paid OB /11 /2011 27.00 For Vending Business um Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: GRETA B SMITH 6781 H SUNRISE BLVD PLANTATION, FL 33313 POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2011 - 2012 Receipt #03A -10- 00011520 Paid OB /11 /2011 27.00 igtel*0 - -141a Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. m C t© r I f l PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) MALMSTEEN, JAY Owner's Address 1009 NE 94 STREET Phone # 305 -542 -2151 city MIAMI SHORES Tenant/Lessee Name State FL Zip 33138 Phone # E -MAIL: Job Address (where the work is being done) 1009 NE 94 STREET City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1132050150011 Zip 33138 Is Building Historically Designated YES NO Contractor's Company Name ALL YEAR COOLING & HEATING Phone # 954 - 5664644 Contractor's Address 6781 W. SUNRISE BLVD City PLANTATION State FL Zip 33313 Qualifier Name GRETA B. SMITH Phone # 954 -566 -4644 State Certificate or Registration No. CAC058160 Certificate of Competency No. CMC511 E -MAIL: CMORGAN@AYCAIR.COM Architect/Engineer's Name (if applicable) N/A Phone # a -566 Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ['Addition DAlteration [New ❑ Repair/Replace ❑ Demolition Describe Work: REPLACE CENTRAL NC ******** *** * * * * *** ** * * * ** * * * * * * * * * * ** ** Fees, * ** * * * * * * * * ** ** * * * ** * *** *** * * * *** * * * * ** * ** Submittal Fee $ � — Permit Fee $ ¶ 31 1r �C% CCF $ CO /CC o..i� Notary $ raining/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ \ 1 o*1 See Reverse side -* LE) Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N/A 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature The foregoing instrument was ac day of OCTOBER , 20 , by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: (11, Print: 10 II _,* tr.- My Commission E NOTARY PL'BLIC•STATE OF FLORIDA Cheryl Morgan a I #DDB97935 yms Ewes: JUNE 28, 2 The foregoing instrument was acknowledged before me this °6 day of OCTOBER 20 , by Greta, B. St► , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: xpi es: c so �Dixc co., INC. $DxDED THRU ATLANrI 4:.:I..(1, APPLICATION APPROVED BY: (Revised 02/08/06) Sign: Print: • , ; PUBLIC'S L . IT OF FLORIDA Cheryl Morgan efloxtil (Yici ' yws COmmissio t}P39793S Expires: JUNE 28, 2013 BEDTHRU ATLANTIC RIMING Ca „ My Commission Ex ire S$O 't,.n. U) I `L� ID Plans Examiner Engineer Zoning 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): 9 Al L 9V S r. City: Miami Shores Village County: Miami Dade Zip Code: 33/36 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 g UNIT BEING REPLACED IIIIIIIIWAMMINalm AIGIIBINWINMIIIIII tardrrill DATA NEW UNIT MANUFACTURER �L AHU or PKG. UNIT MODEL # wirlarerrxmoma MV� COND. UNIT MODEL # 1 �' KW HEAT / 0 <6 AI NOM TONS AHU ()CU PKG 1 M.C.A AH % U ' 5-PKG AHU , d CU O PKG 2 M.O.P AH 6 CU ' ; O PKG AH CU, 30 PKG 3 VOLTS AH if 6C - E KG PKG UNIT / / P G UNIT I I gidif jortimi EER/SEER -�, DM - REPLACING DUCTSV rap■ NO REPLACING THERMOSTAT 471d4 NO YES CO) NEW 4"CONCRETE SLAB YES �z -,' YES 40 NEW ROOF STAND YES Vi�1 YES 1 • ` NEW RETURN PLENUM BOX YES 4 0 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): L. n °A-M 17 3. Voltage of Circuit (208/240/480): 9 3 / z� 4. Size Disconnecting Means: (0 a 11-74 (° S Contractor's Company Name: (I(2. / ( Gam? Phone: q —s66 --se State Certificate or Registration N. LO `S ' Rao Certificate of Competency N. CATIC.A1I Signature (Qualifier's signature only) Date: l 0 6 I U 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): /0 C} 5 Ai 6- 9' ST City: Miami Shores Village County: Miami Dade Zip Code; 3.R/36 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 IA ARHI Sheet Attached: YES NO ❑ Contract Attached: YES g UNIT BEI G REPLACED DATA NEW UNIT iligli�F1"� -�� 111111-41!f4ffF !#. 7A A!!`.1.1111111 IMINIMBERMIIIIMI MIIIIIIMMICIL �,� MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # 111111111111111111 IIIIIMIMIIIIIIIII f ELIMISMMIIIIIIII AH.M i C , ,: KG MEM WI ' Al 111111111111011,2 6 4111111 KW HEAT NOM TONS EZEIMIIIIIMMI11.1111111EMORMEINIIIII 2 M.O.P U PKG AHU o CU Li PKG AN) -MEMEG231.11111.1111 PKG UNIT / / 3 VOLTS -ACIIP I ILVIIIIIIIIIMIIIIIIIIIIIIII Call NO 111111111111116`i� ►b. `^ EER/SEER ('111111r04 REPLACING DUCTS ra ' NO REPLACING THERMOSTAT faiMirerdil.11111111.11. NEW 4 °CONCRETE SLAB COMMILOrt CEMIIIIECCY � liMillIMIMERIM 1E11111110i10 NEW ROOF STAND NEW RETURN PLENUM 1. Minimum Circuit Ampacity (Wre Size): / ) 2. Maximum Overcurrent Protection (Fuse/Breaker Size): (. 11 r'' ,," l p S 3. Voltage of Circuit (208/240/480) : 9-3 0 4. Size Disconnecting Means: t d 16171/ P5 Contractor's Company Name: L 4 (l7 ` Phone: State Certificate or Registration N. C COS- i l6b . Certificate of Competency N. ir.,1(Yi('A t I Signature r L z .Jm-LX (4e IMises signature only) Date: / b t, /I /6 UI °r dory This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. �foc to if Product fiir1 � AHRI Certified Reference Number: 3799429 Date: 10/6/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 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 -2006 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): EER Rating (Cooling): SEER Rating (Cooling): 46000 13.00 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 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.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. The information for the model cited on this certificate can be verified at wwwahriciirectory.org, i CERTIFICATE VERIFICATION click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on and Co frI a atIo Heating, which the certificate was issued, which is listed above, and the Certificate No., which Is listed below. ®an Refrigeration Institute ©2010 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129308564156305578 This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. AHRI Certified Reference Number: 3799429 Date: 10/6/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 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 -2006 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): 46000 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 product(s) listed on this CertMcate 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 Debility 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.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 Obis 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, click on "Verify Certificate" link 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. ©2010 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129308564156305578 ® ®Air- Conditioning, Heating, and Refrigeration Institute Miami -Dade My Home My Home Show Me: Property Information Search By: ........ _ ........................... Select Item • L] Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Summary Details: Page 1 of 2 Folio No.: 11- 3205 -015 -0011 Property: 1009 NE 94 ST Mailing YNGWIE MALMSTEEN &W Address: APRIL Living Units: 1009 NE 94 ST MIAMI Adj Sq Footage: SHORES FL Lot Size: 33138-2942 Property Information: Primary Zone: 1400 SINGLE FAMILY RESIDENCE CLUC: 0009 MIXED USE - RESIDENTIAL Beds/Baths: 0/0 Floors: 1 Living Units: 0 Adj Sq Footage: 196 Lot Size: 14,144 SQ FT Year Built: 1977 $0/$175,861 BELVEDERE PARK PB City: 16-71 BEG SE COR LOT $01$246,229 1 NWLY49.3FT Legal SWLY58.6FC Description: ELY76.58FT BLK 1 TO PCB & LOTS 8 & 9 LOT SIZE SITE VALUE OR 20753- 3796/21654-1315 1002 5 Assessment Information: Year: 2010 2009 Land Value: $152,755 $222,768 Building Value: $23,106 $23,461 Market Value: $175,861 $246,229 Assessed Value: $175,861 $246,229 Taxable Value Information: Year: 2010 2009 $0 Applied Applied Taxing Authority: Exemptmpt Taxable ion! Exe Taxable ion/ disqualified as a result of Value: Value: Regional: $01$175,861 $0/$246,229 County: $0/$175,861 $0/$246,229 City: $0/5175,861 $01$246,229 School Board: ' $01$175,861 $0/$246,229 Sale Information: Sale Dale: 10/2002 Sale Amount: $0 Sale 0 /R: Sales Sales which are Qualification disqualified as a result of Description: examination of the deed View Additional saws Additional Information: Aerial Photography - 2009 0 115 ft My Home I Property Information I Property Taxes I My Nelohborhood 1 Property Appraiser Home I Using Our Site I Phone Directory I Privacy I Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami -Dade County. All rights reserved. ,.,.,,.....,.1 .------- :- 1--1 cirven nr" cri Legend Property /4' Boundary Selected Property Street Highway Miami -Dade County Water 10 /5/2010 Ainw, yR.c,w.e CONTRACT We body submit spectecations for won Indoor Ali 4aalllll 0 Other to Year Cooing wiff turrdse all labor summed necessary to the stake ARMS abtse b gbh cones:Loom not iodude electrical upgrade CONTRACT 6781 W. Sunrise Boulevard, Plantation, Florida 33313 Phone: (954) 566 -4644 • Fax: (954) 667 - 1290 wttwv.aycalr com Eat 1973 with over 150,E installation PURCHASER _NAME ADDRESS WY/STATE/MP E -MAIL HOME PHONE. Jrr! MALMsTf,EA") 4OMl V4011,6,5, Ft 33138: r✓IAU M S1E6,n 6 r 1 eAvo.c. �•r+ CELL PHONE • ' O5 `.S '/Z' 235 et INDOOR AIR IMPROVEMENT 0 Duct Cleaning & Sang * vents #..___. of Duct O UV light O Modify/New Suppiy Duct(s) OModify/New Return s} Par..kage Unit reat Pump Straight Cool Horizontal Application . 0Other. NUE O High Quality Air Filter O High Quality Air Cleaner. RETURN & SUPPLY DISTRIBUTION O New Supply Grill, Sizes x Qty. O Seal Up Leaks In Duets e 0 Modifications of 0 Supply Ptent,SA CI Return Air Planner Location Location .._. x _ Qty. U Electric Recovery Recove Of systems AI Vertical Application Moos. 1 2140/1 a HUH yg a I Li Or) 2 d 'Air Handler Breaker Wire Size O Use Existing y, Reps I' 2INew Breaker AV Brand le ILE,J4 64. 77f rote O. Breaker Wire Size wo NExlatin9 ❑ Replace ;1.:.... .;.: New Breaker Brand and eftiatzeK1czR. 7'flle44 Electrical r}I:.•• Box OTNE . inrrtna Float Switch r, Type ofThermostat SpedtY >�,o�,t,�M n+t'� • Weather Resistant Vibration. Iso ri.Pads , '4 1 Year 1 Visit Maintenance f'+greettt®rtt` ©5 Year Extended Warranty ❑ itlitear Extended Warranty CONDENSATION &COPPER PiPING Condensate Drain Hook-UP' O i Drain . New Condensate Pump _111 Se•ort•al 0 Refrigerant Copper Liquid Une, Size Liability en's Comp for Our Work Performed with 0 og Hardware of Stand far Air Handier Hurricane Code Strapping 0 Refrigerant Copper Suction Unevilifi hsulatlon, Sire O Length of S Q.� {fit cover ❑ New or Odsting Copper OTHER stalls • Smoke DeRector- ExIlstir NeW0 • Qeite / Genie lift O Extend Slab New Slab liitrr Needed WARRANTIES ral 1 Year warranty by All Year Cooling on work performed, and manufachaer'a warranty on equipment unless otherwise stated below Labor provided by seller s pew is Monday Omagh Sunday. INVESTMENT BREAKDOWN Subtotal Permit $ r/O a Utility Rebate! Man. Rebate s--1/5"`4P 5`0 Misc Credits $ Total investment $ 22 -Jet Unit 1 $ q.. IN nt2 UST $ $ Balance Due $ . 5_ _t $ $- TOMMAnyfiromelng nest be arranged pry t startlrt9 ony work. Balance Duet. don Upon CO Mandecturer's Warranties Compressor r Years . Coil t Years /0 Years r ri Years DETAILS OF WORE PERFORMED o✓6 I .1 D L, CA -gedl.. Al ' ittlegi4 1"'1 (A1 DGJGth pde CUSWIRerire 94CMEi 506X, U18711, 08E000413, ER0012903 ogle sEEREVEAse FOR Mit/iS Ate CMNDmONS