Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
MC-11-2203
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C l� Inspection Number: INSP - 169308 Permit Number: MC -11 -11 -2203 Scheduled Inspection Date: February 01, 2012 Inspector: Perez, JanPierre Owner: MILLER, EDWARD Job Address: 142 NW 100 Street Miami Shores, FL 33150- Project: <NONE> Contractor: MASTER MECHANICAL SERVICES, INC. Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)807 -4045 Parcel Number 1131010220340 Phone: 305 - 825 -3004 Building Department Comments REPLACE AIR CONDITIONING UNIT 2 1/2 TONS 2‘1,1 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP - 167111. a/c work OK but need tc seal closet ceiling jpp January 31, 2012 For Inspections please call: (305)762-4949 Page 27 of 39 49 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 Permit No. I f I C t 1' 2tB Master Permit No. --11 L 1•' 24,37 p ) fril P cO % -t �, c 7a� iv7 -4/oy5. OWNER: N //acme (Fee Sim le Titleholder : � �} WI � �CO� PGi l/ � � �%� Phone #: Address: �/ 0 /`% E. 11 5/44" I City: iii /04;4/11 ; ktitO or State: FL- Zip: 3 3 /( Tenant/Lessee Name: Phone #: Email: (41 1 P ilt1 / /'A) ✓r 54'ks , G 0 JOB ADDRESS: (y2 IV t /00 $..ftko e City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: /7 3 / 0/ U 22 0 3Y(9 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 00, di-er`4 TI'S • Address 4S2 01.0 33 RD ,� City: State: 1t Zip: 53/ Qualifier Name:' 4 061,-9 e� Phone #: S 51 �Zt r State Certification or Registration #: /, 16�1� 554/ Certificate of Competency #: Contact Phone #: 30 3 (V Email Address: 1 /1E0© tL e J t > • a r» DESIGNER: Architect/Engineer: P/A Phone #: 118t Phone #: 3% 1 ' of i O Value of Work for this Permit: $ate • b0 Square/Linear Footage of Work: 1 WO • Type of Work: ❑Address ❑Alteration ❑New epair/Replace UDemolition Description of Work: al >14 161 ********* * * * * * * * * * * * * * * * * * ** * ** * * * * ** **F s * ** ******* * * *** * * * * * * * * * ** * * * * ** *** * ** *** Submittal Fee $5 r t Permit Fee $ V ` CCF $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ CO /CC $ 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 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 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 po ted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the ab of posted notice, the inspection will not be approv' < einspection fee will be charged, Signature Owner or Ag- ut The foregoing instrument was acknowledged before me this / day of 1 8 / 11 , 20 1 I , by etoC4c who is personally known to me or who has produced -Die_ As identification and who did take an oath. NOTARY PUBLIC: Contract. t Tile foregoing instrument was acknowledged before me this 1 8 day of kISSISIA.Q9 a , 20 l 1 , y ∎• 44..9.11.0 who is personally known to me or who has produced �L L as identification and who did take an oath. NOTARY PUBLIC: ROXANA PEREZ MY COMMISSION # DD 857995 • ,:,, EXPIRES: June 1, 2013 o ° -1. Bonded Thru Notary Public Under writers P My Commission E 4e�Y**** **** ***** roY3e **** *** ** ***** **** ******** **** * **** ********** ** * *** APPROVED BY (Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) ,,... l J 857995 :ae 1, 2013 .:d notary Public Underwriter; Plans Examiner Zoning Structural Review 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. Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: 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 f] ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT 144-jteAs MANUFACTURER evert* 24r1V1# GA S ®1-4 $ 3o evil AHU or PKG. UNIT MODEL # f}D 2 • 3D 6,D 030iK COND. UNIT MODEL # 4A-if ^ bp KW HEAT f�,{} e.7-� 0¢� NOM TONS 2- a-. AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EERISEER L3/ ' - YES NO REPLACING DUCTS YES %Iv YES NO REPLACING THERMOSTAT NO YES NO NEW 4 "CONCRETE SLAB E NO YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 0J 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: State Certificate or Registration N. Signature Phone: `r-991Ta,2'8 Certificate of Competency N. Date: signature on i Certificate of Product Ratings AHRI Certified Reference Number: 3585482 Date: 11/19/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: MAH- 30-410 Indoor Unit Model Number: HD2-30 Manufacturer: EAIR LLC Trade /Brand name: COMFORTSTAR Manufacturer responsible for the rating of this system combination is EAIR LLC 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): 30000 EER Rating (Cooling): 11.20 SEER Rating (Cooling): 13.00 • Ratings followed by an asterisk (•) indicate a voluntary rerate of previously published data, unless accompanied wtth 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 products) 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 CERTIFICATE NO.: 129661861929953478 PEA IN Air-Conditioning, Heating, ®s ®® and Refrigeration Institute Master Mechanical H.V.A.C. Corp 4521 NW 33 AVE Miami, FL 33142 Name / Address Optimal Repairs & Services,Inc Fernando Toll 10317 SW 24TH St Apto 205 Miami,FL 33165 -7959 Estimate Date Estimate # 11/26/2011 1146 Ship To Miami Property Solutions LLC Miami Shore, FL 33161 USA Description Qty Rate Total Provide,deliver and installations of 1- New 2 TON Comfort Stars 13 SEER air conditioning system. Includes : Materials,Crane and Labor. 1 2,000.00 2,000.00 Thanks for choosing MASTER MECHANICAL H.V.A.0 CORP. Total $2,000.00 Phone # Fax # E -mail Web Site 3053946218 3053595742 info@mastermechanicalair.com www.mastermechanicalair.com Authorize by: Tv: t3ee 6 06 -04 -2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual fisted below has elected to be exempt from Florida Workers' Compensation taw. EFFECTIVE DATE: PERSON: FEIN: 06/04/2010 EXPIRATION DATE: 06/03/2012 DE LA NUEZ RIDER 270782811 BUSINESS NAME AND ADDRESS: MASTER MECHANICAL HVAC CORP 4521 NW 33 AVE MIAMI FL 33142 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED AC CONTRACTOR * * IMPORTANT: Pursuant to Chapter 440 . 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election ander this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates at election to be exempt... apply Daly within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.051131, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shalt revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 PLEASE CUT OUT THE CARD BELOW QUESTIONS? (850) 413 -16C AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OP WORKERS` COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 06 /04/2010 EXPIRATION DATE: 06/03/2012 PERSON RIDER DE LA NUEZ FEIN: 270782811 BUSINESS NAME AND ADDRESS: MASTER MECHANICAL HVAC CORP 4521 NW 33 AVE MIAMI, FL 33142 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED AC CONTRACTOR IMPORTANT F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election �- under this section may not recover benefits or compensation under this D chapter. H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on Rthe notice of election to be exempt E Pursuant to Chatter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shalt be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 CERTIFICATE OF LIABILITY DATE(MNUDD/YYYY) INSURANCE 1 11/28/2011 .l- 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(iee) must be endorsed. H SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement Astafement on tbls ceftlllcate does not confer rights to the certificate holder In Ileu of such endorsem®M(e). PRODUCER ADVANTAGE INSURANCE OF AMERICA 4520 NW 7th St Miami, FL 33126 CONTACT M PHONE No, Extx (305) 649 -5566 IrAl No (305) 649 -5559 ,,DDtss.jackiebatista 749 @hotmail.com PRODUCER CUSTOMER ID e: INSURERIS) AFFORDING COVERAGE WUC# INSURED MASTER MECHANICAL H . V . A. C CORP 4521 NW 33 AVE MIAMI, FL 33142 INSURER A: AMERICAN VEHICLE INSURER B: GL- 788200 INSURER C: 06/01/12 INSURER D: $ 1,000,000 $ 100,000 INSURER E: PREMISES S °( NEN ' ) INSURER F: 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. DOR LTR TYPE OF INSURANCE ADDt rum SUER yam, POLICY NUMBER POLICYEFF (MMIDDIYYYY) - POLICY EXP (MMIDD/YYYY) LIMITS GENERAL IJABIL TY COMMERCI4L GENERAL ICLAIMS-MADE LIABILITY OCCUR GL- 788200 06/01/11 06/01/12 EACH OCCURRENCE $ 1,000,000 $ 100,000 R PREMISES S °( NEN ' ) MED EXP (Anyanepereon) $ 5 , 000 PERSONAE. F ADD INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER POLICY n JEPRer E LOC PRODUCTS - COMP/OP AGO —I $ AUTOMOBILE LIABILITY ANYALJTO ALLOWNEDAUTOB SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ear $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ — PROPERTY DAMAGE ( ) $ — $ $ UMBRELLA UAB EXCESS UAB OCCUR CMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRCPMETCRPARTNEWEXEcUTVE YIN ❑ below N IA y �7 T� pTH_ 'TORY LIAIIAIT$ 1 1 ER EL EACH ACCIDENT $ o F CERNE BER DI C IInED? (tldatWy 111 P01) Ifyes, desate under DESCRIPTION OF OPERATIONS EL DISEASE- EA EMPLOYEE $ EL DISEASE- POLICY LIAR $ - DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD101, Addlt RumarksSchedule,if mmespaoeIs required) - AC INSTALLATION,SERVICE AND REPAIR CERTIFICATE HOLDER CANCELLATION Miami Shores Village. 10050 NE 2nd Ave Miami Shores, FL 33138 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE alfe—el,fo- ACORD25 (2009/09) ®1988- 2009 CORPORATION. All reserved. The ACORD name and logo are registered marks of ACORD EACH NUMBER 66 cansammtwom THIS IS N O T BILL DO NOT PAY 2011 LOCAL BUSINESS TAX RECENT 2012 MIAMI-DADE COUNTY - STATE OF FLORIDA MUST BE DIS��SET%�CE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 A 10 67-3 w;ECEIPr NO. NEWM, NAME/ LOCATION' 690840 -5 MASER MECHANICAL H V A C CORD STATES CAC1816537 45 1 NW 33 AVE 331;2 UNIN DADE°COUNTV OWNER MASTER Sec. stB CHANICAL H V AC CORP nos ffi o 6aC MECHANICAL CONTRACTOR WORMER /S BUSS NOT ° 1 i i ZONING COUNTY �O Puler OR BY IA NOT A THE HOLDERS TONS. U POSTAGE PAID WAHL FL PERMIT NO. 231 - A MWRI ft i TAX 09223/2011 09010255001 001075.00 SEE SIDE DO NOT FORWARD MASTER MECHANICAL H V A C CORP RIDER R DE LA NUEZ PRES 4521 NW 33 AVE MIAMI FL 33142 I.. II. Il... dl. l.. l..1.i.L.I.di.u.ILIi....I.L »Hf