MC-11-2226Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 167214 Permit Number: MC -11 -11 -2226
Scheduled Inspection Date: February 27, 2012
Inspector: Perez, JanPierre
Owner:
Job Address: 320 NW 112 Terrace
Miami Shores, FL
Project: <NONE>
Contractor: DIRECT A/C & REFRIGERATION
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1121360010250
Phone: 305 - 596 -2666
Building Department Comments
REPALCEMENT OF A/C SPLIT SYSTEM 3 TONS
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
February 24, 2012
For Inspections please call: (305)762 -4949
Page 14 of 43
1A0F‘t
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
NOV 302011 J
Permit No. 1\1122 [ 1 aG 2
Master Permit No.
Permit Type: MECHANICAL
OWNER: Name (Fee Simple Titleholder): ' i C3 (K+ A L L-
Addresss :: 14i!2, -A\r ue_
City: W 6g State:
Tenant/Lessee Name: Phone #:
Phone #: WI 4 q; �D t(
Zip: 3 (1-1i31
6410 3�L i
Email:
CISM1) 1•moo AML. COM
JOB ADDRESS: Z, 2t) NW J 12 Ter-42-AG
City: Miami Shores County: Miami Dade
Folio/Parcel #: `
Is the Building Historically Designated: Yes NO `i,/ Flood Zone:
CONTRACTOR: Company Name: ...b) f? e...1 2- i'o4 d / +i, 60 in,/ Phone #: 366 .57(0 ' 2 (/ L4
Address: i 2 ii,, If SO 97% SI •
City: °I1 I'cii` -f 1
Qualifier Name: J \C(/) St,--kb roe() %
State Certification or Registration #: L C((O . . \ - - ) 3 ) . d Certificate of Competency #:
Contact Phone #: Email Address: i U 6q ✓1 0 U i %.t? `7 C&e / 22 • (rLL 1 ,
DESIGNER: Architect/Engineer: Phone #:
trJ-r)
Value of Work for this Permit: $ L Square/Linear Footage of Work:
Zip: i4-,t
State: 0-
zip: 331 7f--
Phone#: 3 (J� -3 -2 Li 7 "a
Type of Work: ❑Address
Description yf Syork:
Alteration
❑New
❑Repair/Replace
❑Demolition
Fee $ Permit Fee
e
s
* ** ***** * ** * * * * * * * * * * * ** * * * * * * * * * * * * * **
Submittal Fe $ �CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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, BOIT.RRS, 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 estimate
promise in good faith that a copy of the notice of commencement and construction li
whose property is subject to attachment. Also, a certified copy of the recorded notic
for the first inspection which occurs seven (7) days after the building permit is
inspection wl not be approved and a reinspection fee will be charged.
Signature
,dize,aafiLf
exceedi 500, the applicant must
re will be delivered to the person
ement must be posted at the job site
absence of such posted notice, the
Owner or Agent
The foregoing instrument was acknowledged before me this The foreg
day of , 20 _, by , day of
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
Contractor
ent was acknowledged before me this
, 20 _, by
NOTARY PUB
MANUELAMAOOR
MY COMMISSION 9 DO 919814
EXPIRES: August 25, 2013
Bonded YAfu Natty Pubic Undernriters
Print:
My Co 'scion Expires
as identification and who did take an oath.
NOTARY PU
Sig:
Print:
My Co ission Expi
i
A It
:,, MY COMMISSION919814
'1 EXPIRES: . ust 25, 2013
San ?;. Nu
s:
** �x.x a� * �x .x** .x�x�x �x �w ` �x �x.x �x�x�x+�* ? �x �e�*** ************************** ** * *** ******* **o * ******** ******
APPROVED BY / ' Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
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): 3 12. fr
City: Miami Shores Village County: Miami Dade Zip Code: 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 ❑
UNIT BEING REPLACED
DATA
I NEW UNIT
yll ,ezil
MANUFACTURER
U 4- te---
all ) '719
AHU or PKG. UNIT MODEL #
b 3 b
Q IL_ L d 3e,
COND. UNIT MODEL #
A 3(,�
11C. LA)
KW HEAT
7 IGLU
3 7,-i
NOM TONS
.3
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 I l
PKG UNIT I l
I L)
EERISEER
I �.
YES NO
REPLACING DUCTS
YES N9i
YES NO
REPLACING THERMOSTAT
E NO
YES NO
NEW 4"CONCRETE SLAB
N��
YES NO
NEW ROOF STAND
YES
YES NO
NEW RETURN PLENUM BOX
YES
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fusel
3. Voltage of Circuit (208/240/480): .7`
4. Size Disconnecting Means:
Contractor's Comp,. Name:
State Certificate or
Signature
F
reaker Size): to e' 6 -
U\
Phone: (..7‘ 1)a Z 1, tk
Certificate of Competency N.
ifler s signature only)
Date:
Direct Air Conditioning
305- 551- 1546 p.2
■ : CERTIFIED TM
www.ahridirectary.ortj
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2011.
Certificate of Productati�I�s aa.
AHRI Certified Reference Number: 4412392 - Date: 11/30/2011
Product: Split System: Air - Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: YCJF36S41S1
Indoor Unit Model Number: AHE36C +TXV
Manufacturer: YORK, UNITARY PRODUCTS GROUP
Trade/Brand name: LX SERIES
Manufacturer responsible for the rating of this system combination is YORK, UNITARY PRODUCTS GROUP
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 (Stull): 35000
EER Rating (Cooling): 13.50
SEER Rating (Cooling): 16.00
* Ratings followed by an asterisk e) Indicate a voluntary rerate of previously publ: hed data. unless accompanied with a WAS. which indicates an involuntary relate.
DISCLAIMER
AHRI does not endorse the product(s) listed en 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 lids Certificate. Certified ratings are valid only for models and configurations listed In the directory etwwo.ahridlrectoryorg.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRi. This Certificate shah 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, exceptforthe user's individual, personal and confidential reference.
CERTIFICATE VERIFICATION
The information fartha model cited on this certificate can be verified at www.ahridirectory.org, ,
click on *Verily 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 fisted below.
�■�Air - Conditioning, Healing.
and Refrigeration Institute
02011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 123671488077008587
305- 551- 1546
Direct Air Conditioning
QUANTITY
• PARTS
Email: directacflorida @aol.com Yr(�
Web: www.directac123.com
r Invoice
p 1 RE --■— trrti
16186
SPECIAL7r
PH: 305- 596 -2666 i Ir '`\ Q WARRANTY
FAX: 305 551 -1546 0 AIR CONDITIONING ❑ CONTRACT
RESIDENTIAL & COMMERCIAL BBB ❑ SERVICE CONTRAC1
12920 SW 128 Street. #7 SINCE 1995 ❑ NORMAL
Miami, FLAA3��3186 STATE CERTIFIED CONTRACTOR / LICENSED & INSURED CACD57328 ❑ RES ❑ COMM.
NAME M C
lQ ki-ikd
I eJe T.
REFRIGERANT/ ENVIRONMENT CHECK LIST
TYPE REFRIG
I RECOVERED? YES NO or;
STREET32 4 l jj i U 2 4-: j UNIT# It (t
CITY rn STATE r ZIP
Qi 1 1 ores i� (. '331 GO
2 RECOVERED? YES NO OT‘ _
3. RECLAIMED? YES No OW _ .
RETURNED TO
THIS SYSTEM? YES NO OT1
4. DISPOSAL
PHONE �C� 5 cell _ _' Q I I E-MAIL
�� Y
MAKE MODEL
NON YES CITY
USABLE NO
5. DISPOSAL
SERIAL NUMBER
Work
Owner
Initial)
DESCRIPTION
MPA
NORMAL
Suggested
Required
Accepts
Declines
Oty
F 1
lloifs oln 3.0 -roi4 t tp s�C.
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1'
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4r4i 0 c0 T-g F'P�
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�- 3 Ad-24
MPA INFORMATION,
TECHNICIAN NOTES
MEMBER ■YES ■ NO
�-
t, f■
-
SAVINGS TODAY
AcHECKM:A
Effective:
I 0 Y�.S Pty-
-s
■CREDIT
II
111
CARD # ENDING IN
1st Visit
1 1 (
CASH
FINANCED (PROMO)
2nd Vie
7[NbOr
DIAGNOSTIC CHARGE
REPAIR CHARGES
JOB TOTAL
'LRESATE
DEPOSIT
BALANCE DUE
TOTggLAMOUNT
Expiration
TECHNICIAN SIGNATURE X i
TERM
W DID YOU HEAR ABOUT US ?-
i have the auth city too
plPHOBOOK 0 INTERNET II CUSTOMER above. It is ag ed that
NE
MAIL ■ RE M/�1E DED THER material furnish d until
Isettlement is not. made
remove same and the
/ • resulting from the removal
UPON COMPLETION
er the above work and do so order as outlined
Direct Air will retain title to any equipment or
final and complete payment is made, and if
as agreed, the seller shall have the rigth to
seller will be held harmless for any damages
thereof
S
J);
Customer Signalefr� Date Note: All prices shown are after FPL rebates have been
applied, 90 day warranty on water leaks.
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