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MC-11-1555Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ,1 L Inspection Number: INSP- 170239 Permit Number: MC -8 -11 -1555 Scheduled Inspection Date: February 27, 2012 Inspector: Perez, JanPierre Owner: LEONE, CAROLYN Job Address: 1611 NE 105 Street 5 -3 Miami Shores, FL Project: <NONE> Contractor: HILL YORK SERVICE CORP Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1122300530740 Phone: (305)756 -6501 Building Department Comments EXACT REPLACEMENT OF 2.5 TON SPLIT SYSTEM 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- 163680. no one home @4:45 February 24, 2012 For Inspections please call: (305)762 -4949 Page 33 of 43 \yo Miami Shores Village Building Department /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 116, (0,113g 71310. AUG 2O11 Permit No. M211 Master Permit No. Permit Type: Mechanical Owner's Name (Fee Simple Titleholder)( .L. L iO.J1'') tlee I i. Phone # Owner's Address 11Q11 105 i `Q_€ i-- Cityl M l l WS State FL- Zip 33.1 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) 1(0 11 PV e Jos �4 City Miami Shores Village County Miami -Dade FOLIO / PARCEL # Zip 33)38 Is Building Historically Designated YES NO Contractor's Company Name O(� Phone # �o 71 Contractor's Address 0) a'�j 3 e c,J to City ., (& do I-€ State i=(v. Qualifier Name 016.X1C Kern2� State Certificate or Registration Noe_ 2C1-31,0 ® E -MAIL: )IC 4 5 fro ( hLLL yo✓t .cm Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 4/9 °° Zip 333 Phone # Certificate of Competency No. l g3 --cQ36919 Phone # Square / Linear Footage Of Work: Type of Work: DAddition ['Alteration ONew Repair/Replace D Demolition Describe Work: I p1QCet' / l2 i- of 4 g.s ion ,e-ALLstisern * * * * * * * + * * * * * * * * * * * * * ** * * * * *** * * *** * ** Fees***+********* * * * * * * + * * * * * * * * * * * * * * * + * * * * * * ** Submittal Fee $ Permit Fee $ 161, "1 CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 19-D.1-1 See Reverse side -+ g 74 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 FJ.F.CTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIT.FRS, 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 roust 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 '; ,� ; 7 Owner or Agent The foregoing instrument was acknowledged be tore me this day of , 20 l l , by Ui1I 0 fjs ss Slur , who is person ly known to me or who has produced 1 LJ(J(.fe--.L..... As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: YARISMAR CASTRO * MY COMMISSION # EE109306 EXPIRES August 07, 2015 My Commission Expires: ***** * * * * * *** * * * * ** ** * * * *** * * * ****** APPLICATION APPROVED BY: (Revised 02/08/06) Co tractor The foregoing instrument was acknowledged before me this day of %.1 �� -, 2b I ,by who is persona' y known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 'K MY COMMISSION # EE109306 EXPI" S •us ,2015 My Commission Expires * ** t- ****** **** *** ** **** *** r* ******* *** * *** * ***** **4****** ******** <c).D 8 tii M 1 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): 1(0l 1 AIE_ 105 61 City: Miami Shores Village County: Miami Dade Zip Code: 3313 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 Uf ARHI Sheet Attached: YES FA NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT i MANUFACTURER iQ-f Le-Wii.va I ® t, 3Cpll AHU or PKG. UNIT MODEL # AALP COND. UNIT MODEL # KW HEAT Q95 NOM TONS , 5 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 / / EE SEE YES NO REP NG DUCTS Y osv YES NO REPLACING THERMOSTAT NO YES NO NEW 4 "CONCRETE SLAB S 0 YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 0 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Brea er Size): 3. Voltage of Circuit (208/240/480): J03 0)4D 4. Size Disconnecting Means: Contractor's Company Name: 4-h 11 ')0ri' - State Certificate or Registration N. CA 0. 0203 (0 0 Certificate of Competency N. 183 —030 &I 9 Phone: Zit ` 55 . 4 Signature (QuaYfier's 4nature only) Date: Miami -Dade County. Real Estate Tax Information Page 1 of 1 Show Me: Property Taxes Search By: Select Item Detail Tax Information: Real Estate Tax Info 2010 Taxes Prior Years Taxes Due 2010 Ad Valorem 2010 Non -Ad Valorem 2010 Back Assessments 2010 Enterprise Folio 2010 Historical Abatements 2011 Quarterly Payments 2010 Tax Notice/Memorandum © 2002 Miami -Dade County. All rights reserved. Real Estate Tax Information Today's Date: 08/18/2011 Last Update: 08/16/2011 Tax Year: 2010 Folio Number: 11 22300530740 MIAMI SHORES Owner's Name: JEFF ORTMAN Property Address: 1611 NE 105 ST 5-3 Mailing Information : JEFF ORTMAN 1611 NE 105 ST #5-3 MIAMI SHORES FL 331382117 Legal Description : HARBOUR CLUB VILLAS CONDO TOWNHOUSE 3-5 UNDIV 1/79TH INT IN COMMON ELEMENTS CLERKS FILES 69R143006 To view 2010 Tax Notice/Memorandum click here 2010 Taxes are in paid status. Amounts due are subject to change without notice. Contact Information E -Mail: proptax@, miamidade.gov (305) 270-4916 Downtown Office: 140 W Flagler St., Room 101 Miami, FL 33130 Office Hours: Mon - Fri 8:00 AM - 4:30 PM Related Links: Tax Collector Property Appraiser Florida State Dept of Revenue Property Tax Home 1 Real Estate Tax Info 12010 Taxes [Prior Years 12010 Non -Ad Valorem 2010 Back Assessments 12010 Enterprise Folio 12010 Historical Abatements 12011 uartedv Payments I 2010 Tax Notice/Memorandum Miami -Dade Home 1 Usino Our Site 1 About 1 Phone Directory 1 Privacy 1 Disclaimer E -mail your comments, questions and suggestions to Webmaster http: / /egvsys.miamidade.gov :1608 /wwwsery /ggvt/txcaw01.dia ?folio =11223 00530740 8/18/2011 A....1 CERTIFIEDTM www.ahridirectary.org 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 Ratings AHRI Certified Reference Number: 3805936 CEE Tier: CEE Tier 3 (Advanced) Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM30 Indoor Unit Model Number: RHKL- HM3821 +RCSL -H *3821 Manufacturer: RHEEM MANUFACTURING COMPANY Trade /Brand name: RHEEM 14AJM SERIES Date: 8/22/2011 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): EER Rating (Cooling): SEER Rating (Cooling): 30000 13.00 16.00 * Ratings followed by an asterisk (1 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 fisted on this Certificate. Certified ratings are valid only for models and configurations listed In the directory at www.ahridlrectory.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 othennise 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.ahrldirectoryorg, click on "Verify Certificate" Zink and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is Bated above, and the Certificate No., which Is listed below. ©2011 Air - Conditioning, Heating, and Refrigeration Institute 11-110' Air - Conditioning, Heating, rill No a/ and Refrigeration Institute CERTIFICATE NO.: 129585157428747500 HILL YO ' SERVICE CORPORATION P O. Ben nuts Fort Laode.dok, FL 33135 -0155 Phase: 954•525.4200 - Fax: 954-70.754S • Toll Free: ldCTl- 5.4 C) Project Estimate Re: ANC that Eridateetannt Date: August 41, 2011 To: Mac Fax: WElitma Steele 1611 NE 105th Stream Miami Shows, Flodda 33133 936.499 -2641 Proiltel ale We propose to supply labor and material to remove and replace your existing 2.5 -tens split A/C system. The new equipment will be a RHEEM High Efficiency 16 SEER Split System with t'araable Speed Blower, and will match the specifications of your existing equipmei a Included in our price is the reconnection of existing power wiring, control wiring, ductwork drain piping, refrigerantpiping, ate of refrigerant charge, disposal of existing equipment, permit and associated fees. This unit has a 00 0.00 FP&L rebate that will be deducted from your price and also qualifies for the Energy Efficiency Tax Credit. Upon completion of the project the system will be started and tested for proper operation. Thank you for providing Hill York Service Corporation this opportunity to serve your air conditioning needs. This price will include all materials, labor and applicable sales tax. Any questions please call. W M Mail` (10) year on pmts with on-line migration. Hill York Service Corporation (90) days on all labor inclusive of this contract and does not y to any other par& of the system. NOTE: Any buntling ogle »ineadm that may be required rnne Au work must be done during nomad business bola "Wine the pdntartmiedal,aq ,aroma, hletmmdmoamaem Csoishestedief theo dsmmea.eent,laergd r4 1bytlwcode.A sisdatimptice io xxxam chola ioprice fiomtffiBm .imm the dataapdarmaeey® emirs aae x5* pasta S Hpriea ustme,sErabas tp gma9.m� ,, WAIN xxxiptearaberdreensvisof a ltoe.' w4molhaddivaydmaxxhlx iaddenzstesnoi smded wale pamrt,0a:artga nlpa, vatveaF .DOMte;PAM At 1.0.,, P.,1°N Sewefiaftew Sim brs MW'.ork.e1.9". eassitalltsda utxrahxd.blitixfod tough Do Nth arrmaa awtc«vsr l nol kid docuatoolar Wit korradtettaditod wibtsathdelty.' Your Investment On A Meese 16 SEER w/$580 'P&L Rebate ......... Your Investment On A Rheem 15.5 SEER iv/ $320 bsP&L Rebate .... . Your Investment On A Rheean 14.5 SEER w!$165'EP&L Rebate ....... Pater Term: S4% deposit with the balsam deewon (WS Blower Ale ∎garrtw Alex Garcia, HVAC Consultant General Conditions: I have authority to order the work as outlined above. it is agreed that the seller will retain title to any equipsstent or mulish that only furnished until final payment is made. In case the total changes are collected by snit or upon demand of an attorney, the purcluscr beseby avers to pay reasonable attorneys fees for the making of such collection. l � T)rb es, is anGdJbs• 36 }yS Si e: Print: Authorization tt9 Proceed Dart: 000/ .14 . l ied