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MC-11-1761Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 164826 Permit Number: MC -9 -11 -1761 Scheduled Inspection Date: March 26, 2012 Inspector: Perez, JanPierre Owner: SAENZ, DOROTHY Job Address: 1330 NE 105 Street 202 Miami Shores, FL Project <NONE> Contractor: C&R AIR CONDITIONING CO Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1122320580060 Phone: 305 -685 -6394 Building Department Comments REPLACEMENT OF 3 TON SPLIT SYSTEM 3 Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 23, 2012 For Inspections please call: (305)762 -4949 Paae 9 of 37 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 NUMBED: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Ac a X35-1P-N%-11/3.1_. Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) –1 i a ZZZJJJ JL. 1 a RECEIVED SEP 2 6 2011 Permit No. P1C_E 1 —11(0 1 Master Permit No. i 41,L.i- l N J Phone # 717. 91 77.0 6 2. Email Job Address (where the work is being done) ( .3 O NE 1 OS sT Pc 202 City Miami Shores Village County Miamiade FOLIO / PARCEL # Zip Is Building Historically Designated YES NO s Flood Zone Contractor's Company Name C.+ R A r 621,N • C O Contractor's Address 6071 I) LJ 16 I $T C • L� City m 1 Q WM ( `- State Fi . Qualifier Name R 0 J�f� Z C State Certificate or Registration No. Contact Phone Phone # 3 OS'6 $S 7 LI zip 33 0 I S" CAC oa6t q Phone # 3 Cdr 6 9 L( Certificate of Competency No. C- AC ®a 6 7 / y e E -mail C et v� a cur-v.1049 4 o L, Co ei Name (if appli Value of Work For this Permit $ Type of Work: ['Addition Describe Work: Phone # 7_•'`7 R C. Square / Linear Foot ['Altera A on ['New 3 e Of Work: Repair/Replace E Demolition a.a ** * ** * * ** ** * * *** * * * ** * * * **** * * * ** * *** Fees***•*•**•*********** * ** * * *** ** *•* ** ** * *•* *,* * * *•* ** Submittal Fee $ Permit Fee $ 0/1 yam' Notary $ Scanning $ Double Fee $ Training/Education Fee $ Radon $ Structural Review. $ CCF $ CO /CC $ DPBR $ Violation date: Technology Fee $ Bond $ Total Fee Now Due $ See Reverse side -+ 1 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, 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 cif/V.2,1J, Signature Al ��11 I ner or Agent ontractor The foregoing instrument was acknowledged before me this (9'6 The foregoing instrument was acknowledged before me this a® day of Se 41 2011 , by , day of .S eft . , 20 II i , by who i ersonally kno � to me or who has produced who personally known me or who has produced as identification and who did take an oath. As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: NOTARY PUBLIC: Expires May 9, 2015 s%onaednwrpognim mw ooasme * * * * * ** * * * * * * * * * * * * * * * * * * * * * * ** * * ** **************************************** * ** ** * * * *,* * ** * * * * * * *** * * * ** *** Id�itnA i APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) s Examiner Engineer Zoning Clerk checked 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 1 I r� ' I 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): 13 .3c) NE- 10, 41 09-- 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 ❑t ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT i, MANUFACTURER "' '' &4ANFO90_ AHU or PKG. UNIT MODEL# F)( r, O 41=041 • R o 3 C COND. UNIT MODEL # II A (3N A (Do 6 7 • a- KW HEAT S NOM TONS AHU CU PKG 1) M.C.A AHU :24:1,U Ie1PKG AHU CU PKG 2) M.O.P AHU40141CU 30 PKG AHU CU PKG 3) VOLTS 2 4 O V 1P44 AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER I C YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT ( NO YES NO NEW 4 "CONCRETE SLAB YES 0, YES NO NEW ROOF STAND YES . •; YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity (Wire Size): 1310 Co r ct d A /N 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 30 Co v J. -10 /A /,y 3. Voltage of Circuit (20 80): 4. Size Disconnecting Means: Contractor's Company Name: C -1-R 4 i rC 0 h . Co Phone: 30-6 .8*S 6.� R �i State Certificate r egistrati N. 7.0 6 4 114 Certificate of Competency N. (1 AC. 02 t y 1 W Signature Date: 1 ..D • C &R Air Conditioning Co. 6073 NW 167(h Street Suite C -4 Miami Gardens, FL 33015 -4330 CandRacCompany@aol.com DADE: 305- 685 -6394 BROWARD: 954- 680 -4494 www.CandRac.com CU J ER J J J b lU 6-104-4-1-P202 DP■ HOME PHONE NUMBERS WORK CELL rAVIA.O.NO 11 11 `i®Iy Email We hereby propose to: Furnish, install and sery ce the regular working hours of Monday through Friday 8:30 NEW EQUIPMENT System #1 $ FPL Rebate (instant) Total Before Rebate/Tax credit Dealer Rebate Tax Credit Your Investment Manufacturer Condensing Unit Model # Air Handler Model # Package Unit Model # Refrigerant Heating KW Btuh S.E.E.R. Warranty Parts 1 bYr. Compressor 10Yr. Parts _ Yr. Compressor _ Yr. Parts _ Yr. Compressor _ Yr. 1 Year Labor $ DATE (1•261t 11 °1.91? l69a ❑ UNDER CONSTRUCTION EXISTING STRUCTURE equipment and materials listed below with the conditions and specifications detailed below during our ®m 145 BNAo36 FXyDNi= ©4q Rye) e) 3,-(goo ig System #2 $ System #3 $ $ $ Condensing Unit Stand ❑ Concr�lab ❑ Other 'Y IP I Year Labor Air Handler Stand Thermostat S PD MISCELLANEOUS loat Switch Auxiliary Drain I] Ref. Line cover -1 Year Labor ❑ Condensate Line an ❑ UV •ght • Fie Dampers .,Gil Y:'.7JlC�a- _- �tza ■/_y.n-.l i.j LJL m..w._ .�rY�i,i�r.., w11•:i�. _ ^.r.c; DUCT SYSTEM ELECTRIC SYSTEM FREON LINES ❑ Package Unit Change -out Reconnect to Existing System Existing Reconnection" ❑ New Electric iJ Existing Reconnection ❑ Ref. lines ft. A qualified air conditioning expert will start and test the system and explain its operation. This proposal is good for a two week period from date of proposal and at that time is subject to review. Title to the system shall remain in us until all sums due us have been fully paid. In the event the purchaser fails to comply with any of the requirements of this contract and such default results in litigation, the Purchaser agrees to pay reasonable attorney's fees and all court costs and expenses incident to such litigation. Delinquent payments shall bear 1.5% per month interest from due date until paid. All work is to be performed during our regular work hours unless otherwise specified. This contract contains all agreements. Neither party shall be bound by any representation, warranties nor agreements, oral nor written not herein contained. This proposal shall become a contract when accepted by you and approved in writing by our duly authorized corporate officer. We agree to furnish and install the above described labor and materials on the terms indicated below for System # $y66J.e' a B $- S �J• $ Lloko,° TOTAL INVESTMENT FPUDEALER REBATE YOUR INVESTMENT PERMIT FEE NOT INCLUDED UJ 2oyp.° 50% DEPOSIT $ a� 0L-10.c4 50% DUE WHEN o ^ tea READY TO OPERATE $ dL q - • PURCHASER DATE Olaf I1 1 REPRESENTATIVE VAL D O 2 WEEKS JOB NOTES CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: PERMIT # ADDRESS: I :i ' O IU 1 ©S s T dL B FOLIO NUMBER: FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): F Ca r 0 COST OF PROPOSED IMPROVEMENTS: `l O O (ATTACH COPY OF CONTRACT) 6 ybtO. TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): VALUE OF PRINCIPAL STRUCTURE (attach ap s raisal): LoN-1(7102. -OWNERS SIGNATURE: G} DATE: ` ' PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 SUBSTANTIAL IMPROVEMENT / DAMAGE LIST (NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE) ITEMS TO BE INCLUDED ALL STRUCTUAL ELEMENTS, INCLUDING Foundations including; Spread footing, Continuous footing, isolated footing, piles and pile caps Slabs including; Monolithic, floating, elevated Walls including; Exterior walls, Bearing walls, Shear walls Beams, Tie Beams, Columns and Posts Wood decking, Floor and Roof Sheathing Trusses, Joist Windows /Doors ALL BUILDING ELEMENTS, INCLUDING Interior Partitions, Walls, Columns Drywall, Ceilings, Built in Furniture, Cabinets, Vanities All Fixtures Flooring, Tile, Carpet, Stone, Linoleum, ect. All Finishes including Drywall, Paint, Stucco Plaster, Paneling, Tile, Marble, and Moldings Roofing Material ALL HARDWARE ALL UTILITY and SERVICE EQUIPMENT HVAC Electrical System and Equipment Plumbing System and Equipment Security System and Equipment Central Vacuum System Plumbing Fixtures Lighting Fixtures and Ceiling Fans Water Systems including Softeners /Filtration Created on June 2009 ALSO: All Labor and other Costs associated with Demolition, Removing, Replacing, Installing Building or Altering Building Components Construction Management / Supervision Overhead and Profit Equivalent cost for: Donated Materials Volunteer Labor (including owners and friends) Any Improvements Beyond Pre - damaged Condition, including; Utility Upgrades Code Upgrades ITEMS TO BE EXCLUDED Plans and Specifications Survey Costs Elevation Certificate Costs Permit fees Debris Removal Items not considered to be REAL Property Rugs, Furniture, Refrigerator, Appliances not Built -in Outside Improvements, Including; Landscaping Sidewalks Patios Fences Yard lights Sheds Gazebos Irrigation Pool