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MC-12-992Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174293 Permit Number: MC -5 -12 -992 Scheduled Inspection Date: August 15, 2012 Inspector: Perez, JanPierre Owner: GITTNER, CORY & LISA Job Address: 551 NE 102 Street Miami Shores, FL 33138 -2454 Project: <NONE> Contractor: RESIDENTIAL AIR CONDITIONING CORP Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060170980 Phone: 305 -652 -6040 Building Department Comments REPLACE EXISTING 2 1/2 TON A/C SYSTEM WITH HR 5KW Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 14, 2012 For Inspections please call: (305)762 -4949 Page 8of34 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 3313g Tel: (305) 795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 UI DI PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Owner's Name (Fee Simple Titleholder) f � t/ O is Address j 5 )% r� (0 City 4WD /te State Zip MOMEWLK; la MAY 31 Z2 BY: Permit No. ‘11C) 1 9NJ Master Permit No. Phone # LtAi -'sV' 3 '14J Tenant/Lessee Name 6001--- Email Job Address (where the work is being done) Phone # City Miami Shores Village County Miami -Dade FOLIO / PARCEL # // --' 3 4060/ 9 0 9 ea Is Building Historically Designated YES NO ✓ Zip 33/ f Contractor's Company Name % -C) It Sit 4)4". . u .en Con actor' Address c20 n) �4 / fi City - t 64-W- State Zip .3� I 1 Qualifier Name / 64,5 /a v#044,11 Phone #30r- £r- -hail State Certificate or Registration No: 3„ 1/ <5 Certificate of Competency No. Flood Zone Phone # J8r— 6-rot -6 o fir Contact Phone E -mail Architect/Engineer's Name (if a. licable) A1- Phone # 357 60 Value of Work For this Permit $ ∎ Square / Linear Footage Work: Type of Work: ddition ❑Alteration ['New t.J''Repair/Replace [] Demoliti n Describe Work: 2 t St t ci' �� 3) * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** F'�' ** * . �r, * * * * *** * * ** *,�* ,� * * *,� *,x * *,r **** * *,� Submittal Fee $ Notary $ Scanning $ Double Fee $ Permit Fee $ CCF $ CO /CC $ Training/Education Fee $ Technology Fee $ Radon $ DPBR $ Bond $ Violation date: Structural Review. $ Total Fee Now Due $ See Rever 6 e tde -+ 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 UnImik whose property is subject to attachment. Also, a certified copy of the recorded notice of c t /st be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue � ' .;�H•�. -'4[ such posted notice, the inspection will not be aproved and a reinspection fee will be charged. . 8`oN0 tUUlyl // tt,?oe.- E z. • !!4 T> Signature QA s # owner etrg,4' ex : Signatur ,t'•.4 The acki ovdedged before me this 3/ The foregoing instrun%4 I vledged before me this 3/ may ; . oQ'� day of J4 r9i� !. 'T •- ,•::db.?'' day of ',` , 20 /— , by who is per:. •pally' , 'd,t i \who has prod I w o is personall own to me or who has,produced As identification and , ' 0 d take an oath. who di take an oath. My Commission Expires: My Commission Expires: * ** **** * **** *** ** * * * ** ** * ** * ****f **** -/ ************************************ **** * * ** * ** ** *** * * **** * * **** *** APPROVED BY ans Examiner Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) 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 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): -537 n£ A® h -917l " City: Miami Shores Village County: Miami Dade Zip Code: 2.4 act 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 SUBIMI 'ALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ® ARHI Sheet Attached: YES ErNO 111 Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT ai9-At MANUFACTURER 4 15/ rnm -'te V 30 HU r PKG. UNIT MODEL # A Al 4- 1- /-/xi 3,b/ Trifo 3® COND. UNIT MODEL # r (L'/--/-`/ 3' .5744) KW HEAT 4-04141/ 2 4L NOM TONS %'z yo.,/ AHU .® CU /8 PKG ' 1) M.C.A AHU,20CU /1 PKG AHU30 CU 3® -PKG 2) M.O.P c, AHU ,30 CU jo PKG AHU CU PKG 3 VOLTS ,e ,.., , ' AHU CU PKG PKG UNIT / / hi IF PKG UNIT / i , ICI 0 /V e e2 EERISEER /6.0 YES NO - REPLACING DUCTS YES NO V YES NO REPLACING THERMOSTAT YES V NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO °••e YES NO NEW RETURN PLENUM BOX YES NO „ 1. Minimum Circuit Ampacity (Wire Size): /0 Co-..m 2. Maximum Overcurrent Protection (Fuse /Breaker Size): . 6i 3. Voltage of Circui'(208 40/480): d 1 02-56 4. Size Disconnecting Means: Contractor's Company Name: /e5-44troranot, Ae. Oct/P° Phone: 3or -r 2 6°90 State Certificate or Registrafon N. .rl i 1 Certificate of Competency N. Signature (Qua/ ` is signature only) Date: es73r /iY Residential Air Conditioning Corp. 20250 NE 15 Court Miami, Florida 33179 305 -652 -6040 * 954 - 764 -0489 * Fax: 305 -651 -4992 State Licensed and Insured CAC035484 Serving South Florida Since 1973 A+ Rating Member BBB May 30, 2012 Cory Ginner 551 NE 102 Street Miami Shores, Florida 33138 Residential Mr Conditioning will furnish and install the following Rheem 2 % Ton High Efficiency Split Cooling System -16 SEER: Installation includes the following: Condenser model 14AJM30 will be installed and secured on the existing slab. Air handler model RHLLHM36 will be installed on the existing stand. Connections to existing ductwork, refrigeration lines, drains and electric. Remove and dispose of existing equipment. Float switch Digital Thermostat Heat Flush lines with RX - 11 Start up system and check for proper operations. All labor and materials for a complete and professional installation. One year warranty labor and ten year warranty parts. Price does not include permit fee *Prices include $95 credit paid for service charge. Payment terms are 50% deposit and balance upon installation. Total price $3576.00 - $500.00 FPL Rebate - $95 = $2981.00 NET Deposit paid $1400 balance $1581 + permit Respectfully, Richard Vanni Residential Air Conditioning Corp. ' . mi 131i CERTIFIED T, t +lww.al ridirectory.org This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2010. Certificate of Product Ratings AHRI Certified Reference Number: 3412355 Date: 9/17/2010 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number 14AJM30 Indoor Unit Model Number: RHLL- HM3617+RCSL -H *3617' 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 2101240 -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): 29200 EER Rating. (Cooling); 13.00 SEER Rating (Cooling): 16.00 .;r Ratings followed by an asterisk (ry Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which lndtcates an Involuntary rerate. DISCLAIMER • AHRI does not endorse the product(s) listed on this Certificate and makes no repmsentadons, warranties or guarantees as to, and assumes no responsibility for, the productts) listed on this Certificate. AHRI expressly dtsckdms ell liability for damages of any kind arising out of the use or performance of the productts), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed M the directory at www.shrldlrectory.org. TERMS AND CONDITIONS _ This Certificate and Its contents are proprietaryproducts of AHRI. This Certificate shati only be used for Individual, personal and confidential reference purposes. The contents Otitis 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 dr by any means, except for the user's Individual, personal and confidential reference. CERTIFICATE VERIFICATION ®� The hdonnation for the model cited on this certificate can be verified at www.ahridirectory org, Air -t ;onditioning, Heating, click on "Verify Certificate" fink and enter the AHRI Certified Reference Number and the date on 'WI p ®* and Refrigeration Institute 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.: 129292209008035274 ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B EEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING rifiltAi 6 DISPOSAL RECEPTACLES NC (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) d ''t" GREASE TRAP SERVICE SIZE IN AMPS S DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT/3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. [ MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP TRANSPORTING ASSEMBLIES URINAL x' MOTORS OVER 8 -10 HP ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS` OVER 25-100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT • NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER- REPLACE GENERATORS TRANSFORMERS +! LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS ity SWIMMING POOL GENERATORS TRANSFORMERS] 221 ei- WATER SERVICE SPECIAL PURPOSE OUTLETS COMMERCIAL .0 41 SEWER CONNECTIONS UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE/RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING 1/1 t/r.4, /Xee1. lek-typtg- -Oriciao if MIAMI-DADE ' CULTURAL CENTER 50 M.N. 2nd AVENUE MIAMI, FL 33128 GARAGE 1 SITE ID 2 CASHIER 3-2 TICKET 00-000031 5/23/12 14:22 ARRIVE 12:28 PARKING FEE SALES TAX 748 AMOUNT PAID 8.00 $ 0.00 CHANGE 601-0400-524 OK BY: BUILDING DPT DATE: 0.52 2za RESID -1 OP ID: E0 AACCM LE CERTIFICATE OF LIABILITY INSURANCE 05/01'12 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 POUCIES 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 954- 776 -2222 Brown & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 954.776-4446 P.O. Box 67727 Ft. Lauderdale, FL 333104727 Commercial Lines House Carl. PHONE FAX Aro. No. Exit (ANC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE MSC 0 INSURER A : *FFVA Mutual Insurance Co.+ 10385 INSURED Residential Air Conditioning, Corp 20250 N.E. 15th Court N. Miami Beach, FL 33178 INSURER B: Harleysville Mutual Ins. Co.+ 14188 INSURER C : 11110/12 INSURER D: $ 1,000,000 INSURER E: $ 100,000 INSURER F ; ES CERTIFICATE NUMBER: SION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DER LTR TYPE OF INSURANCE ADDL INSR SUBR /AND POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS B GENERAL X UABIUTY COMMERCIAL GENERAL LIABRIry GL82251H 11110111 11110/12 EACH OCCURRENCE $ 1,000,000 P" MIsEs ) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 6,000 PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GGE�NT AGGREGATE POLICY F LIMIT APPLIES PRO- PER LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ X SCHEDULED AUTOS NOVWNED 13A82252H 11/10111 11110112 (Ea jD SINGLE LIMIT $ 1,000,000 Boom, INJURY (Per person) $ BODILY INJURY (Per accident) $ (Per a acciRdTeYntQAMAGE ) $ $ UMBRELLA LIAR EXCESS UAW _ OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOt ARTNER/EXECUTIVE Y! N OFFICEWMEMBER EXCLUDED? (Mandatory In NH) under If DESCRIPTION OF OPERATIONS below N / A WC84000269042011A 03123112 03/23/13 X f WC STATU- 1 TORY LIMITS OTH- ER E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more apace Is required) Mr Conditioning Contractor CERTIFICATE HOLDER CANCELLATION MIAM Miami Shores Vii 10050 NE 2nd Avenue Miami Shores, FL 33138 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .1/1(104, dm21444 ED 1988-2010 ACORD CORPORATION. Alt rights reserved. 063960 -0 THIS IS NOT A BILL - DO NOT PAY RENEWAL. STATE rEn0 5484 063960 -0 "Ifff f4VIT I CONDITIONING CORP 20250 NE 15 CT 33179 UNIN DADE COUNTY ° RESIDENTIAL AIR CONDITIONING COR n °iT9 Skt M%CHANICAL.CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 09/26/2011 09010611001 000075.00 SEE OTHER SIDE FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 WORKER /S 10 DO NOT FORWARD RESIDENTIAL AIR CONDITIONING CORP RICHARD M VANNI 20250 NE 15 CT MIAMI FL 33179 155