MC-12-1741Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 178657
Scheduled Inspection Date: October 10, 2012
Inspector: Perez, JanPierre
Owner: GREGOIRE, ALAIN & ROCIO
Job Address: 9818 NW 1 Avenue
Miami Shores, FL 33150-
Project: <NONE>
Permit Number: MC -9 -12 -1741
Contractor: BEST AIR SOLUTIONS
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1131010240070
Phone: (786)251 -5463
Building Department Comments
A/C REPLACEMENT
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passed
=/m
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
0-61/4e
Ltyt:b1 N./1'4e
October 09, 2012
For Inspections please call: (305)762 -4949
Page 26 of 46
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORM
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. `3 COPY OF QUALIFIER'S STATE LIC CARD
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. V COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT)
D. \) • COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
COMPLETE CONTRACTOR'S INFORMATION
kk
arep /66A 66.s( �4ig �trfu1,oaus.
IO2 tow $Q cITY ■ A 1
BUSINESS NAME:
4�
BUSINESS ADDRESS:
STATE C ZIP CODE 3 l Z •
BUSINESS PHONE: O 2 a - C(� Q FAX NUMBER (3�5) 2.4 `� - / 6 3 °t •
CELL PHONE (�% ) ZS l - S�!v 3 QUALIFIER'S NAME: �+. i ( o 6,4 i 2 .
QUALIFIER'S LIC NUMBER: ( C. 7 2.. 3 9 3
E -MAIL ADDRESS (IF APPLICABLE): �'�rv' U Cwt
Created on 3119109 BY MLDV 1 RV 3126109 MLDV
644126 -5
BUSINESS NAME / LOCATION
THIS S NOT A B1. DO NOT PAY
RENEWAL
RECEIPTNU. 670970 +
BEST AIR SOLUTION STATE* CAC032393
10237 NW 9 ST CIRCLE 102
33172 UNIN DADE COUNTY
OWNER
I & M CORPORATION
Sec. Type of Business
nits is 46A 6 A SAC
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
MOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR UCENSE
REQUIRED BY LAW. THIS IS
NOT A CERTIFICATION OF
THE N HOLDER'S QUAUFICA-
PAYMENT RECEIVED
MIAMI DADE COUNTY TAX
COLLECTOR:
MECHANICAL CONTRACTOR
08/27/2012
09010156001
000075.00
SEE MI-MD QIne
DO NOT FORWA
BEST AIR SOLUTION
DANIEL GOMEZ QUALIFIER
10237 NW 9 ST CIRCLE 102
MIAMI FL 33172.
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STATE OF FLORIDA
DEPARTMENT OP BUSINESS AND PROFESSIONAL REG
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
GOMEZ, DANIEL
BEST AIR SOLUTIONS
10237 NW 9TH STREET CIRCLE #102
FL 33172
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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
UI D
PERMIT APPLICATION
FBC 20
V SOME v EET
Mt SEP 1 232
BY; - -- - ----------- 0000
Permit No.MCI
Master Permit No.
Permit Type: MECHANICAL nn
OWNER: Name (Fee Simple Titleholder): t2 .. i o E le w! A • z Q o ■ Q C. Phone#: - 3 — ro3 o�
Address: q $1 $ OW 1 A U a
City: ► i r ..1 i e k el e 5 • State: r( Zip: 3,315 0 •
Tenant/Lessee Name: I t '3 `0 (0 Z. Li 0 0 A 0 Phone #:
Email:
JOB ADDRESS: 9 (g .0 W l hod
City: Miami Shores County: Miami Dade Zip: 5 315 0
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name:
Address: 1 O A.) La)
City: A.i(t A w.-4
Qualifier Name: 16, A A.9 Q £
State Certification or Registration #:
C €s f A: 2 So 1 u1' cO L) S • Phone #: 6'63 Z51 -- 1L/6
St aitrtcf, 131/02.
State: c i Zip: 33/92,
®e� 411-2- • Phone #:
A C 0323/3, Certificate of Competency #:
Contact Phone #: 4 $6 -• 25 r 5i 4 3 . Email Address: r �� e • c ��t
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 2 ?00. ® Square/Linear Footage of Work:
Type of Work: ❑Address
Description of Work:
UAlteration New , ORepair/Replace
A/c
ODemolition
******** * * * * * * * * * * * * * *x: * * * **** * ******* Fees*** * * * * * * * * * **** * * * * * * * * * * *a: * * * * * * * * * * * * * **
1,00 i r)
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
CCF $ CO /CC $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
Ozi
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 A}'FIDAVIT: 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.
Si s ature
Owner or Agent
The foregoing instrument was a
day of
,20_,by
who is personally known toprme or who has produced
F 3Is•# a 624a 425 —6G As identification and who did take an oath.
ttt11111IlU/ j11�'''''
NOTARY,2 y� t
f% 1 t,00��s •.••
y 1. �.g.2oi4
Sign: ; ®4) l' g E
Print: f- A.2- 0. @® p0pO �
� A
• A.
Co e°yy Ft• 0 r Y
,
",,,,�m °,0
/ to O
*** * * * * * * * * **** **** **** ********* *. ******
APPROVED BY
flans Examiner Zoning
Contractor
•
The foregoing instrument was acknowledged before me this 7 /1'
day of ;i1 ,20I 2, by Amelia 1 Qoi.ta?_
w is personally known t�; me or who has produced
as identificattiwpg who did take an oath.
NOTARY PUB . G �� ®so
a
..... issio• 0,,_' ,�.
o'tr
a
G/1
Sign: �`
Print: I., el 2 a� N- A. Z.
My Commission
e 'VC STATE OF���� ®a ®®
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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): 'Mg A) W I 0,0 4
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
NEW UNIT
MANUFACTURER
(2 .y f AA
AHU or PKG. UNIT MODEL #
a (.4 L -- 4-i fti `� E2 t .
COND. UNIT MODEL #
i tj A M 3 62 .
KW HEAT
S ii 1ki .
NOM TONS
7.1 TO Ai ,
AHU CU
PKG
1) M.C.A
AHU4o CU20 PKG
AHU CU
PKG
2) M.O.P
AHU 50 CU 35 PKG
AHU CU
PKG
3) VOLTS
AHU2140 CUiCPKG
PKG UNIT
/ /
PKG UNIT / /
EER/SEER
1 s Ef'2 .
YES
NO
REPLACING DUCTS
YES CO
YES
NO
REPLACING THERMOSTAT
E NO
YES
NO
NEW 4 "CONCRETE SLAB
YES
YES
NO
NEW ROOF STAND
YES
YES
NO
NEW RETURN PLENUM BOX
YES C 0
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse /Breaker Size): (, 0 fux 9 •
3. Voltage of Circuit (208/240/480): Z D U o 111
4. Size Disconnecting Means:
Company Name: e e 9 `f r 6 i0 S , Phone: k6 " ZS ( S 4 t24
State Certificate or Registration N. ,4C 0 SZ 3 �, Certificate of Competency N.
Signature Date:
(Qualifier's signature only)
1
BestAirSolutions
AIR CONDITIONING A HEATING
10237NW 9st Circle Suit 102
Miami FL 33172
License & Insured CAC032393
Phone:(786) 251-5463
Fax:(305) 223 -1698
email:bestairsolutions@gmail.com
NAME
STREET j
1 is I �) a.-Ai 1\4", e %'
DATE
/t 9 A
DATE ORDERED
/ /
DATE SCHEDULED
l
CITY t
MAKE
MODEL
TE ZIP
PHONE
WK. PHONE
SERIAL NUMBER
E
JOB
LOCATION
REPAIR NLh!STR.
I (d SE(i?
o WARRANTY
ercONTRACT
❑ SERVICE CONTRACT
p NORMAL
o RES Q COMA
{ /1
?vto . Psj ,LAla u.
e 1° h'AI2c$2t
CUSTOMER
REQUEST:
TECHNICIAN
SIGNATURE
TERMS DUE UPON COMPLETION
CERT p
TOTAL
OTHER
CHARGES
I have the authority to order the work which has been satisfactory performed as outline above. 11
Is agreed that the seller will retain title to any equipment or materials that may be burnished until
final payment is made and settlement is not made as agreed, the seller shag have the right to
remove same and Beslj rSotutions will be held Rainless for any damages resulting there of
Al cost of collection shat be paid by the customer, including reasonable attorney's free. Mer
cfiendise covered by this invoice is sold sub)ect to manufactures guarantee only. Al ° °a per
month service charge kv..l be charged on the unpaid balar..ce alter 30 days <'
Authorised s, • nature P •.
DIAG t TRIP
CHARGE
ABOVE ORDERED WORK HAS BEEN COMPLETED AND I ACKNOWLEDGE RECEIPT OF MY COPY
DATE
CHECK LIST
❑ COMPRESSOR
Q SUCTION - PSI
Q HEAD PSI
Q VOLTS AMPS
Q ELECTRICAL CONNECTIONS
Q CONTACTS TIGHT & CLEAN
Q OIL LEVEL & CONDITION
❑ CONDENSER COIL
Q CLEAN COIL & CHECK FIN COND.
Q ENT °F LVG
❑ REFRIGERANT
Q LEAK QCHARGE
❑ FAN AND MOTOR
Q VOLTS — AMPS —
Q ELECTRICAL CONNECTIONS
Q CONTACTS TIGHT & CLEAN
Q FAN PULLEYS (ADJUST BELT)
Q CHECK. LUB BEARINGS & MOTOR
Q CFM
['EVAPORATOR COIL
0 CLEAN COIL & CHECK FIN
O ENT 08_FI LVG DB_F
Q ENT WB_F LVG WB_F
['CONDENSATE AREAS
Q INSPECT & CLEAN DRAIN PAN
Q INSPECT & CLEAN DRAIN
DAIR FILTERS
Q CLEANED QREPLACE.D
FILTER SIZE
CHEATING ASSY.
Q BURNER & HEAT EXCHANGER
❑ FUEL SUPPLY & PRESSURE
Q PILOT ASSEMBLY
0 FLAME ADJUSTMENT
Q PRIMARY RELAY P. FLUE
0 FAN & LIMIT SWITCH OPER.
Q BLOWER ASSEMBLY
Q RV VALVE
Q STRIP HEAT
Q DEFROST CYCLE
['ELECTRICAL COMP'TS.
Q RELAYS QCONTACTORS
Q OVERLOAD QPRESS. SWITCH
['THERMOSTAT
0 O.K. 0 REPLACE
Q RELOCATE
QUANTITY ITEM OR PART DESCRIPTION
Our TRAINED PERSONEL recommend
r:'o f GJ
f a 543 t) 6) •
We wish to provide the highest level of professionalism and quality service along with the best customer assuranw policy
in the Industry. Our service report warrant/ policy is:
1. All parts replaced by us win be warranted to be free of defects fora period of O L '2j --'•4.
Many service companies provide 30. E0 or 90 day warranties We feel that the parts we insla a been carefully selected
and meet or exceed manufacturer specifications. For this reason we feel comfortable offering this excellent warranty rTbe
labor to install the warranted part(s) is discussed in item #2 below
2. Our repair labor is warranted for a period of
This is the tabor to repair or replace the part we installed in me initial repair. aiMnot to correct problems that may
have arisen in tha Interim.
3. In the case of refrigerant (freon) leak repair our parts and labor warranty is as stated above wM me following
clarification.
a. You are strongly urged to let the technioan show you the location of the leak prior to and after repair. R this Is not
possible due to attic or other inconvenient location. be sure the technician accurately describes the leak location on his
service ticket Our warranty is for the specific leak repaired
b - Unfortunately many times there can be more than one leak in a system. We may only locate one and complete an
effective repair only to be called out again later and final another one Our warranty on me previous leak repair would
not cover the new one However, if within 90 days of me first leak location, we will provide a no charge diagnostic and leak
search You win then only pay for the repair of the leak lust as you would have done if we had located it on the first cop.
TRAVEL TIME
TIME
ARRIVED
TIME
DEPARTED
TRAVEL
TIME
MILEAGE
ENDING
EVIRONMENT CHECK LIST
START
A MILES
L
IHR.=
CRRG.
R CODE
E
F 1
E
R
G
R
A
N
TYPE
REFRIG
n
RECOVERED?
SYSTEM
QTY
NO QTY
RECYCLED?
RECLAIMED?
RETURNED TO
THIS SYSTEM?
DISPOSAL
YES IIQTY
El EJ
YES NO
ElEl QTY
YES NO
QTY
(2
E CHANGED
OUT (OR
U REPLACED)?
1-1YES NO
1 DIS-
p MANTLED?
M YES NO
E REFRIGERANT DISPOSAL
T
OUR PERSONEL
RECOMMEND:
NON USEABLE 1-1 El
YES NO QTY
DEPOSAL
OWNER'S INITIALS
ACCEPTED
DECUNED