Loading...
MC-12-1048Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 187693 Permit Number: MC -6 -12 -1048 Scheduled Inspection Date: March 20, 2013 Inspector: Perez, JanPierre Owner: PERRY, ROXANNE Job Address: 868 NE 100 Street Miami Shores, FL Project: <NONE> Contractor: ALL AIR OF SOUTH DADE INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060340020 Phone: (305)247 -3443 Building Department Comments REPLACE 3.5 TON NC SYSTEM Infractio Passed Comments INSPECTOR COMMENTS False 6''B 3/2t13 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 - 174564. need p trap and fix drain jpp March 19, 2013 For Inspections please call: (305)762 -4949 Page 47 of 49 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 B LDING PERMIT APPLICATION Permit Type: MECHANICAL JOB ADDRESS: V D % WE" 0)I) .>ilte -}' City: Miami Shores County: Folio/Parcel #: I ° , °a, ()1„D 0,54 - 00,0 JUN 0 7 2612 {I/ BY: " FBC 2Q Permit No. P" L./ I0 Master Permit No. 1tarni flOV 5,.F1. 3,313( Miami Dade Zip: 313 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 1-0X (krone }�°_y Phone#: Address: D L p 1.1E Ob 5{ Yee.4- City: arm\ 3hOYt3 State: • Zip: J313 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: p'1 4 V ` `a 56 ,f(,rt... Phone#: , J'o1 -4l' ' 43 Address: `c 01q 0 p11 NyLlI If�j�tNKic k\ City: - 4(yryy 3-Li State: P I . Qualifier Name: ' - C.C) e Zip: 913033, Phone#: +13 State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ �>ata8 ' Cp Square/Linear Footage of Work: Type of Work: C)Address OAlteration C]Demolition NOCC. P.3 'h)rt 141x. 5 Description of Work: New ORepair/Replace ******** ** * * * * ** ** * *** * * * ** * ** * * * * * * * ** ems* Submittal Fee $ Permit Fee $ { s b 3 Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CF $ CO /CC $ DBPR $ Bond $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ I'S 2 _59 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 FT.F,CTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AL'Fl1)AVIT: 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 construct'' n law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the reco notice t commencement must be posted at the job site for the first inspection which occurs seven (7) days after the build', permit is • d. In the absence of such posted notice, the inspection will n.t be approved andnspection fee will be c ed. iOr Signatur, ! I;/ _/� / /d J Signature. Owner or Agent The foregoing instrument was acknowledged before e this 17 day ofJL e ,20 /2,by RV ff P€thr_/ who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY JOANA POULOS MY COMMISSION 4/6E023875 cPIRES: SEP 08, 2014 _11111Iv�ans Examiner Contractor The fore oing instrument was acknowledged before me this day of , 20 12 , by item ,Dl me or who has produced as identification and who did take an oath. NOTARY PUBLIC: who is Structural Review Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Sign: _ jiviumr ,. Print: l My Commission Expires: JOANA POULOS MY COMMISSION #EE023875 Banded through 1st State Imam Zoning Clerk A m'? CERTIFICATE OF LIABILITY INSURANCE 6R/2012 DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(lei) 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 Bateman Gordan and Sands 3050 North Federal Hwy Lighthouse Point FL 33064 CONTACT ' NAME: A/°NIN .Ext) :954- 941 -0900 FAX .Nor.954 -941 -2006 E L ADDRESS :Ecastillo @bgsagency.00Jf INSURER(S) AFFORDING COVERAGE NAIC # INSURER A•Am ure In rance Co INSURED ALLAI2 All Air of South Dade, Inc. 29790 Old Dixie Highway Homestead FL 33033 INSURERB:Homeland Insurance Company Qf N Y 4/16/2012 INSURER C : EACH OCCURRENCE INSURER D: DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER E : INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POUCY NUMBER POLICY EFF TIM/DD/YYYYI POLICY EXP I( jM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GPP2076179000001 4/16/2012 4/16/2013 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 CLAIMS -MADE X OCCUR MED EXP (My one person) $5,000 GE PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 1.. AGGREGATE POLICY X UMIT APPLIES PER: PE LOC PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE X X LIABIUTY ANY AUTO ALLOOWNED HIRED AUTOS X _AUTOS SS��ULED NON -OWNED CA20761780002 4/16/2012 4/16/2013 MBINED STNGLE LIMIT (CEOs acC(dent) " $1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA UAB EXCESS LIAR X OCCUR CLAIMS -MADE CU20783560203 4/16/2012 4/16/2013 EACH OCCURRENCE $3,000,000 AGGREGATE $3,000,000 DED X RETENTION$0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N/A WC207618001 4/16/2012 4/16/2013 X '/'/C $TATU- ' OTH- TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE 81,000,000 E.L. DISEASE - POLICY LIMIT $1,000,090 A Rented & Leased Equipment Pollution Liability CPP2076179000001 7930004900000 4/16/2012 1/29/2012 4/16/2013 1/29/2013 $25,000 Limit $1,000 Deductible $1,000,000 Aggregate $2,500 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) CERTIFICATE HOLDER Miami Shores Village 10050 N.E.2nd Avenue Miami Shores FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE • ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD A,R OF SOUTH DADE Lic. # CAC1815233 AIR CONDITIONING & REFRIGERATION Sales • Service • Installation 786- 270 -1860 www.all- air.com DATE: a DS #:1 INVOICE #: - 21221 CUSTfIVIER NAME (Financially Responsible Party) CALLER NAME JOB CONTACT NAME '114)W roe exr JOB ADDRESS CITY STATE $68 WE 1 60 -Ivrti-- &rn nharen BILLING ADDRESS (If Different) PH1 E -MAIL ADDRESS ZIP PH2 ,ORIGINAL REASON FOR THE CALL: 3 SUMMARY: ❑ See Summary of Endings sheet WORK AUTHORIZATION: I, the undersigned, am owner /authorized representative/tenant of the premises at which the work above is being done. 1 hereby authorize you to for additional information rm the above recommendation, and to use such labor and materials as you deem advisable. Unless prior- authorization for billing, payment for all work done is due upon ?�co_ pletion (C.O.D.). A $10.00 BIWNG CHARGE is due thereafter. An office billing charge and/or finance charge of 1.75% per month (21% per annum) wit be added after 10 days 4i past due. I agree to pay reasonable attomey's fees, court costs and collection fees in the event of legal action. I have read this contract including the terms and conditions on the id HERE „reverse side hereof and agree to be bound by all the terms contained herein. All old parts will be removed from premises and discarded, unless otherwise specified herein. BY AUTHORIZE YOU t.TO;PROCEED WITH THE ABOVE VORK AT THE UPFRONT FEE OF $ =Task# tivid . Signature: Print Name: Description< Service CaII Charge Service Partner Membership '1'. 141q C1t - L41 Rate'" C. V (1-1 1th - 611- - uneweli ? (loot) IPre- Approved Financing Terms: AILMENT 1 Cash ❑ Check ❑ MC;❑ Visa. ❑ Disc ❑ AmEx ❑ Card #: AILMENT 2 Cash d Check ❑ MC ❑ Visa ❑ Disc ❑ AmEx ❑ Card #: sova i .5c\k Check #: Auth #: ❑ Please pay from this invoice - Work performed C.O.D. Check #: Auth #: Exp: IMIMI IvIYI Exp: FOrli DISCOUNT SUBTOTAL 6n.00 ,9,14-ct.ao 02 -b4.3i TAX TOTAL COST CCEPTANCE OF WORK PERFORMED: I acknowledge satisfactory completion of zabove'described work and that the premises has been left in satisfactory condition. I defstand that if my check does not dear, I am liable for the check and any charges from the nk. I agree to pay 1.75% per month for past due contracts (minimum charge $15). In the nit that collection efforts are initiated against me, I shall pay for all associated fees at the sted:rates as well as at cost of collection fees and reasonable attorney fees. I agree that the aunt set forth in the space marked 'TOTAL COST is the total flat price I have agreed to. 'NATURE SERVICE TECHNICIAN ACKNOWLEDGEMENT Prior to the customer entering into the contract, I have discussed the nature of the service and cost and 1 have given a copy of the contract to the customer. All work I have done has been in compliance with company standards in a workmanship manner, to building codes when applicable. SIGNATIIRF CUSTOMER SERVICE IS OUR #1 FOCUS If you are not-co any reaso col : w= with the Your f- 1 tely•satisfied for 4 a to speak anager. to us. This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. ertificate of roduct Ratirr.s AHRI Certified Reference Number: 3869097 Date: 6/7/2012 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14ACX -041 -230* Indoor Unit Model Number: CBX27UH -048- 230 * +TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: 14ACX SERIES Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC. 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): 39000 13.00_ 16.00 * Ratings followed by an asterisk ( *) 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 Usted on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRL This Certificate shag only be used for Individual, personal and confidential reference purposes. The contents Odds 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, 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.ahrldtrectory org, click on "Verify 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 listed below. ®Air - Conditioning, Heating, and Refrigeration Institute ©2012 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129835542800639056