MC-11-2345Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 180050 Permit Number: MC -12 -11 -2345
Scheduled Inspection Date: October 17, 2012
Inspector: Perez, JanPierre
Owner: , LEOCAVA LLC
Job Address: 9534 NE 2 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Permit Type: Mechanical - Commercial
Inspection Type: Final
Work Classification: A/C Replacement
Contractor: RELIABLE AIR CONDITIONING REFRIGERATION & APPLIAN
Phone Number
Parcel Number 1132060132630
Phone: (305)325 -9283
Building Department Comments
BRING EXISTING 2 TON PACKAGE UP TO CODE FOR
UNIT #166
Infractio Passed Comments
INSPECTOR COMMENTS
False
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- 168082. missing outside air jpp
I /r7 /z,
October 16, 2012
For Inspections please call: (305)762 -4949
Page 13 of 18
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
- 'yy),�t�'� INSPECTION'S PHONE NUMBER: (305) 762.4949
LDING� rittit---A54-45
Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: MECHANICAL Le.®crt,o 4 —LC_
OWNER: Name (Fee Simple Titleholder): 2)
3-4,e,))( Phone #: �O'S LSs2j GS G.
Address: --�4 s 0 s z P 3 3 703
City: j1,1 t e 5 \ti®ces State: R—okrA. c Zip. 1'.1 :a '53Z3
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: I CG ` 9t C, 4it °
City: Miami Shores County:
Folio/Parcel #:
Miami Dade
Zip: N 11 8
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: (k e`i>\ e Wr C\ t 04.11 Phone#: 3OS 31S e'l /$i
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect /Engineer: Phone #:
Value of Work for this Permit: 2.. Co 00 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration New kepair/Replace U ❑Demolition
Description of Work: !i Q 4t-- MC-411 3 7 �_
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees` * * ***** ****+ x*** ***** *x:**** ***a:*********
Submittal Fee $ Permit Fee $ F $
Scanning Fee $ Radon Fee $ DBPR $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CO /CC $
Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address n
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 whi h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be apprs ed and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this'
20A®l,by "\- a U,1 i e0i& °
day of
who is personally known to me or who has produced
s identification and who did take an ' ath.
NOTA
Sign:
Print:
My Commission Expires:
APPROVED BY
''°` VIOLET SOLOMON
Signature
The foregoing instru
day of
who is pe
ontractor
ent waas b acknowledged before me this 20.�y
ally kno o me or who has producedI
M MN�ficarion and who did
tak e
NOTARY PUBLIC:
Sign:
Print:
`1\1111111/1//
I. 1
My Commission Expires:
an oath.
NOTARY ? 8U
Cummi$$inrl I
% s''• .,EEinoss . •
�x�x> k�x�x�x�x�x�x�x�x********* �x* �x�x* * ** *�xx��x�x�a****woip�S��'F'Il kov\* *** * **
a2Eofi finer
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
)
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: MECHANICAL
DEC 2 1 2011
Master Permit No.
OWNER: Name (Fee Simple Titleholder): t.
Address: Ye-Co CI
a
a State:
Phone #:3 !7D ((7)
Zip:
Phone #:
Tenant/Lessee Name:
Email:
JOB ADDRESS: j or. C- CO 73-
City: Miami Shores County: u0 ami Dade
Folio/Parcel #: k \3,1-� LI (lqC
Is the Building Historically Designated: Yes NO Flood Zone:
Zip:
CONTRACTOR: Company Name:
Address: 446 co./
City:c ~--
Qualifier Name:
State Certification or Registration #:
/('i fi /;4m:
j__ k a v yG
State:
C'-c / A 9 / 1
Phone #: 3 0 c- 3 2 C Q Z d7 3
(Dpirytes.,
Phone #:
Certificate of Competency #.J �'"K�
Contact Phone #:3Dr - C- 9 Z-0 Email Address: Ac iZ- 044,01t 1t.e A �L c.rs
DESIGNER: Architect/Engineer: Phone #:
zip: 3 3 ! 3
30 r- 32s- 92 3
. X41
Value of Work for this Permit: $
o
t
Square/Linear Footage of Work:
Type of Work: Address UAlteration New ?' pair/Replace
Description of Work: 13(2 S 6'f`^ D'� 2 i" � �-�- �Co
ODemolition
e9 ********* * ************ * **** *** * * * *******
Submittal Fee $ Permit Fee $ v " U CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ _ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
\,\
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 tha a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject o attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection w ich occurs seven (7) days after the building permit is issued. In t; absence of such posted notice, the
inspection will not be pp oved a ,, a einspection fee will be charged.
Owner or Agent
The foregoin instrument was acknowled
day o
20 f , by
me or who has produced
M. identification and who did take an oath.
9
ed before me this
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * ** *** * **
APPROVED BY
Signature
Contractor
The foregoin s instrument was acknowledged before
day of , ,20 I`, by
who is personally wn to me or who has produced
as identification and who did take an oath.
ANA LORENA ALARCON
Notary Public, State of Florida
Commission #DD818968
My Commission Expires Sep. 01, 2012
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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): IV. \r eet
City: Miami Shores Village County: Miami Dade Zip Code: ")1-'2, 3 Y3
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 [r
UNIT BEING REPLACED
DATA
NEW UNIT
MANUFACTURER
Rfs, eO Ak et -
AHU or PKG. UNIT MODEL #
NM 1.>2-I.A. t'. tA 1
COND. UNIT MODEL #
KW HEAT
NOM TONS
2 .
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
/ / 2 o
EERISEER
YES
NO
REPLACING DUCTS
YES
N
YES
NO
REPLACING THERMOSTAT
YES
cN
YES
NO
NEW 4 "CONCRETE SLAB
YES
0
YES
NO
NEW ROOF STAND
YES
N0
YES
NO
NEW RETURN PLENUM BOX.
YES
--N NO
1. Minimum Circuit Ampacity (Wire Size): 1 g a
2. Maximum Overcurrent Protection (Fuse /Breaker Size): ., to
3. Voltage of Circuit (208/240/480): 2 t 0
4. Size Disconnecting Means:
Contractor's Company Name:,44-4(3/i... A n- Qt, vc=F`o% Phone: 3 DC 3 2 C q 2? 3
State Certificate or Registration N. C C h91 Z ° Certificate of Competency N.
Signature
gnature only)
Date: / 2' Z
LICENSED & INSURED
CAC 1814210
RESIDENTIAL
COMMERCIAL & INDUSTRIAL
acreliable @aol.com
AIR CONDITIONING
REFRIGERATION & APPLIANCES
(305) 325-9283
6/.°
546 S.w.1 ST # 604
MIAMI, FL 33130
WWWACRELIABLE.COM
MAKE
MAKE
MODEL
MODEL
SERIAL NUMBER
SERIAL NUMBER
CONDENSING UNIT
❑ RECOVERED
CLEANED COIL
❑ RECLAIMED
❑ RETURNED
REPAIRED
LEAK IN COIL
COND'SATE DRAINS
CLEANED
MAIN DRAIN
REPAIRED
MAIND DRPJN
CLEANED
PAN DRAIN
REPAIRED
PAN DRAIN
REPAIRED
LEAK IN COPPER
FURN. OR FAN COIL
CHANGED OUT ' EPLA ED
TOTAL $
REFRIGERANT R- LBS.
FILTERS
FILTERS
BELTS
CHECKED
MOTOR
CHANGED
MOTOR
REPLACED
BELT
ADJUSTED
BELT
REPLACED
CONTACTOR
REPL STARS
RELAY
REPL START.
CAPACITOR
REPLACED RUN
CITOR
CLEANED OR
ADJ. CONTACTOR
REPAIRED
WIRING
ADJUSTED BELT
REPLACED
PULLEY
ADJUSTED
PULLEY
CLEANED
BLOWER
REPLACED
BEARINGS
OILED MOTOR
OILED BEARINGS
CLEANED
HEAT EXCH.
REPLACED
HEAT EXCH.
CLEANED OR
ADJ. PILOT
REPLACED FUSE
REPLACED
COMPRESSOR
EVAPORATOR COIL
REPLAOED
EXR VALV
ADJUSTED
EXR VALVE
REPLACED
CAP. TUBE
CLEARED
CAP. TUBE
REPAIRED
COIL LEAK
REPAIRED
COPPER CONN.
CLEANED COIL
REPAIRED
VALVE
REPLACED
VALVE
REPAIRED
ADJUSTED
THERMOSTAT
TOTAL MATERIALS
ELECT. HTR.
REPLACED LINK
REPLACED KLIX
REPAIRED WIRE
CLG TOWER
PUMP (S)
MATERIALS a LABOR MAY BE
CONTINUED ON OTHER SIDE
TERMS
TOTAL LABOR
I have authority to order the wo • +dined above which has been satisfactorily completed. I agree that
Seller retains title to equipmen materials furnished until final payment is made. If payment is not made
as agreed, seller can rem id equipment/materials at Sellers expense. Any damage resulting from
said removal shall no • +e rea.. 0I • Seller. We are not F.P.L
LIMITED WARRANTY: All materials, parts
and equipment are warranted by the
manufacturers' or suppliers' written warranty
only. All labor performed by the above named
company is warranted for 30 days or as
otherwise indicated in writing. The above named
company makes no other warranties, express
or implied, and its agents or technicians are
not authorized to make any such warranties
on behalf or above named company.
❑ REGULAR ❑ WARRANTY
GREASED
REPAIRED
ALTERS ❑ CLEANED ❑ REPLACED
TOTAL
MATERIALS
LABOR
Not responsible for water damage
CUSTOMER SIGNATURE DATE
CHARGE
TAX
glade* TOT
Alr- Condltloning, HeatUg,
and Refrigeration Institute
December 12, 2011
2111 Wilson Boulevard, Suite 500
Arlington, VA 22201, USA
www.ahrinet.org
PH 703.524.8800
FX 703,528.3816
AHRI's Directory of Certified Products at www.ahridirectory.orq provides information regarding current products.
Active units are in production, Discontinued products are no longer in production but still available from the
manufacturer. Once products are no longer available from the manufacturer, the records are archived, they are
no longer viewable in the online directory and certificates cannot be printed. These models are no longer certified
by AHRI and are sent to the recipient for informational purposes only..
AHRI reference number 1168999
Manufacturer Arcoaire
Model Number. PAM324K *0A1
Cooling Capacity: 23000
EER: 11.3
SEER: 13.2
Sincerely,
Sunil Nanjundaram
Director, Certification Programs
Prepared by:
Mari -Lou Paul
Technical Analyst, Certification Directory
Phone: 703 - 600 -0384
directory @ahrinet.org