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MC-11-1683
Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address 76 NW 7 Street Miami hores, FL 33150- Parcel Number Applicant 1131010330360 Block: Lot: BRADLEY MORRIS Owner Information Address Phone CeII BRADLEY MORRIS 76 NW 97 Street MIAMI SHORES FL 33150 786/367 -9554 Contracto!(s) Phone Cell Phone AIR SYSTIMS ENTERPRISES INC (954)974 -9857 Valuation: Total Sq Feet: $ 1,944.00 0 1 Tons: 2 Additional Info: AH AND COND Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: CHANGE OUT Fees Due Amount CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Sur harge $0.40 Permit Fee $100.00 Scanning Fee $3.00 Technology Fae $1.60 Total: $110.20 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -9-11 -42017 09/19/2011 Check #: 23250 $ 60.20 $ 50.00 09/14/2011 Check #: 23223 $ 50.00 $ 0.00 Available Inspections: 1 Inspection Type: Ventilation Final Hood Rough Duct Underground In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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 aid zoning. Futhermore, I authorize the above -named contractor to do the work stated. September 19, 2011 Auth¢rized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy September 19, 2011 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1 It( 1 INSPECTION'S PHONE NUMBER: (305) 762.4949 DING Permit No. c( ( - kC (3 PERMIT APPLICATION FBC Permi Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): ,c2) L ISO r% I S Phone#: '1t(j) • Nil- aISSy Address: rt.0 1\-W c114-41 S-r‘E City: N11. `Urv\A S Ore_S State: Zip: ?jSISCD Tenant/Lessee Name: Phone#: Master Permit No. Email: JOB ADDRESS: I lo iQUJ c 1 `4-t S-k-ce+ City: Miami Shores County: Folio/P 1 #: 1 (" J I 0 ® LA O Is the Building Historically Designated: Yes Miami Dade Zip: 3.3 \SO NO Flood Zone: CONTRACTOR: Company Name: Q V(S S-Y1S "En ytses 1.rriC. Phone #: q1 £fl L(. -q&s Address: l OC) t%) • PQ(- e lack s u.�.1 -e E -3 City: -T 1a lQh State: 4:1--- 4:1--- Zip: --53513 Qualifier Name: MCt ( Ste eX rciy k Phone#: State Certification or Registration #: aft l3 Certificate of Competency #: Contact Phone#: 9 °-0I14`-ctgs -') Email Address: r lcurceA as'e-t@ c\c j . ()C.+ DESIGNER: Architect/Engineer: Phone#: Value o Work for this Permit: $ V"l,`"VA Square/Linear Footage of Work: Type of Work: °Address °Alteration UNew l Repair/Replace °Demolition Description of Work: PAC. tC. C < 00*- Q `10 ) Submit4al Fee $ Fee $ Notary Double Fee $ �x ** *** * ** ** ** **s Fa _ *s***** *e**f *+ x+ xs * * *a ***** *e **** ***s*e * *** Permit Fee $ �� ' CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Moi Mor City Lender's Name (if applicable) Lender's Address 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 comme ced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construcion 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 OWNE�'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicab a laws regulating construction and zoning. "WA.tNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO o I NCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMP ' OVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FIN CING, 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 firs e on which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspectia reinspection fee will be charged Signa The fo day of Owner or Agent oing instrument was acknowledged before me this / / 20 I , by Coutiactor The foregoing instrument was acknowledged before me this g , day of ��" , 20 / 1, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC-STATE OF FLORIDA NOTARY PUBLIC: ..0" " %. M uita M. Ragin ( Commission # EE103397 '••.,p.rs Expires: JUNE 15, 2015 BONDED THUG ATLANTIC BONDING CO., INC. r Print: 1K-A ` ■( 140 My Commission pires: as idenfifcat l di A NOTARY PUBLIC: .o•"1.44, Mar(3Uita M. Ragin Commtssion # EE103397 " „r,�,, Expires: JUNE 15, 2015 si D W'D1aD MU MUM BONDING ca, vic Print: LCCC/it ►tom `C '(_.CO My Commissic lExpires: uflQ, 1 �J, APPROVED BY Plans Examiner Structural Review (Revised U7 /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 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This fo must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. lultiple units on single sheets are not acceptable. Job Address (where the work is being done): n(.0 al l 1+1 Sir ef City: Miami Shores Village County: Miami Dade Zip Code: 3� \ 5 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 Coirr a, r-F situ( O Pa 112 AHU or PKG: UNIT MODEL # GC4-0 -I CD-9 LCi-i Nl COND. UNIT MODEL # CC {4 0 '-IC n -40- to r INV HEAT it Po NOM TONS a AHU CU PKG 14). to 1) M.C.A AHU CU PKG is AHU CU PKG a 5 2) M.O.P AHU CU PKG CU PKG .0 (a?�® 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / WA' EEP/ EED 13 YES NO REPLACING DUCTS YES N • YES NO REPLACING THERMOSTAT YES YES NO NEW 4 °CONCRETE SLAB YES 0 YES NO NEW ROOF STAND YES (� YES NO NEW RETURN PLENUM BOX YES 0, 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): a 5 3. Voltage of Circuit (208/240/480): 90g J, 3® 4. 0 e Size Disconnecting Means: U L�1.4A'_(._t. 4- cUsur1A' -Qk non. - rtu C coo OL,i'�j� Contractor's Company Name: R11( -tuVIA Enierprisesiine,. Phone: c1S,1,--q1 4- S 1 State Certiic ate or Registration N. GPrC a555(f1) Z Certificate of Competency N. Signature Date: c1-(4--D-01, l ■-■ :1, (2 • DATE BATCH NUMBER ate,ig141.1i: CERTIFICATE OF LIABILITY INSURANCE OP ID: R3 DATE (MMIDD/YYYY) 09/08/11 THIS CERTIFICATE 15 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(ies) 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 Brown & Brown of Florida, Inc. 1201 W Cypr Creek Rd # 130 P.O. Box 57 Ft. Lauderd e, FL 33310 -5727 Michael Go am 954 -776 -2222 954.776 -4446 CONTACT NAME: PHONE jr. No. Ext): EADDRESS: FAX No): PRODUCER ARSY -1 OM D INSURER(S) AFFORDING COVERAGE HNC 0 INSURED Air Systems Enterprises, Inc. Attn: Wayne Murchison 4100 N Powerline Rd. Ste 13 Pompano Beach, FL 33073 INSURER A: Charter Oak Are Insurance Co 25615 INSURER B : Travelers Indem Co of America 25666 INSURER c :Travelers Prop Cas Co of Amer 25674 INSURER D : FFVA Mutual Insurance Co. 10385 INSURER E : INSURER F : COVERAG CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO INDICATED CERTIFICATE EXCLUSIONS CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDffIONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE AODL INSR SUER WVD POLICY NUMBER POLICY EFF IMNUDDIYYYYI POLICY EXP (MNUDDIYYYY1 UMJTS A GENERA(}unarm COMMERCIAL GENERAL CLAIMS -MADE LIABILITY OCCUR 4TC01448X013COF11 01/16/11 01/16/12 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT POLCY X JECT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 7 LOC $ B AUTOMOBILE ANY ALL SCHEDULED HIRED NONLOWNED LIABILITY AUTO OWNED AUTOS AUTOS AUTOS AUTOS 4TBA1448X013CNS11 01/16/11 01/16/12 COMBINED SINGLE LIMIT accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acddent) $ X X $ $ C X UMBRELLA LIAR EXCESS ma X OCCUR CLAIMS -MADE 4TSMCUP1448X013 01/16/11 01/16/12 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DEDUCTIBLE RETENTION $ 10,000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LAB1IJTY ANY PROPRIETOR/PARTNER/EIECUTNE OFF10ERIMEMBER EXCLUDED? (Mandato)'y In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y1 N N 1 A WC84000254582011A 01/16/11 01/16/12 X TWRY LIAMTIU- S OR - EL EACH ACCIDENT $ 500,000 EL DISEASE - EA EMPLOYEE $ 500,000 below EL DISEASE - POLICY UNIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional RemaNrs Schedule, N more space Is required) MIAMISH Miami Shores Village 10050 NE 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 POLICY PROVISIONS. AUTHORIZED R`EPREESENTATIVEQ. ACORD 25,(2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1,2010 THROUGH SEPTEMBER 30, 2011 DBA: Business Name: AIR SYSTEM ENTERPRISES INC Receipt #:183-1117 Business Type: TINC /AIRCONDITbON CON' 2ACTR (CLASS A A /C) Owner Name: BALDERRAMA MARCELINO Business Opened:o7 /09/1993 Business Location: 4100 N POWERLINE RD I -3 StateICounty /Cert/Reg:930u477 /CAC056718 UNINCORPORATED Exemption Code:NONEXEMPT Business Phone: 954 - 974 -9857 Rooms Seats Employees 5 Machines Professionals Number of Machines: For Vending Business Only Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00. 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: BALDERRAMA MARCELINO 4100 N POWERLINE. RD #I -3 POMPANO BCH, FL 33073 -3041 This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Receipt #04B -09- 00010026 Paid 07/16/2010 27.00 2010 - 2011 Air SysLems Enterprise, Inc. 4100 N. Powerline Rd Suite 1-3 Pompano Beach, FI. 33073 CONTRACT PROPOSAL Date: 6- Sep-11 To • Bradley Morris 76 NW 97th Street Miami Shores, Fl Attn: Bradley Project: Replace 2 ton Mini -Split HeatPump Phone: 954 - 974 -9857 Fax: 954 -974 -9842 Scope: Install new Comfort Star 2 ton Mini Split Heat Pump. Mini Split to be supplied by Cross Country Home Services. Proposal includes recovery of refrigerant and removal and disposal of existing system per epa requirements. Also included all labor and materials necessary to install system and connect to existing condenser Pad and electrical, refrigerant and condensate lines. Note: Permit Fees, Engineering, Drawings Not Included Our Price To Complete The Above Work: Paid By Cross Country Home Service: $ Balance To Be Paid By Customer: $ Goodman $ 1,944 1,389 555 This Quotation DOES NOT Include: (x) Roofing work, repairs or warranties from roof leaks. (x) Asbestos Abatement of any kind. (x) Cutting, patching, sealing or painting of any surface. (x) Test & Balance - Independent T&B Report. (x) Electridal work / Controls / Control work / Motor Starters. (x) Permit Fees / Any Code Violations or Upgrades (x) Any overtime labor - all work during normal business hours. (x) Repair or replacement of any ceiling tiles or grid work (x) Smoke'! Detectors /Fire Dampers / BZZU Radiant Dampers / Fire Stats /Accessories. This proposal, as submitted, is good for 15 Days Air Systems Enterprises, Inc. Sincerely, Roger Gerken Service Manager Your Approval: Date: 1,- 1 Our Acceptance: Date: CERTIFIEDTM www.ahrid rer.tory.org= Certificate of Product Ratings AHRI Certified Reference Number 3319577 Date: 9/8/2011 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower, (Free Delivery) Outdoor Unit Model Number: CCH024CD -410 (0) Indoor Unit Model Number: CCH024CD- 410(1) Manufacturer: EAIR LLC Trade/Brand name: COMFORTSTAR Manufacturer responsible for the rating of this system combination is EAIR LLC 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): 22000 EER Rating (Cooling): 11.20 SEER Rating (Cooling): 13.00 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 Certtflcate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the products) 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 listed 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 AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, In whole or in part, be reproduced; copied; disseminated; entered irdo 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 ww w.ahridir a tory.org, Air - Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on al WEI and Refrigeration Institute which the certificate was issued, which Is listed above, and the Certificate No., which Is listed below. ©2011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129599793029500689 AHRI Certified Reference Number: 3319577 Date: 9/8/2011 Product: Split. System: Air - Cooled Condensing Unit, Coil with Blower, (Free Delivery) Outdoor Unit Model Number: CCH024CD -410 (0) Indoor Unit Model Number: CCH024CD- 410(1) Manufacturer: EAIR LLC Trade/Brand name: COMFORTSTAR Manufacturer responsible for the rating of this system combination is EAIR LLC Rat d 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 (Stub): EERRating (Cooling): SEER Rating (Cooling): 22000 11.20._ 13:00 • Ratings followed by an asterisk (*) indicate a voluntary mate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI dies not endorse the product(s) listed on this Certificate and makes no rapr a mutations, warranties or guarantees as to, and assumes no responsibility for, the products) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out Otto use or performance Mite produd(s),orthe unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and conflgumtions fisted in the directory atwww.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and confidential reference mitoses. The contents of this Certificate may not, in whole or in part, be reproduced; copied; ; entered hnto a computer database; or otherwise utNzed, in any form or manner or by any means, except for the no's individual, personal and co nfidentiaf reference. CERTIFICATE VERIFICATION .. per,. �p y� p�� _ Air-Conditioning, pq�g�gg The 1ntOrmaton for the model cited on this cw WSLa a can be verified at www.ahridire to y.o g, fl` - .. , ating, dick on 'Verify Certificate" link and enter the AHRN Certified Reference Number and the date on which the certificate was isoual,vetdchls I tabove,andthheCieNo,whichIs bdarx ®� and Refrigeration institute ©2011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1219599793029500889