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MC-13-157 f Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33 138 3 Y: Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No.,' C PERMIT APPLICATION Master Permit No.gCz Z- 9-A aQ FBC20 Permit Type: MECHANICAL OWNER:Name(Fee Simple Titleholder): o �� Phone#: , Address: C� net R1 QJ1 agm City: )tflq �� State: Zip: Tenantdxssee Name: Phone#: Email: JOB ADDRESS: 76 6 AlE wh,i L City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: .I/-_ �.. ® _ DF76— Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: 4 4 h JA kC Phone#:,.-3a L�2 X2 M Address: City: State: Zip: —K C2 Qualifier Name: / Phone#: State Certification or Registration#: 4040 ,S✓ ��®/ Certificate of Competency#: Contact Phone#:m (� � 22. �?Z ail Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ 06 Square/Linear Footage of Work: Type of Work: DAddress DAlteration tew ORepair/Replace ❑Demolition Description of Work: J\,j u e,, ,,,,Fe Submittal Fee$ Permit Fee t® ' CCF$ ACC: Scanning Fee$ Radon Fee$ DBPR$ Bond*- Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 34010 4)1 V , 1 r 3 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 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 w zotbproved and a reinsAection fee will be charged. {Signa 0 Signature Owner or Agent -L Contractor The foreg ing instrument was acknowledged bef r me this The foregoing instrument was acknowledged before me this day of 20 by y fi , day of AxJ� J20 rZ by L b'L- r-ZV45(.J45 1,,Lx0) who is rsonall kno a or who has produced who is personally known to me or who has produced l Pe y P P Y P As identification and who did take an oath. as identification and who did take an oath. NOTARY PUB NOTARY PUBLIC: jSign• Sign: Print.- A/&4A// Print: My Commission Expires: My Co ssion s: %k%W11111 E SI#RI k RTMO Notary?ubtic•St boJ?r Commiss�o. 9r"APPROVED BY d lhrou r^ xaminerFFo �l ,ionia g tructural Review a�10R 1 D�'0\��`���Clerk �tfirH4}i4 (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 1 r i 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): .66 �� .� r- City: Miami Shores Village County: Miami Dade Zip Code: 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 Q NO❑ ARHI Sheet Attached:YES❑ NO© Contract Attached:YES El UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG.UNIT MODEL COND.UNIT MODEL# KW HEAT NOM TONS AHU CU PKG ® 1 M.C.A AHU CU PKG AHU CU PKG d 2 MAP AHU CU PKG AHU CU PKG ®,6 3 VOLTS AHU CU PKG PKG UNIT 1 I PKG UNIT EERISEER NO REPLACING DUCTS YES NO NO REPLACING THERMOSTAT YES NO NEW 4°CONCRETE SLAB YES NO aw NEW ROOF STAND YES NO NO NEW RETURN PLENUM BOX I YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 3. Voltage of Circuit(2081240/480): 4. Size Disconnecting Means: Contractor's Company Name: ►/ Phone: 30-s:] °s�Z,01 State Certificate or Registr n N. Ced-111caite of Competency N. Signature Date: — Z�z- alifie s signature on AIR CONDITIONING BY WORD, INC. P.O.BOX 660808 MIAMI SPRINGS,FL 33266-0808 (305)887-2291 CAC0055490 CQi-��� PROPOSAL&ACCIEPTANCE Purchaser— ' 901 Address Phone Jobfr-� Address City s� HEATING AND AIR CONDITIONING BOUIPMENT. O New Construction ❑ Existing Structure O Replacement OUANTITY MAKE MODEL SIZE SEASONAL E.E.R. PACKAGE CONDENSER CONDENSER AIR HANDLER AIR HANDLER HEATER 44 C- HEATER FURNACE"' EVAPORATOR COIL HEAT RECOVERY AIR WILL INCLUDE--�SUPPLY OUTLETS AND _RETURNS(1'DUCTED OFREE) DISTRIBUTION: OWILL BE INSTALLED,ACCORDING TO: Plan No ' BY, SUBJECT TO MODIFICATION ACCORDING TO STRUCTUBAL OR OTHER REQUIREMENTS. ❑EXISTING SYSTEM OWRAP&SEAL EXISTING)DUCTS..., DUCTS: WILL BE OGALVANIZED OINSULATED FIBERGLASS ALL MATERIAL WILL BE NEW.FIRST QUALITY, DESIGNED.FABRICATED AND INSTALLED ACCO TO ACCEPTED ENGINEERING PRACTICE AND IN COMPLIANCE WITH ALL APPLICABLE MECHANICAL CODES IN FORCE ON ABOVE DATE.DIFFUSERS WILL BE ALL ALUMINUM WITH DAMPER CONTROLS. THERMOSTAT: WILL BE AUTOMATIC WALL TYPE ,COOLING IIlINFATING OEXISTING PARTS WARRANTY: MANUFACTURERS YEAR WARRANTY ON COMPRESSOR. MANUFACTURERS YEAR WARRANTY ON ALL OTHER COMPONENTS. SERVICE: AIR CONDITIONING BY WORD,NO.WILL PROVIDE FREE SERVICE FOR A PERIOD OF 0 &, FROM DATE OF START UP.SERVICE WILL BE PERFORMED DURING NORMAL WORKING DAYS AN URS ONLY UNLESS AUTHORIZED BY PURCHASER AT ADDITIONAL CHARGE. , RESPONSIBILITY SHALL BE ASSUMED AS INDICATED BELOW: ACW ow"m WA Reconnect ACW OWN6tU wA necon"at Af G.C. AiC O.C. Installation of equipment............. 13 13 Thermostat wiring ....... ......... ❑ 13 Drain piping ............... ❑ ❑ ❑ Service change from Amps to Amps 13 Refrigerant piping....... ... [[[��� ❑ ❑ Wiring from existing panel to equipment ... ❑ ❑ ❑ Water'piping heat recovery ...... ❑ ❑ Thermostat installation..... .... ..... ......M ❑ ❑ Install ducts and grilles.. ,( ❑ ❑ ❑ Cutting,patchingofholestorpipss,ducts,etc.....❑ ❑ ❑ Kitchen exhaust vent..................I�` ❑ ❑ Access S clearance for ducts grilles B equip ❑ ❑ ❑ Bath exhaust tans/ducts. ....13 '13 13 masonry .❑ ❑ 0 Structural suppers for equipment..., ❑ (((]]] ❑ Carpentry.......................................❑ ❑ Pitch pans and/or root supports .a ❑ ❑ Painting ......... ......... .... ❑ ❑ ❑ Attic Insulation to inches..........❑ ❑ ❑ Start up and balancing equipment .............($ ❑ :OMMENTS ' 'opossl: •agree to furnish and initall the above described labor and materials for S ,odtht'arms Indicated below. 114RD,INC. .ceptence :we),the undersigned Purchosehs)acknowledge,than(we)have read the conditions on the reverse side and agree tote bound by them on this bssls.I(we) rapt the foregoing proposal and sgrea(s)to make,payment as follows: with on:11 ,when ducts roughed In delivery of units upon start up of equipment — d. Purohoser(s): (Read conditions o c of page) 2013-03-28 10:29 primary 3052465755 >> 1 800 685 7530 P 1/2 '4F bP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 03/28/13 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED i REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If tho cortlflcato holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain Polleles may require an endorsement. A statement on this cortiflcato does not confer rights to the cortlAcnto holder In[IOU of such ondamomont(s), PRODUCER CONTACT Mary's Insurance gERTA OAVALOS FAX NAME PRONG 305 24 j IP4 No,Ellt): ( ) 6-7700 (yC No)_ (305)246-5765 j 27132 S.Dixie Highway ODR96S: marysinsuraneoobollsouth.not Naranja,FL 33032 Phone (305)246-7700 Fax (305)246-6755 { ►NSURER(S)AFFORDING COVERAGE NAIL at i 1NyURt:D INSURERA: WESTERN WORLD INSURANCE CO ' . INSURER D Air Conditioning Word Inc INSURER C! PO 60X901588 i INSURER°: 'HOMESTEAD,FL 33090- (786)255-0059 I INSURER E: COVERAGES CERTIFICATE NUMBER: — REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ADOVE FOR THE POLICY PERIOD j INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMCNT 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. I INSR' IADDLSUBRI LTR: TYPE OF INSURANCE ;INSR I WVD; POLICY NUMBER (IAApt/DCD YYYY).(NIMlDO/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000,00 COMMERCIAL GENERAL LIABILITY I DAMAGG TO RENTED i I A ��I L_1 CLAIMS-MADC W1 OCCUR j I GATMC-I j PRCMISGS t @a occUrronou) ' s 100,000.00 MED EXP(Any aia parson) S 5,000,DD i 06!20!2012 06120/2013 PERSONAL 8 ADV INJURY s 1,000,000,00 J7 GENERAL AGGREGATE 2,OOD,000.00 i GEN'L AGGREGATE LIMIT APPLIES PER: I I , i j PRODUCTS•COMP/OP ACC i s 1,000,000,00 r] POLICY LI ACC°T [I LOC i a j AUTOMOBILE LIABILITY I ( OMDINED SINGLE LIMIT Cj ANY AUTO i I ! ! to.acc:donl) _,—+5. ..... — ! ALL OWNL'D — SCIiGDIJLED I I BODILY INJURY(Par parson)I S C_1 AUTOS LJ AUTO;, I f NON'OWNED I BODILY INJURY{Poraccitlontt $ HIRED AUTOS i Ll AUTOS I j (P PROPf•R pAMACE ' S ' xaCCi�tt i , r� UMBRELLA LIAB OCCUR I LIAR EXCESS I CAG14 OCCURRENCE S j ❑CLAIMS-MADE AGGREGATE g U BED L RETENTIONS WORKERS COMPENSATION ! j 1 Y AND EMPLOYERS'LIABILITY WC STATU• 0TH- Y t N l I I IJ TORY LIMITS 17 cR ANY PROPRIETOR/PARTNrPJFXECUTIVE i C.L.EACH ACCIDENT' I S i DED� OFEICERIMEMBER GXCLU i N/A I (f Uvs,d ory In NH) ! C.L.DISEASE-CA EMPLOYGE � II yes,tlasrn6a urtdar � , DESCRIPTION OF OPERATIONS We. S,t DISEASE-POLICY LIMIT 3 — i I I I I I I I 1 j I j i I DESCRIPTION OF OPERATIONS/LOCATIONS I VGNICLES (Attach ACORD Rot,Additional Romarks Schodule,If amro apace Is roquirod) AIR CONDITIONING SERVICE AND REPAIR CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE; THE EXPIRATION GATE THEREOF,NOTICE WILL BE DELIVER9D IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 i AUTHORIZED REPK,,SIINTATIVE 306.156.8972 .• �y/ BERTA DAVALOS ACORD 25(2010/06)OF ®7588-2010 A06 CORPORATION, All rights reserved, Tho ACORD name and logo are registered marks of ACORD r . Licensed CAC 055490 Insured AIR CONDITIONING BYWORD, INC. Air Conditioning,Heating and Commercial Refrigeration Sales•Service•Installation•Pool Heat Pumps FP&L Participating Contractor•Home Inspection Services Available Air Quality&Mold Remediation Services DALE WORD-Owner North Ph:(305)232-7070 P.O.Box 901588 South Ph:(305)245-4221 Homestead,FL 33090 www.ACbyWord.com 2013-03-28 10:30 primary 3052465755 >> 1 800 685 7530 P 2/2 v ' I F1 XMLASS U.S.POSTAGE PAID MIAMI,ILL. PERMIT NO,231 282765-8 THIS IS NOT A BILL'-D©NOT PAY RENEWAL 95995-6 ......... . ........... - - -a -t �G••BY-'WORD...INC STATEWMIS'SG90 2 0"V9 5 CONDITIONING BY WORD INC $*gT,lr'9afte"WCHANTCAL CONTRACTOR Wt1RKSIlS Th19 ig ®NWI a L 1. OYOINl,SB 7A7C aa{sawr..T Bonn mar Pen" TNR H6t���pp TQ Y{Q{,gTR dNY '� r.%'ISTfNQ RnQtlLATORY QR • cou°w"Nn•aa cma°i•roa... DO NOT FORWARD NOW rt �1Fi Y+ae No room aaroTMea 1 o"u�"iaeron°v1A TM"M AIR CONDITIONING BY WORD INC N°o►(OLD as U,,PICA- DALE WORD PRES PO Box 901588 FATUNNTA�.r�.-.�u•.�r�t . HOMESTEAD FL 33090 WLLOFOACCOa VViIli 1.TAX 0 oloiiiuol I1 11 If 11,111111411 11 1 1 ! 1 11 00007$.00 . Ir{Iltrr�l{ r{+ + ►r rrr { I SEE OTHER SIDE .+ .• ....•. . ........... I ;: �DERA"FtR'MEDi'.D:°-,O'F.' 8�II32N:E3:3?,•.AND:=°;; CAC 05•54.9 0 =, "' h77FT G w•. ' ,e. •'•Sy 'y�I�•i4i/„%�,.: iw�'iiJ V .'4'�`:�itiG•},.,'q.;.,:..,� t'p '"'' ,.J 'fit e:1•t• '�'�.•M•... , • •.C:• :•:% �:.4 ..o :,..� Txr�6 uaerx; i , ;italXsaC,loa d+ C XUG'3,1r,:„`2•Ql4 ;ao7 `; x•6y6 ' � , STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW EFFECTIVE: 11/09/2012 EXPIRATION DATE: 11/09/2014 PERSON: DALE WORD FEIN: 650360819 BUSINESS NAME AND ADDRESS: AIRCONDITIONING BY WORD INC I 20020 $W 286 ST HOMESTEAD, FL 33030 SCOPE OF BUSINESS OR TRADE: 1- CONTRACTOR-PROJECT MANAGER, CO 2- HEATING, VENTILATION, AIR-CONE k 3- SKIMMING POOL CONSTRUCTION-NOT $T jE 01.'FLORIL} AUG E j..6 AM �RO�'E�s�� �R�GIILAZ'ION 3 CAC 055490 i-8019z�4 CTZFE .: 1A � R - i I$ E1tTIFD. under. the pravtsiema Af Ch: $9 86 r atioa date: 3►TI 3Y,.�.-2lj.T�! 4 1207310'1.596 C 13 15-7 EMS Heat Loss/Heat Gain Calculation AMCONDITIONING BY HSL CAPTIAL WORD INC. DALE WORD 3052327070 766 N.E. 96 ST.N AW FL. 33138 954 918 9905 �1 This HVAC load calculation has been performed using sound engineering principles as prescribed by Manual J seventh and eighth abridged editions and ASHRAE Fundamentals.Duct sizing has been performed as prescribed by Manual D. 1.Design Conditions Indoor Outdoor Temp. Diff. Front of home is facing: Winter- 70 55 15 North Summer 75 95 20 2.How would you describe the summer humidity in your area? Average 30 3.How tight is the house? Average-under 1500 Sq. Ft. Winter air change/hr: 1 Summer air change/hr:0.5 4.Fireplace evaluation : Number. 1 Tightness:Average 20 5.Number of occupants: 4 b.Overhang characteristics(optional) East West S/SE/SW Distance of overhang from 5 .5 .5 G' to of window Ft.) th 16 5 7 Tab 0 } 7.Solar gain through glass Faeing Total area-S .Ft' T e of lass HTM Linear ft. Unshaded Shaded BTUH N/Shaded 15 S' a 32 Below OH 15 NE/NW y Select-� 0 0 South 13 Sin a 50 13 0 650 SE/SW ®® Select-- 0 0 0 East 16 Sine 90 16 0 1440 West 4 Sine 90 4 0 360 Sk light --Select-- 0 Total North and Shaded 15 480 Total Solar Gain 2930 dust for tinted or reflective window coatin No 1 2930 8.DuctstPipes Kocation: rank and branches in attic Attic Tem Insulationeaka a Area 130 Select-- sealed 1 1100 Tab 1 9.Load Calculation Elements of Load : Insulation 1 R-value Arealiin.ft. U-value Heat Loss Heat Gain ross Wall 176 Glass solar gain 2930 lass 1 in e 48 .98 J750 lass 2 Select-a k"li ht Select®� ours a wood .56 7 et walls o Insulation 122 .27 59 eilin s o Insulation 1000 .6 7000 loors select-- en floors Select lab floors Select— plume of our building or zone 'cu.Ft.) 800 1613 eo le 1200 lances 1200 ub Total 13000 4669 net Loss/Gain ensible Load 13000 4669 tent Load 416 4TAL BTIUH 013000 E1085 Summary BTUH Tons Total heating Ioad 13000 Total cooling load 37085 3.1 Tab 2 Equipment selection as per Manual S BTUTH Nom.Tons Total heat loss 13000 Desi n tem Outdoor Indoor Total heat ain 37085 3.1 Winter 55 70 Sensible heat gain 1 34669 su;nmer 95 75 Latent heat gain 2416 1D design RH 50°l0,63F WB Sensible/total ratio 0.93 Altitude Target coolin 'TD 17 Predominantly Cool climate Manufacturer's Equipment Specification Equipment Manufacturer Model 13TU11 No. output Furnace lam. ea `aci fug UD design temp. Boiler Total Sensible Latent Heat pum": 0 AC.' Evaporator Air handler OTAL CAPACITY with altitude correction 0 0 0 0 elected equipment size OK OK ✓ 3�` " a Heating Cooling;(rFM1I Ext. static pressure of blower CFII rec, 0 Available static pressure for duct Supplemental beat needed for heatpump Blower ext. static 'press. HP capacity ra% 47F i.,oil pressure d rop HP capacity (o-) 17F filter pressure dro HP ca acit , ii.ODDT register ressure dro Ell+H supplemental heat grille ressure dro' Y supplemental heat other' G t I I F C 6 i4 t F Tab 7