MC-13-882 Miami Shores Village
Building Department
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1� 2013,
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 No.
' PERMIT APPLICATION Master Permit No.rn
FBC 2010
Permit Type: MECHANICAL
Owner's Name(Fee Simple Titleholder) L T Phone# _30-Ir-1 or
O er's Address ���` �(L- Jl✓ �-�
City S/VXaState Zip 31dr
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Tenant/Lessee Name Phone#
II Email
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Job Address(where the wbrk is being done)
City Miami Shores Village County Miami-Dade Zip
FOLIO/PARCEL#
t
Is Building Historically Designated YES NO Flood Zone
s Contractor's Company Name 42594>6417#4 II/9— Phone#20J "
Contr tor's Address /6 a - - �J — "jam
City / State F-e4q- Zip
Qualifier Name M Phone# JL15" 6 6 kee
State Certificate or Registration No.. 84 6D d °y5 Certificate of Competency No.
Contact Phone E-mail
Architect/Engineer's Name(if applicable) Phone#
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Value of Work For this Permit$ k4a Square/Linear Footage Of Work:
Type of Work: DAddition ❑Alteration ONew VRepair/Replace ❑Demolition/j
' Describe Work: 0 t(C Ii
i D� � v �
Submittal Fee$` f�� Permit Fee$ 42M 196 CCF$ CO/CC$
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Notary$ Training/Education Fee$ Technology Fee$
Scanning$ .Radon$ DPBR$ Bond$
Double Fee$ Violation date:
I iew.$ Total Fee Now Due$ 2Utig(�
1 See Reverse side
tj Mt.
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=Bondin"E Company's Name(if applicable)
Bonding Company's Address 1-17 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (1) 'days after the building permit is issue the absence of such posted notice, the
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inspection will no e approved and a reinspection fee will be charged.
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Signature ® BUNC®O®°< Signa •
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The fore oin me aclrnbdvP ed before me this 4410 The tore *���owled ed before me this-4
so
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day of n '?° (# � da h 'O! °. ® by
who i ersonall�j®? °,� ,` o has produced _ who is person known to me or who has produced
°ts 'f4�11t cation and who did take an oath. as identification and who did take an oath.
NOTARY P NOTAR C:
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Si Sign:
Print:
Print:
My Commission Expires.. My Commission Expires:
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APPROVED BY Plans Examiner Zoning_ CV-7V
Engineer Clerk checked
(Revised 07/10/07XRevised 06/10/2009)
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Apr 01 13 07:48a Suburban Fax 9549441899 p.6
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CON CERTIFICATE OF UABIUTY INSURANCE FOMM013
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the tPa and oanditl*W of the pokey,aerE a poliOw flay require an endorsement. A atatament on this eerWkm to does not confer rig)d+e to the
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Reeldon lal Air
1082 NE 205 TwIvas
I' 1018ml Fl. 33179
COYERME3 CWRFiCATE NUMM: news DM HL"EER:
THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LlgTED BELOW HAVE WEN ISSUED TO THE INSURED NAMM ABOV$FOR THE POLICY PERIOD
U�CATTM NOTNTHBTANDING ANY REQUIREMENT,TM OR OONDMON OF ANY CONTRACT OR OTHER DOCLAIE t YM MPEC 1 TO WHICH TH18
CERTIFICATE MAY se ISSUED OR&MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUEJECr TO ALL THE TERMS,
EXCLUSIONSAND CONDMONS OF SUCH POLICIES.L"T$BROWN MAY HAVE BEEN REDUCEDBY PAID CLAM _ _»
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CERTIMATEHOLDER TION
aflo=ANY OF THE ABOVE DEMISED POLMS BBCANMLW 88FORi:
Village df Miami Shores 'ME EXPRAnOx DA TROP, NOTICE VALL 0 Di LIMMED IN
Building Departrtlent AaxDAltca Rrlt+ oNS.
10050 NE 2 Ave
Miami Shines,Ft_33138
t019W2010 Aa=CoRPORA71oN.AR righft reewwd.
ACORU 25 GtO9is" The ACORD norm and logo are 4latered rrwft of ACORD
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Residential Air Inc.
1662 NE 205 Terrace
North Miami Beach,Florida 33179
305-652-6040*954-764-0489*Fax:305-651-4992
State Licensed and Insured CACO35494
Revised April 18,2013
Marie Duron
395 NE 97 Street
Miami Shores,Florida
Residential Air Conditioning will furnish and install the following:
Rheem STon High Efficiency Split Cooling System—15 SEER
Installation includes the following:
R410 Eco Friendly Equipment listed blow.
Condenser model 14AJM60 will be installed and secured on a Dade County approved slab.
Air handler model RBLLIHM6024 will be installed on an air handler stand.
Remove and dispose of existing ductwork and equipment.
Fabricate and install new ductwork,boots,cans and grills.
Balanced returns
Float switch
Digital Thermostat
Heat
Refrigeration lines
Relocate air hander to new closet as discussed
Start up system and check for proper operations.
All labor and materials for a complete and professional installation.
One year warranty labor and ten year warranty parts.
Price does not include permit fee
Payment terms are 50%deposit and balance upon installation.
This system qualifies for the Rheem Design Star Energy calculations.
All Electrical work by others.
Total Price$9125.00-$725.00 FPL Rebate=$8400.00
Respectfully,
Richard Vann
Residential Air
Approved by FPL Account 946222-8280