MC-13-2122Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INS P- 199461 Permit Number: MC -9 -13 -2122
Scheduled Inspection Date: November 25, 2013 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Owner: MILLER, WAYNE
Job Address: 258 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number (305)606 -6450
Parcel Number 1132060133390
Contractor: RESIDENTIAL AIR CONDITIONING CORP Phone: 305 -652 -6040
Building Department Comments
REPLACE 4 TON AC SYSTEM Infractio Passed Comments
INSPECTOR COMMENTS False
November 22, 2013 For Inspections please call: (305)762 -4949 Page 9 of 33
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 22, 2013 For Inspections please call: (305)762 -4949 Page 9 of 33
R
r
r
Miami Shores Village 4
Building De p artment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 _ sEP � �a��
Tel: (305) 795.2204 Fax: (305) 756.8972 r' V: - ® ® ® ® ®o
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING •` Permit NACI 3 .► oC j
PERMIT APPLICATION muster Permit No.
FBC 20W
Permit Type: MECHANICAL
Owner's Name (Fee Simple Titleholder) J�ZMYffe t i[ IL— Phone - 9-6-17P' I ! o
O er's Address .�'� C' s
City C 40 State Zip - -13
Tenant/Lessee Name — /07 Phone #
Email
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade AD
FOLIO / PARCEL # - 3 do & 0 3 3,317-a
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name A, z 6-N[7,94- !Z G.- Phone #
Co tractor's Address 6162- h9, 4e,5-1!!6 7Z WWA 4-c
City r State Zip
Qualifier Name t Av9 Phone # go-r -- /a-s 40 X®
State Certificate or Registration No. _ _ :9$'I/J� � Certificate of Competency No.
Contact
E -mail
Architect/Engineer's Name (if applicable) ' Phone #
Value of Work For this Permit $
Type.of Work: QAddition ElAlteration
Describe Work:
Submittal Fee $ V v. Permit Fee $
Notary $
Scanning $
Double Fee $
Structural Review. $
Square / Linear Footage Of Work:
New [�Repair/Rep� ❑ Demolition
CCF $ , ) • U U CO /CC
Training/Education Fee $ w 0 Technology Fee $
Radon $ J,63 � DPBR $ Bond $
Violation date:
Total Fee Now Due $ /°
See Reverse sid -�
V�
Bonding Company's Name (if applicable)
bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
zip
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 will not be approved and a reinspection feewill be charged.
r
Signatur(V > 04— Signature
�`• Un
O r or Agent oa,\4®Qkeeeeta >v
I r
J v. �S .. bs,,
The foregoin `® lnt wasi' owledge before me this The foregoin v *1Wckno d b fore me
day of P e;0°� of day of , y06'�
P S
ho is persoz�. y n tcb orechas produced ho is personall otto m `r roduced _
;t.9 Ja 65 an o. did take Aath. id tak an oath.
NOTARY PAiE L' �r�;;:' `.�` NOTARY PIJ)E fill%
tI I0%
Sign: Sign:
Print: 67 `. 0 t /Lel}' B0 Il) G Print: t%! IV
My Commission Expires- ~ My Commission Expires:
APPROVED BY Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)
Miami Shores Village
Building Department
90050 ME.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. I
Job Address (where the work Is being done):
City: Miami Shores Village County: Miami Dade
Zip Code: 3 -31-,?f
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 E� NO ❑ Contract Attached: YES.[
Y
UNIT BEING REPLACED
DATA
NEW
VNIT
a4E'iio- i
M NUFACTURER
ft fir PKG. UNIT MODEL#
74 a e sorr
COND. UNIT MODEL #
KW HEAT
NOM TONS
®N,g
AHU 3 iOCU
PKG
1 M.C.A
AHU aU
PKG
AHU4,5 CU
-PKG
2 M.O.P
AHU4 ,CU
PKG
CU
PKG V
3 VOLTS
Af V CU
PKG
NIT
/ f 00y,
PKG UNIT
EE ER
/1,0,0
YES
NO
REP G DUCTS
YES
NO
YES
NO
REPLACING THERMOSTAT
YES
NO
YES
NO
NEW 4 °CONCRETE SLAB
YES
NO
YES
NO
NEW ROOF STAND
YES
NO
YES
NO
NEW RETURN PLENUM BOX
YES
NO ✓ .
1. Minimum Circuit Ampacity (Wire Size): r!
2. Maximum Overcurrent Protection (Fuse /Breaker Size):
3. Voltage of Circuit (208/240/480):
4. Size disconnecting Means:
Contractor's Company Name: ®�Esn�L btu��
State Certificate or Registration N. �7-2 a 'Certificate of Competency N.
A �-
Phone:'- lob 4 0 t
Signature —— Date: -,
(Qualifier's signature only)
E
h
r.
✓ t
a® CERTIFICATE OF LIABILITY INSURANCE m'>D o 3'"
'THIS Ct_RIM90ATE IS ISSUED As A MATTER OF WFORBIATION ONLY AND CONFIW NO Rlt> M UPON T14E OERTIFICA•TE HOLDER. THIS
dERT cATE 0090 NOT AFFIRMATIVELY Olt 11*01ATIMY AM9ND, t#JCrEW OR ALTER TH6 COVERAGE AFFORDED BY THE POLICIES
MOW. THIS CERTIFICATE OF MURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING fl: URERl91, AUTHORiS
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDIOL
IMP RT'ANT: If the certifloate tickler Is an ADDITIONAL MU RIM, the pal cy(iea) WAd be onda sea N SUB T—M 11 WANED, Subject to
the twava and conditions of RTe policy, asrdrin palialas may require on endomement. A statement on this certificate does riot confer rights to the
cartiflcate holder In Asa of each vm:1*rswncnVsy
panoucaR _ - RNg Kaplan r .
Suburban Assodales, Inc gg�q, 7 ®6 454 -9185 ltF ,l1 a 1�9 «» .«
17071 W Dbde H19hwaY orv.Asuburbanessodatea.net _.. .
North Miami Beach, FL 33190 _.. _iF$Yk1�1.4>��mP E _ Fyaas.,
gq�AB: Endt�antee American spec�ity "��' ..»
esuep� _ .. _, _ . .._..�._.. _.. _.– -- - --- _ -_ - -- •• �yE_Asso l lIndustries inaurenae."P0 _.
Residential Air
1662 NE 2DS Terrace
a ,
Miami FL 33179
nniien■a.*ef r- =crnCtf-lt -r= mu ucc. - �crsln�nrualltenaRQ±
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCET. UVrED SaOW HAVE SP.EN ISSUED TO THE INSURED 11AMOD ABOVE FOR THE POUOY PERI013
RUCA'fED. NOTWTHSTAHDWO ANY REQUIRE MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VMICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE P01.101E8 DESCRIBED HEREIN 19 SUBJECT TO ALL THE TEMIS,
EXCLUSIONS AND OONDITiONS OF SUCH POU01ES. LMM SHOWN MAY HAVE SMN REDUCED BY PAID CLAN& _ ._..
rMA aF WOUPANaIt _ u aER L�AiB
A oa+aawlLLU�anJtY
Y
CBP1000024OWD 03/23/18 OW23114
e, 9,OOO,t;•00
x , c eaE wr oeNt iiunewrY
ogees o of
9 100 -009
ums -was �, x� ocWR
, ? Qtiq�«r t
s O iBi4Al pB _ TIS
11 2,QnQ
iWJM A03MATELWAPPLrtsPEA
�Pjeocnlcq- 00WROPAOO
a 1;00QDOi)
K policy p C
0
AUTOMOSIL9 UARRITY
4 +8 $ .
ARYAUM
! aOOriYrtdJ1 RYlr'el P N e _
tl8 MED DUI.®
ED
BIXNi. WARY (Per SWCM ,4! S
MW
$
- E►ICP88 Eua_gll�t&a�Ab3,
A6a0AE0A1E _ .. -
R
B
Aral sMpLOylena' L1A911JTY r i4VVC1021387 03123f201303Pt3/2014:
AND x RB 00MlpEiRI=L
100,00
NfA
6d_Df- SAEMR.pY� $ 100,000
!'opmamm
` 500,000
tg orb'°` eRA ce LL D—Ows -P Lrwer
A!
Business Personal
Y ICBP10000248000
03/23 OIJO31W21=14 50,000 Limit of Insurance
I Property
I
1 $1,000 A®P Deducible
o acRIPTION OF a r Lot,A71r w,Iva Pa ea rAlacb At�RD 901, AQdiduern! Rar�mrsa aahodnh, r maro apses N nqubvll
Blanket Additional Insureds
Village of Miami Shores
Building Depar"ent
10050 NE 2 Ave
Miami Shores, FL 33138
ACORD $S P61100S)
The ACORI) mum and logo are
SHOULD ANY OF THE ABOVB
WE RVIRAT108 DATE T
O*ft of ACCRO
HO poLCM IN CANCELLEDWORL
11=11 VA LL AZ ORL WBRED N
reserved.
I I .*Mil
ilfna( I3 ou
FIRST -CLASS
ST, U.S. POSTAGE
b
MIAMI, FL
R . �7 PAID
I I,. EL 35130'liAAii sat PERMIT NO. 231
THIS 18'NOT A BILL DO NOT PAY
713669-0 TRANSFER
13UIWgl flg%lV&EARW INC STATelcEWM5484 063960-0
1662 NE 205 TERR
33179 UNIN DADE COUNTY
'n%IDENTIAL AIR INC
See WORK8R7S
i'ffc0'9MCHANICAL CONTRACTOR 10
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOSS NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR*
ZONING LAWS. OF THE DO NOT FORWARD
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REGUIRPD BY LAW. TMS 10 RESIDENTIAL AIR INC
NOT A CERTIFICATION OF
mmrl DERIS QUALIFICA- RICHARD M VANNI•
1662,NE 205 TERR
PAYMENT RECEIVED MIAMI j-FL 33179
MIAMVUADE COUNTY TAX
COLLECTOR:
04/2.5/2013
6,0000000009
000007.50
SEE OTHER SIDE
STATE OF FLORIDA
DEPART BUSINESS AND
PROF
CAC036484 ULATION
410412013
GERTIFIEL) Al
VAN
RESluttNTIAL-Al ..,j
IS ""thel) Under the Pr6vlsfon5 Of ChAS
t*f 460ndafO': AU031,2014 1 9 FS.,
k L130464ftl398
I
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17, 2009 and Dec 31, 2013.
`=
AHRI Certified Reference Number: 5942900 Date: 9/512013
Product: Split System: Air- Cooled Condensing Unit, Coll with Blower
Outdoor Unit Model Number. 4A7A7048A1
Indoor Unit Model Number: *AM7AOC42H31
Manufacturer: AMERICAN STANDARD, INC.
Trade/Brand name: PLATINUM XM
Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD, 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): 48500
EER Rating (Cooling): 13.00
SEER Rating: {Cooling):.. 7.-:00
Ratings followed by an asterisk (`) Indicate a voluntary rerate of previously published date, unless accompanied with a WAS, which irdcates an kWuntary rerate
DISCLAIMER
AHRI does not endorse the product(s) haled on this CerNflcate and makes no rapresenlallona, warranties or guarantess as to, and assumes no responsibility for,
the product(s) listed on this•CerttffcabL AHRi expressly disclaims ag Ilabi8ly for damages of any kind arising out ofthe use or performance of the product(s), or the
unauthorized afteration of data listed on this Certltieete. Certfftad ratings are valid only for models and cordfguratkrns listed in the dhockwy at www.ahridirectaty.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHR4 This Corti [mft shall only be used for Individual, personal ant confidInrtial reference purposes.
The contents of this Certiflcake may not, In whole or In pert, he reproduced; copied, disseminated; entered hft a computer database; or otherwise utilized, In any
form or manner or by any means, except for the umes Individual; personal and confidential reference.
CERTIFICATE VERIFICATION
The infomiatlon for the model cited on this certificate can be vertiled at www.ahtichrectmy.org. Air- Condiflon)ng,1°leating,
click oir °Verity Cori icater link and enter the AHRI Carew Reference Numberand the data on � and RflM eftafion Institute NU which the cartHicate was Issued, which is listed above, and the Certifksts No„ which Is listed below,
@2013 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130228802873978751
Ti�� New Osgmc,7! Coueon"
0- 0 a a a
0 6,
Ceiling height
9
VVall U value 11 R��,Vaft:je
..........
D'� 09: 131
Floo-r L3 -value f R-vafue
0. 2 51
-Celfing, Uq-value RValue
!0x053,1 19
..........
--------- - ..........
Window U-value
.. ......... ..
..... ..........
Window SFtGF
Moisture grains 58
Duct ga. in % to
Heating infiltration (ACH) 0.8
&jv itner vent-ation
S-urnroer Outdoor 900F
Summer indoor 75'F
atimorper uesi alllfi
V71)
Mnt,.C, Outd,,00r 5 0 r
....... ...
Winter Indoor: 70 f
Outdoor Heating Cooling
Daily range L
Moisture difference 58
Indoor Heating Cooling
Design ternperatUre differenceff) 20 15
H e °a�i3ri oa, s.
Cooling Loads
39446�� BTUftir
Latent Infiltration
Sensible People Load
Latent People Load
Sensible Infiltration
et Wall
Residential Air Inc.
1662 NE 205 Terrace
Miami, Florida 33179
305- 652 -6040 * 954- 764 -0489
Fax: 305 - 651 -4992
State Licensed and Insured
Air Conditioning Contract
July 29, 2013
Mr. and Mrs. Wayne Miller
258 NE 92nd Street
Miami Shores, Florida 33138
Residential Air will furnish and install the following:
American Standard 4 Ton SuAer High Efficiency -17 SEER — 2 Stare Coolina System.
Installation includes the following:
R410 Eco Friendly Equipment listed below.
Condenser 4A7A7048 will be installed and secured on a new Dade County approved slab.
Variable speed air handler model TAM7A042 will be re — installed horizontally.
Rework and replace hanging materials where needed.
Connections to existing ductwork, refrigeration lines, drains and electric.
Remove and dispose of existing equipment.
New float switch
Touch screen thermostat.
Heater'
Flush lines with RX - 11
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.
Payment terms are 50% deposit and; balance upon installation.
Discounts given for FPL Rebates and Service work.
Price does not include permit fee.
Total Price $5000.00
Respectfully,
Richard Vanni
Residential Inc. ,
Approve L Account
(43450 - 51