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MC-14-4040Miami Shores Village Building Department BY' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 i/ INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: MECHANICAL JOB ADDRESS: FBC 20 Permit No. MAR 0 5 2014 Master Permit No.�_ / Ll _ L City: Miami Shores County: Miami Dade Zip: 0 C) D \�D Folio/Parcel #: N X '0- \ 3 ( e2 33r' Is the Building Historically Designated: Yes NO Flood Zone: OWNER Name City: V 1l Vl!(M` Tenant/Lessee Name: Email: State: CONTRACTOR: Company Name: (cA )k hir Phone #: "6 Address: City: V1 Zip: Qualifier Name: __1W C—t tC M U f! Phone #: State Certification or Registration #: ��1( Certificate of Competency #: _ Contact Phone#: Email Address: DESIGNER: ArchitecVEngineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: _ Type of Work: OAddress ❑Alteration A ONewtepair/Replace A Description of Work: lgan 1 CIQ e `?l 2D-N N j 0_V �` 1 1 h Submittal Fee $ Permit Fee:- e CCF $ CO /CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ODemolition Bonding Company's Name (if applicable)! Bonding Company's Address City State Mortgage Lender's Name (if applicable) N1 / PS, 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 s d at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such poste noti e, the yspection will not be approved and a reinspeStiea ee will be charges( Si Signature d gyner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of V 20 day of �` S- by who ' p orally -own me or oho hasp duced who is ffrsly known to ho has produced As identification and who did take an oath. identification and who did take an oath. N AR UBLIC: NOTARY UBLIQ Si Si . n t H P't W COMMESION fffmv5l WB.UWS My Commission EXPIRES: AUG 12, 2017 My Commission W COW== #FF035961 Bonded through lot $tate Insurance EXPI ft AUG 12, 2017 Bonded through 1st stets Insurance APPROVED BY Plans Examiner Zoning Structural Review Clerk Revised 3 /1=012XRevised 07 /10 /07XRevised 06110/2009xRwised 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): cg ®3 IA*� M 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 ❑ N0I,;Rf ARHI Sheet Attached: Yq,2rNO ❑ Contract Attached: YES. 1. Minimum Circuit Ampacity (Wire Size): 0 2. Maximum Overcurrent Protection (Fuse /[Breaker Size): _(42 3. Voltage of Circuit (208/240/480): ..Q-kV 4. Size Disconnecting Contractor's State Certificate or Signature Certificate of Competency UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # '� COND. UNIT MODEL # Z) KW HEAT NOM TONS AHU X CU 2V PKG 1 M.C.A AHU CU PKG AHVWV CU 07 PKG 2 M.O.P AHU CU PKG AH CU KG 3 VOLTS AHUZV CU TiO PKG PKG UNIT / / PKG UNIT I I b 4 EER/SEER YES NO V REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4 °CONCRETE SLAB YES V NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX I YES NO 1. Minimum Circuit Ampacity (Wire Size): 0 2. Maximum Overcurrent Protection (Fuse /[Breaker Size): _(42 3. Voltage of Circuit (208/240/480): ..Q-kV 4. Size Disconnecting Contractor's State Certificate or Signature Certificate of Competency 1P 111I I 11 Oil 11 OR mmal" �l• s u AHRI Certified Reference Number: 3799429 Date: 3/4/2014 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number:14AJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD, WEATHERKING Series name: Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, 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 tesiin * Ratb ils lbl owed by an asterisk (*) Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an Involuntary rerste. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) 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 �Ilng C pac!ty (i tuh . 46000 :+ Rating, Cool, 13.00 MR!' irrg }�fi.G AM TF iS m� ysx .� hF entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual, * Ratb ils lbl owed by an asterisk (*) Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an Involuntary rerste. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) 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.ahridifectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRL This Certificate shall only be used for individual, personal and AM eonfidenthd reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered Into 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. AIR - CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahrldireetory.org, click on 'Verify Certificate" link ,v,nake life better- and enter the AHRI Certified Reference Number and the date on which the certificate was hued, which is listed above, and the Certificate No., which Is listed at bottom right ©2014 Air- Conditioning, Heating, and Refrigeration Institute �rj,T Nib?.: 130343532 "!6$' PUN %*Wig LIL010111V ®i GNCb`INUCH i.►ti�11LIQ�:�Vr� Affordable i 1 LTIL& CAC048111 WHERE QUALITY IS AFFORDABLE 515 N.E. 190th Street - Miami, FL 33179 Dade (305) 940 -0777 Broward (954) 987 -9943 C. M JOB EC0001140 MANUFACTURER C0N0EN$Ek1fiACr -101 *0DEI. AIRHANII=MODEL &L IESTAN CAL NEATER TONS OPERATING COST KYY A 1y Ac M=-4dV . 61 u j Ll El C JOB DESCRIPTION: -COQ, AIR DISTRIBUTION: Ductwork will be designed, fabricated and installed in accordance with accepted engineering practices and in compliance with all building codes in force on above date. DUCTWORK: System of flexlfiber and/or t ductwork with outlets and returns. Subject to mofticatt,on according to structural or other requirements. LABOR WARRANTY: Service will be provided free by us for a period of A_J_ B C year(s) from date of installation during regular working days & hours. MANUFACTURER WARRANTY: Parts Warranty (Yrs.) A to B C Compressor Warranty (Yrs.) B C EXTENDED WARRANTY: Provided through for year(s). Title to the above merchandise remains with Affordable Air and Heat, Inc. (seller) until paid for in full. In case of default in any terms of this contract, the seller shall have the right to take immediate possession of said merchandise and full amount of the purchase price then unpaid shall become immediately due and payable atthe seller's option without notice or demand. All monies paid shall remain with the seller as liquidated damages. In the event the services of an attorney arerequired to enforce the interest of the seller, the purchaser shall be required to pay all, reasonable attorney's fees together with interest and all costs thereto. No warranty service shall be performed on accounts with an outstanding balance. Labor warranty excludes, existing ductwork, existing electrical systems, and maintenance related repairs. In the event the purchaser-refuses to allow seller to commence work after the contract has:been executed, purchaser shall be responsible to the seller for 250/9 of:the.,total price as liquidated and agreed damages. Seller shall not be responsible forany existing building orelectrical code violations. All material-Is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the contract specifications Involving extra costs will be executed upon written orders and will besubjec tto charges over and above this estimate. Mt' Initial Here AFFORDABLE AIR 8 HEAT, INC. WILL PROVIDE: Y S NO EXISTING YES NO EXISTIh INSTALLATION OF EQUIPMENT n ❑ THE RNOSTAT� REFRIGERATION LINES( ) OR FLUSH ( ) 6? ❑ ❑ CARPENTRY ' GRILLES( ) RETURNS ( ) ❑ PERMIT FEE(S) S PLANS, IF REQUIRED ❑j ❑ BALANCE AIR FLOW ❑ ILEMOVAL OF JOB SITE DEBRIS - t>' . J DRAIN PIPING ( ) OR FLUSH ( ) .g" n ❑ ELECTRICAL•WIRING (POWER-CONTROL) AIR HANDLER SUPPORTS �1 ❑ ❑ CONNECT TO EXISTING SERVICE/PANELS CONDENSATION PUMP d0' ❑ INCREASE ELECTRICAL SERVICE AMPS F7 EMERGENCY FLOAT SWITCH ❑ ❑ OTHER ^, X HURRICANE TIE -DOWNS ❑ ❑ OTHER F-1 CONCRETE SLAB ❑ ❑ OTHER r COST REBATE41CREDITS TOTAk,06sT A IS C FINANCING AVAILABLE No Payment to be made as follows: y �. deposit, balan start-up. Authorized Company Signature Data This proposal subject to acceptance within daya-pnd Is void there after at the - option of the seller. TIM Af" MM, PECIRUTM = CIRIMM AIEPM. YOU ARE TO � TBE W= AS . PAYIiBIR MLLE BE i1 M a AROYE. Option Chosen Slgnatur® 771^/' �' .� �n s_-- nom_ Ll •� E. ` ! MAR 0 5 2014 AHRI Certified Reference Number: 3799429 Date: 3/4/2014 Product: Split System: Air - Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number: WJM49 Indoor Unit Model Number: RHLL- HM4821 +RCSL -H *4821 Manufacturer: RHEEM SALES COMPANY, INC. TmdeBrand name: RHEEM, RUUD, WEATHERKING F MEOW Series name: Manufacturer responsible for the rating of this system combination C PANY, INC. Rated as follows In accordance with AHRI Standard 210/240 -2008 for nitarVy it onditi ing and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testin,, * Ratlrs followed by an asWM (*) indicate a voluntary rerate of previously published data, unless ac comparded with a WAS, which indicates an invoiuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) 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.ahrldireatory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRL This Certificate shall only be used for individual, personal and AM confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered Into a computer database; or otherwise utilized, in any form or manner or by arty means, except for the user's Individual, personal and confidential reference. AIR- CONDIFIONiN6, NEWING, CERTIFICATE VERIFICATION & REFRIGERATION INSSnUTE The Information for the model died on this certificate can be verified at www.shrldirectory.org, dick on "Verify Certificate' link we make life better- and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which Is listed above, and the Certificate No., which is listed at bottom right ©2014 Air- Conditioning, Heating, and Refrigeration Institute C �iF1dATE N€3. 130384351;3��?1 l Fa --C.e -f r - +-1 _A \ ko DESCRIPTION OF SERVICES PERFORMED AIR DISTRIBUTION: Ductwork will be designed, fabricated and installed In accordance with accepted engineering practices and in compliance with all building codes in force on above date. DUCTWORK: System of flexi iber and/or - 4'" ductwork with outlets and returns. Subject to moftcatt,on according to structural or other requirements. LABOR WARRANTY: Service will be provided free by us fora period of A—L B C year(s) from date of installation during regular working days S hours. MANUFACTURER WARRANTY: Parts Warranty (Yrs.) A�� t B C Compressor Warranty (Yrs.) B C EXTENDED WARRANTY: Provided through for yme'(s)• O 4 Title to the above merchandise remains with Affordable Air and Heat, Inc. (seller) until paid for in full. In case of default in any terms of this contract, the setlerehatl have the right to take Immediate possession of said merchandise and lull amount of the purchase price then unpaid shall become immediately due end payable atthe seller's option without notice or demand. All monies paid shall rem n with the,aeller as liquidated damages. In the event the services of an attomeyere required to enforce the interest of the seller, the purchaser shall be required to pay all reasonable attorney's fees together with interest and all costs thereto. No warranty service shall be performed on accounts with an outstanding balance. Labor wgirranty excludes, existing ductwork, existing electrical systems, and maintenance related repairs. In the event the purchaser refuses to allow seller to commence work after the contradhas been executed; purc hasershall be responsible to the seller for 25% of the total price as liquidated and agreed damages. Seller shall not be responsible foranyexisting building orelectrical code violations. All material Is guaranteed to be as specified. All work to be completed in a workmanlike manner acco' to standard practices. Any alteration or deviation from the contract s c atione Involving extra costs will be executed upon written orders and will be subjedto charges over and above this estimate. C F Initial Here AFFORDABLE AIR S HEAT, INC. WILL PROVIDE: Y S NO EXISTING A► YES NO EXISTIN INSTALLATION OF EQUIPMENT ', ❑ El THERMOSTAT—'N -, - n \ r Ell REFRIGERATION LINES ( ) OR FLUSH ( ) (5 El E] CARP GRILLES ( ) RETURNS ( ) ❑ ❑ �?J BALANCEAIR FLOW PERMIT FEE(S) & PLANS, IF REQUIRED �Z El El . REMOVAL OF JOB SITE DEBRIS .� DRAIN PIPING ( ) OR FLUSH ( ) ❑ ❑ ELECTRICAL WIRING (POWER-CONTROL) 6.2- Ell El AIR HANDLER SUPPORTS ❑ ❑ CONNECT TO EXISTING SERVICEIPANELS ❑ CONDENSATION PUMP ❑ ❑ INCREASE ELECTRICAL SERVICE AMPS ❑ r_ EMERGENCY FLOAT SWITCH ❑ .. ❑ OTHER' ❑ .�r' HURRICANE TIE -DOWNS ❑ ❑ OTHER El CONCRETE SLAB ❑ ❑ OTHER El This proposal subject to acceptance within days .:and Is void there after at, the option of the seller. Option MMM-YOUMEMMMMOTONMWMMVMM.PAWMWUMMMMORMOmWa. COST REBATES11;REDITS TOTAL COST A► B, C FINANCING AVAILABLE Payment to be made as follows: _ deposit, balance upon start-up. Authorized Company Slgnature Date This proposal subject to acceptance within days .:and Is void there after at, the option of the seller. Option MMM-YOUMEMMMMOTONMWMMVMM.PAWMWUMMMMORMOmWa.