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MC-14-68Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 205708 Permit Number: MC- 1 -14 -68 Scheduled Inspection Date: January 29, 2014 Inspector: Perez, JanPierre Owner: LEVASSER, GEORGE Job Address: 967 NE 99 Street Miami Shores, FL Project: <NONE> Contractor: AC MASTERS INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060340270 Phone: (305)661 -5111 5unaing Department comments CHANGE OUT EXACT A/C REPLACEMENT 3 TONS Infractio Passed Comments INSPECTOR COMMENTS False January 28, 2014 For - Inspections please call: (305)762 -4949 Page 25 of 39 Inspector Comments Passed Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 28, 2014 For - Inspections please call: (305)762 -4949 Page 25 of 39 i "I�� Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 PERMIT APPLICATION Permit Type: MECHANICAL JOB ADDRESS: Irv% NC=F- FBC 20 Permit No. JAN 1.4 201 Master Permit No. W. f ! 6 ff City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO ✓ Flood Zone: OWNER: Name (Fee Simple Titleholder)2�' ��"SS -- Phone #: State: ". Zip: TenanvI,essee Name: Phone #: Email: CONTRACTOR: Company Address: 5;Q!T0 .7S\0 Name: �' � i ✓ State Certification or Registration #: C G� Certificate of Competency #: Contact Phone #m -3057 / % Email Address: AM? DESIGNER: Architect/Engineer Phone #: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑Address OAlteration ONew Repair/Replace Description of Work: dW 4+NG€ 04o,7— 4F)(40- Submittal Fee $ M c/t/ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ per" CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 ODemolition Bonding Company's Nwhb (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip zip 0 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 ?I such posted notice, the inspection will not be approved and a reinspection fee will be charged. Si ginza lure -ZlI e– (S_ `t rm_�� Signature Owner or Agent Contractor The foregojpg-ipstrument was acknowledged before me this/ The foregoing instrument was acknowledged before m' a this day of ✓��"'~; 20 y Cleo a c � �� U� 5�.day of 20 L by �is— �rrif�l i �2, o is personally known to me or who has produced vyh y crown to me r who has produced As identification and who did take an oath. C as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: `t° c- My Commission Expires. f ♦ 9� APPROVED BY (\ 9 Notary PublIC - state or nonud-- My Comm. Expires Nov 28, 2015 Commission # EE 141607 Bonded Through National Notary Assn. tPlans Examiner Structural Review (Revised 3 /12/2012XRevised 07/10/07 )(Revised 06 /102009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: 0 Commission # EE 141807 Bonded Through National Notary Assn. Zoning Clerk Miami Shores Village Building Department 10050 N. E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 2204 AIR CONDITIONING REPLACEMENT DATA Fax: (305) 756.8972 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):_ 1967 /16�- 9T S'T- 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 ❑ NO q� ARHI Sheet Attached: YES E2/N0 ❑ Contract Attached: YES UM BEING REPLACED I DATA I NEW UNIT APW ' U or PKG. UNIT MODEL # YES CNOL �% �+ �1 N. COND. UNIT MODEL # REPLACING THERMOSTAT KW HEAT YES S.19 CU PKG NOM TONS NEW RETURN PLENUM B0; 1 M.C.A AHU CU PKG AHU CCU2 PKG 2 M.O.P AHU CU PKG PKG 3 VOLTS C PKG PKG UNIT / / AVIA- 6� EER/SEER gr6jW YES CNOL REPLACING DUCTS YEV NO REPLACING THERMOSTAT YES NO NEW 4 °CONCRETE SLAB YES NEW ROOF STAND YES NEW RETURN PLENUM B0; 1. Minimum Circuit Ampacity (Wre Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): �y 3. Voltage of Circuit (2 /240 80): 2-40 4. Size Disconnecting Means: YES YES YES Contractor's Company Name: —4PVjC– Phone:�.�r%�" State Certificate or R ' tration N F3 70 Certificate of Competency N. Signature Date: (Quenhees sl store only) ACMAS -1 OP ID: NMIS '`' -'`w" CERTIFICATE OF LIABILITY INSURANCE DATE(M TYPE OF INSURANCE 05/220/13 0/13YI� 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 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 888 - 828 -6411 Montgomery Insurance PO Box 188065 800 -845 -3666 Fairfield, OH 45018 SIHLE INSURANCE GROUP INC CONTACT NAME: A /C. No Ext : AtC No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: American States Insurance 19704 06/19114 INSURED AC Masters, IrIC 6250 SW 41 st St INSURER B PREMISES Ea occurrence INSURER C: MED EXP (Any one person) Miami, FL 33155 INSURER D: $ 1,000,00 INSURER E: GENERAL AGGREGATE $ 2,000,00 INSURER F: PRODUCTS - COMP /OP AGG $ 2,000,000 COVERAGES CERTIFICATE NI)MRFR• Q=%/IQInnl nu InnQCQ. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE.LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY /D EFF POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FK OCCUR 01C146510530 06/19/13 06/19114 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 200,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL AUTOSULED HIRED AUTOS NON -OWNED AUTOS L COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ 1 $ UMBRELLA LIAB EXCESS LIAB HCLAIMS_MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILI Y YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? F—] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- T Y IMITS E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) U/- XNUtLLA I ICJIV MIASH01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION- DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF MIAMI SHORES ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING & ZONING 10050 NE 2ND AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES, FL 33138 11 a /► '1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Insured Report Viewer I - Fl 1: 6- I --- iF00% Page I of I JEWAIMTM CHWFWAICMLCFFCM STATE OF FLORA MWARTMEW OF MANUAL SERVO MWWW OF VWOMGMV COMPE3MMM GM SW41 STWEr mm FL =55 SCOPES Or-RUMESSORMUMM MAC TM.VEWMATM AR-OND OF84"W,=CEffOWA'MCFELEMMTOBEEXBOTEEMMeWI2 QUESMOMQMVAWlM 11 https://appsg gH6TEP,6-- 9=013 AC# 620537 °DSLsi STATE OF FLORIDA v . T_:�- LICSN3 ' NBR . F GOD I H Locat Business T- � � �'T This combination qualifies for a Federal E 121ficlenicy Tax Credit when placed In e between Feb 17, 2009 and Dee 31, Certificate of Product Ratings AHRI Certified Reference Number: 3805983 Date_ 1/1•x, 2014 Product: Split System: Air - Cooled Condensing Unit, Call with Blw*vr Outdoor unit Model Number:14AJM36 Indoor Unit Model Number: RHLL44M3821 +RCSL- H`3821 Manufacturer: RHEEM SALES COMPANY, INC. Tridetl3rend name: RHEEM, RUUD 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 sutdect to verification of rating accuracy by AHRI- sponsored. Independent, third party testing: Cooling Capady (Btuh): 36800* EER -Rating (Cooiin& 13.00 SEEIRft (ng:(Cooling): c . 96.00 IEE4 Rating (CoollM- )* 42013 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: UO3=10 eareosso o 6360 EKED t � t t DesignStar Load Calculation Results are intended %r use with Rheern hading and coding syswm The Now Qegm of " NOmber idents' 2 Ceiling height 9 Floor U -value I R -value 0.215 Getting U -v Window U -value 0.5 Moisture grains 58 DO, loss Duct gain % 10 Indoor Heating Cooling. Indoor tern erature ( °F) �..�......_ 7p 75 Design temperature difference( °F) 20 15 ' L Heating • • Ariea Btuh % of load W "I� X693 10,5 Floor 6976 27.1 i Windows 39$0 15.5` Infiltration 6798 26.4 System Effic)ency I_os .2338 9.1 s: ,. Taal. 2 72� Heating Loads 25,721 BTU /hr System Efficiency Loss ® i- Wall f�,f ,�. ,�,',:i��r+a�,. ,�;� +�i .r ds' 4e'�^a p pda > �t]j t kk �}. ''y ✓�N f � ki�4i� i k i Q Windows System Efficiency � Y Sam gam loam 11am 12pm ipm 2pm 3pm 4pm 5pm 6pm 7pm 8pm ® Hourly Loads — Average System equipment selection will be made using the following derived values. Glass (E) 201 sq. ft Glass (N) 28 sq. ft Summer Outdoor 90 °F Summer Indoor 75 °F S�Imimer Ike 19�irG�rai S0% Winter Outdoor 50 °F Sensible Cooling 40,692 Btuh , Required Cooling Airflow 1,850 CIF