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MC-14-756Inspection Worksheet Miami Shares Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 211179 Permit Number: MC -4 -14 -756 Scheduled Inspection Date: April 23, 2014 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: SCHAEFER, NORAH $ PAUL Work Classification: A/C Replacement Job Address: 47 NE 93 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060130390 Project: <NONE> Contractor: CENTRAL COMFORT AIR CONDITIONING Building Department Comments REPLACE FIVE TON AIR CONDITIONING UNIT Infractlo Passed Comments INSPECTOR COMMENTS False April 22, 2014 For Inspections please call: (305)762 -4949 Page 27 of 37 Inspector Comments Passed Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re4nspection fee is paid. April 22, 2014 For Inspections please call: (305)762 -4949 Page 27 of 37 0a( rlcrcJa $ ri-P-1 Son BUILDING 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 FBC 20 Permit No Master Permit N . �" Ls JOB ADDRESS: City: M iam'' i shores Coun t y:nND C Miami Dade EL— Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): f� 6 C S C-kCG° Phone #:13 0 (a ��o 5-21- Address: ,3 Q g ME � 6 57F City: M f F'r fYM I State: r-- L- Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: ul gmlel-& Phone #: a Address: City: I State Zip: 33 19 Qualifier Name: E� �/ Phone #: State Certification or Regidstration #: r /C l /_Certificate of Competency #: Contact Phone #:�6 Email Address: 5(010-41-ThafiOl `62r-J7 DESIGNER: Architect/Engineer: Phone #: Value of Work for this Per ' Square/Linear Footage of Work: Type of Work: ❑Address %Alt—eration ❑New *epairAteplace ❑Demolition Description of Work: ' _ Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond Technology Fee $ TOTAL 1 1 i i� Bonding CompanyrPs Nrar (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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature o u� d durl��_ Own4 or Agent The foregoing instrument was acknowledged before me this 1 day of M-1 , 2013 ,by by INlOaA l SCr4A;kFAQ2_ who is personally known to me or who has produced r 1 As identification NOTARY PUBLIC: Sign: Print: ®� ©b� to an oath. a # UQ SS�WWO� �cf� a1190d A�yiO�' Signature ontractor The foregoing inspament was acknowledged before me this l day of �"A 20 /y, by J��`1 AP '%y �!' . who is personally known to me or who has produced A46 • as identification and who did take an oath. NOTARY Sign: Print: "1 .Y NOVAL88 WOMOMONOMINO :MffeV.M My Commission Ex p ires: 4 ", , 4 ���$"S,ua � � My Commi sion Expires: ®� °a ®t, "0 APPROVED BY h� P Examiner zoning Structural Review Clerk Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) Nov.15. 2013 8:40AM Local Business Tax Receipt Miami -Dade County, State of Florida THtSIS NOTA BILL -W NOT PAY 7127848 1 No, 9101 P. 1 BUSINESS NAME&OCATION RECEIPT NO. EXPIRES COMFORT AIR CONDITIONING RENEWAL SEPTEMBER 30, 2014 INC 4771 NW 177 ST 7406129 Must t c dispta at platy of t irn„;s MIAMI, FL 330 t to to a Par Coda .- Art..r Pt0r Cfispt¢r8A •• Art.8 & 10 OWNER SEC. TYPE OF BUSINESS PAYa1ENT RECEIVED COMFORT AIR CONOiTIONING INC 1941 SPEC MECHANICAL BY TAX C & I VCCOR CONTRACTOR 75.00 0%/09!2013 Woftgs) 1 CACIS17379 TXH51 -13 15190 Tills Laval 0wh=7azRca4f only confines payment aftho Looal Bod==Tm7hoRawiptis cotaRcaaso, perdLoracw0ce ionoHhebubWagaali5c4ow .todohn®ness.Balderma9c mplywftbanygavemmaatal ofnoagovemmenlelfaw btwyPaws and rgwFamentswhichapplytothehashatss. -Me RECOPT fill. above masthedisplayedon all comwel ivaNclas- illiand- ftadsWeSee89-276. ®For mm inknnftn, vlslt www_demldede gaWWmoU@cW STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION r CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 RODRIGUEZ, NELSON COMFORT AIR CONDITIONING, INC. 4771 NW 177 STREET MIAMI GARDENS FL 33055 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! (850) 487 -1395 STATE OF FLORIDA DEPARTME Qf BUSINESS AND PROFESSi'GULATION. CAC1817379 ° "o . ` 02/20/2013 CERTIFIED AiiCQ%IE3t0!#"'. RODRIGUEZ54 t31�t P COMFORT Ai` i 1. t : is _cER T iFIED under the provWons of Ch.4E9 ¢S. Fxpiretiondate [ AUG 31 ; 2014 - L13022000OU462 The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more information, please go to www.VivaFlodda.org. VIVA fIIl1IA-`' DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION. INDUSTRY LICENSING BOARD CACIS17379 'he CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under,the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 r1 I I STATEOF FLORIDA NCIAL SERV►CES w RT,MENT`OF FINA S. COMPEI'ISA•DON pEPA XENIpT►ON DNISION OF CORKERS CONSTRUCTION INDUSTRY E CTION708EEXENIPIFR�F'�DA Q�yyp15 c"10CA ON DATE: .,I WOROO COOMPF.NBA X13 Soto NEI -SON i EFFECAWEOA'W' R,ORIGUEZ 4 �80N: ZOW6755 ` SIN' NAME AND ADDRE BUSINESS CONDITIONING' INC COmpOR7 AIR 4771NW 177 ST FL 33055 -.► MIAMI GARDENS TRkoE* SCOPES OF BUSINESS OR TILATION, IIEA7ING, VEN e IFt:COND u; t '4(;, Er-w CERTIFICATE OF LIABILITY INSURANCE 14 YY' 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 pollcy(les) must be endorsed. If SUBROGATION IS WANED, 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 Accurate 8300 West Flagler Suite 114 Miami, FL 33144 Phone (305)226-8727 Fax 305)226 -8767 CAMONTAE• CT Lucia Estrella N PHONE , (305)226 -8727 FAX No (305)226 -8767 - AIL Iudaestreita@belisouth.net INSURER(S) AFFORDING COVERAGE NAIC A INSURER A: Ascendant Insurance Company INSURED Comfort Air Conditioning Inc 4771 NW 177th Street Miami Gardens, FL 33055- 786- 282 -4396 INSURER B: 12/11/2013 INSURER C: EACH OCCURRENCE INSURER D DAMAGE TO RENTED EMI 'E Me occurrence INSURER E: MED EXP (Any one person) INSURER r: PERSONAL & ADV INJURY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. Mfg L TYPE OF INSURANCE ADD SU POLICY NUMBER POLICY EFF MiD POLICY EXP LIMITS A GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE © OCCUR ❑ GL- 43525 -0 12/11/2013 12/11/2014 EACH OCCURRENCE S 1,000 000.00 DAMAGE TO RENTED EMI 'E Me occurrence $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER O POLICY ❑ MST - ❑ Loc PRODUCTS - COMPIOP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ AUTOS El OMBWEO SINGLE LIMIT Ea accldant) $ BODILY INJURY (Per person) S BODILY INJURY (Per accident $ PPRor 1' IMAGE $ ❑ UMBRELLA LIAR ❑OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S ❑ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTiVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) ❑ N yyes describe under DESCRIPTION OF OPERATIONS below N I A Q WC STATU ❑ R- E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLO $ E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace is required) Certificate Holder is named as additional insured. Mechanical Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Ave Miami, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE QrDUCY PROVISIONS. AUTHORIZED Lucia Estrella CORPORATION. All rights reserved. ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD =v COMFORT AIR CONOITIONINO. AIR CONDITIONING DESIONO INSTALLATION t& SERVICE UCEEiNSED $c Y:3: <:> 4I If -1 NW' 177 St. INSURED C�4C1817379 Miami, F.1 33056 )(786 -262 -4396 RESIDENTIAL. & COMI ERClAL 1016 306623 -9410 CONTRACT & AGREEMENT STATE MIIEt°.HANICA►.L. CONTRACTOR CUSTOMER z �'y 0: g HOMEPHONE SUSAiONE LOT SLIC SUS SECTION FOLIO# ❑ CENTRAL AIC SYSTEM ❑ ATTIC- INSTALATION ❑ HEAT RECOVERY SYSTEM ❑ REPAIR- ELECTRICALS AREPLACEMENT WORK TO BE PREF.ORMED ❑ NEW INSTALLATION. WARRANTY ✓ YEARS ON COMPRESSOR 1 - YEAR PARTS & LABOR COMMENTS: PRICING GOOD TIL �` v We Propose hereby to furnish material and labor - complete in accordance with above spec' trans, f the um Of. doll : ($ i Payment to be made as fbDms: AR msterial is guaranteed to be as spadfled. AN work to be completed In a workman4ke manner atxxvding to standard ptacdos. Any siteroWn or dwAatton from above spscitioaUons kwotving extra costa win be executed only upon writtao orders, and wUl became an extra charge over shit abova the estimate. AB agreemenffi contingent upon strikes. eaddents of delays beyond our control. Owner to Carry fire. tomado and Amer naessary Insurance. W warkors are fWiy covered by Wmtanen's Compensation Insurance. Aemptance of Proposal: Tne at eve prices, speacauons and axndi — are sstistactoty and we hereby accepted. You we authorized two /do the work as spscflied. PaymsM wrl be made as otditned above. Date of Acceptance: Note: This propsal accepts n - - -�- = � - tvithdrawrr t►Y t� if not accepted tartthln .days Slgnehrre AIR C.ONDITIONi G SYSTEM � Comfort Air Inc. shall install a Y tons.. Make Model S.E.E.R, according to the ollowing ecificatlons, terms and conditions on the premises above described. EAGIPAitENT Heat K.W. NEW DUC'r WORK Supplies & Return NIiSCELLANEOus All slectical work Is existing service Outside Condensor L. Room Increase existing electrical ser Ace to AMPS Inside Air Handler D. Room Change fuse to breatkor Refrigerant Lines K{tchen �, �_ Eleabicai hook -up 220V Line Condesate Drain 17 Heat & Cool Therm. Bedrooms Low voltage line Safety disconnect switch Line cover for refrigerant lines Self cores d Pkg Fla. Room $" Blown all is insulation .� Remove Exist Baths Heat Recovery CLOSET SIZE DEPTH WIDTH FIAT ROOF ATTIC SPACE WARRANTY ✓ YEARS ON COMPRESSOR 1 - YEAR PARTS & LABOR COMMENTS: PRICING GOOD TIL �` v We Propose hereby to furnish material and labor - complete in accordance with above spec' trans, f the um Of. doll : ($ i Payment to be made as fbDms: AR msterial is guaranteed to be as spadfled. AN work to be completed In a workman4ke manner atxxvding to standard ptacdos. Any siteroWn or dwAatton from above spscitioaUons kwotving extra costa win be executed only upon writtao orders, and wUl became an extra charge over shit abova the estimate. AB agreemenffi contingent upon strikes. eaddents of delays beyond our control. Owner to Carry fire. tomado and Amer naessary Insurance. W warkors are fWiy covered by Wmtanen's Compensation Insurance. Aemptance of Proposal: Tne at eve prices, speacauons and axndi — are sstistactoty and we hereby accepted. You we authorized two /do the work as spscflied. PaymsM wrl be made as otditned above. Date of Acceptance: Note: This propsal accepts n - - -�- = � - tvithdrawrr t►Y t� if not accepted tartthln .days Slgnehrre Ar rOR� 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): W / Ale, ' - �S City: Miami Shores Village County: Miami Dade Zip Code:3 3. 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 ❑ NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER 01 AHU or PKG. UNIT MODEL COND. UNIT MODEL # KW HEAT y ffa /40 NOM TONS AHU CU PKG 1 M.C.A AHU CU PKG AHU ttr PKG 2 M.O.P AHU CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EEL EE 15 1=4 YES NO REPLACING DUCTS YE NO YES NO REPLACING THERMOSTAT YES YES NO NEW 4 °CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX I YES (,"NO) 1. Minimum Circuit Ampacity (Wire Size): db 2. Maximum Overcurrent Protection 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Mean; Contractor's Company Name: State Certificate or Registration Signature Certificate of Competency N