MC-14-641Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 210038 Permit Number: MC -3 -14 -641
Scheduled Inspection Date: April 02, 2014 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Inspection Type: Final
Owner: TING -LEN, SUE Work Classification: A/C Replacement
Job Address: 152 NW 103 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: RESIDENTIAL AIR INC
Phone Number 305 - 757 -9942
Parcel Number 1131010230040
Building Department Comments
REPLACE EXISTING 3 TON A/C SYSTEM. 12.0 SEER Infractio Passed Comments
WITH 7.5 KW HEATER INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
on ❑
nspection ❑
Fee
Additional Inspections can be scheduled until
nspection fee is paid.
April p1, 2014 For Inspections please call: (305)762 -4949 Page 25 of 42
- , 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
BUILDING Permit No.
PERMIT APPLICATION Master Permit N
FBC 20
Permit Type: MECHANICAL
Owner's Name (Fee Simple Titleholder) 4gd Srd.,7t71 - G�iV Phone # y� ®g 95-17 9 9
Owner's Address �c'� , ,! . V, f
CityjY{111 %/$ State ,f%t . Zip �/�
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) .� /gam 4-"
City Miami Shores Villaee County Miami -Dade Zip ;�3 /.$'a
FOLIO / PARCEL # _ // - 3 / n / p a 3 ® 0 qua /
Is Building Historically Designated YES NO lO Flood Zone
Contractor's Company Name 1f z-71,6 14 Phone #_JV.s-- 6..5
Contractor's Address /& .2 ® 5- M
City 1, I _ State IC 4 . Zip J-3/!29
Qualifier Name lMAA_,) i��) C. �i�Ald o' Phone #
State Certificate or Registration No.. Certificate of Competency No.
Contact Phone jjt� o ' ^ (p 0 Y;0 E -mail
Architect/Engineer's Name (if applicable) the Phone #
Value of Work For this Permit $ C;2-1/,040,00 Square / Linear Footage Of Work:
Type of Work: ElAddition ❑Alteration FINew &�IRe air/Re lace
p p ❑Demolition
Describe Work: 4681-0-6&- 6 1.-� 1-126 3 y- Al &Q- ��/'�►'i
�, ���, ��*• x, �** �, �� •x� *x�,� *,�,�,�,�,�,��,�,u�ar• *�k•� ees��* �� ��e* x**** re*, �* x*, �** ,���r�r�x�,r�,a,�,�,�,a,r•�,�,�
Submittal Fee $ Permit Fee $ v CCF $ CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side
/10�,
F
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
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
'inspection will not be approved and a reinspection fee will be charged. ,
Signature ,„ _ Signature F
3 A A Owner gent tZiClftW Contractor
�vt - i fal & - /, &/iu �� Uy¢ru�/
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 1►7l4% , 201 �ypg�lt4iiitlt//
who is personally know � ®tt�!�ro ® °duced
i
s take an oath.
NOTARY PUBLI v `•�
WS
mss,.!
Sign: °ii:�!
Print: AFr
My Commission Expires..
day of /009,0 , 20 ?
I
My Commission Expires:
APPROVED BY i/ la
ns Examiner Zoning
(Revised 07 /10 /07)(Revised 06/10/2009) . .
Engineer
Clerk checked
61-,, q��) '79L- F97 9-
CERTIFICATE OF LIABILITY INSURANCE
DATE [MMlQW" -f)
03/2412014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFiRMATiVEi -Y OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 eartiiicato dove not confer rights to the
certificate Bolder in lieu of such andorsement(s).
PRMUCER
suburban Associates, Inc
17071 W Dixie Highway
North Miami Beach, FL 33160
INSURED
Residential Air Inc
1662 NE 205 Terrace
Miami
FL 33179
S
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
954 -944 -1
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
TYPE OF INSURANCE
am
VM
yOLICYNUMBER
ffl
03123114
(imam
03123/15
L1MIT5
A
X
COMM9RCIAL,GlINERALLIASILI Y
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1000201370141
BAOHOCCURRENCE
a 1,000,000
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S 100.000
MEDE*(Anyeea n )
4 51000
PERSONAL &AbV INJURY
S, 1,000,000
GEN'L
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AGGREGATE LIMITAPPLIES PE R
POLICY n JIRRCI' ] I=
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - DWROP ACG
'S 2,000,000
�
OTHER;
AUTOMOBILE
LIABL ffT
pMB�IN..DISINGLE LIMiT
3
BODILY NMRY (Par pawn)
$
ANY AUTO
LoNED SCHEDULED
AUTOS
HIRED AUTOS p
BODILY INJURY (Per isefcttlani)
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$
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UTABRELLALIAB OCCUR
601.93 LIAR CLAIMS -VADE
EACHOCCURRP.NCE
S
AGGREGATE
u
DfiA RETENTIONS
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B
WORKERS COMPENSATION
AND FAPLOYEW LIABILM YIN
ANY PAMIETOR/PARTNERIEXECUTR/E
OFFICMiMEMEEREXCLUDED? N
(MonddtorylaNN)
If DES�� IPTIdo O OPERATIONS below
NIA
AWC1021397
03/23/2014
03/2312015
1'k U'IH-
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E.L. EACH ACCIDENT
9 100,000
E.L DISEASE - EAEWLO
S 100,000
EL DISEASE -POLICY LIMB
1 S 500,000
A
Business Personal
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1000201370141
03/23120140312312015
50,000 Limit of Insurance
Property
$500 AOP Deductible
DI; rMPTM OF OPERATIDNS t LOCATIONS t VEHICLES (ACCRV iN, AddNional Remvrtm Schadule, maybe atindud U mole apaaa Ic re"Ind)
Mechanical Contractors
Village of Miami Shores SHOULD ANY OF THE ABOVE DESCRIBEP POLICIES BE CANCELLED BEFORE
Building Department TM EXPIRATION DATE THEREOF, NOTICE WILL, BE DELIVERED IN
9 p ar ACCORDANCE WITH THE POLICY PROVISION&
10050 NB 2nd Ave.
Miami Shores, FL 33138 AUTH'PME6
® 1988 -2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014107) The ACORD rome and logo are registered marks of ACORD
RESIDENTIAL AIR CONDITIONING CORP.
SALES AGREEMENT
AIR CONDITIONING HEATING SERVICE
20250 N.E. 15TH COURT MIAMI, FLORIDA 33179 DADE 652 -6040
BROWARD 764 -0489
I /we the owner(s) or lessee(s) of the premises mentioned below, hereby contract with and authorize you as a contractor to furnish all necessary materials, labor
and workmanship, to install, construct and place improvements according to the following specifications, terms and conditions on the premises below described.
Purchaser's Name 1 (rr Phone (� Bus Phone Date
Address !l' %. i City r" / ctrl "� l State Tip
Lot Bilk
Plat Book No
Page No.
Subsection
4. Unpaid Cash Balance to be Financed f,'A & "A to
3. Unpaid Cash Balance 4 AS
5a. Finance Charge ���( 0 N C C. ``-
WORKTO
BE PERFORMED
Application
RESIDENTIAL shall install a it 111- "A,
central air conditioning system.
Model Number . Cooling capacity
rating �f N BTU
hr. Heating capacity rating
BTU hr. Energy efficiency ratio Cooling BTU's watt-hr.
Heating BTU's watt-hr.
b. Annudl Petceni.dge Rate
Start-up Demonstration' i
EQUIPMENT
NEW DUCT WORK
EXISTING; DUCT WORK
MISCELLANEOUS
FIBER GLASS
Heat
` f Supplys & 1 return
Insulate Duct --
ki All electric work to existing service
Outside Condenser
" L Room
where required
} increase existing electric service to _ AMPS
Inside Air Handler
D Room
Vapor seal seams
t Electric hook -up 220V Line
Refrigerant Lines
Kitchen
where required
Low voltage line Safety disconnect switch
Condensate Drain
Bedrooms
Remove existing
Line cover for refrigerant lines
Heat & Cool Therm.
Fla Room
duct work
4- Blown fiberglass attic insulation
Self Cont'd Pkg
Baths
Plaster existing
Ait Remove exist equip
wall grills
Engineering_Plans_Permfts
LIMITED WARRANTY AND SERVICE. Manufacturer's Limited 5 year Warranty on compressor. Manufacturer's Limited One -Year Warranty on all other oomponents.
Seller will provide free service and all necessary labor for a period of one year from date of start-up. Start-up is part of a warranty and not Installation. If the total cash
price includes all electrical work it shall be connected to adequate existing service according to local code by a licensed electrician. If service is deemed inadequate
by electrician at such time extra charge for service increase at our cost will be charged for an addition to the contract price or purchaser may have option of own
electrical contractor. When increase in service is deemed necessary and purchaser exercises his option to obtain his own electrical contractor, electrical service must
be completed within ten (10) days of notification. If electrical increase is not completed within the specified time RESIDENTIAL shall increase service as necessary.
Purchaser will then be liable for cost involved in completing electrical service increase. This amount will be due upon completion of electrical service increase.
1. Total Cash Price
FINANCIAL SCHEDULE
2. Down Payment
4. Unpaid Cash Balance to be Financed f,'A & "A to
3. Unpaid Cash Balance 4 AS
5a. Finance Charge ���( 0 N C C. ``-
CASH PROGRESS PAYMENT SCHEDULE
5b. Other CZ Q� r ✓' �' 17, i L
Application
6. Total of Payments
i v c- tw^
Duct Delivery
7. Deferred Payment Price (1'+5)
Equipment Delivery �
b. Annudl Petceni.dge Rate
Start-up Demonstration' i
9. Terms Equal Mo. Pymts. at $ per Mo.
Purchaser hereby agrees to pay therefor to Contractor or his nominee the total contract price as stipulated above, with monthly payment commencing no later
than 60 days from date of note and all subsequent installments on the same day of each month until paid in full. The finance charge applies from date of note.
CONDITIONS OF SALE: Purchaser is responsible for all equipment and material delivered to jobsite. System is designed, fabricated and installed according to
accepted engineering practice and in compliance with all applicable building codes in force on above date. Any alteration or deviation from above specifications
involving extra costs will be executed only upon orders, and will become an extra charge. Florida room temperatures will vary due to excessive glass area. Temperature
differential of plus or minus 3° due to variations of construction, window crac kage, etc., in the above residence. Local outdoor design conditions is 91 °. Temperature
differential is the difference between outdoor design temperature and indoor temperature. Any room or rooms which do not have direct air supply, or adjacent rooms
will not come under the above temperature differential guarantee. The limited warranties provided herein are expressly in lieu of all other limited warranties or
obligations expressed or implied and it neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of this equipment
Ownership of the above equipment and materials shall remain in seller's name and title is hereby retained until same is fully paid in accordance with the schedule of
materials and retake possession whether or not same have been permanently attached or affixed to the realty. Purchaser agrees to pay seller reasonable attorneys
fees and costs if necessary to enforce or defend any claims arising from this agreement Purchaser shall sign all necessary Bank papers as may be required by the
lending institution upon start-up. Purchaser assumes responsibility for closing up all openings after room units are removed unless otherwise stated. No painting or
decorating is included. It is agreed that the purchaser releases the seller from and that the seller assumes no liability and shall not be responsible for any loss, damage,
or delay caused by acts of government, strikes, lockouts, fire, explosion, theft, floods, rain, water damage, riot, civil commotion, manufacturer or distributor malicious
mischief, picket lines, Acts of God or by any cause beyond its control and in any event for consequential damages.
Purchaser and his assigns agree to hold seller harmless and releases seller from any and all claims for damage, including water - damage, resulting from the use and/
or the installation of any equipment, duct work, or drainage facilities specified in this agreement
In the event the purchaser repudiates this contract after 72 hours and refuses to allow seller to commence work under contract provisions, then and in that event the
purchaser shall pay to and be responsible to the seller in the sum of 2V% of the contract price as and for liquidated and agreed damages and not as a penalty. Seiier
discloses that no completion date is provided unless otherwise noted above.
The contract may be voided at the option of the seller, if work has not commenced on the property within 30 days of acceptance.
Purchaser agrees to pay interest of 1 % per month on all past due amounts regardless of Status on Job. Whereas RESIDENTIAL AIR installs equipment to the existing
duct system, this does not constitute a guarantee of said duct system or its operation as it is understood that this is the purchasers responsibility.
Purchaser shall provide lending institution with flood insurance naming institution as loss payee. Energy efficiency ratios may be affected by interchanging of oompo-
nents from different manufacturers. System designed to maintain inside temperature at 75° F at 91 ° outside air temperature. Service work will be performed Monday
through Friday during normal working hours. All services shall be suspended on past due accounts
Purchaser hereby acknowledges that only RESIDENTIAL AIR will determine the exact location of the equipment specified above.
No purchaser may incur ANY expenses to be charged to the seller against this contract without previous written approval by the seller. If purchaser is furnishing his own
electrical work, upon notification from RESIDENTIAL AIR he has ten days to complete electrical work. In the event it is not completed, the total sum of the contract is
due and payable and limited warranty date will not go into effect until equipment is started.
RESIDENTIAL AIR is insured for workman's compensation and Public Liability.
BUYERS RIGHT TO CANCEL: This is a home solicitation sale, and if you do not want the goods or services, you may cancel this agreement by mailing a notice to the
part of any cash down payment, not to exceed the lesser of 5 percent of the cash price or $50.
NOTICE TO BUYER
1. Do not sign this contract before you read it or if it contains any blank spaces.
2. You are entitled to a copy of the Contract you sign. No verbal agreements.
3. You have the right to pay in advance the unpaid balance of this contract and obtain a partial refund of the finance charge based on the
'Rule of 78's Method"
4. The lending institution is subject to all claims.
Representative Signed
(Purchaser)
Approved by Signed
(Authorized Company Acceptance) (Purchaser)
RESIDENTIAL AIR CONDITIONING CORP.