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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 cLaMS -MADE � OCCUR y 1000201370141 BAOHOCCURRENCE a 1,000,000 -DAWMF TO •srE„ S 100.000 MEDE*(Anyeea n ) 4 51000 PERSONAL &AbV INJURY S, 1,000,000 GEN'L X 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) S Pof iden D $ R UTABRELLALIAB OCCUR 601.93 LIAR CLAIMS -VADE EACHOCCURRP.NCE S AGGREGATE u DfiA RETENTIONS S 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- 3TA—DA ER 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 Y 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.