The URL can be used to link to this page

MC-14-920BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1e1: (305) 795 -2204 Fax: (305) 756 -8972 INSPECTION LINE PHONE NUMBER: (305) 762 -4949 FBC 20 '[D Master Permit No. Sub Permit No. MC - ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING I MECHANICAL EPUBLICWORKS CHANGE CONTRACTOR ❑ CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: City: c\5-LS tANA 0 C:v. Miami Shores County: Miami Dade Zip: i '5® Folio /Parcel #: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): Address: City: VUttt S1 tins '‘)Ai\o CAS c A .bili Flood Zone: c\ 32 111) State: BFE: FFE: Phone#: Zip: 3'.D Tenant /Lessee Name: Phone#: Email: CONTRACTOR: Company Name: V-\W' -S2 S \O ,\ S f• ko°\ State: Qualifier Name: 7VE-(A.L —/L. Address: City: NL- Phone #: C3�Z ��o ° 04-0 Zip: State Certification or Registration #: DESIGNER: Architect /Engineer: Address: Value of Work for this Permit: $ 1� Type of Work: ❑ Addition noA Phone#: C CO Certificate of Competency #: Phone #: 8630. (X7City: State: Zip: a Square /Linear Footage of Work: Alteration ❑ New ❑ Repair /Replace Description of Work: C\ &€ WI- A °") Q S 1fl ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ e)412)111/ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ _ DBPR $ Bond $ 71 Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ <4 TOTAL FEE NOW DUE $ 0969 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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. 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 wh• 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 rens•ecti• fee .ill b charged. Signature Owne or g t Contractor The foregoing instrument was acknowled ed before me this The foregoing instrument was cknowledged before me this, day of 1� ; 20 14 by Ow day • viii .4.4 J 20 by 7 who is personally known to me or who has produced 0 who - • n to me or who has produced As identification and who did take an oath. v`---- as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: p F. °: 14 �o+; j u I Ili" NOTARY PUBLIC: Sign: Print: My Commission Expires: Y, EXPIRES: o NOTAR`Lown * * * * * * ****************** * * *** * * **V** **4**** * *** ** k****** **** ****** ******* * * * ** * * * * ** *** LAM ******** ** *** **** 51-k APPROVED BY iilans Examiner Zoning Structural Review Revised02 /24 /2014)(Revised 5 /2 /2012)(Revised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) Clerk 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 A ddress (where the work is being done): I �� \ c ' : Miami Shores Village County: Miami Dade Zip Code: J30 DD 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 ti ARHI Sheet Attached: YES ■i NO ❑ Contract—Attached: YES 0 UNIT BEING REPLACED DATA NEW UNIT TWA Adk MANUFACTURER CA 0.-1f—IL- AHU or PKG. UNIT MODEL # •1 Ids T O N1\ Pt COND. UNIT MODEL # 2,4114, %\AS /..\00 y0 KW HEAT 1-v A NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YEl NO YES NO NEW 4 "CONCRETE SLAB ESQ NO , YES NO NEW ROOF STAND YES 0.) YES NO NEW RETURN PLENUM BOX YES 010 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: \ U S P' Phone: (3.b5) ` L - t440 State Certificate or Registration N. Cf CO22 °I2_ Certificate of Competency N. Signatur uallfier's signatu only) Date: MAY /06 /2014 /TUE 01:53 PM FAX No, P. 001 .A "" CERTIFICATE OF LIABILITY INSURANCE DATEMN° i� ' 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 en ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement cm this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Stahl & Associates Insurance Inc, 91 Lake Morton Drive P 0 Box 3609 Lakeland FL 33802 CT Belinda Farris P „° E 063)686-3495 I � Fill. Noy. (863) 688-4344 E.ATaIL ABBR 1belinda .ParriS0Stehlineuranae.con INSURER(S) AFFORDING COVERAGE NAIL 0 ►NSLIRCRAgCCI Commercial Insurance Co INSURED Harper ! s Air Ino 1031 SW 69 Ave. Miami F. 33144 musette Auto Owners Insurance Co 18988 INS+mER c :FCC! insurance Croup _ INSURER O: INSURER E : INSURER F :14 /1D w/0 master 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, TSRM 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. IIiBR A c TYPE OF INSURANCE GENERAL LIABILITY ADEL INSR WVDR POLICY NUMBER X COMMERCIAL GENERAL LIABILITY OLA1MS -MADE El OCCUR COIL AGGREGATE LIMIT PER: X I POLICY n n 1 AUTOMOBILE LIABILITY ANY AUTO a-srED ®SCHEDULED HIRED AUTOS �WNED =+0009756 5 (MMipR1Y ) 7/1/2013 MODYI”) 7/1/2014 X UMBRELLA LtAB ' 1'L OCCUR EXCESS LAB Ij'--11 CLAIMS.MADE DES 1 X 1 RPTPNTON$ WORKERS COMPENSATION AND EMPLOYERS' LJA9Wtjf Y IN ANY PROPRIETOR/PARTNER/EXECUTIYE OFFICER/MEMBER EXCLUDED? (EAandatcry m NH) If ye& deadrRbe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE LIMITS ES � ePREMIS (Ea nce ) MED EXP (Any ono Imo) $ 1,000,000 100,000 $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE PRODUCTS - COMP /OP AGG g 2,000,000 2,000,000 'COMBINED SINGLE LIMIT (Ea accident) 5 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ $ 5,000 4730457400 7/1/2013 7/1/2014 EACH OCCURRENCE AGGREGATE 5 $ 5,000,000 $ 5,000,000 NIA D01WC13A63217 1/1/2014 1/1/2015 x ITORYLIPAITS I °PR 4 E.L. EACH ACCIDENT E.L DISEASE . EA EMPLOYEE DESCRIPTION OF' OPERATION$1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional ReMarke Seized, e, iP more space le required) CACO23492 CERTIFICATE HOLDER E L DISEASE . POLICY LIMIT $ 500,000 S 5001000 $ 500,000 CANCELLATION Miami Shores Village 10050 NE 2nd Avenue Miami shores, FL 33138 ACORD 25 (2010/05) INS02t1 mum ni SHOULD ANY OF THE ABOVE Moms= POLICIES BE CANCELLED EEFQRt THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gerald Powell /PARRIB • ®1988 -2010 ACORD CORPORATION. All rights reserved. Tka drrlph name And Irvin Fora rpniatared marina rf ht'ARh A. ■isa C E RTi FIE This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. Certificate of Product Ratings AHRI Certified Reference Number: 5806432 Date: 5/6/2014 Product: Split System: Air - Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 24ANB148A**31 Indoor Unit Model Number: FE4AN(B,F)005 +UI Manufacturer: CARRIER AIR CONDITIONING Trade/Brand name: CARRIER AIR CONDITIONING Series name: INFINITY SERIES PURON AC Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING Rated as follows in accordance with AHRI Standard 2101240 -2008 for Unitary Air - Conditioning and Air- Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: *Ratings followed by an asterisk (') Indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which Indicates an involuntary 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.ahridlrectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRL This Certificate shall only be used for individual, personal and 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 any means, except for the user's Individual, personal and confidential reference. CERTIFICATE VERIFICATION The Information for the model cited on this certificate can be verified at www.ahrldlrectory.org, click on °Verify Certificate° Unk 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 CERTIFICATE NO. AIR- OONDmONING, HEATING, & REFRIGERATION INSTITUTE we make life better' 130938591976373636 • .1 HARPER'S AIR, INC. Certified Air Conditioning Contractors Sales & Services • CACO23492 Proposal TO: David Castaneda 9525 NW 1d Ct. Miami Shores, Fl. 33150 dacasta@hotmail.com 03/27/2014 Furnish all labor and materials to replace existing Rheem system with a new 4-ton Carrier Infinity system Remove and properly dispose of existing system (Air Handler only /Condenser Missing) New 4-ton Carrier Infinity system 17.50 SEER Mod: 24ANB148A003/FE4ANF005T00 with Wi -Fi Programmable thermostat,10kw heater and air handler stand. Connect to existing refrigerant lines, electrical, drain lines and ductwork. Start up and check equipment operations l0yr parts, l0yr compressor and 2yr labor warranty TOTAL MATERIAL AND LABOR: $ 8,070.00 FPL Rebate: ($1,020.00) Carrier Instant Rebate: $ 900.00 Grand Installed Total: $ 6,150.00 By: Fernando Obeso Cell: (786) 501 -4882 Note: This proposal maybe withdrawn if not accepted within 30 days. ACCEPTANCE OF PROPOSAL - The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. DATE: SIGNATURE: 1031 Southwest 69"' Avenue • Miami, Florida 33144 • (305) 266- 1040 FAX (305)262 -2219 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 CV Inspection Number: I NSP- 211889 Permit Number: MC -5 -14 -920 Scheduled Inspection Date: June 09, 2014 Inspector: Perez, JanPierre Owner: CASTANEDA, DAVID & KARA Job Address: 9525 NW 1 Court Miami Shores, FL Project: <NONE> Contractor: HARPERS AIR, INC. Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number (786)281 -1825 Parcel Number 1131010240300 Phone: 305 - 266 -1040 Building Department Comments CHANG OUT 4 TON AC Infractlo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed 1 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 06, 2014 For Inspections please call: (305)762 -4949 Page 8 of 15