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MC-14-485Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218180 Scheduled Inspection Date: August 25, 2014 Inspector: Perez, JanPierre Owner: MENNES, JAS Job Address: 770 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: POTENTIAL BTU'S A/C INC Isunamg uepartment comments REPLACEMENT OF EXISTING A/C SYSTEM. THE SAME SIZE AS EXISTING AND RECONNECT EXISTING ELECTRIC, DISCONNECT, DUCT -DRAIN PIPES, CONDENSER UNIT, AIR HANDLE UNIT & HEATINGA TONS Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. C� Permit Number: MC -3-14-485 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060142200 Phone: (305)300-1302 INSPECTOR COMMENTS False �� �lzslr4 Inspector Comments CREATED AS REINSPECTION FOR INSP-208871. CANCELLED BY INSPECTOR August 22, 2014 For Inspections please call: (305)762-4949 Page 20 of 31 Miami Shores Village • Building Departme ` 10050 N.E.2nd Avenue, Miami Shores, Florida 138 Tel: (305) 795.2204 Fax: (305) 75 6.8972 INSPECTION'S PHONE NUMBER: (305) 762.4 '9 BUILDING PERMIT APPLICATION Permit Type: MECHANICAL FBC 20 Permit No. Master Permit Nomc Lf r JOB ADDRESS: :j-4 ® Al C - 2 ;� 15 7 - city: Miami Shores County: Miami Dade Zip: Folio/Parcel#: C .r -2!!Z Z01-3 6 73 P,02! Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): -q M55 F,- M en/NES Phone#: 30 7Zj -z3 c7 9 City: ,� vri1/ S�rY��� State: Z--6 Zip: 3 3/9 d -P Tenant/Lessee Name: Phone#:.3 Of --7- J -2-3 Email: CONTRACTOR: Company Name: City: Qualifier Name: I W (- ,, Phone#: ?05- 3 00-/--?02-- State State Certification or Registration #: G A C IRI (6 57 Certificate of Competency #: Contact Phone#: 3oL 3oo-lloZ,Email Address: DESIGNER: Architect/Engineer: Phone#: 'dip Value of Work for this Permit: $ z Z ® 0 Square/Linear Footage of Work: Type of Work: ❑Address OAlteration ONew ARepair/Replace zip: 3 3 % 3 -?OJ-500-13 2 - ODemolition Description of Work: vi- o All& s o -G Submittal Fee $ Permit Fee $ 1'` CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE ;�4 71 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 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 Owner or Agent The foregoing instrument was acknowledged before me this 1,2* day of Mg,,di , 20 Ly, by S0+MA5 The foregoing instrument was acknowledged before me this day of Ar �1 20 I U , by LC M, e-1 0 Ve I�C- who is personally known to me or who has produced who is personally known to me or who has produced Ff 1 ff rs Ll L -"A°1& As identi c V : 7-2Jo' C - as identification and who did take an oath. ��� VEUSSA R. LAX NOTARY PUBLIC: Notary Public, State of Flodda NOTARY PUBLIC: A Commission# EE 107488 my comm. expires June 28, 2015 ° Sign: ' Sign: S S Print• 1--Lej 1 ss cs P, - LeV, Print: My Commission Expires: (0' Z - 1 My Commissiottpcomm. otary Publlic, stSA atts off Flodda Commission# EE 107488 explres June 28, 2015 APPROVED BY ZI Plans Examiner Structural Review (Revised 3/12/2012)(wised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) zoning Clerk S C Miami Shores Village AIR CONDITIONING REPLACEMENT DATA Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel (305) 795 2204 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 A17-9-75%" City: Miami Shores Village County: Miami Dade Zip Code: 33J'3d"7 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 a NO ❑ Contract Attached: YES 1.` Minimum Circuit Ampacity ire Size): W — I/ --Iry 2. Maximum Overcurrent Protection (Fuse/Breaker Size): _ 3. Voltage of Circuit (208/240/480): 2o 4. Size Disconnecting Mean; Contractor's Company Name: 0 State Certificate or Registration N. 6 Certifi ate of Competency N Signatur (Qu is signature only) Phone: �0 p 0 - /,?®z- 8 ,Date: UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER CAWor PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT l �p NOM TONS no- A-) S' AHU CU PKG 1 M.C.A AHU C1 I 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 ..�� YES NO REPLACING THERMOSTAT YES YES NO NEW 4°CONCRETE SLAB YESIf NO YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1.` Minimum Circuit Ampacity ire Size): W — I/ --Iry 2. Maximum Overcurrent Protection (Fuse/Breaker Size): _ 3. Voltage of Circuit (208/240/480): 2o 4. Size Disconnecting Mean; Contractor's Company Name: 0 State Certificate or Registration N. 6 Certifi ate of Competency N Signatur (Qu is signature only) Phone: �0 p 0 - /,?®z- 8 ,Date: Potential BTU'S A/C,Inc 8950 NE 8th Avenue Suite #308 Miami,FL 33138 305-300-1302 Lic. & Ins. CAC1816435 Name /Address I James F. Mennes 770 NE 97th Street Miami Shores, FL 33138 Estimate Date Estimate # 3/12/2014 201220 �� >� 174 V r Project Description Qty cost Total Air conditioning Replacement Reconnecting to existing duct plenum, electrical, refrigerant pipes and drain pipe Set Condenser on 4" concrete slab 13 SeerRheem Air HandlerUnit # RHSL - HM 4821JA136 3,200.00 3,200.00 13 Seer Rheem Condenser Unit # 13AJA48A0I Heating #7.5 KW Includes: Labor and materials Potential BTUs A/C is not responsible for permit fees/ drawings/ Heat -Load calculation. It is agreed that, in the event the buyer fails to pay that total amount of this invoice within 30 days,same hall bear interest at the rate of 3% per month. Seller shall be untitled to recover from buyer all court cost and reasonable attorney's fees necessary to enforce payment of this invoice. All materials is guaranteed to be as specified.All work to be completed in a workmanship manner according to standard practices.Any alteration or deviation from above specifications involving extra cost will be execute only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikesaccidents or delays beyond our control.Owner to cavy firetornado and other necessary insurances. Total $3,200.00 �� >� 174 V r AHRI Certified Reference Number: 4526116 Date: 3/13/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 13AJN48 Indoor Unit Model Number: RHSL-HM4821+RCSL-H*4821 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM, RUUD, WEATHERKING 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 subject to verification of rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (Btuh): 46000 EER Rating (Cooling): 10.50 SEER Rating (Cooling): 13.00 IEER Rating (Cooling): * 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.ahridIrectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. 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. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org, click on `Verify Certificate" link wv ,,,,,l,e lite better - 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.130391936530786091 1 ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIf KATE NO.: To: 3057568972 From: Pinnacle Insurance 3-13-14 10:20am p, 2 of 2 ........... -............................................................... .. .. . ............................................................. DATE (MMIDDIYYYI� ....................... CERTIFICATE OI~ .LIABILITY INSURANCE:—* 03/13/14 . 3...33..,3_..._.—.. .. ..__.— .�._. .. _...... .._.--. THIS CERTIFICATE I3 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 ..... BEL01N..'THIS CERTIFICATE OF INSURANCE DOES. NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), -AUTHORIZED' REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _.__._._.._....._9.333. ._�.— _ ___ _._. _.... _�..--.u. ...._.�..�..,.... IMPORTANT. if the certificat® holder Is an ADDITIONAL INSURED, the t WWles) must be endorsed -If SUBROGATION 15'WAIVED, s*6d to theternisend•tmndi4ions of the'polrcy.,ew sin policies may require an endorsement, A statementon this certiHeete-does not confer rights to the' cartificltts holder in of such endorsement s _ —_ PRODUCER . • ...... , CONTACT * ..-A ola yCAUyel BZ > - ................ . . I Plh tacre Insurance Gro( -IM...:. ; .............. PHONNAME P IAIC. N F (305) 854-9898- (A; C(gy (305) 8f 4-9899 29 Ponce D6 Leon•Blvd : ' ..... �9''- Ennacfeins comcast.net Core -Gables, FL.33135 .: , .. ; • ; MoTWO v _ Poona (305) 854-9898' "Fall {305)' 8549899 .:.' ORMO COVERAGE_ I.__ 3....033 _......................._..__.� 30.-._....5.....9' — _.._ ._—.. ::..._........ _._ ._..._. INSURED : _INSURER A :.._Ascendant Cornmardai Insurance. .... ......... PotentiaitfU'S'A?,dnc 00:00. :0000. INSURER .. .' 0303___ ... .. 0000. .IN c' 0000 �. ..:" -0000.. �8fa5tS NE :gfti Ava;Apf #308: .:.' • 000'0:.: • ..• 3000 . ..{305y30CI�13(3`L :.. ,>tlsuReR'�. -.. . � R:SURPIt F_ "MVYCRAl7W .•4CRIIr'IYMIG nVipOCR: � ,. RGrN7lVl\l\Vflff�GR: "'���� -"'�'� .._-..._. 0300. ..:.............::— �—�..•, IS TO CERTIFY THAT THE POUCIES OF iNSURANCB LISTED BELOW HAVE BEEN ISSUED TO THE INSURED tIAMED ABOVE FOR THE POLICY PE!`HOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ; CERTIFICATE MAY BE ISSUED OR MAY PERTAIK THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 19 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7.0k ,_' .:' . TYPEOP�tSURANCE,. $R �. POLtCYNUIIdBER����.�.ES61MfQD/YYYYiYY1f�_'Z + : ..__..._��$' ::• _ J EACH OCCURRENCE - - 1 OOOfl00+ 'CiENERAI WIBILtTY E COMMERCIAL C3ENERAL LU1l3ii ITY : �s>as c _ $ 100,000 " f — _. t ❑ ❑ cLAmnsrADE .00CUR ! t,`1.w3S258=4 ..::' 0000.:. .......w : 1 0 5,000 A. �❑ _ ........ �1/3U/2 1d E1}1/30/2015 PERSONALaADvtNItIRY..:. S.__ 1,000000 ❑:..-_........_:...... :.:.:':..:.......... _.::.,::_::....._._... I. GENERALAGGREGATE ! .$ 1,000;000 1. �_....- - At Cit r...=�._ OEN L AGGREGATE LIbO I APPLIES 0 0 0 0 .. ' ' pR $ t ❑ POLICY • ❑ D t aC $: pRp Ji�_::,.__.._�._ . O CTS'-COMP/OP^. AUTOMOBILE LIABILITY :0 000.. , COMBINED SENGLE LIMIT ❑❑ , 000000.,.• . . 0000 F-/YAUTO...'.,: BODILY '._$. .-. ..-,_Y( ALLOWNED'AUTO..... BODILY INJURY �.. •.—. ❑ tcmu= AUTOS - .. .. ❑ :HIRED AUTO$ - 0000..�aPROPERTV;AMA - $T - . .. , .. � � ... .. 0000. _._ ❑ - — ^--^ NC4*WN£D AUTOS ❑ .UMBRELLA LUIS ❑ OCCUREACW OCCURRENCE $ EXCESS tlAt3 ............. .. ❑ IA�S-I�WE ' •. .. AG{;RECrATE $ ..• .._ ❑ DEDUCTIBLE : • ' ..: ... 0000.. , : 0000. $._. �, .❑�.RET£NTfON...$_�:..:..: W. - . 0000.. -...�- _ $ t WORKERS COMPENSATION ^WC SIATU OTIi- AND ovLOYERv LIABILITY ; ' : 0 000.. ' . 6 1 TaRY tIMiTS .� MOTH..:_. i ANY PROPRIETORIPARTNER0MCU`fl1/6Y f N ... ......., _ E L EACH ACCIDENT S E OFFICER/MEMSEREXCLUDED? WIN i (Mandatory in NH) : -.... . • L ` EL -DISEASE -15A DISEASE - EA EMPL'O $ _ i ! III . deanriba ottd6r C y�g . • 0000 i DF5GRIPTION OF OPERA'rliN78 itBlalV .: _ . E.L.DISEASE - POLICY LIMIT �_....._ ._ _�_ _ 3003 _..._....__. _ _.� 0000. 0000 , 0000 .• ..•-........ ... - 0000 0000_. :• ... .. _., .. DESCRIPTION OP OPERATMS'f LOrATtONS 1 VEHICLES (Aitach ACORD 17t, AddMorral Remartc8 9ohedalo tf mora apace Is.gailad) ....... - Air CondiUoning"Contractor .......................... • 0000.. - ,' : • .........' ... ,- .......... 0000. _._..:� •__ 0333.. 00:00. ... , . .. .: _ _ 0000 ............... _ CERTIFICATE HOLDER :... CANCELLATIDPI Report Viewer 13+ Lz� F7 /1 100% Page 1 of 1 https:llapps8.fldfs.comlcrreportviewerlreportViewer.aspx?data--kdvpginc9D7Q3gH6TER6... 2/12/2014 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 6670831 BUSINESS NAME/LOCATION POTENTIAL BTUS A C INC 8950 NE 8 AVE 308 MIAMI, FL 33138 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2014 6943006 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED POTENTIAL BTUS A C INC 196 GENERAL MECHANICAL BY TAX COLLECTOR CONTRACTOR 75.00 09/16/2013 Worker(s) 1 CAC1816435 0229-13-001436 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 6a-276. MIAMFO DFor more information, visit www.miamidade.govRaxcollector Aja, n 0 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIO14 CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 • TSSE 1940NORTH FMONROE STREET LT32399-0783 VELASEEQUEZ, LEONCIO POTENTIAL BTU'S A/C -INC .889950 NE.8TH 8T8 AVENUE #30088 50FL 33138 - — - ...... . Congratulationst 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. ,:....' 10 Every day we work to improve the way we do business in order to serve you better. Every For information about our services, please log onto www.myflorldalicense.cont There you can find. more Information about our divisions and the regulations that , impact you, subscribe to department newsletters and learnmore 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 licensel ...T3 DETACH HERE rim uader t#6 provision L#glfXUQ 31..2014 7 aii*�e 7'i7 °yy