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MC-13-1991�A fib 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) 762A949 BUILDING PERMIT APPLICATION Permit Type: MECHANICAL RECEIVE SEP 0 9 2018 BY: 62 FBC 20 R Permit No. j Master Permit No. JOB ADDRESS: 10025 NE 5 AVE City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11 -3206-017-1200 Is the Building Historically Designated: Yes NO w Flood Zone: no OWNER: Name (Fee Simple Titleholder): Joseph Ronald Piperato Phone#: (305) 613-1925 Address: 10025 NE 5 AVE City: Miami Shores State: Fl Zip: 33138 Tenant/t.essee Name: Phone#: Email: Joe Piperato <jrcpmd@aol.com> CONTRACTOR: Company Name:American Service Air Conditioning . Phone#: (754) 234-8787 Address: 114 Lake Emerald Drive #208 City: Ft Lauderdale State: Florida Zip: 33309 Qualifier Name: Donald N. Nystrom Phone#: (754) 234-8787 State Certification or Registration #:CMC032350 Certificate of Competency #: Contact Phone#: same Email Address: DonN omJr@yahoo.com DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 12.832.00 Square/Linear Footage of Work: Type of Work: OAddress ❑Alteration ❑New 1Repair/Replaee ODemolition Description of Work: —1tep>acx Rxiting 5 Ton Split unit W �M s3�Ks�9�9b. oto t�M�P4�N:g*�#�9��#britA+k+B���A�$�b#6��Pft�#�9&+ 1'Ceti4�3 tls��a�@�%��klt:M�im4�M�sPWsktid��d�@�+R#�M�kd+l�+P8�ff�4+U��FQ��M Submittal Fee $_ i5_ , Permit Fee $ 1 CCF $ CO/CC $ Scanning Fee $ � _,.# Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ . _. 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 ed and a reinsp on will be charged. Signa I� ipat�L) W . W, Owner or Agent The forego' instrument was acknowledged to fore¢,e this The foregoing �nt was acknowledged bet r this�f�l day of �, 20 �, by ���� � 1/ , � '��J day of 20 Li by 4J , ' who is personally known to me or who has produced As identification and who did take an oath. NOTARY Sign: Print: My APPROVED BY M RarMs Cammh"n M031M duras 10/0412014 who is personally known to we or who has produced s�� �L J L>�ar->= as identification and who did take an oath. Plans Examiner Structural Review Revised 3/12/2012)(Revised 07/10/07)(Revised 0&1012M)(Revised 3/15/09) NOTARY PUBLIC: Sign: 4,J,%4X- Prints-6....-- -- ___-- MyC d#.. AWISSION . Lf -:025201 E3iI^IRLI:3 3opferober 12, 2014 Zoning Clerk CLAUDIO CARSONELL '•; •. MY COMMISSION t# EE025201 • EXPIRES September 12.2014 7 39H Service. M 9/2/13 ' Property Search - Report Property Information: Folio 11-3206-017-1200 Property Address 10025 NE 5 AVE Owner Name(s) JOSEPH RONALD PIPERATO Mailing Address 10025 NE 5 AVE MIAMI SHORES FL 33138 Primary Zone 1200 SGL FAMILY - 2501-2800 SQ Use Code 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths/Half 3/3/1 Floors 1 Living Units 1 Adj. Sq. Footage 3,325 Lot Size 15,086 SQ FT Year Built 1955 Full Legal Description MIAMI SHORES SEC 4 AMD PB 15-14 LOTS 8 $ 9 BLK 95 LOT SIZE 15086 SQ FT OR 15871-0996 0493 1 Assessment Information: Current Previous Previous 2 Year 2013 2012 2011 Land Value $280,600 $215,730 $182,960 Building Value $271,552 $304,272 $305,966 Market Value $552,152 $520,002 $488,926 Assessed Value $318,905 $312,414 $303,315 Benefits Information: Current Previous Previous 2 Benefit Type 2013 2012 2011 Save Our Homes Assessment Reduction $233,247 $207,588 $185,611 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: not all benefits are applicable to all Taxable Values lie County, School Board, City, Regional). Disclaimer. MIAMI-DADE COUNTY OFFICE OF THE PROPERTY APPRAISER PROPERTY SEARCH SUMMARY REPORT Carlos Lopez-Cantera Property Appraiser Aerial Photography 2012 P. Taxable Value Information: Current Previous Previous 2 Year 2013 2012 2011 Exemption/ Taxable Exemption/ Taxable Exemption/ Taxable County $50,000/$268,905 $50,000/$262,414 $50,000/$253,315 School Board $25,000/$293,905 $25,000/$287,414 $25,000/$278,315 City $50,000/$268,905 $50,000/$262,414 $50,000/$253,315 Regional $50,000/$268,905 $50,000/$262,414 $50,000/$253,315 Sale Information: Date Amount OR Book -Page Qualification Code 5/2013 $870,000 28666-2680 Sales qualified as a result of examination of the deed 4/1993 $214,000 15871-0996 Sales which are qualified 12/1979 $140,000 10607-1410 1 Sales which are qualified The Office of the Property Appraiser and Miami -Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information and GIS positional accuracy. No warranties, expressed or implied, are provided for data and the positional or thematic accuracy of the data herein, its use, or its interpretation. Although this website is periodically updated, this information may not reflect the data currently on file at Miami -Dade County's systems of record. The Property Appraiser and Miami -Dade County assumes no liability either for any errors, omissions, or inaccuracies in the information provided regardless of the cause of such or for any decision made, action taken, or action not taken by the user in reliance upon any information provided herein. See Miami -Dade County full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp. Property information inquiries, comments, and suggestions email: pawebmail@miamidade.gov GIS inquiries, comments, and suggestions email: gis@miamidade.gov Generated on: Mon Sep 02 2013 gisweb.rnianudade.gov/PropertySearch/printMap.httn 1/1 ik 3u n o P Cooling.com August 20, 2013 Joseph Piperato 10025 NE 5th Avenue Miami Shores, FL 33138 Description of the work to be performed: • SunAir will install one 5 Ton Ultra Efficient Split Heat Pump System a. Dual Air - 5.0 Ton R410A • Includes one (1) digital programmable thermostat. • Reconnect to existing electric, copper and ducts. • Drill two (2) well (supply & return water), Installation 1.25 hp irrigation pump and One pressurised tank. • All work will be done per Florida Code - in conjunction with A.S.A.0 • Permits Fees Inc. for City Mechanical, City Wells & State Wells. • SunAir will perform complete start up, laser review of existing ducts and system check. MANUFACTURER: Dual Air SYSTEM & INSTALLATION: $12,832.00 FPL IMMEDIATE REBATE TO CLIENT (SUNAIR 60 DAYS) $ 1,125.00 PROJECT PRICE: 30% FEDERAL REBATE: Energy Star AC System. $ 3,849.60 TOTAL PRICE AFTER 30% REBATES: ($4,974.70 in FPL+Fed Rebates = M 9 Warranty: 5 YR MFR, 2 YR LABOR Jim Theckston 954-456-2274 Jim@SunAirGS.com Terms and conditions: (Client Signature) (Management Signature) 1. % De'X& of Total PAM c 2.e , Bal; ce miry; FPL rebat is due ipoj"y—st0ff—sW'ff-ft. or credit card payments there will be a fee charged of 3.6%. Only includes what is described and specified above. Proposal is valid for 10 days from date stated above. SunAir Cooling/American Service Air Conditioning Inc.LIC #CMC032350 is not responsible for any existing electrical, ceiling or wall repairs. DUAL AIR HEAT PUMA Saving the environment for future generations WATER SOURCE & GEOTHERMAL HEAT PUMPS CFX060 SPECIFICATION DATA SHEET WATER SOURCE & GEOTHERMAL HEAT PUMPS 1050 NW 21st Street, Miami, Florida 33128 1 Phone: 305-545-6666 1 Fax: 305-325-1966 R410A REFRIGERANT WATER LOOP GROUNDWATER Cooling Heating Cooling Heating Capacity EER Capacity COP Capacity EER Capacity COP 60,000 16.0 70,000 1 45 68,000 1 22.0 58,000 4.1 ELECTRICAL SPECIFICATIONS Electrical Characteristics Eft. Symbol Compressor Mtn Cirtadt Ampacity, Max Fuse She ALA IRA 208-230/l/60 A 26.4 134 39 60 208-230/3/60 C 16 110 26 40 460/3/60 D 1 7.8 52 1 1 13 20 575/3/60 E 1 5.7 38.9 1 10 15 GROUND LOOP FLOW RATE Cooling Heating AIR WATER Capacity EER Capacity COP CFM GPM 63,000 17.2 45,000 3S 1,900 15.0 ..• *o 460ur. C30 cus UNIT WEIGHT (lbs) DIMENSION Unit Weight I Shlpphrg Welght Length Width Height Verb 320 340 26.00 24.00 43.00 Horhor►tai 340 360 4550 26.00 21.00 "`S Entering Fluid Temp. tell Entering Air RW tell Total Capactty (MBtuH) Sensible Capacity (MBtuH) SHF Power Input (kW) Heat Rejection (MOWH) EER 50 70 db 61 wb 64S5 42.23 0.65 3.17 73.68 24.1 59 62.22 41.18 0.66 3.43 72.25 21.2 70 59 28 39.78 0.67 3.79 70.54 18.0 86 54.84 37.70 0.69 4.40 68.18 14.0 100 5087 35.95 0.71 4.97 66.14 11.14 50 75 db 63 wb 66.82 47.60 0.71 3.17 75.96 25.0 59 64.42 46.48 0.72 3.44 74.48 21.8 70 61.41 45.02 0.73 3.80 72.71 18S 86 56.74 43.42 0.77 4.38 70.00 14.6 100 52.66 41.43 0.79 4.97 67.95 11.7 50 80.6 db 66.2 wb 7059 52.08 0.74 3.19 79.79 26.2 59 68.00 50 92 0.75 1 3.58 78.55 22.0 70 64.77 49.65 0.77 3.81 76.09 195 86 60.00 47.41 0.79 4.24 72.80 16.0 100 55.49 45.97 0.83 4.98 70.83 12.3 50 85 db 71 wb 76.35 50.74 0.66 3.22 85.66 28.0 59 73.61 49S6 0.67 3.49 83.83 24.6 70 70.11 48.63 0.69 3.84 81.54 20.9 11664.94 46.19 0.71 4.42 78.36 16S 1001 60.10 1 44.68 0.74 5.04 1 75.63 13.2 As a recut of Continuing research and development specWmtlom are subject to change witlrout notice. Please contact factory for up -u date values. Wim: www.deakfthp coin HEATING FLUID PRESSURE DROP Fhthi Flow Preawre drop (GPM) (FOH) (PSIG) 75 4.6 2.0 10.1 83 3.6 13.2 14.2 6.2 15.0 1 18A 8.0 18.8 1 28.8 125 Entering Fluid Temp. CF) Entering Air Fluid (°F) Total Capacity (MBtuH) Power Input (kW) Heat of Absorb. (MBtuHI CAP 50 60 58.0.5 4.39 44.74 4.4 60 65.48 4.53 SL70 4.8 68 71.67 4.66 57.46 5.0 80 81.88 4.89 66.87 55 50 68 58.00 4.64 43.85 4.1 60 64.01 4.82 49.24 4.3 68 70.10 S.05 54.44 4.5 80 8057 5.23 64.39 5.0 50 80 55.68 5.19 39.62 35 60 62.84 5.37 46.20 3.8 6869.02 5.53 51.82 4.0 80 78.65 5.80 6053 4.3 LOW TEMP HEATING with Anti hXMbyAWSO1325rs1 Entering Fluld Temp. CF) Entering Air Flahi (°F) Total Capacity (MBtUH) Power Input (kWj Heat Of Absorb. (Mettdt) COP 25 60 4L94 3.92 30.24 3.6 32 45.83 3.98 33.91 3.8 40 50.74 4.07 3851 4.2 25 68 41.34 4.18 28.73 3.3 32 45.00 426 32.14 3.5 40 49.69 4.36 365 3.8 25 80 40.41 4.65 26.23 2.8 32 44.14 4.74 29.63 3.0 40 48.47 4.83 1 33.65 3.3 • INIMS mill IMI SHR .75 Number of residents 2 Ceiling height 9 Wall U -value I R -value 0.09111 Floor U -value I R -value 0.2 15 Ceiling U -value I R -value 0.053119 Window U -value ........... 0.5 Window SHGF 0.85 Moisture grains 58 Duct loss % 10 Duct gain % 10 Cooling infiltraction (ACH) 0.6 Heating infiltration (ACH) 0.8 Winter ventilation 0 Summer ventilation 0 Mlww-iti,665 Outdoor Heating Cooling Dry bulb ('F) 50 90 Daily range L Relative humidity 50% .... . . ........ ......... . .. . .......... . . Moisture difference 99 Indoor Heating Cooling Indoor temperature (OF) 70 75 Design temperature difference(OF) 20 15 System Efficiency Loss 2494 9.1 Total: 27434 Heating Loads 27,434 BTU/hr Floor Y tass Ceiling WS keatiRqlder ds Area Btuh % of load Weill 2707 9.9 Floor 8380 30.5 Ceiling 2968 10.8 Windows 4010 14.6 Infiltration 6875 25.1 System Efficiency Loss 2494 9.1 Total: 27434 Heating Loads 27,434 BTU/hr Floor Y tass Ceiling WS Windows Latent infiltration Sensible People Load Latent People Load /'----- wait 'Mzt ; _ Sens able infiltration System Efficiency( Ceiling Internal FIRM= 1-1001 ELI AED Graph 30000 20000 3 10000 0 Sam gam 10am 11am 12pm 1PM 2pm 3pm 4pm 5PM 6pm 7pm 8PM ® Hourly Loads Average System equipment selection will be made using the following derived values. Glass (W) 203 sq. ft. Glass (N) 28 sq. ft. Glass (S) 28 sq. ft. Glass (E) Summer Outdoor ........... 142 sq. ft. . ................. 90°F Summer Wet Bulb 77°F Summer Indoor 75°F Summer Design Grains 50% Winter Outdoor 50°F Winter Indoor 70°F Sensible Cooling 46,208 Btuh Latent Cool in g 9,703 Btuh Required Cooling Airflow ............ ... ... . 2,100 CFM Sensible Heating 27,434 Btuh Required Heating Airflow 356 CFM All calculations are based upon approved hvac industry standards and procedures, and comply wb all local, state and federal code requirements. All computed results are Estimates. Product provided by Energy Design Systems and Idea Tree AHRI Certified Reference Number: 4547270 Date: 1/24/2013 tStatus: Active Product: Wated/Brine to Air Heat Pump Packaged Unit Model Number: CFX060 Manufacturer: COLDFLO INC. Trade/Brand name: DUAL AIR Rated as follows In accordance with ANSVAHRVASHRAEASO Standard 13256-1 for Wats'-to-Air and Brum-To-Alr Heat Pumps and subject to verification of rating accuracy by AHRI-sponsored, independan% third party testing: Cooling Air Flow Rate: 1900.0 Heating Air Flow Rate: 1900.0 WLHP(Water-Loop Heat Pumps) Full Load CooliCooling EER Rati�Bi hfwatt) 1600 Cooling Fluid Flow Rate(gpm) 15.00 Heating Capadly(Btuh) 70000 Heating COP(wattAitratt) 4.50 Heating Fluid Flow Rate(gpm) 15.00 GWHP(Ground-Water Heat Pumps) Cooling Capacityr(Btuh) 68000 Cooling EER Rating(Btuh/watt) 22.00 Cooling Fluid Flow Rate(gpm) 15.00 Heating Capacity(Btuh) 58000 Heating COP(wattANatt) 4.10 Heating Fluid Flow Rate(gpm) 15.00 GLHP Ground -Loop Heat Pumps) Coaling city(Btuh) 63000 Cooling EER Radng(Btuh/watt) 17.20 Cooling Fluid Flow Rate(gpm) 15.00 Heating Capacity(Btuh) 45000 Hea" COP(waWwatt) 3.60 Heating Fluid Flow Rate(gpm) 15.00 t Modelswith an'AcdW status are those that are currently In production. Models with a'Discontlnued' status are those that the nmuracturer has elected to stop pmdudng, yet stook Is still available. Models with an'Obsotets' status are those that the manufacturer Is required to stop manufacturing dim to an AHRI cerNncedon program last failure. • Ratings Mowed by an asterisk (•) indicate a vamlary rests of previously published data, unless accompanied with a WAS, which indicates an involuntary rests. DISCLAIMER AHRI does not endorse the product(s) listed an Oft Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the produr4s) listed an tris Certificate. AHRI y disdalms all liabft for damages of arty kind arising out of the use or performance of the product(s), or the unauthorized alteration of data fisted on this Certificate. Certified ratings are valid only for models and configurations listed in the ctra tory at www. ah ridirectory.org. TERMS AND CONDITIONS This Certificate and its conte are proprietary products of AHRL This Certiflrate shall only be used for intgvidual, personal and confidential reference purposes. The contents of this Certificate may not, In whole or in lean, be reproduced; copied; disserNrertmt, entered Into a computer database, or otherwise, utilised, In any form or maturer or by any means, except for the user's Individual, personal and confidential reference. CERTIFICATE VERIFICATION AM The Information forte model cited an this certificate can be verMsd at www.ahridirectory.org, r Air-Conditloning, HGafing, that on "Verify certificate link and enter the AHM Certified Reference Numb and the dab on ® and Refri er®titan Institute which the certificate was Issued, which is fisted above, and the Certificate No., which is Rated below g ©2012 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13003531870167/399 I l 1 111 18H111 NOTICE OF COMMENCEMENT GF N 20131'gtO71412 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION Bk 23811 F's 2240?' { 1Ps )N RECORDED 09/09/2013 14:20:28 HARVEY RUVIN7 CLERK OF COURT MIAMI-DAt3£ COUNTYg FLORIDA PERMIT NO. - 13 -1 (TAX FOLIO NO. l /-3Z � -®/7 - /ZA` LAST FAG£ STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street / address. 2. Description of improvement: .te e.& .44rA/f ,2r i 3. Owner(s) name and address: 4. 5. Name and Address: _ Amount of bond $ Interest in property: Q� Name and address of fee simple WS_ SAIE .J,313? r 8. Lender's name and adt 7. Persons within the state of Florida designated by provided by Section 713.13(1)(a)7., Florida Statu Name and Address: HFREBY CERTIFY that this is a this office on of the D.C. 8. in addition to himself, Owners designates the following person(s) to receive a copy of the Uer&s Notice as provided In Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) /7 Signure of Owner/ Pt Owner's Name �Prepares! by ,,A, Sworn to and subscribed do, of q .2015 r— 'N oftr state of fi(o a gq Asht3a Ashley nez Address: j Notary Public: ar Commission EE031M 3-300:1 Print Notary's Name. ig" My commission expires: 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. MultiDle units on single sheets are not acceptable. Job Address (where the work is being done); "o O'Z- <�— d r" � N ✓ �— City: Miami Shores Village County: Miami Dade Zip Code: 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: PESO U T BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # r aT- COND. UNIT MODEL # O KW HEAT NOM TONS AHU CU PKG 1 M.C.A U CU PKG AHU CU PKG 2 M.O.P U CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT / I PKG UNIT / I 57 EER/SEER 22— YES Z02 REPLACING DUCTS YE 0 YES YES No NO REPLACING THERMOSTAT NEW 4°CONCRETE SLAB YES NO N YES NO NEW ROOF STAND YES 00 YES NO NEW RETURN PLENUM BOX ES NO 1. Minimum Circuit Ampacity (Wire Size): /0 2. Maximum Overcurrent Protection (Fuse/Breaker Size): G U )q"n 19 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means:, Z Contractor's Company Name: Phone:�7 State Certificate or gistration N. ® ?� Certificate of Competency N. Signature Date: (QuaU}feees signature only) A. . Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. A. COPY OF QUALIFIER'S STATE LIC CARD B. C Y OF LOCAL BUSINESS TAX RECEIPT C. — COPY OF LIABILITY INSURANCE CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEP D. �OCOPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr� BUSINESS NAME: C/6 BUSINESS ADDRESS: lli` 4266` 9dw. STATE �L ZIP CODE BUSINESS PHONE:F _ r'7Ax' BER cam) CELL PHONE (_) QUALIFIER'S LIC NUMBER: E-MAIL ADDRESS OF APPLICABLE): CmaW on 3M90 BY M.DV I RV 3909 WMV QUALIFIER'S NAME: !.4f /Vyjxw/yl FIM 9/2!13 American Service broward..beg BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100. Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VAUD OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013 DBA: 4-1 AMERICAN SRRVICE AIR C IMTTIONT1.r Receipt'BLrATI)13/AiRC0Vr)"$IO2t CC Business Name: INC Business Type: (MRC;V;SCAL COmp) Owner Name:umaLD is .1Y5TRQ.M/Q.TAT• Business Opened:oa/31/1.988 Business Location: 114 LA= E14F.RA=.Ti nR 202 Stah0/C0Unty/CQrb?4g:Crt('032350 FT LAUDERVALE Exemption Code: Business Phone: t 2, r Rooms Sub tynptoy3res r r 1eaaAlnaS Pro/0ealonats ,, __ .. Fw Vaiidtng F3utimta Onty Number of MovItImm. Vendin Typo: Tex Attu Trar,fQr Fee N5F Fehr Fenatty _ .. Prier Ye am Co5ection cost Total Paid ?.hp 0. U4, an.Ca ry,7Q THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied tar the privilege of Wing businesswithin Broward County and is non-requlstury in nAture. You must meot all County andor RSunlc: arty planning WHEN VALIDATED and zoning requiements. This Business Tax Receipt must be transtarreti when tho business is sa:d, business n i.nf D has ounged or you havo moved this businos8 tocation. INS rar-eipt does not indicates that the busin355 i6 1: -gal or that it Is in =;Oianue w1h State or 1=1 raves and regutattons Mailing Address: DOMV N t"YSTROM/QUAT. Receipt #02A-12-00000512 114 LAKE EMERALD DR it?.09 Paid 10/18/2012 29.70 FORT LAUDERDALE, Fr. 13309 2012 .2013 haps;//drive goo&.comNu*=cbrom appftamh/nysftm u1 `UZ 5 - J,u Zlu: STATE OF FLORM, 10ESSION t AL -X tom.:o. NALD—N ..SERV: EMERALD I FT. SCOTT SEQOL12081100857 UNCO rOR D Llj, -201' CR CONDri' .. .... 142 0 8 FL, 333JQ9 KEN LAWSON SECRETARY DISPLAyA0UlRED-9-)L-LAIN -.-- STATE OF KDRM DUARTIANT OF fi?IAN=. SERVICES CMTM=LGN INDUSTRY TO Be EMAPT MOM FLORIDA CERTYWATIE OF MECTM %VMW_qr CWAPBURATION LAW Fmc-ciive. 08/09/2012 EXPIRATION DATE: 03/09/2014 pMS4V rA)"Lo WSTROM Him 562307352 .,c, N_"j7 AND A009� BUSINFe - Awft,:-&-4 crxrll:o4 *4 114 LW f CAI L:=�Uln- 41 FFL ?J SCOPE CF GUST -NESS I w�Am.,, lv'�%—ATOtC 41 CiF IMPORTAN'f F c6 I• I ottic r &Wjk;" Ul fiin; a I Ilii ate uF,'ec"c'rl L rai 11.1, recCvc! 0' LO the, H rcP;Q'l,j %j*.";ll the 5=.t: rij the tr.? E 44U J51 I Y-, r—rl, t;Jt:reS of of ejC;jj..-;j t.:, be cj,.t:-,pt sell lutlitct to "it., Win; at zilt; lol-ce v Utr e an Ij�p. rQ 'If I p - - — ��ke _, �v!iifir.ale it jlo fi. e per -,j I "rre., w .t SEP -03-2013 09:26 From: 9543519913 To:13057568972 Pa9e:1/1 AGM CERTIFICATE OF LIA13ILM INSURANCE DATE 9/3/1.3 PRODUCER THIS CERTIFICATE. Z9 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THE CERTIFICATE FULTON AGENCY, INC. 1500 W. CYPRESS CREEK RD STE $04 DOES NOT AMEND, EXTEND, OR BELOW ALTER THE COVERAGE AFFORDED OY THE P LICIF.S DELOW. FORT LAUDERDALE, FL 33309 COMPANIES AFFORDING COVERAGE 954 776-9015 COMPANY A WESTERN WORLCI INSURANCE COMPANY INSURED COMPANY AMERICAN SERVICE AIR CONDITIONING, INC. B COMPANY 114 LAKE EMERALD DR #208 OAKLAND PARK, FL 33309 C COMPANY D COVE GE$. 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 I9 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND ONDITIONS OF SUCH PO ICIE .LIMITS H WN MAY HAVE BEN REDUCED BY PAID CLAIMS. CO LT R TYPE OF INSURANCE POLICY NUMBER POLICY EFFNCTIVE OATS M DD YY POLICY EXPIRATION DATE MM DD YY LIMITS A GENERAL LIABILITY NPP1360582 7/22/23 7/22/14 GENERAL AGREGATE $2,000,400 GOMMeRCIAL GENERAL, PRODUCTS - COMP/OP ACCs $ 1,000,000 PERSONAL & ADV INJURY $1,000,000 LIABILITY I J CLAIMS MADE EACH OCCURRENCE 41,000,000 I X ] OCCUR OWNER'S CONTRACTOR FIRE DAMAGE (Any ame PirA 100,000 PROTECTIVE BROAD FORM PROP DAMAGE MED EXP (Any one son 5'1,000 AUTOMOBILE POLICY COMBINE=D SINGLE UMTT $ „,,,,,,,,.ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) BODILY INJURY (Per Accident) $ HIRED AUTOS -NON OWNED AUTOS PROPERTY DAMAGE $ EDCCE LIAIBILTY —UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WOOER COMPENSATION AND EMPLOYERS LIABILITY WCOTMER STATUTORY LIMITS :,!'• �a °i s"-' �• GN: '� •:i•;b:Y�i�• ..j:+t:',+ • ..w p;.:iY cr ;: Gr': i'v�;::a+ :7 LL H ACCIDENTL $ EL DISEASE - POLICY LIMIT $ EL DISEASE - CA EMPLOYEE $ OTHER — TCSCRIPTION OF OPERA'YION/LOCATIONS/VEHIC4ES/BPECIAL ITEMS SAME AND TEMPORARY WORK SITES BL511WHERE IN THE STATE OF FLORIDA. CERTIFICATE HOLDER CANCELLAT1001 VILLAGE OF MIAMI SHORES BUILDING AND ZONIr1(i 100550 NE 2 AVE SHOULD ANY OF THR ABOVE DESCRIBED POLICICS Be CANCELLED BEPORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL, ENDEAVOR TO MAIL 10 DAYS WR.MIN NOTICE TO THE CER'1 MCATt HOLDER NAMED TO THE LEFT, BUT FAILU" YO MAIL $UCH NOTICE SHALL IMPOSE NO OBWaATION OR LIABILM Of ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, MIAMI SNORES, FL 33138 AUTHORIZED REP NTATIVI; ACOAD 2E-9 (2/99) t — I I 1�14JAK "AA_,� - AGORA CORPORATION 1988