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MC-13-189EM Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-209658 Permit Number: MC -2-13-189 Scheduled Inspection Date: March 26, 2014 Inspector: Perez, JanPierre Owner: MIRAMONTES, CARLOS & BARBARA Job Address: 674 GRAND Concourse Miami Shores, FL 33138 - Project: <NONE> Contractor: CAC058169 ALL YEAR COOLING & HEATING INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060171950 Phone: (954)566-4644 dunaing uepartment comments MECHANICAL WORK FOR NEW ADDITION Infractio Passed Comments INSPECTOR COMMENTS False T4 3 March 25, 2014 For Inspections please call: (305)762-4949 Page 30 of 40 Inspector Comments Passed 192 CREATED AS REINSPECTION FOR INSP-185027. Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 25, 2014 For Inspections please call: (305)762-4949 Page 30 of 40 BUILDING 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 Permit PERMIT APPLICATION Master Permit No FBC 20 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): CARLOS MIRAMONTES Phone#: Address: 674 GRANDCOURSE City: MIAMI SHORES State: FL Tenant/Lessee Name: Email: JOB ADDRESS: 674 GRANDCOURSE MAR_19 2014 MC2013-189 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#. 11-3206-017-1950 Is the Building Historically Designated: Yes NO x Flood Zone: 33138 CONTRACTOR: Company Name: ALL YEAR COOLING Phone#: 954-566-4644 Address: 1345 NE 4 AVE City: FORT LAUDERDALE State: FL Zip: 33304 Qualifier Name: THOMAS A. SMITH Phone#: State Certification or Registration #: CAC058159 Certificate of Competency #: CMC537 Contact Phone#: 954-566-4644 Email Address: DDANIELS@AYCAIR.COM DESIGNER: Architect/Engineer: N/A Phone#: Value of Work for this Permit: $ 11,400 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: A/C CHANGEOUT OF A 4TON, 2 TON, & 1.5 TON RUUD UNITS Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 3 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) N/A 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 which occurs seven (7) days after the building permit is issued. In the absence of such post90 notice, the inspection w' t be approved and a reinspection fee will be charged. w �-- �LJ'0- Signature Signature 24 — Owner or Ag t Contractor The foregoing instrument was acknowledged before me this 26 The foregoing instrument was acknowledged before me this 27 day of FEBRUARTOd-, by CARLOS MIRAMONTES , day of FEBRUARY , 20 A4, by THOMAS A SMITH , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si Sign Print: Print: �' My Commission Expires: ;2a� �PZa4� ASML My Commission Expires: sot !S4 ASHLEY JENSSEN EY JENSSEN =?:' * •_ �' MY COMMISSION #FF001816 tag;... : et MY COMMISSION #FF001816 �,�.... : Q? 1f'Z; 'rF o�°'' EXPIRES March 19, 2017 ''••.,'s';;e_n,'o...•• EXPIRES March 19. gni � .. oPFl....., APPROVED BY (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Plans Examiner Zoning Structural Review Clerk 0Today's Comfort. Yesterday's Prices. RON' TRACT C]ESTIMATE ' / 1345 HE 41h Ave, Fort Lasgin ie, FL UM w t✓ Phots (934) NO -4644 Flow (ON I.= 11 emWAYCRlroom Es'9IMwith aver139,008kAWW rsa DATE PURCHASER'S WMEM&M Aft, ADDRESS gindwAlrQwft hereby submit speacations for. Cn.fm mp._/Jrf F� �,� Equipment hmiellaUors r—ri'- � e„4 -7-�C FMAa O fter HOME PHONE CELL. PHONE Ag Yam Cmnng win tmnisb an pmts, tabor and REFERREn sY moo_ C. 2,n r. J!6 f Z tsto 13 iowummaesuaaem� uma a a® aasmstacr n m wa can t Dass O macwNewsupprywo)13 matwiNew mo O dew suppytrID s>m x ❑OSew UpLeatmInDucts 9 Otaooilcub suf ❑ ORdS&Fftan apnttwm URElseft Red Padewia tleatpump ❑►��ttRemvm unn Gd�ofsyatams- HOICHUMApplIcaft APpftenoa fm,m OAU Hmalmrerealauwtre efts Otba wtag erea, C3an ❑NewerWaRrW tt� qjmBnDjw— +�..._ e.ewiaauauoujamnmm-rp t�rur�y LJSm duy DgaSlgmmafhppmssef�lUrmwahtlmWaaon,sly O New conam�ate tlunp ❑ AuvBtsry Drain Pass O UnUM of gun ❑ I1ehOereet cam Lbndd Wm, site ❑ Nm m ring Coag O Refige mat une covin t OSkft mm WmtarmKS c;mnp fur arnwmb fttarraed ❑ smake Dom. WMBdsftCoft ❑ us dmdwareof BMW furAUHander Ei59raps ❑ Crmm/serdeLat ❑ rfnd s m ❑ Newffieb Cc& stopping ❑ LOU Nmdtl ft WAR Year Coonagona *pwbtmd,aad Y an Wui"M unless durvilSSaffiled bow Lea omm2ebsorerbemPew BUMIV ebbard* UItRyAe6ate 9 %� � s��eL_s Mal Rob& Mccreaks s faxes rmats &-S_$ (Parts f�--Yams u�earaooaataammn.oammeae�mmeam � 017u -e Property Search Home I Departments I Government I Employees I Calendar 0P,�_ MIAMII-DADECDUNTyPROPERTY APPRAISER Carlos Lopez -Ca r PROPERTYAPPRAISER Page 1 of 2 Call 3-1-1-._.._..___� Search Property Appraiser Exemptions & Real Estate Tangible Public Online Tax Rolf About Us Contact Us Home Other Benefits Personal Property Records Tools Administration The Property Appraiser does not send tax bilis and does not set or collect taxes. Please visit the Tax Collector's website directly for additional information ou Facebook aTwitter - 4/3/0 JAPrint E mai! link Search Fo io, Or Name or Address wne Folio: 113206-017-9950 Adjusted Sq. Footage: Property Address: 674 GRAND CONC Enter either folio, owner name, or address, Year Built: 1935 Owner- CARLOS MIRAMONTES Selected Property Information BARBARA MIRAMONTES .._. _.._ _. -- - --- -- Mailing Address: 674GRANDCOURSE Property Information MiAMi SHORES FL 33138 Full Legal Description Property Information Assessment Information ` - -- - - -- ` Primary Zone: - Lan Use d U 1300 SGL FAMILY - 2801-3000 SQ 0102 RESIDENTIAL SINGLE FAMILY 2 LIVING UNITS Benefits Information Sales Information Additional Information Featured Online Tools Report Homestead Fraud Tax Comparison Tax Estimator TRIM Notice View Taxes Additiona! Onifne Tools Comparable Sales . Beds/Baths/Half: - 4/3/0 Floors: 2 Living Units: 1 Adjusted Sq. Footage: 3,186 Lot Size: 14,612 SQ FT Year Built: 1935 http://gisweb.miamidade.gov/PropertySearch/ 1/23/2014 Permit N. PC,"7013` /n Miami shores Vilage ;141A 192014 Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Pau: (305) 756.8972 OF CONTRACTOR / ARCHITECT oker's Name (FO Sl�ie iti�=jdoi older). {%�'�;,�,9rfy�ifS Phone Owner' Address: _/ Cp xsk City: I State: L Tip Code --3313'S Job' Address (of where work is being done):/T �1i•� U�C2 City: Miami Shores State:—Florida Tip Code,331 Contractor's Company Name: �114l�� Phone#:Addres • 45-A E A-- City:� off£- State: P -L V �e:4— Qual er's Name : �5 A • �; ; - Lic. Number. ';W/SS Architect/ Engineer of Record Name: t4l& Phone #: Address: City: State: Zip Code: Describe Work: I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and. the Miami Shores harmless for all legal Invohoement. Si natu _ ` g Signatu a 1� ownetor.Age O'0*80bDr orA #&,d The fore oing instrument was aknowledged before me The foregoing Instrument was aknowledged before me thday of 20)ub I I�Q thi da of I� 1 Y .U�, 2dybY-� A &AI Who is personally known to me or who has produced as indentfffcagon, Notan► Public: Sig r 1, ' r' =teal -e< ,' JENSSEN seal' _* MY COMMISSION #FF00181 `! p EXPIRES March 19, 2017 .� OF PO.•••• (407)398.0153 FlorldallotaryServlce.com who is personally known to me or who has produced Public: 398.0153 as Indentitication. JENSSEN MY COMMISSION #FF001816 EXPIRES March 19, 2017 Mrs £t Mr Miramontes 674 Grand Concourse Miami Shores FL 33138 To Mechanical Air Masters Carlos Hernandez January 27, 2014 Dear Carlos, This letter is to inform you that we have requested a change of contractor on our residence Mechanical permit no. MC2-13-189, therefore as of today, Mechanical Air Masters is no longer our contractor of record. Thank you for your business. Carlos Miramontes Builder Owner. ,ry' pC, 10 13- IZC) Miami Shores Village n,- .4 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 forroust 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 done): 674 Grand Concourse City: Miami Shores Village County: Miami Dade Zip Code: 33138 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 ❑ NO ❑ Contract Attached: YES 31 UNIT BEING REPLACED DATA NEW UNIT R MANUFACTURER RUUD RAKA024JAZ AHU or PKG. UNIT MODEL # UASL-025JEC RBHA14-00 COND. UNIT MODEL # RHPN-HM2421 5.0 KW HEAT 5.0 2.0 NOM TONS 2.0 AHU30 CU 20 PKG 1 M.C.A AHU 30 CU 20 PKG AHU 30 CU 25 PKG 2 M.O.P AHU 30 CU 25 PKG AHU 230 CU 230PKG 3 VOLTS AHU 230CU 230 PKG PKG UNIT / / PKG UNIT EER/SEER 18 YES NO X REPLACING DUCTS YES NO x YES NO X REPLACING THERMOSTAT YES x NO YES NO X NEW 4°CONCRETE SLAB YES x NO YES NO X NEW ROOF STAND I YES NO x YES NO X NEW RETURN PLENUM BOX I YES NO x 1. Minimum Circuit Ampacity (Wire Size): #10 2. Maximum Overcurrent Protection (Fuse/greaker Size): 30 AMPS 3. Voltage of Circuit (208/240/480): 2d8-230 4. Size Disconnecting Means: 30AMPS Contractor's Company Name: ALL YEAR COOLING Phone: 954-566-4644 State Certificate or Registration N. CAC058159 Certificate of Competency N. CMC - 537 Signatur 4"- 2Date: 1/23/14 (Qualifier's )gnature only) wrightsof Project Summary Job: ® 1 �'Y pate: Entire House By: ALL YEAR COOLING AND HEATING 1345 NE4TH AVE, FORT LAUDERDALE, FL33304 Phone: 954 566 4644 Fax 954 640 0200 Web: ALLYEARCOOLINGANDHEATING.COM • • r • For: MIRAMONTES ZONE 2 674 GRAND CONCOURSE, MIAMI SHORES, FL Notes: Desic in [nformationa�.,,,. Weather: Fort Lauderdale/Hollywood, FL, US Winter Design Conditions Summer Design Conditions Outside db 50 OF Outside db 90 OF Inside db 70 OF Inside db 75 OF Design TD 20 OF Design TD 15 OF Daily range Relative humidity L 50 % Moisture difference 61 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 26651 Btuh Structure 11959 Btuh Ducts 2383 Btuh Ducts 4145 Btuh Central vent (84 cfm) 1854 Btuh Central vent (84 cfm) 1390 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 30888 Btuh Use manufacturer's data n Rate/swing multiplier Equipment 0.95 Btuh Infiltration sensible load 16619 Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 2690 Btuh Ducts 1090 Btuh Area Heating Cooling Central vent (84 cfm) 3523 Btuh (ft2) 836 836 Equipment latent load 7303 Btuh Volume (ft3) 6688 6688 Air changes/hour 0.61 0.32 Equipment total load 23922 Btuh Equiv. AVF (cfm) 68 36 Req. total capacity at 0.70 SHR 2.0 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make Ruud Trade n/a Trade Model n/a Cond UASL-025JEC AHRI ref non/a Coil RHPN-HM2421+RCSN-H*2421 AHRI ref no5504415 Efficiency n/a Efficiency 14.0 EER, 18 SEER Heating input 0 Btuh Sensible cooling 18060 Btuh Heating output 0 Btuh Latent cooling 7740 Btuh Temperature rise 0 OF Total cooling 25800 Btuh Actual air flow 0 cfm Actual air flow 800 cfm Air flow factor 0 cfm/Btuh Air flow factor 0.050 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.71 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. A= wr1ghtsaft° Right -Suite® Universal 201212.0.07 RSU12433 2014 -Jan -23 18:39:51 Page 1 C:\Users\iphillips\Documents\Wrightsoft HVAC\tom smith.rup Calc = MJ8 Front Door faces: W This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. AHRI Certified Reference Number: 5504415 Date: 12/11/2013 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: UASL-025JEC Indoor Unit Model Number: RHPN-HM2421+RCSN-H*2421 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RUUD 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: * Ratings followed by an asterisk (*) indicate a voluntary rerete 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 ail 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.ahridirectoryorg. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shag 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 Irmo 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 informaUon for the model cited on this certificate can be verified at www.ahridirectoryorg, click on "Verify Certificates link and enter the AHRI Certified Reference Number and the date on 11IM and Air -Conditioning, Heating,®nditfRedid which the certificate was Issued, which is listed above, and the Certificate No, which is listed below. ins Refrigeration Institute ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130312596168380376 ATTACHMENT QF -AQ TO CONCRETE PAD EXAMPLE OF TYPICAL A/C UNIT LESS THAN 36V X x 36L INSTALL 4 CUPS PER UNIT, EXAMPLE OF LOCATIONS: TWO CUPS AT 80TH SHORT SIDES, ONE CUP AT EACH CORNER, ONE CUP EACH SIDE le K F C UNIT _ ON APPROVED CONCRETE PAD 1. UNITS LESS THAN 36" W x 36: L USE 4 ANGLE CUPS. SEE BELOW (ONE EACH CORNER, ONE EACH SIDE, OR TWO EACH AT SHORT SIDES) WITH (2) STAINLESS STEEL OR ZINC PLATED #12 TEK SCREWS INTO UNIT. AND (1) Y4 x 1N4 TAPCON CONCRETE SCREW INTO CONCRETE PAD. 2. UNITS OVER 36' LONG IN ANY DIRECTION, USE. TWO (2) ADDITIONAL CUPS ALONG BOTH LONG SIDES. TYPICAL CONCRETE PAD OR DECK 4 TYPES OF ANGLE CLIPS TO CHOOSE FROM 1. STAINLESS STEEL 16 GAGE ANGLE CUPS %7 WIDE x 2" BASE x4.5" AND 5.5' LONG 2. GALVANIZED 6-90 16 GAGE ANGLE CUPS 1Yt" WIDE x 2' BASE x 4,5" AND 5.5" LONG 3. ALUMINUM ANGLE CUP X x 1%' WIDE X 2" BASE x 5" LONG 4. ALUMINUM ANGLE CUP 3/8" x 3" WIDE x 3" BASE X 1.5" LONG CUP SPECIFICATIONS ARE ENGINEERED IN ACCORDANCE WITH THE CURRENT FBC VERSION 2010. IN ACCORDANCE WITH ASCE 7 2010 WIND LOAD AND FOUND IN SECTION 301.12 OF THE MECHANICAL CODE AND SECTION 1620 OF 111E BUILDING CODE MILTON CLIBAS, P. E., INC. CONSULTING ENGINEERS P.E. # 51902 C.A. # 27267 S.I. # 6999901 1302 NE 125 ST NORTH MIAMI, FLORIDA 33161 PHONE: (305) 891-4174 FAX (305) 891-4175 www.miltoncubaspe.com E MAIL: miltoncubas@msn.com 1/4 *ASCE705W.xls* Program Version 1.0 WIND LOADING ANALYSIS Chimneys, Stacks, and Vertical Tanks Per ASCE 7-10 Codefor Cantilevered Structures Classified as Other Structures V = 176 mph (Wind Map, Figure 6-1) Class. = A (Occupancy Category form Table 1-1) Exposure = C (Exposure Category from Sect. 6.5.6) Wind Kzt = 1.00 (Topographic Factor from Sect. 6.5.7) h = 3.00_ ft. (Height of Stack/Tonk itself) Hb = 6.00 ft. (Ht. of Stack/Tank Rase Above Ground) D = 3.00 ft. (Diameter or Width of Surface Normal to Wind) Shape? Square (Round, Hexagonal, or Square) a = 0.010 (Damping Ratio = 0.010-0.070) Ct = 0.0412 (Period Coefficient = 0.020-0.035 Kd = 0.90 (Direct. Factor, Table 6-4) Wind Load Tabulati Elevation on for Stack / Tank Cf = 1.300 (Force Coef. from Fig. 6-21) z Kz qz p=gz`G,C F=-grG'Ct*D If z < 15 then: Kz = 2.01*(15/zg)^(2/a) If z >= 15 then: Kz = 2.01*(z/zg)^(2/a) a = 9.50 _ (Table 6-2) zg = 900 (Table 6-2) I=. 1.00 (Table 6-1) (Import. Factor) h/D = 1.000 freq., f = 10.648 Hz. (f >=1) Rigid G = 0.850 (Gust Factor, Sect. 6.5.8) Velocity Pressure (Sect. 6.5.10, Eq. 6-15): qz = 0.00256*Kz*Kzt*Kd *VA 2*I Net Design Wind Pressures (Sect. 6.5.13): p = qz*G*Cf (psf) Net Design Wind Forces (Sect. 6.5.15, Eq. 6-28): F = qz*G*Cf'D (Ibtft) Resulting Total Base Shear & Moment: EV(total) =0.60 kips EM(total) = 4.52 ft kips ft s s Ib/ft 6.00 9.00 0.85 0.85 60.58 60.58 66.95 66.95 200.84 200.84 n7 1 of 3 3/26/2012 11:32 AM STAND Won Cubes PE, Ino., Milton Cubes (Net 26,2012; 11:32 APA Result Case. WZ IES VsuaiAnaiysis 9.00.8017 4 TYPES OF ANGLE CUPS TO CHOOSE FROM I 1, STAILESS S(FEI, 16 GAGE ANGLE CLIPS 1 !¢' WIDE x 2' YASE x9.5" AND 8.5" LONG 2. GALVAN17F0 6 -99 Q. -UM ANGLE CLIPS t )J' WIDE x 2" BASE x 4.5' AND 5.5' LONG i 3. ALUMINUM ANGLE CUP 76' x 1%" WE x 2" BASE x 5' LONG 4. gang". ANGLE CLIP 46' x 3' WIDE x 3' BASE x 1.5' LONG • �1>1 A TENSION = 151 Ib 01719 +° p2� q7; 01% 01119 °0. Q �S Vic mE 4. 6WUM. ANGU: CUA ij" x 3" 1ME x 3° BAvE x 1.5" LONG c A1>1 rrr9 dAo + a Y �AO rrr9 O u z• TENSION = 151 Ib I Miami Shores Village Building Department 90050 N.E.2nd Avenue Miami. Shores, Florida 33138 Tel. (305) 795.2204 Fax. (305) 756.8972 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 Address (where the work is being done): 674 Grand Concourse _ City: Miami Shores Village County: Miami Dade Zip Code: 33138 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 0 NO ❑ ARHI Sheet Attached: YES ® NO Contract Attached: YES F1 UNIT BEING REPLACED DATA NEW UNIT RHEEM MANUFACTURER RUUD RBHC14-05 AHU or PKG. UNIT MODEL # 14AJM19 RAKA018 COND. UNIT MODEL # RBHP-17J06 5.0 KW HEAT 5.0 NOM TONS 1.5 AHU 30 CU 20 PKG 1 M.CA AHU 30 CU 20 PKG AHU 30 CU 25 PKG 2 M.O.P AHU 30 CU 25 PKG AHU 230 CU 230PKG 3 VOLTS AHU 23MU 230 PKG PKG UNIT / / PKG UNIT 10.0 EER/SEER 15.50 YES NO X REPLACING DUCTS YES NO x YES NO X REPLACING THERMOSTAT YES x NO YES NO y NEW 4"CONCRETE SLAB YES x NO YES NO X NEVV ROOF STAND YES NO x YES NO X _ NEW RETURN PLENUM BOX YES NO x 1. Minimum Circuit Ampacity (Wire Size): #10 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 30 AMPS 3. Voltage of Circuit (208/240/480): 208-230 4. Size Disconnecting Means: 30AMPS Cobtmctoes Company Name: ALL YEAR COOLING Phone: 954-5664644 Stale Certificate or istration N. CAC058159 Certificate of Competency N. CMC - 537 O SinatuB _ Date: 1/23/14 (Qualifier's signature only) Project Summar Job: vvlrightsoft� J Y Date: Entire House By: ALL YEAR COOLING AND HEATING 1345 NE 4TH AVE, FORT LAUDERDALE, FL33304 Phone: 954 566 4644 Fax 954 640 0200 Web: ALLYEARCOOUNGANDHEATING.COM Proilect Information For: MIRAMONTES ZONE 3 674 GRAND CONCOURSE, MIAMI SHORES, FL Notes: Desi nInformation.;,...�a.�,�i��i114:1���� ill Weather: Fort Lauderdale/Hollywood, FL, US Winter Design Conditions Summer Design Conditions Outside db 50 OF Outside db 90 OF Inside db 70 OF Inside db 75 OF Design TD 20 OF Design TD 15 OF Daily range L Relative Humidity 50 % Moisture difference 61 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 17382 Btuh Structure 6892 Btuh Ducts 1474 Btuh Ducts 2528 Btuh Central vent (96 cfm) 2101 Btuh Central vent (96 cfm) 1576 Btuh Humidification 0 Btuh Blower 0 Btuh Pi in Equipment load 209507 Btuh Use manufacturer's data n Rate/swing multiplier 0.95 Infiltration Equipment sensible load 10447 Btuh Method Simplified Construction quality Average Latent Cooling Equipment Load Sizing Fireplaces 0 Structure 2219 Btuh Ducts 655 Btuh HeatingCooling Central vent (96 cfm) 3993 Btuh me2(ft3)4576 Equipment latent load 6868 Btuh Volume 4576 Air changes/hour 0.61 0.32 Equipment total load 17315 Btuh Equiv. AVF (cfm) 47 24 Req. total capacity at 0.70 SHR 1.2 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make Ruud Trade n/a Trade RUUD Model n/a Cond 14AJM19 AHRI ref non/a Coil RBHP-17+RCHL-24A2 Efficiency n/a AHRI ref no5550124 Efficiency 13.0 EER, 15.5 SEER Heating input 0 Btuh Sensible cooling 12250 Btuh Heating output 0 Temperature rise 0 Btuh OF Latent cooling Total cooling 5250 17500 Btuh Btuh Actual air flow 0 cfm Actual air flow 583 cfm Air flow factor 0 Static pressure 0 cfm/Btuh in H2O Air flow factor Static pressure 0.062 0 cfm/Btuh in H2O Space thermostat Load sensible heat ratio 0.62 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. writ htsoft* is 2014 -Jan -2318:42:49 9 R M -Suite® Universal 2012 12.0.07 RSU12433 C:\Users\iphillips\Documents\Wrightsoft HVAC\tom smith.rup Calc = MJ8 Front Door faces: W Page 1 ■®� � E RT 11= f E D FN' � � wwq�;aluitlirector .or Cedificate '! Pr9ouct Ratings RI Certified Reference Number: 5550124 Date: 1/23/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM19 Indoor Unit Model Number: RBHP-17+RCHL-24A2 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): 17500* EER Rating (Cooling): 13.00 SEER Rating.(Cooling): 16:50 LEER Rating (Cooling): Ratings followed by an aster'sk (7 indicate a voluntary rerate of previously publisiied date, unless accompanied with a WAS, which Indicates an involuntary rerate DISCLAIMER AHRI does not endorse the products) 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 unaui4horized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www ahrldirectoryorg. 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. CERTIFICATE VERIFICATION �® The Information forthe model cited on this certificate can be verified at www.shridirectoryorg, Air -Conditioning, Heating, click on "Ve Certificate" link and enter the AHRI Certified Reference Number and the date on ^, On and Refri which the certificate was Issued, which Is listed above, and the Certificate No., which is listed below. g®ration Institute 02013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130349659040447990 • ATTACHMENT OF - AC TO CONCRETE PAD EXAMPLE OF TYPICAL A/C UNIT LESS THAN 36V X x 36L INSTALL 4 CUPS PER UNIT, EXAMPLE OF LOCATIONS: TWO CUPS AT BOTH SHORT SIDES, ONE CUP AT EACH CORNER, ONE CUP EACH SIDE F A/C UNIT ON APPROVED CONCRETE PAD 1. UNITS LESS THAN 36" W x 36' L USE 4 ANGLE CUPS. SEE BELOW (ONE EACH CORNER, ONE EACH SIDE, OR TWO EACH AT SHORT SIDES) WITH (2) STAINLESS STEEL OR ZINC PLATED X112 TEK SCREWS INTO UNIT. AND (1) Y4 x 1% TAPCON CONCRETE SCREW INTO CONCRETE PAD. 2. UNITS OVER 36" LONG IN ANY DIRECTION, USE. TWO (2) ADDITIONAL CUPS ALONG BOTH LONG SIDES. TYPICAL CONCRETE PAD OR DECK 4 TYPES OF ANGLE CLIPS TO CHOOSE FROM 1. STAINLESS STEEL 16 GAGE ANGLE CUPS 1JZ" WIDE x 2" BASE x4.5" AND 5.5" LONG 2. GALVANIZED 6-90 16 GAGE ANGLE CUPS 1Xa" WIDE x 2" BASE x 4,5" AND 5.5" LONG 3. ALUMINUM ANGLE CUP 3" x 1%" WIDE X 2" BASE x 5" LONG 4. ALUMINUM ANGLE CUP 3/6" x 3" WIDE x 3" BASE X 1.5" LONG CUP SPECIFICATIONS ARE ENGINEERED IN ACCORDANCE WITH THE CURRENT FBC VERSION 2010. IN ACCORDANCE WITH ASCE 7 2010 WIND LOAD AND FOUND IN SECTION 301.12 OF THE MECHANICAL CODE AND SECTION 1620 OF THE BUILDING CODE MILTON CLIBAS, P. E., INC. CCONSULTING ENGINEERS P.E. # 51902 C.A. # 27267 S.I. # 6999901 1302 NE 125 ST NORTH MIAMI, FLORIDA 33161 PHONE: (305) 891-4174 FAX (305) 891-4175 www.miltoncubaspe.com E MAIL: miltoncubas@msn.com a 1/4 ' "ASCE705W xis" Program Version 1.0 WIND LOADING ANALYSIS - Chimneys, Stacks, and Vertical Tanks Per ASCE 7-10 Code -for Cantilevered Structures Classified as Other Structures Job Number: V = 176 mph (Wind Map, Figure 6-1) Class. = II (Occupancy Category form Table 1-1) Exposure = C (Exposure Category from Sect. 6.5.6) y nd Kzt = 1.00 (Topographic Factor from Sect 6.5.7) h = 3.00 ft (Height of Stack/Tank itself) Hb = 6.00 ft (Ht. of Stac klTank Base Above Ground) D = 3.00 ft. (Diameter or Width of Surface Normal to Wind) Shape? Square (Round, Hexagonal, or Square) P = 0.010 (Damping Ratio = 0.010-0.070) Ct = 0.0412 (Period Coefficient = 0.020-0.035 Kd = 0.90 (Direct. Factor, Table 6-4) Wind Load Tabulati( Cf = 1.300 (Force Coef. from Fig. 6-21) z < 15 then: Kz = 2.01 *(1 5/zg)A(2/a) z >= 15 then: Kz = 2.01 *(z/zg)A(2/a) a = ....--9.50 (Table 6-2) zg = . 900 (Table 6-2) I=. 1.00 (Table 6-1) (Import. Factor) h/D = 1.000 freq., f = 10.648 Hz. (f >=1) Rigid G = 0.850 (Gust Factor, Sect. 6.5.8) Velocity Pressure (Sect. 6.5.10, Eq. 6-15): qz = 0.00256*IWKzt*Kd*V^2*I Net Design Wind Pressures (Sect. 6.5.13): P = qz*G*Cf (psf) Net Design Wind Forces (Sect. 6.5.15, Eq. 6-28): F = qz*G*Cf"D (lb/ft) BV(total) = 0.60 kips EM(total) = 4.52 ft -kips 1 of 3 z Kz qz p=qz-G� F=qz'G"CfD ft Ib/ft 6.00 0.85 60.58 66.95 200.84 9.00 0.85 60.58 66.95 200.84 3/26/2012 11:32 AM 2/4 "ASCE705W.xis" Program Version 1.0 Flexible? No f >=1 Hz. 1: Simplified Method for Rigid Structure G=1 0.85 Parameters Used in Both Item #2 and Item #3 Calculations (from Table 6-2): a^ = 0.105 = c*(33/z(bar))A(1/6) , Eq. 6-5 b^ = 1*(z(baru33)^(E(bar)) , Eq. 6-7 gq = 3.4 a(bar) _ 0.154 (3.4, per Sect 6.5.8.1) b(bar) = 0.65 Q = 0.979 c= 0.20 G=1 0.914 I = 500 ft. s(bar) = 0_.200 N.A. z(min) = 15 ft. Calculated Parameters Used in Both Rigid and/or Flexible Structure Calculations: z(bar) = 15.00 = 0.6*h , but not < z(min) , ft. Iz(bar) = 0.228 = c*(33/z(bar))A(1/6) , Eq. 6-5 Lz(bar) = 427.06 = 1*(z(baru33)^(E(bar)) , Eq. 6-7 gq = 3.4 (3.4, per Sect 6.5.8.1) gv = 3.4 (3.4, per Sect 6.5.8.1) gr = 4.720 = (2*(LN(3600*f)))A(1/2)+0.577/(2*LN(3600*f))A(1/2) , Eq. 6-9 Q = 0.979 = (1/(1+0.63*((B+h)/Lz(bar))^0.63))^(1/2) , Eq. 6-6 Calculation of G for Ri idStructure G=1 0.914 = 0.925*((1+1.7`gq*lz(bar)*QY(1+1.7*gv*iz(bar))) , Eq. 6-4 Calculation of Gf for Flexible Structure 0 = 0.010 Damping Ratio Ct = 0.041 Period Coefficient T = 0.094 = Ct*h^(3/4) , sec. (Approximate fundamental period) f = 10.648 1/T, Hz. (Natural Frequency) V(fps) = N.A. = V(mph)*(88/60) , ftJsec. iar,zbar) = N.A. = b(bar)'(z(bar)/33)^(a(bar))'V`(BB/60) , ftJsec. , Eq. 6-14 N1 = N.A. = f*Lz(bar)/(V(bar,zbar)) , Eq. 6-12 Rn = N.A. = 7.47*N1/(1+10.3*N1 x`(5/3) , Eq. 6-11 rlh = N.A. = 4.6*f*h/(V(bar,zbar)) Rh = N.A. _ (1/rlh)-1/(2*rih^2)`(1-a^(-1'rlh)) for rlh > U, or = 1 for rlh = U, Eq. fi-13a,b rib = N.A. = 4.6*f*D/(V(bar,zbar)) RB = N.A. _ (1/rlb)-1/(2*rib^2)*(1-e^(-2*71b)) for rib > 0, or = 1 for rlb = 0 , Eq. 6-13a,b rld = N.A. =15.4*f"D/(V(bar,zbar)) RL = N.A. _(1/rldr1/(2*rld^2)*(1-e^(-2*rld)) for r1d > 0, or = 1 for rld = 0, Eq. 6-13a,b R = N.A. _ ((1/(i)*Rn*Rh*RB*(0.53+0.47*RL))A(1/2) , Eq. 6-10 Gf = N.A. = 0.925*(1+1.7*lz(bar)*(gq^2*Q"2+gr^2*R^2)A(1/2)Y(1+1.7*gv*lz(bar)) , Eq. 6-8 Use: G = 0.850 2 of 3 3/26/2012 11:32 AM STAND Milton Cubas PE, Inc., Mi ton Cuban Mar 26,2M Z 1131 AM Load Cam. W+Z IES VisjWAnaWb 9.00.0017 W iz STAND Midas Cubes PE, Ino., Mikan Cubes Mgt 26, 201 x 11.32 AM Road Cass: W2 IES VoialAna"Is 9.00.0017 4 TYPES OF ANGLE CLIP& TO CHOOSE FROND I. StAILE55 SWEL `WE16 CAGE ANGLE CLIPS 1 1i' WEE x 2' ME x4.50 AND 5.5" LONG 2. GALVANI7FD 0-29 I§,—QZ ANGLE CLrS 1 )1" WOE x 2' EASE x 4.5' AND 5.6' LONG 3. ALMNUM ANGLE CLS'' 7b' x 1%" WIDE x 2' BASE x 5' LONG 4. &IMIMM ANGLE'. CUP 46" x 3' WIDE x 3' BASE x 14' LONG • P1> AO 0 TENSION = 151 Ib Z• 0 �C�3 d J90 Miami Shores Village Building Department .AIR CONDITIONING REPLACEMENT DATA 10050 N.E.2nd Avenue Miami Shores, Florida 33136 Tel. (305) 795.2204 Fax. (305) 756.8972 PERMIT NUMBER: MC This fonTWst accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its ov n data sheet. Multiple units on single sheets are not acceptable. Job Address (when: the work is being done): 674 Grand Concourse City: Miami Shores Village County: Miami Dade Zip Code: 33138 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 ® NO[:] Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT RHEER MANUFACTURER RUUD R13HA21 J10 AHU or PKG. UNIT MODEL # UASL-048JEC RAK:A048JA2 COND. UNIT MODEL # RHPN-HM4824 10.0 KW HEAT 10.0 4.0 NOM TONS 4.0 AHU 50 CU 40 PKG 1 M.C.A AHU 50 CU 40 PKG AHU 60 CU 45 PKG 2 M.O.P AHU 60 CU 45 PKG AHU 230 CU 230PKG 3 VOLTS AHU 23000 230 PKG PKG UNIT / / PKG UNIT in EER/SEER 18 YES NO X REPLACING DUCTS YES NO x YES NO X REPLACING THERMOSTAT YES x NO YES NO X NEW 4'CONCRETE SLAB YES x NO YES NO X NEW ROOF STAND YES NO x YES NO X NEW RETURN PLENUM BOX YES NO x 1. Minimum Circuit Ampacity (Wire Size): is 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 AMPS 3. Voltage of Circuit (208/240/480): 208-230 4. Size Disconnecting Means: 60AMPS Contractor's Company Name: ALL YEAR COOLING Phone: 954-566-4644 State Certificate or Registration N. CAC0584 59 Certificate of Competency N. CMC - 537 Signature _ _ Date: 1/23/14 (Qualifier's signature only) This .combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. A ;� • AHRI Certified Reference Number: 3858343 Date: 12/11/2013 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: UASL-048JEC Indoor Unit Model Number: RHPN-HM4824+RCSN-H*4824 Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RUUD 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: * 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 responsibtiity for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of arty kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings RM valid only for models and configurations listed In the directory at www.ahridimetory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products ofAHRL This Certificate shall only be used for Indhrldual, 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.ahridirectory.org, Air -Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on and Refrigeration institute which the certificate was Issued, which Is listed above, and the Certificate No. which Is listed below ©2013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130312595906598952 9 Project Summa Job: Wri htsoft® 1 I"Y Date: Entire House BY: ALL YEAR COOLING AND HEATING 1345 NE 4TH AVE, FORT LAUDERDALE, FL33304 Phone: 954 566 4644 Fax 954 640 0200 Web: ALLYEARCOOLWGANDHEATING.COM For: MIRAMONTES ZONE 1 674 GRAND CONCOURSE, MIAMI SHORES, FL Notes: Design Fnformation M� Weather: Fort Lauderdale/Hollywood, FL, US Winter Design Conditions Summer Design Conditions Outside db 50 OF Outside db 90 OF Inside db 70 OF Inside db 75 OF Design TD 20 OF Design TD 15 OF Daily range L Relative humidity 50 % Moisture difference 61 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 54082 Btuh Structure 26085 Btuh Ducts 6749 Btuh Ducts 11849 Btuh Central vent (74 cfm) 1632 Btuh Central vent (74 cfm) 1224 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 62463 Btuh Use manufacturer's data n Rate/swing multiplier 0.95 Infiltration Equipment sensible load 37200 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 3112 Btuh Ducts 3315 Btuh Area Heating Cooling Central vent (74 cfm) 3101 Btuh (ft2 1716 1716 Equipment latent load 9528 Btuh Volume (W) 13728 13728 Air changes/hour 0.38 0.20 Equipment total load 46728 Btuh Equiv. AVF (cfm) 87 46 Req. total capacity at 0.70 SHR 4.4 ton Heating Equipment Summary Cooling Equipment Summary Make n/a Make Ruud Trade n/a Trade RUUD UASL SERIES Model n/a Cond UASL-048JEC AHRI ref non/a Coil RHPN-HM4824++RCSN-H*4824 AHRI ref no3858343 Efficiency n/a Efficiency 13.0 EER, 18 SEER Heating input 0 Btuh Sensible cooling 33950 Btuh Heating output 0 Btuh Latent cooling 14550 Btuh Temperature rise 0 OF Total cooling 48500 Btuh Actual air flow 0 cfm Actual air flow 1617 cfm Air flow factor 0 cfm/Btuh Air flow factor 0.043 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.80 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. WI°i111IMS01t 2014 -Jan -2318:37:06 9 Right -Suite® Universal 2012 12.0.07 RSU12433 Page 1 C:\Users\iphillips\Documents\Wrightsoft HVAC\tom smith.rup Calc = MJ8 Front Door faces: W ATTACHMENT OF - AC TO CONCRETE PAD EXAMPLE OF TYPICAL A/C UNIT LESS THAN 36V X x 36L INSTALL 4 CUPS PER UNIT, EXAMPLE OF LOCATIONS: TWO CUPS AT BOTH SHORT SIDES, ONE CUP AT EACH CORNER, ONE CUP EACH SIDE cc F' 1. UNITS LESS THAN 36" W x 36: L USE 4 ANGLE CUPS. SEE BELOW (ONE EACH CORNER, ONE EACH SIDE, OR TWO EACH AT SHORT SIDES) WITH (2) STAINLESS STEEL OR ZINC PLATED #12 TEK SCREWS INTO UNIT. AND (1) Y4 x 1% TAPCON CONCRETE SCREW INTO CONCRETE PAD. 2. UNITS OVER 36" LONG IN ANY DIRECTION, USE. TWO (2) ADDITIONAL CUPS ALONG BOTH LONG SIDES. TYPICAL CONCRETE PAD OR DECK 4 TYPES OF ANGLE CLIPS TO CHOOSE FROM s 1. STAINLESS STEEL 16 GAGE ANGLE CUPS U¢" WIDE x 2" BASE x4.5" AND 5.5" LONG 2. GALVANIZED 6-90 16 GAGE ANGLE CUPS W WIDE x 2" BASE x 4,5" AND 5.5" LONG 3. ALUMINUM ANGLE CUP W x IW WADE X 2" BASE x 5" LONG 4. ALUMINUM ANGLE CUP 3/8" x 3" WIDE x 3" BASE X 1.5" LONG CUP SPECIFICATIONS ARE ENGINEERED IN ACCORDANCE WITH THE CURRENT FBC VERSION 2010. IN ACCORDANCE WITH ASCE 7 2010 WIND LOAD AND FOUND IN SECTION 301.12 OF THE MECHANICAL CODE AND SECTION 1620 OF THE BUILDING CODE MILTON CUBAS, P. E., INC. CONSULTING ENGINEERS P.E. # 51902' CA. # 27267 S.I. # 6999901 1302 NE 125 ST NORTH MIAMI, FLORIDA 33161 PHONE: (305) 891-4174 FAX (305) 891-4175 www.miltoncubaspe.com E MAIL: miltoncubas@msn.com ol'� 1/4 "ASCE705W.xis" Program Version 1.0 WIND LOADING ANALYSIS - Chimneys, Stacks, and Vertical Tanks Per ASCE 7-10 Code -for Cantilevered Structures Classified as Other Structures Job Name: JALUMINUM STAND Subject: Job Number. I Originator Checker Input Date: p V = 176 mph end Map, Figure 6-1) ia Class. = 11 (Occupancy Category form Table 1-1) Exposure= C (Exposure Category from Sect. 6.5.6) yyind y Kzt = , 1.00 (Topographic Factor from Sect. 6.5.7) h = 3.00 ft. (Height of Stack/Tank itself) Hb = 6.00 ft. (Ht. of Stack/Tank Base Above Ground) D = 3.00 ft. (Diameter or Width of Surface Normal to Wind) Shape? Square (Round, Hexagonal, or Square) Gr nd jj R = 0.010 (Damping Ratio = 0.010-0.070) Elevation Ct = 0.0412 (Period Coefficient = 0.020-0.035 Kd = 0.90 (Direct Factor, Table 6-4) Wind Load Tabulation for Stack / Tank Cf=1 1.300 ](Force Coef. from Fig. 6-21) z Kz qz p=qz•G• F=geG'Cf D ft s Ib/ft 6.00 0.85 60.58 66.95 200.84 Resulting Parameters and Coefficients: 9.00 0.85 '60.58 66.95 200.84 If z < 15 then: Kz = 2.01 *(15/zg)(2/a) If z >= 15 then: Kz = 2.01•(z/zg)"(2/a) a = 9.50 (Table 6-2) zg = 900 (Table 6-2) I=. 1.00 (Table 6-1) (Import. Factor) h/D = 1.000 freq., f = 10.648 Hz. (f >=1) Rigid G =1 0.850 (Gust Factor, Sect. 6.5.8) Velocity Pressure (Sect. 6.5.10, Eq. 6-15): qz = 0.00256'Kz•KzrKd"V^2•I Net Design Wind Pressures (Sect. 6.5.13): p = gz•G•Cf (psf) Net Design Wind Forces (Sect. 6.5.15, Eq. 6-28): F = gz•G•Cf*D (Ib/R) Resultina Total Base Shear & Moment: EV(total) = 0.60kis 1 . P IM(total) = _4.52 ft kips U P. / 1 of 3 3/26/2012 11:32 AM 2/4 "ASCE705W.xls" Program Version 1.0 Determination of Gust Effect Factor, G: Flexible?l No f >=1 Hz. 1: Simplified Method for Rigid Structure G = 0.85 Item #2 and Item #3 Calculations (from Table 6-2): e = 0.105 b" _ 1.00. __ a(bar) = _ 0.154 b(bar) _ 0.65 C = 0.20 l = 500. _.. E(bar) _ 0.200 z(min) = _ 15 Calculated Parameters Used in Both Rigid and/or Flexible Structure Calculations: z(bar) = 15.00 = 0.6*h , but not < z(min) , ft. Iz(bar) = 0.228 = c*(33/z(bar))A(1/6) , Eq. 6-5 Lz(bar) = 427.06 =1*(z(barN33)'`(e(bar)) , Eq. 6-7 gq = 3.4 (3.4, per Sect. 6.5.8.1) gv = 3.4 (3.4, per Sect. 6.5.8.1) gr = 4.720 = (2*(LN(3600*0))"(1/2)+0.577/(2*LN(3600*0)"(1/2) , Eq. 6-9 0=1 0.976** = (1/(1+0.63*((B+h)/Lz(ber))^0.63))^(1/2) , Eq. 6-6 2: Calculation of G for Ri idStructure G=1 0.914 = 0.925*((1+1.7*gq*lz(bar)*Q)/(1+1.7*gv*lz(bar))) , Eq. 6-4 3: Calculation of Gf for Flexible Structure 0 = 0.010 Damping Ratio Ct = 0.041 Period Coefficient T = 0.094 = Ct*h"(3/4) , sec. (Approximate fundamental period) f = 10.648 = 1R , Hz. (Natural Frequency) V(fps) = N.A. = V(mph)*(88/60) , ft.lsec. V(bar,zbar) = N.A. = b(bar)-(z(bar)/33)A(a(bar))"V"(tt8/bU) , tt.Jsec. , Eq. 6-14 N1 = N.A. = f Lz(bary(V(bar,zbar)) , Eq. 6-12 Rn = N.A. = 7.47*N1/(1+10.3'N1)^(5/3) , Eq. 6-11 rih = +'N.A. = 4.6*1*h/(V(bar,zbar)) Rh = N.A. _ (1/rlh}1J(2"rlh^1)'(1-a^(-1'nh)) for rih > 0, or = 1 for rih = U , tq. 5-13a,b rib = N.A. = 4.6*f`D/(V(bar,zbar)) RB = N.A. = (1/rlb)-1/(2*rib^2)*(1-SA (-2'rlb)) for r)b > 0, or = 1 for rIb = 0. Eq. 6-13a,b rld = N.A = 15.4*f'D/(V(bar,zbar)) RL = N.A. =(1/rldY1/(2*rld^2)*(1-e^(-2*rld)) for rld > 0, or = 1 for rrd = 0, Eq. 6-13a,b R= N.A. = ((1/(3)*Rn*Rh*RB*(0.53+0.47*RL))^(1/2) , Eq. 6-10 G = N_.A. = 0.925'(1+1.7*lz(bar)*(gq^2*Q"2+gr"2*R^2)A(1/2)Y(1+1.7*gv*lz(bar)) , Eq. 6-8 Use: G = 0.850- 2 of 3 3/26/2012 11:32 AM STAND Won Cubes PE. lac., Won Cubes Mat 26. ZDI Z 11:31 AM Lead Cess: W+Z IES MsuelAnalysW 9.00.0017 STAND MMM CUbas PE, kw., MRan Cubw Mar 26.201211:32 AM ReM Can. WZ IES NisualAna"b 9.00.0017 4 TYPES OF ANGLE CLIPS TO CHOOSE FROM 1, STlx1E55,SfFE1 16 GAGE ANGLE a1PS 1 )r WOE x r SASE x4.5' AND 5.5" LONG 2. CiALVAN17 6-90 1Q. -M ANGLE'CLFS 1 j§` WIDE x 2' SAM x 4.5" AND 5.5` LONG 3. BEd ANGLE CLIP X* x 1%' WIN x 2' BASE x B' LONG i 4. ALLUM ANGLE CUP ai° x 3' WVE x 3' SASE x 14' LONG CP TENSION =151 ib 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: (303) 762.4949 BUILDING PERMIT APPLICATION FSC 20 10 Permit Type: MECHANICAL OWNER: Name (Fee Simple Tideho)der): /o Permit No.n Cl3 Master Permit No.-,ZZ/.S �� City: State: gip;/ TenanA,essee Name: Phone# Email• JOB ADDRESS: (/ 9/del �,d l✓,e1 �s c� City: Miami Shores County: Miami Dade Zip: 331352 Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Address: � -<'L4/ City:_ � 164f Qualifier Name: ��. Zip: 39/73 State Certification or Registration #: Certificate of Competency #: Contact Phonek Email Address: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ d'/, ®<9�. ®� Square/Linear Footage of Work: Type of Work: OAddress AAlteration ONew ORepair/Replace ODemolition Description of Work: Q h Submittal Fee $ Permit Fee $ '300 CCF $ ' CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $, Notary $ Training/Education Fee $ Technology Fee $ Doable Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 i bject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first ins ectio which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n t e proved and a reinspection fee will be charged Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this - The foregoing instrument was acknowledged before me this day of �U�, 20 3 by BRZ&CA M 1104f°n�-ri'4cSl)\."� . 20V 3 byl f Q who is personally known tome or who has produced 12�� who is personally known tome or who has produced 2 1 `J As identification and who di4QMlito�h��i/ NOTARY PUBLIC: - �,:'.d; Sign: y � " Print: My Commission Expires: 4' •••....•• "/�0/8111111%%0\ 0� APPROVED BY (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 331ans Examiner as identification and who did take an oath. NOTARY PUBLICA CM Sign: Print: �A My Commission Expires � _W o ? * 0 ; a - Zoning Structural Review Clerk FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 THIS IS NOT A BILL - DO NOT PAY 614339-0 RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 640672-2 MECHANICAL AIR MASTERS STATE* CAC1815267 6947 SW 115 PL G 33173 UNIN DADE COUNTY OWNER AIR MASTERS LLC See. Type of Business HIS Is N96A SPEC MECHANICAL IUSINESS TAX RECFJPT. IT ICES NOT PERAUT THE ICLOER TO VIOLATE ANY DUSTING REGULATORY OR .ONING LAWS OF THE ICUNTY OR CITIES. NOR ICES IT EXEMPT THE (OLDER FROM ANY OTHER 'ERMR OR LICENSE IEQUIRFD BY LAW. THIS IS IOT A CERTIFICATION OF HE HOLDER'S GUALIFICA- tONS. -AYMENT RECEIVED HAW DADE COUNTY TAX ICLLECTOR: 08/22/2012 02220002001 000075.00 SEE OTHER SIDE 'AC# 6239990 WORKER/S CONTRACTOR 1 DO NOT FORWARD MECHANICAL AIR MASTERS CARLOS HERNANDEZ 6947 SW 115 PL G MIAMI FL 33173 �till}}Ililtfll�itl�l.fl�}if}���itfilffl�t�F�lilltil�ilYlYiffi� STATE. OF .FLORIDA DEPARTMENT OF BUSINESS. PROFESSIONAL REGULATIONCONSTRUCTIpN INDUS RY LICENSING $OARD LICESEQ# L12080101838 NSE NBR ,> DA'MooAmDlYYM Ae'R CERTIFICATE OF LIABILITY INSURANCE 6/27/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF 114FORMAWN ONLY AND CONFERS NO MGM UPON THE CERTIFICATE HOLDER THS CER`FICATE DOES NOT AFFiR]IIATI14MY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF BOURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(St AUiHORURD REPRESENTATIVE OR PRODUCER, AND THE CERTFiCATE HOLDER. IMPORTANT: If the holes is an ADDITIONAL INSURED, the po®cy(tes) must he enftm h. N SUBROGATION IB WAIVED, sutf ed to the tM= and coyMone of the poky, cwtft poncles may reg0q an enclicasomeft A dowwo on this cerhlkata does not confer rights to the corbiledo hoWer in Qeo of such � PRODUCER NAME: A&D ALL -LINES INS ASSOC INC Aw (305) 463-6781 , (305) 387-29: 56Q0 SW 135 Ave Ste 106 vw . samador8bellsouth.net Miami, FL 33183 WACO eA-QT R POINT IldSURANCE CO. INSURED AIR MASTERS, LLC. INSURER B: D/B/A NECHANICAL AIR MASTERS. INSURER C: 6947 SW 115 PLACE INSURER D: SUITE G. INSURER E: MIAMI FL 33173 INSURER F THIS IS -TO CERTIFY THAT THE POLIES OF INSURANCE LISTiED BELOW HAVE BEEN IS.SUMTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUNT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DANT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13E ISSUED OR MAY PERTAIN, THE. INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMSSUM. LTR T1/PE OF INSURANCE THE EXP RAMM DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 HE 2ND AVENUE POLICY NUMBER A—Am LIMITS GENERAL LLABILRY COMMERCIAL GENERAL LIABILITY ClANS­MADE ❑ OCCUR EACH OCCURRENCE S (Es 2MRO as $ MED IMP ate pwson) $ PERSONAL&ADVONJURY S GENERAL. AGGREGATE $ G8ft AGGREGATE LIMIT APPLIES PER: POLICY M PRO Lo PRODUCTS - COMPIOP AGG S AUTOMOBILE LIABILITY ANYAUTO ALL OWNED ASCHEDtILED UT WNED PORED AUTOS AUS COMMIONMEMurr$ LEa awkM ri SODO.Y BNJIJRY (Per pef8" S BODILY NAM owamt} S S 8 UMBRELLAEACH EXCESS IJAB CLAIBSMADE OCCURRENCE $ AGGREGATE S Dw I REnwno $ S Amy WO RKERS COMPENSATION AND EMPLOYERS LIAR RY PRopmurcwpARrmavmcEmmvE "Q L Na OF NS bebw WA 13-0131 osllo/18 os/lo/1e1 g TO E.L. EACH ACCIDENT $ 100 000 E L_ DISEASE . EA EMPLOYE t 100 000 F -L DISEASE _ POLiCY Lwy S 500,000 DESCRIPTION OF OPERATION I LOCATIONS! VEHICLES (AiLaM ACORD 101. AdManed Remaft SdMLe; LV mate lF'l-IsrQqLdFvQ AIR CONDITIONING INSTA T-aTIONS, SERVICE, AND REPAIRS. CITY OF MJ:AI>11I SHORES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPAR2MENT THE EXP RAMM DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 HE 2ND AVENUE ACCORDANCE WIM THE POLICY PROVISIONS. MIAMI SHORES, FL 33138 AUTHOFA" REPRESENTATIVE "..-- ACORD25(2010/05) The ACORD name artd logo are registored marts of ACORD DA> CERTIFICATE LIABILITY I CANCELLATION - 7 /13 PRODUCER Accurate _ _ THIS CERTIFICATE IIS ISSUED ASA MATTER OF INFQRRIIATION 8300 West FWqler Suite 114 i ONLY AND CONFERS NO RIGHTS UPON THE CERTFICATE 30 DAYS WRITTEN NOTICE HOLDER NAMED TO HOLDER. THIS CERTMATE DOES NOT ALIEND, EXTEND OR Waml, FL 33144 ALTER THS COVERAGE AFFORDED BY THE POLICIES EL W. Phone (305}228.8727 Fax 05}22641787 ! WSURERS AFFORDING COVERAGE NAIL # AUTHORI$D REPRESETATIVE INSURERa:_ Accident Insurance Company INSURED Air Maters LLC D/B/A INSURER B: Ascendant Insure erce Company Me Ienical Air Masters - ...—. —__ 6547 SMV 115 Plane Apt G wsut y INSURER D: Miami, FL 33173 - INSURER E COVERAGES INSURER F. _ THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIM 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADM: TYPE OF INSURANCE IPOLCY EFFECTWE'._POL Y EXPIRATION QATE.(MMDNV DATE @q!RpM ---- .— —LIMITS — — GENERAL LIABILITY EACH OCCURRENCE 1_,000,000 ® COMMERCIAL GENERAL LIABILITY CPP0001043-00 03R)9/13 03/08/14 PREMISEAMAGE S@ t 100,000 ❑ ❑ CLAW MADE ® OCCUR MED EXP (Any one peraw) 5,flQQ °� ® ❑ PERSONAL & ADV INJURY _ ^ 1,000,000; ❑ ,GENERAL AGGREGATE 2,000,000 i GEN'L AGGREGATE LIMIT APPLIES PER: _— PRODUCTS _COMPfOP AGG 2,000,000' ® POLICY ❑ PROJECT ❑ LOG r AUTOMOBOE LIABILITY - r-- 1—M81NED SWI $ L. AIT— ❑ ANY AUTO SEa as den )• ❑ ALL OWNED AUTOS (ELY INJURY ❑ ' ❑ SCHEDULED AUTOS Pex pe�n� ❑ HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS � (Pereccbmnt) PROPERTY DAMAGE i •. GARAGE LL49WTY AUTO ONLY - EA ACCIDENT j ❑ I ❑ ANY AUTO OTHER THAN EA ACC _ AUTO ONLY- i EXCESSIUIIIBRELLA ABILITY EACH OCCURRENCE I ❑ OCCUR ❑ CLAIMS MADE ( AGGREGATE ❑ DEDUCTIBLE — -- - - - ❑ RETENTION $ `WORKERS COMPENSATION AND EMPLOVEFUrLIABILnY `.WC -328173 11/26/12 11126/13 ! � ��-- B ANY PROPRIETOR / PARTNER t EXECUTIVE I E.L. EACH ACCIDENT 500,000: OFFICER/ MEMBER EXCLUDED? ;-- •-----.. __--- ._ —_. E.L. DISEASE - EA EMPLOYEE 500,00 gym � I— _ : SPECUIL PROVIS�M1IS belorw _ .. _ EJ_ DISEASE POLICY LIMIT 5001000 1 OTHER I, DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i EXPIRATION DATE THEREOF, THE MNG ENDEAVOR TO AVAIL City Of Miami Shores 30 DAYS WRITTEN NOTICE HOLDER NAMED TO 10050 Northeast 2nd Avenue THE LEFT, BUT FAILURE T� DO N, OBLIGATION OR LIABILITY Miami Shores. Florida 33138 OF ANY KIND UPON THE, I11 - -- - TATIVES. AUTHORI$D REPRESETATIVE 305-756.857_2 Luda Estrella _ ACORD 25 (2I IDS) OF __ ® RD CORPORATION 1888 _ Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION JEITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT 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 WORKERS 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 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: 'l ��%`i��►,'r_�a / sA &4s BUSINESS ADDRESS: ��% .Sri /'/� _CITY /11-. ' ,' STATE erg ZIP CODE 332 7 3 BUSINESS PHONE: ( j 9717 ° 9K�y FAX NUMBER ( ) CELL PHONE (_—) QUALIFIER'S NAME: 4:�14 4-440 a!L QUALIFIER'S LIC NUMBER: E-MAIL ADDRESS (IF APPLICABLE): Created on 3119109 BY MLDV 1 RV 3126109 MLDV 1 RV 6127111 AS we UNITED STATES POSTAL SERVICE 8 First -Class Mail Postage & Fees Paid r USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • k1324599rllti,Ili,���tt�lit�;,tllttlltttlll,�Itt►ltttltltltltll}tI� ■ Complet0tems 1, 2, and 3. Also complete item.4 if Restricted Delivery is desired. IN Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailplece, or on the front if space permits. 1. Article Addressed to: ooswins A;�$If t�u ;•: ❑ Agent X ❑ Addressee B c v by (Printed Name) C. Date of Delivery ` D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No Nl_ .3 3. Service Type -11 ��,•(/�1�'N�/�� E3 Certified Mall C3 Express Mail � ' E3 Registered ❑ Return Recelpt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7013 3O20 DDDO 5285 9616 _ (transfer from senrlce labeq PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540 071