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MC-15-2Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225923 Permit Number: MC -1-15-2 Scheduled Inspection Date: January 12, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: BEEHNER, ZACHARY Work Classification: A/C Replacement Job Address: 57 NE 93 Street Miami Shores, FL 33138 - Project: <NONE> Phone Number Parcel Number 1132060130400 Contractor: CAPITAL AIR INC Phone: 9541792-4942 sundmg uepartment comments A/C REPLACEMENT Infractio Passed Comments INSPECTOR COMMENTS False <� i � i)11'' `S January 09, 2015 For Inspections please call: (305)7624949 Page 8 of 26 Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. January 09, 2015 For Inspections please call: (305)7624949 Page 8 of 26 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tet: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING &,MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: S2 N16 43 j JAN A 5 2015 !. FBC 20 o Master Permit No -M - 1 2• - Sub Permit No. ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS the Building Historically Designated: Yes NO Occupancy Type: Load:_ Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Add s City: MI -11- State: L_ Zip: 300 P Tenani/Lessee Neme: Al f Phone#: � �1 Email. "1 c. ')'1 � ( � � CI )79_1N01'_. CONTRACTOR: Company Name:A Phone#: Address: I. I '_S1 IA 5 City: d -t; �Vt�ti ��{-``� State: �`t..- Zip: Qualifier Name: j Vi lg O� t l (t Phone#: State Certification or Registration #: P l.' i 5 ] 1-L j�4 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ e��' Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: _ Ale- 1%21 11>jM_m, ± Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $l� t Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 abse ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. J, Signature Signatur OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of JY-Le4-)Le 20 I q by (9161" Yt 'tf 'P iiiP 1- who is personally known to Me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:, Print: {*�t.�C Cib AJ1e-n, AAo 7tk,-,, i1- Seal: u* NATLIE ALIMONDE�R MY COMMISSION # EE 846275 EXPIRES: November 17, 2016 Bonded Thru Notary Public Undemb's The foregoing instrument was acknowledged before me this 36 t'+�t 41 0d��t� ay of %�'L —I 20 � by JP ec .t. k4-0 whoersonally kn as me or who has produced identification and who did take an oath. NOTARY Print: Seal APPROVED BY A Plans Examiner Structural Review (RevisedO2/24/2014) CONSUELO Rl ZZI.HARPER MY COMMISSION #FF070613 ,11,oF f oq./ EXPIRES December 8. 2017 as Zoning Clerk ' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 3 CAC058746 The CLASS B AIR CONDITIONING CONTRACTOR?- -` Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 CALLAHAN, PETER MICHAEL CAPITAL AIR INC 17111 SW 64TH..COURT FT LAUDERDALE" {Ft"33331 n ISSUED: 07/21/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1407210000668 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 DBA:3-1722 Receipt AIR INC ReCelpt#:HEAT NG/AIRCONDITION CONTRACTR Business Name: Business Type: (A/C LTD 15 TONS CONTR) Owner Name: PETER M CALLAHAN Business Opened: 05/13/1985 Business Location: 2951 SIMMS STREET State/County/Cert/Reg:CAC 058746 FT LAUDERDALE Exemption Code: Business Phone: 954-792-4942 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.000.00 0.00 0.00 0.00 29.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS CITY OF HOLLYWOOD LOCAL BUSINESS TAX RECEIPT PRINT DATE: 9/15/14 THIS IS YOUR LOCAL BUSINESS TAX RECEIPT. PLEASE DETACH AND POST IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. 'PLEASE DO NOT REMIT ANY PAYMENT. THIS IS NOT ABI Business'Name' CAPITAL AIR, INC. Business Locafiont 2951 SIMMS ST A Business Class: CONTRACTOR/AIR CONDITIONER Tax Basis: 5 - 25 WORKERS Receipt Number: 15 00050579 Receipt Year: 10/01/14 Expiration 'Date: 09/30/15 NEW CHARGES• (Itemized Below) Base Fee Additional Charges: 316.00 comments• 316.00 CAPIT10 OP ID: XR '°,<:'C> RrJ' CERTIFICATE OF LIABILITY INSURANCE DATE 12/15/20/15/20 4 14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES `FLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED .EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:305-364-7800 NAMTACT E: BROWN & BROWN OF FLORIDA INCF3057144401 14900 NW 79th Court Suite#200 Fax: - - Miami Lakes, FL 33016-5869 Marc D. Jacobson PHONE FAX Alc No Ext): VC No): E-MAIL nDDREss: 09/16/2014 09/16/2015 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Commerce and Industry Ins Co 19410 MED EXP (Any one person) $ 5,00 INSURED Capital Air, Inc. INSURERB:Amerisure Insurance Company 19488 dba Capital Air Conditioning Callahan Properly INSURER C: Amerisure Mutual Insurance Co 23396 INSURER D: Acquisitions, Inc. 2951-2953 Simms Street Hollywood, FL 33020 INSURER E AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOSAUTOS NON OWNED X HIRED AUTOS X AUTOS INSURER F: CAVFRAGFS CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILICYEXP LTR TYPE OF INSURANCE ADD UB POLICY NUMBER EFF MM DD/YYYY MLICY M DD/YYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X GL206442005 09/16/2014 09/16/2015 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOSAUTOS NON OWNED X HIRED AUTOS X AUTOS CA206442105 09/16/2014 09/16/2015 COMBINED SINGLE LIMIT 1,000,000 Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Peraccidenf A X UMBRELLA LIAB X EXCESS LIAB OCCUR CLAIMS -MADE BE032469107 09/16/2014 09/16/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,00 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F—] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A C208028703 01/01/2015 01/01/2016 X WC STATU- OTH- TORYLI IT ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) A/C Contractor. regards to General Liability when required by written contact. Miami Shores Village 10050 NE 2 Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED �REPRESENTATIVE —'1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD JAN 5 f2015 �> t 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 m c pan LL 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): 7 N, C .13 S- -- City: Miami Shores Village County: Miami Dade Zip Code: 3_; 1 3 g 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 ❑ 1. Minimum Circuit Ampacity (Wire Size): + 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 4/40 � 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: 40 ® + O Contractor's Company Name: C,RP%TiA1' (- A- I a Phone: State Certificate or Registration N. CA COS -77 0 Certificate of Competency N. Signature Date: alifier's at � UNIT BEING REPLACED DATA NEW UNIT AA, MANUFACTURER G A 2P_1 0-Z I U F 4 AHU or PKG. UNIT MODEL # f V 4 C N 8 66 0 A O COND. UNIT MODEL Zy Be (o &0 Q KW HEAT / 0 $ NOM TONS AHU,Yq CUZ $ PKG 1) M.C.A AHU L19CUTy PKG AHU CU 5'0 PKG 2 M.O.P AHU 6o CU J40 PKG AHUz3o CU z3oPKG 3 VOLTS AHU? oCUZ oPKG PKG UNIT I I PKG UNIT ( I 12 EER/SEER j YES NO REPLACING DUCTS YES 0 YES NO REPLACING THERMOSTAT ES N YES NO NEW 4"CONCRETE SLAB YES >N YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 0 1. Minimum Circuit Ampacity (Wire Size): + 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 4/40 � 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: 40 ® + O Contractor's Company Name: C,RP%TiA1' (- A- I a Phone: State Certificate or Registration N. CA COS -77 0 Certificate of Competency N. Signature Date: alifier's at � This combination qualifies for a Federal Eneri Efficiency Tax Credit when placed in servi4 between Feb 17, 2009 and Dec 31, 201 Certificate of Product Ratings AHRI Certified Reference Number: 3631815 Date: 1/9/2014 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 24ABC660A**30 Indoor Unit Model Number. FV4CNB006 Manufacturer: CARRIER AIR CONDITIONING TradeiBrand name: CARRIER AIR CONDITIONING Series name: Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING 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): 55000* EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): - Ratings followed by an asterisk 0 IntfiCaie a voluntary relate of WeViously published dam, unless accompanied with a WAS, which indicates an irnWuntary rerate. DISCLAIMER AHRI does not endorse the product(s) fisted on this Cerdficals and makes no repmentadons, warranties or guarantees as to, and assumes no responsibility for the product(s) listed on this Certificate. AHRI expreedy dim all labaRyw for damages of any kind arising out of the use or performance of the product(s), or the unaudwrixed alteration of data listed on this Cer6fiwmte. Certified ratings are valid only for models and configurations fisted in to directory at www ahridirectory org. TERMS AND CONDITIONS This Certificate and its contents are propnetasy products otAHRL Tin Certificate shall only be used for indhddual, personal and confidenbal reference purposes. The contents of this Certificate may not In whole or in part, be reproduced; copied; disserninaled; entered into a computer database, or otherwise utilized, in any fate or m mw or by any meanes oweptforthe user's individual, personal and confidential reference_ CERTIFICATE VERIFICATION The information for the model cited on this cefdrKwde can be verified at wwwahridirectoryorg, Air -Conditioning, Heating,, dick on `Verity certificate" Cshlc and enter AHRI Cchrtfied Reference Number and the date on /� ILI and Refrigeration Institute vA*: h the cerdficate was assured, which is Cued above, and the CdYttiicate No., which is slated below. 02013 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130337699409444880 ii �iN1111�1 .�� Mi Mb MOL 15A4%PFK WASD /OIOM ® ar rlt ar r�ul. sa uaesl�r�t MWMOf AOYAOW MFMSDlK GTO I1�AIf � �u�cn�t� N� t11�.' 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