MC-14-2192r
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-221087 Permit Number: MC -10-14-2192
Scheduled Inspection Date: March 04, 2015 Permit Type: Mechanical - Residential
Inspector: Perez, JanPierre
Owner: HUTCHINSON, JEANNE
Job Address: 150 NE 94 Street
Miami Shores, FL
Project: <NONE>
Inspection Type. Final
Work Classification: A/C Replacement
Phone Number
Parcel Number 1132060132970
Contractor: C&R AIR CONDITIONING CO Phone: 305-685-6394
Building Department Comments
REPLACEMENT OF 3 TON SPLIT UNIT Infractio Passed Comments
INSPECTOR COMMENTS False
3
March 03, 2015 For Inspections please call: (305)762-4949 Page 6 of 38
Inspector Comments
Passed 691
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 03, 2015 For Inspections please call: (305)762-4949 Page 6 of 38
L
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ZMECHANICAL [:]PUBLICWORKS
JOB ADDRESS: I �-o /V t 9 4 4T
OCT 0 7 2014
FBC 20 c-�
Master Permit No.rn C, ��4 — 2-191
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �&� �r
Phone#: ®� ° 71 "
Address:: ( So 1j
tlL
c 1 o T �-7
City: 1-f I i Q m t '� k ®t` e State: Zip: ®S�
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name: C 't „ A c r C o n j Co. Phone#: 130TW 6 2 9 4
Address: 6 ®? I (7 '(T
City: M IAS State: �, Zip: �j3®(If"'
Qualifier Name: - 66 -e rt C `'► o q J Phone#:
State Certification or Registration #: C Ac o 6 w q Certificate of Competency #: ® 4 18 ® ).
DESIGNER: Architect/Engineer:
Value of Work for this Permit:
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
Specify color of color thru tile:
—State: Zip:
Square/LinearFoo ge of Work:
El New Repair/Replace
Submittal Fee $ Permit Fee [A CAI
Scanning Fee $ 61 ( Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ 0
(Revised02/24/2014)
❑ Demolition
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ k2-9 '30
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 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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
lw�t
Signat a Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day off ®CiA t r 20 1 q , by
leQ v% r "e H CAC -h ttiW who is ersonally know o
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
The foregoing instrument was acknowledged before me this
day of S e Je Ir►, b t r . 20 I L4 , by
Poberi T C � rqi T who is personally nown to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print: e®bertk C� 11.4 _ Print:
ROBERT J. CHR' =*' Commission # EE 091937
Seal: CanrtdssIM# ��
0 7 Seal: May 9M
�- Exom May 24, 2018 • „ B TIa�T,wy �g g0Q3BS7018
Qandtl7hVT?rFeleftUW B T010
�k�k**�k�k*�k�k�k*�k�k�k**8e�k�U�k�k�k�k�kN��k�kffi�kM�kffi�k�N&�k/44, 4+�Rl�k�k�k�k�kM�k�k+k+kN��k�N�k�k�k�k�k�k�k&�k�k�kakak�k�k�F�Fi�k**�k4��k�k�k�k�k�k�k*�k�k�k�k+k�kile�k�k�k�k�k�k�le*Me�k�k�k�k�k�N�k
APPROVED BY �® ` Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax:(305) 756.8972
AIR CONDITIONING REPLACEMENT DATA
PERMIT NUMBER: MC
This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must
be on its own data sheet. Multiple units on single sheets are not acceptable.
Job Address (where the work is being done): S ® C IT
City: Miami Shores Village County: Miami Dade Zip Code: 3 j
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
AHRI DATA SHEET REQUIRED
Change disconnecting means: YES ❑ NO 1+ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse/Breaker Size):
3. Voltage of Circuit (208/240/480):
4. Size Disconnecting Means:
J
4�_
Contractor's Company Name: C_-` R A i r CO nj Co • Phone: a 016 &,-6 � qG1
State Certificat r e i tratio No. CA 09-6 ' W f Certificate of Competency No. 4 Z&6 A-3
Signature Date:
(Revised02/24/2014)
UNIT BEING REPLACED
DATA
NEW UNIT
MANUFACTURER
AHU or PKG. UNIT MODEL #
FA L4 UO Aj F 0 3 7
COND. UNIT MODEL#
f I& ONA6.36
KW HEAT
-7, S
NOM TONS
AHU
CU
PKG
1) M.C.A
AHU CU 18.1 PKG
AHU
CU
PKG
2) M.O.P
AHU CU 30 PKG
AHU
CU
PKG
3) VOLTS
AHU;j CU 2 KG
PKG UNIT /
/
PKG UNIT
EER/SEER
YES
NO
REPLACING DUCTS
YES 0
YES
NO
REPLACING THERMOSTAT
E NO
YES
NO
NEW 4"CONCRETE SLAB
ES NO
YES
NO
NEW ROOF STAND
YES N
YES
NO
NEW RETURN PLENUM BOX
YES 60
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse/Breaker Size):
3. Voltage of Circuit (208/240/480):
4. Size Disconnecting Means:
J
4�_
Contractor's Company Name: C_-` R A i r CO nj Co • Phone: a 016 &,-6 � qG1
State Certificat r e i tratio No. CA 09-6 ' W f Certificate of Competency No. 4 Z&6 A-3
Signature Date:
(Revised02/24/2014)
C&R C&R Air Conditioning Co. C&R
6073 NW 167th Street Suite C4 Miami Gardens, FL 33015-4330 < >
DADE: 305-685-6394 RROWARD: 954-680-4494
CUSTOMER
PHONE
NUMBERS
DATE
Hutchinson Residence
HOME
- -
3057570587
9/25/14
ADDRESS
150 NE 94 Street
❑UNDER CONSTRUCTION
CITY Miami Shores 33138 ZIP
Email:
® EXISTING STRUCTURE
We hereby propose to: Furnish, install and service
the equipment and materials listed below with the conditions and specifications detailed below during our
regular working hours of Monday through Friday 8:30 — 4:30.
NEW EQUIPMENT system #I s 4280.00
FPL Rebate (instant)
- 585.00
Your Investment
3695.00
Manufacturer
BRYANT
Condensing Unit Model #
116BNA036
Air Handler Model #
FX4DNF037
Refrigerant
R410
Heating KW
71/2
Btuh
34200
S.E.E.R.
16.0
Warranties 'SIF REGISTERED Parts 10 Yr. Compressor 10 Yr.
1 Year Labor
❑ Condensing Unit Stand ® Air Handler Stand ® Float Switch
❑ Ref. Line cover ❑ Condensate Line
® Concrete Slab ® Thermostat
D ® Auxiliary Drain Pan
❑ UV Light ❑ Fire Dampers
❑ Package Unit Change -out
® Existing Reconnection
® Existing Reconnection
® Reconnect to Existing System
❑ New Electric
❑ Ref. lines
❑
❑
❑
A qualified air conditioning expert will start and test the system and explain its operation. This proposal is good for a two week period from date of proposal and at
that time is subject to review. Title to the system shalt remain in us until all sums due us have been fully paid. In the event the purchaser fails to comply with any
of the requirements of this contract and such default results in litigation, the Purchaser agrees to pay reasonable attorney's fees and all court costs and expenses
incident to such litigation. Delinquent payments shall bear 1.5% per month interest from due date until paid. All work is to be performed during our regular work
hours unless otherwise specified. This contract contains all agreements. Neither party shall be bound by any representation, warranties nor agreements, oral nor
written not herein contained. This proposal shall become a contract when accepted by you and approved in writing by our duly authorized corporate officer.
We agree to furnish and install the above described labor and materials on the terms indicated below for System #
TOTAL
INVESTMENT $ 4280.00 50% DEPOSIT $ 1850.00
FPL/DEALER FPL Account #
REBATE $ - 585.00 50% DUE WHEN
YOUR READY TO OPERATE $ 1845.00
INVESTMENT $ 3695.00
PEFEE NOT CL E
PURCHASER DATE / REPRESENTATIVE
VALM FOR 2 WEEKS
JOB NOTES
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: 6945495 Date: 9/25/2014
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number:116SNA036****A
Indoor Unit Model Number: FX4DN(B,F)037L
Manufacturer: BRYANT HEATING AND COOLING SYSTEMS
Trade/Brand name: BRYANT HEATING AND COOLING SYSTEMS
Series name: LEGACY LINE PURON AC
Manufacturer responsible for the rating of this system combination is BRYANT HEATING AND COOLING
SYSTEMS
and Air -Source
cadent. third
* Raftro followed by an asterisk (*) indicate a voluntary rerate of previously published data, unless acx ompanled writ a WAS, which indicates an involuntary rerste.
DISCLAIMER
AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responslb ty for,
the product(s) listed on this Certificate. AHRI expressly disclaims all fiabfifty for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized afteration of data listed on this Certificate. Certified ratings are valid only for models and configurations IlsUed in the
directory at vmv✓.ahrldirecto ry.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for Individual, personal and
confidential reference purposes. The contents of this Certificate may not, in whole or In part, be reproduced; copied; disseminated;
entered Into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's Individual,
personal and confidential reference. AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at wwvj.ihvidiveciovy.org, dick on "Verify Certificate' link we make life hetter
and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which is listed above, and the Certificate No., which is listed at bottom right. 1 3=14.0
02014 Air -Conditioning, Heating, and Refrigeration Institute GVRTIFICATE N
Q..
008876
Local Business tax Receipt
Miami—Dade County, State of Florida
THIS IS NOTA BILL - DO NOT PAY
4=23
BUSINESS NAMR&OCATION RECEIPT NO. EXPIRES
C & R M CONDm6NING CO RENEWAL SEPTEMBER 30, 2015
6073 NW 167 ST C4 488023 Must be displayed at place of business
MAN FL 33015 Pursuant to County Code
Chapter SA - Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS
PAYMENT RECEIVED
C & R AIR CONDITIONING CO 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR
Worker(s) 10 CACO26414 $75.00 07/17/2014
CREDITCARD-14-028337
This Local Bulam Tu Receipt only mdh= payment of the Local Buslam Tax The Receipt Is not a 6
110101% Of 8 cwffi=&R Of the holder quatificatim to do business. Holder mat comply with any governmental
Or 00011MI0010111111 Ngub"rY lawn and mialromeam which apply to the bmanew
The RECEIPT No. above must be displayed op an congogrolgi "blel" - Nami4lods Code Soo go -27L
For mom leformaticiL visit wwwmlamidadaamdtmmoIIMftr
STATE OF FLORIDA
DEPARTMENT, OF BUSINE
CONSTRUCTION INDUSTF
1940 NORTH MONROE ST
TALLAHASSEE FL 32,'
CHRYST, ROBERT JAMES
C & R AIR CONDITIONING COMPANY
6073 N.W. 167TH ST, C-4
MIAMI Fl. 33016
Congratulationsi With this license you become one of the nearly
one million Floridians. licensed by the Department of Business and
Professional Regulatiom Our praftsionals and businesses range
from architects to yacht brokers, from boxers to barbeclue restaurants,
and they keep Florida's economy strong.
Every day we work to Improve the way we do business In order to
serve you better. For Inforrriallon about our services, please _ log onto
www.myflorldalloonse There you can find more Womiddon
about our divisions and the regulations that Impact you, subscribe
to department newsletters and leam more about the Department's
Initiatives.
Our mission at the Department Is: License Effidenft Regulate Fairly.
We constantly strive to serve you better so that you can serve your
customers. I hank you for doing business In Florida,
and congratulations on your now license!
DETACH HERE
. . ... . ........... . .............
FUCK WOTT, GOVERNOR'
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL:REGULATION'
CONSTRUCTIOXIND1.11MYLICENSING BOARD_"
.-CACQ26414
The CLASSAAIR CONDITIONING CO
NamedN 0
bobW IS,CE"FIE
Unclqr thepjbojoris ofCita ter489.FS I
%
HRY,
ST, ROBE
,4-RAIR,CONDIM -
...........
'171 M W 1A7TWAQ'M1 I
Tuesday, October 07, 201410:23 AM C & R Air Conditioning Co 305-685-6395
P.01
C&RAI-1
CERTIFICATE OF LIABILITY INSURANCE
OP ID: KE
DATE(MIV/°Dmmr)
10/08/2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: N the eertMents holder Is an ADDITIONAL INSURED, the polley(les) 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 endorsems e .
PRODUCER. Phone: 3015-384-7800
DROWN & DROWN OF FLORIDA INC
149Fax: 305-714-4401
00 NW 78th Court Sulte#200
Miami Lakes, FL 33016.5869
House Accounts
POLICY EFF
PHIONE Fax
Na :
FNMLLSEe
WURE B AFFORDING COVERAGE NAIL •
INSURERA:FCCI Insurance Company 10178
INSURED C& R Air Conditioning Company
8073 NW 167 Street, C-4
Miami Gardens, FL 33013
INSURER B!
INSURER C
INSURER D!
INSURER E!
PREMISE a occrrnBnce $ 100,00
I—f1V1V1\ 1\V-w1wFn-
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,
ILTR
TYPE OF INSURANCEJwM
POIJCYNUMBER
GLOOOS0858
POLICY EFF
POLICY EXP
uMlr$
A
GENERAL LIABILUT
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
09/01/2014
09/01/2015
EACH OCCURRENCE 1,000,0
PREMISE a occrrnBnce $ 100,00
MED EXP (Any one pwam) $ 5,00
PERSONAL W ADV INJURY 5 1,000,0
GENERAL AGGREGATE $ 2,000,0
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY F7 PRD-F1Loc
PRODUCTS - COMPMP AGO $ 2,000,0
AUTO
ma" LiABIITY
SINGLE LIMIT
WMAA
ANYAUTO
ALL AUT08 NEO SCHEDULED
A
HIRED AUTOS AUTOSNED
BODILY INJURY (Per person) $
BODILY INJURY (Per Emden) $
PROPERTY.Y DAMAGE
Per acc $
$
UMBRELLA UAB
EXCEEB LIAB
OCCUR
CLAIMS -MAGE
EACH OCCURRENCE
AGGREGATE $
DED I I RETENTION S$
WORIMRSCOMPENSATION
AND EWLOVEHE' LIABILRY
YIN
ANY PROPRIETORMARTNE191EM UIIVE
OF19CEPJMEWER EXCLUDFM
(Magddury In NH)E.L.DISEASE
"98"tlesollDe under
DESCRIPTION OP OP RATIONS nolo.
A
NIA
001WC13ASS728
OW31/2014
08/31/2015
X
E.L.EACHACCIDENr 1,000,0
$
- EA EMPLOY $ 1100010
E•L. DISEASE - POLICY LIMIT 51,000,0
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attadr ACORD 101, AddlOenal Remarks Schedule, If mere sparse Is requtred)
LICENSE # C&CO26414
CFRTIEIr-ATC ul11 nun _
Vlllege Of Miami Shores,
City Hall
10050 NE 2 Avenue
Miami Shores, FL 33138
ACORD 25 (2010105)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORRtZED REPREEENTATI VE
J s
c�–
wO 1I1104;Aulu AGORD GORPORATION. All rights reserved.
The ACORD name and logo are ragistered marks of ACORD