MC-14-2609Inspection Worksheet
Miami Shores Village '
10050 N.E. 2nd Avenue Miami Shores, FIL I
Phone: (305)795-2204 Fax: (305)756-8972 V
Inspection Number: INSP-224166 Permit Number: MC -12-14-2609
Scheduled Inspection Date: February 11, 2015
Inspector: Perez, JanPierre
Owner: HORD, MARJORIE
Job Address: 574 NE 95 Street
Miami Shores, FL 33138 -
Project: <NONE>
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: A/C Replacement
Phone Number
Parcel Number
1132060140790
Contractor: C&R AIR CONDITIONING CO Phone: 305-685-6394
tsunaing uepartment comments
EXACT REPLACEMENT OF 3 1/2 SPLIT SYSTEM Infractio Passed Comments
INSPECTOR COMMENTS False
February 10, 2015 For Inspections please call: (305)762-4949 Page 3 of 29
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
February 10, 2015 For Inspections please call: (305)762-4949 Page 3 of 29
6A05
BUILDING
PERMIT APPLICATION
❑BUILDING
❑ PLUMBING
❑ ELECTRIC
MECHANICAL
Miami Shores Village
Building Department DEC 01.20%
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 )0
Master Permit NoHr, R-26014
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: O Li N6 9,5'-"r
Citv: Miami Shores Cnuntv- Miami Dade Zin: 33 1 .S
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholde.
Address: S? H ME 9S
City:
T
Construction Type: Flood Zone:
Awf'ry, L-ohd
State:
BFE: FFE: y
1: a3 ®T • 7T 6 • 712 9,
_Zip:�33139
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C i R A l r CoyJ • Co. Phone#: �3 0 r( & a'6 29 Lf
Address: 6®"7,2 N W 16'7 4T C_ j4
City i q rt, I State: E) - Zip: 3�3 O) J -
Qualifier Name: R oVe t --t C k i-(jJ T Phone#: �3 ®'� 6 g-' i`o 3 q ` i
State Certification or Registration #: C— ID 6 Lf I y Certificate of Competency #: 049
DESIGNER: Architect/Engineer:
Address:
City: State:
66
Value of Work for this Permit: $ � Square/Linear FFoo age of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New LJ Repair/Replace
Description of Work:
Specify color of color thru tile.:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews
(Revised02/24/2014)
F2
CCF $
DBPR $
Zip:
❑ Demolition
"yea
CO/CC $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ ,as's EQ
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) ays after the building permit is issued. /n the absence of such posted notice, the
inspection will not Oe approved and a reinspectio ee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of /J 0dayvn b'C a 20 i LI , by
_M U Vre Yrt %,b w j , who i ersonally know to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: %-7%01
Print: be r I _ C k c w�
Seal:
�k4�kk�B«k
APPROVED BY
(Revised02/24/2014)
ROBERTJ.CHRYST
Commission # FF 086047
Expires May 24, 2x18
B"4W Thau Troy Fdn wwMMM019
l-L�'
&I V
CONTRXCTOR
The foregoing instrument was acknowledged before me this
day of NOU a w% )10 20 j , by
---,who i ersonally know to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
v 'S Ct v%e`T % r��l 2.
Print:
Seal: _ ^1'.& ,�-NET EE 091937
. Expires May 9, 2015
&nWTt-TMyFdnka=ae80a3 &Mq
4 �k�Ik&#�k�kakih�kaK*+Rah&�k�k�k+k�k�k�k+leak�kskak&*�k�F�k�k+I��NN�*�k�k�k�k**�kffi&�kffi*�kK�**+Kffi�k�k**�k�kakak�k><e
6 $ns Examiner Zoning
Structural Review Clerk
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): 74 N E 9C"' D�
City: Miami Shores Village County: Miami Dade Zip Code: a 1
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 � ARHI Sheet Attached: YES [/J NO ❑ Contract Attached: YES [f]
1. Minimum Circuit Ampacity (Wire Size): #
2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 A / i"t 40 COIJ .
3. Voltage of Circuit (208)Z40 480):
4. Size Disconnecting Means: &o A t H 4
J.
Contractor's Company Name: C. t a A e r Conj. C O . Phone: 30,S-6 &,& - 6 �j 9 Ll
State CertificateAegistNtiop4 C: -► C. O A 6 41 N Certificate of Competency No. fffl 4 k TO a 3
Signature
(Revised02/24/2014)
Date: 11-30'14
UNIT BEING REPLACED
DATA
EW UNIT
MANUFACTURER
vuua
aQ 4
AHU or PKG. UNIT MODEL #
H f T3
42
1
Liz
COND. UNIT MODEL #
®
KW HEAT
10
NOM TONS
AHU
CU PKG
1) M.C.A
AHU CU3#PKG
AHU
®CU 40 PKG
2) M.O.P
AHU(,0 CU 40 PKG
AHU
CU PKG
3) VOLTS o
AHU CU
PKG
PKG UNIT / /
PKG UNIT
EER/SEER
YES
NO
REPLACING DUCTS If'X
YES
NO
YES
NO
REPLACING THERMOSTAT
E
NO
YES
NO
NEW 4" CONCRETE SLAB
E
NO
YES
NO
NEW ROOF STAND
YES
YES
NO
NEW RETURN PLENUM BOX
CN%q
NO
1. Minimum Circuit Ampacity (Wire Size): #
2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 A / i"t 40 COIJ .
3. Voltage of Circuit (208)Z40 480):
4. Size Disconnecting Means: &o A t H 4
J.
Contractor's Company Name: C. t a A e r Conj. C O . Phone: 30,S-6 &,& - 6 �j 9 Ll
State CertificateAegistNtiop4 C: -► C. O A 6 41 N Certificate of Competency No. fffl 4 k TO a 3
Signature
(Revised02/24/2014)
Date: 11-30'14
Dec 01 141Q:1 7a C & R Air Conditioning Cc 305-685-6395 p,2
AHRI Certified Reference Number: 7174217 Date: 12/112014
Product: Split System: Air -Coop Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 14AJM42
indoor Unit Model Number: RH1T3621MTAN+RCH362'IMTAM
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 2101240-2008 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 (Otuh): 41000
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 16.00
IEER Rating (Cooling):
Ratings to lowed by are astartsk (') indicate a voluntary rerate of previously published data, unless accornpanied with a WAS, which indicates an involuntaryrerate.
DISCLAIMER
AN RI does not endorse the products) listed on this Certificate and makes no representations, wanantles m guarantees as to, and assurrres no responsibility for,
the ptoduct(s) listed an this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the
unauthorized alteration of data Bated on this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at wmAy.ahr[directory.org.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products ofAHRI. This Certificate shall only be used for individual, personal and.
confidential reference purposes. The cant" of this Certificate may not, In whole or in part, be reproduced; copied; disseminated; .10. r -:.- . �
entered Into a computer database; or otherwise utilized, In any form or manner or by any means, except for the user's individual. prat
persona[ and confidential reference. AIR-COWDiTIONI tG, H�ATING.
CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE
The information for the model cited on Lhis certlflcate can be verified at www.ahridirectory.org, dick on "trerify Certificate" link ,,,. malkelife better -
and enter the AHRI Certified Reference Number and the date on which the cerWIcate was Issued,
which is listed above, and the Certificate No., which is Bated at bottom right—'- ---- - — — --
02014 Air-Condition)ng, Heating, and Refrigeration Institute CERTIFICATE NO.: 130618175358276939
x5b�°? C&RpAir Cond�tion�n CQ. NCJM
6073 NW 167 Street Suite C-4 Miami srdeaa, b'L 33015.4330
a
TAMt.-'ZA4-A24"'%QA RRAWARn
We hereby prof to* Ftud and service the equipment am mater" ttstea arrow win rue ooawuons aua Spr�;uua41
tiuvua�
NEW EQUIPMENT r3 �� System #1$__e• co a System #2 $ `System #3 $
Your Ir}vestment
Manufacturer U U J
Condensing Unit Model # .:.:; a.A 3 M 40,
Package Unit Model #,�
Heating KW
Btuh r; L41, 000.
S.E.E.R. � 6 • �
warranties .)lt Labor Yr. Parts 10 Yr.
, : M n 144 1 �'- a• Compressor, i 0 Yrs.
p Condensing IItit s
[Concrete Slab
0M
ready plc Handler stand
'
}r ..
71,
[Thermostat So PD
Float Switch Rot Line cover , ❑Condensate Line
❑ Auxiliary Drain Pan [+� Rei: lines Al ft ❑ Fire Dampers
a gX
❑ Package Unit Changeoirt t
FrDmicat to Existing system File* * +Mast:
p14c� 1.6`'..1 t, �chahy� c
n t l -A
[Existing Reconnection
❑ New Electric
A qualified air conditioning expect 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. T[tla,to the system shall remain IOUs until all sums due us have been fully paid. In,the event the purchaser falls to comply with any
of the requirements of this contract such default results In llllgatlon, the Purchaser agrees to pay reasonable attorney's fees and afi court costs end expenses
Incident to such litigation. Delinquent payments shall bear 1.6% per month interest from due date until paid. AD 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 representatlon, wanantles nor agreements, oral nor
written not herein contained. This proposal shall become a contract when accepted by you and appy In writlrtg 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 #
pgO
00 -I $ 0®
TOTAL NETMENT $ �
6 �S.
FPL!DEALER REBATE S. ' 00 50% DUB WEN
60 Q T G _ READY TO OPERATE $
(Y1 MA eiA
AD ,
WORK
UNDER CONSTRUCTION
♦ . a t 1- ✓ � . ,.. tt
CM1
� � STRUCTURE '
We hereby prof to* Ftud and service the equipment am mater" ttstea arrow win rue ooawuons aua Spr�;uua41
tiuvua�
NEW EQUIPMENT r3 �� System #1$__e• co a System #2 $ `System #3 $
Your Ir}vestment
Manufacturer U U J
Condensing Unit Model # .:.:; a.A 3 M 40,
Package Unit Model #,�
Heating KW
Btuh r; L41, 000.
S.E.E.R. � 6 • �
warranties .)lt Labor Yr. Parts 10 Yr.
, : M n 144 1 �'- a• Compressor, i 0 Yrs.
p Condensing IItit s
[Concrete Slab
0M
ready plc Handler stand
'
}r ..
71,
[Thermostat So PD
Float Switch Rot Line cover , ❑Condensate Line
❑ Auxiliary Drain Pan [+� Rei: lines Al ft ❑ Fire Dampers
a gX
❑ Package Unit Changeoirt t
FrDmicat to Existing system File* * +Mast:
p14c� 1.6`'..1 t, �chahy� c
n t l -A
[Existing Reconnection
❑ New Electric
A qualified air conditioning expect 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. T[tla,to the system shall remain IOUs until all sums due us have been fully paid. In,the event the purchaser falls to comply with any
of the requirements of this contract such default results In llllgatlon, the Purchaser agrees to pay reasonable attorney's fees and afi court costs end expenses
Incident to such litigation. Delinquent payments shall bear 1.6% per month interest from due date until paid. AD 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 representatlon, wanantles nor agreements, oral nor
written not herein contained. This proposal shall become a contract when accepted by you and appy In writlrtg 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 #
pgO
00 -I $ 0®
TOTAL NETMENT $ �
6 �S.
FPL!DEALER REBATE S. ' 00 50% DUB WEN
60 Q T G _ READY TO OPERATE $