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MC-15-447W Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-229236 Permit Number: MC -3-15-447 Scheduled Inspection Date: March 09, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Owner: GRAHAM, BARBARA Job Address: 9132 NE 3 Avenue Miami Shores, FL Project: <NONE> Inspection Type: Final Work Classification: A/C Replacement Phone Number (305)751-8765 Parcel Number 1132060133360 Contractor: AIR GUIDE AIR CONDITIONING Phone: 3051264-6027 Building Department Comments CHANGE OUT AC UNIT 2.5 --- ------ INSPECTOR _____INSPECTOR COMMENTS False J March 06, 2015 For Inspections please call: (305)762-4949 Page 15 of 28 Inspector Comments Passed L'. Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 06, 2015 For Inspections please call: (305)762-4949 Page 15 of 28 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 PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑ ROOFING MAR 0 Q 2015 �- FBC 20' Master Permit No. M (-- 1 '�5 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL OWNER: Name (Fee Simple Titleholder): �1ki'ei �, c�/d Gti 'Y/ Phone#: N -A 4 0� Address: T13d /1r 3'Q'°. e City: P lmm' Ao rev State: FL Zip: J3/.?p Tenant/Lessee Name: Phone#: rx- Email: barb 0 /llamlhA/ ."Ips, ®r9 CONTRACTOR: Company Name: A 1 K V 1 o e- "/ c- Phone#: 3 Address: Y2-62- S w % 10 1i' Ly City: �" 1 "^^ State: C J L Qualifier Name: J 1L) c 'eW S w Phone#: State Certification or Registration #: G A G J 2 C, f` 1 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Add P: 331 9 3() S 2( G 6Sixo City: State: Zip: Value of Work for this Permit: $ & © to C- Square/Linear Footage of Work: Type of Work: ❑ Addition El Alteration ❑ New A❑ Repair/Replace ❑ Demolition CADescription of Work: �LA4-0 a JA Specify color of color thru tile; Submittal Fee $ .-_ Permit Fee $ l �'� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP `C CONTRACTOR DRAWINGS JOB ADDRESS: A - C/ 13.Q N+F -3 �',4 V6" U e City: Miami Shores County: Miami Dade Zip: 33133 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �1ki'ei �, c�/d Gti 'Y/ Phone#: N -A 4 0� Address: T13d /1r 3'Q'°. e City: P lmm' Ao rev State: FL Zip: J3/.?p Tenant/Lessee Name: Phone#: rx- Email: barb 0 /llamlhA/ ."Ips, ®r9 CONTRACTOR: Company Name: A 1 K V 1 o e- "/ c- Phone#: 3 Address: Y2-62- S w % 10 1i' Ly City: �" 1 "^^ State: C J L Qualifier Name: J 1L) c 'eW S w Phone#: State Certification or Registration #: G A G J 2 C, f` 1 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Add P: 331 9 3() S 2( G 6Sixo City: State: Zip: Value of Work for this Permit: $ & © to C- Square/Linear Footage of Work: Type of Work: ❑ Addition El Alteration ❑ New A❑ Repair/Replace ❑ Demolition CADescription of Work: �LA4-0 a JA Specify color of color thru tile; Submittal Fee $ .-_ Permit Fee $ l �'� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature �2/`�°'v Signature OWNER or AGENT CONGACTOR Theforegoing instrument was acknowledged before me this �. ; day of Febra,4 20 I by C&e Q PQ w. who is personally known to me or who has produce identification and who did take an oath. NOTARY Sign: Print: The foregoing instrument was acknowledged before me this 2-�J day of 1'�4-� �? , 20% - by S1�Y' , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: j Print: If�vl as Seal: IVOieryru""""`.,�..,,,.,_ Seal: / / o1N':°�g Elizabeth Yelin (./ � ; • •., 4 KEVIN C. KYNE My Commission FF 01,3558 * * MY COMMISSION i FF 101472 '1'o►n Exp;�sion612017 EXPIRES: May 6,2018 �rfOFfl � 6crMThru1W0Notary$mku APPROVED BY ` Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 4262 S.W. 73 AVE., MIAMI, FL 33155 (305) 264-6027 FAX: (305) 262.6623 proposal AIRGUIDE Airconditioning Co. Family Owned and Operated Since 1960 CACO2U31 1210 PROPOSAL SUBMITTED TO At"ASTREET PERMIT# DATE W "p^C' �� q 1,!,2 - may` JOB NAME CITY, S E AND ZIP CODE JOB LOCATION PHON - WORK PHONE FOLIO# JOB PHONE rf ,� -Co q 2C,, We hereby propose to finish aid instar the following. NEW EQUIPMENT #1: ❑ Condencing Unit2z Tons X G i ? -o3 odel ❑ Air Handler Torts G Ax , IN d (A"I ❑ SEER rating BTU o Z0 U j at Strip K.W. NEW EQUIPMENT #2: ❑ Condencing Unit Tons Model ❑ Air Handler Tons Model ❑ SEER rating BTU ❑ Heat Strip-K.W. DUCT STEM: Reconnect existing to existing duct system ❑ New duct system outlets ❑ additional outlets ❑ RQtum air grill with fitter ❑ return air grill Etter in air handler ❑ Air handler stand. ❑ Other PIPING• eeonnect to existing piping ❑ New suction line with thermal barrier size copper ❑ New liquid line size copper ❑ New condensate piping ❑ Condensate pump ❑ Other ELEC AL AND CONTROLS nre function heating & cooling thermostat ❑ Pr & connect all necessary electrical circuits & disconnects to existing lectrioal connections is not part of this proposal and any electrical work will be at an additional charge if necessary ❑ Other SPE TIONS: AJLwork will be in Accordance with existing codes / fired permits ['ya�y movmov al of the existing equipment from the premises [� Bather resistant vibration proof isolation pads ❑ Pr ast reinforced concrete slabs' j�tdoor unit will be attached with hurricane proof fasteners ❑ 244auge galvanized steel outdoor pipe wall cover 2xAil work to be performed in a neat & professional manner by journeyman class technicians. Sweeping, dusting and vacuuming will be accomplished at the end of each day's work and all debris removed from the premises. REEIgra ETThis unit will qualify for a rebate ofC- WARRA ©' year warranty on all parts [�year warranty on compressor 3_year warranty on labor ❑ Other Pe propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: # 1 t0 'VIE dollars ($6196 F ^ ) #2 Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Note: Thispprroposal may be withdrawn by us iF not accepted within V days. AIRGUIDE AIR CONDITIONING COMPANY Authorized ✓ Signature �. Ky �- r * * 4y COWN" # F 141472 21 EXPIRE& May 6, 2018 �TFarti '0p*dthruBudget Notary SMiCe5 dollars ($ 1 ,ArCeptancr of Vruposat - I accept this proposal & all the terms & conditions contained on the face & back. The above prices, specifications are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. I HAVE AUTHORITY TO ORDER THE WORK WHICH HAS BEEN SATISFACTORY PERFORMED AS OUTLINED ABOVE. IT IS AGREED THAT THE SELLER WILL RETAIN TITLE TO ANY EQUIPMENT OR MATERIALS THAT MAY BE FURNISHED UNTIL FINAL PAYMENT IS MADE AND IF SETTLEMENT IS NOT MADE AS AGREED. THE SELLER SHALL HAVE THE RIGHT TO REMOVE SAME AND AIRGUIDE AIR CONDITIONING CO. WILL BE HELD HARMLESS FOR ANY DAMAGE RESULTING THEREOF. ALL COSTS OF COLLECTION SHALL BE PAID THE CUSTOMER, INCLUDING REASONABLE ATTORNEY'S FEE. CUSTOMER'S SIGNATURE Signature - Tie Signature Title Date of Acceptance - `� • r -- r°1+w. is # * MY SSIQtt1� 2 pn per. S: May 6, 18 A poade&r4w el�jEnF Ft fiudget Notary$eNim A. _ Local business Tax Receipt Miami --Dade County, State of Florida —THIS Is NOTA BILL — 00 WT PAY 1215085 RkMWOM NAMMILOCATWN AIKCuicE AIR CONDITIONING CO 4262 SW 73 AVE MUNI FL M155 OWNER t4iRWME A9t COW1TMW [0 Wa wKsj i 1 1Ecprr ew. EXPERE3 RENEWAL SEPTEMBER 300 2015 zi 5M= 1e aspWad al 0"Cof Pum m Com" tads Chv0W BA—Arr 9810 sec. �N TvM OF sus= PAvaasmi' 196 SPEC MECHANICAL CONTRACTOR sY TAx ea# t.wvon CACO2MI $75.0D DW 3/2014 CRECK21—f4--049021 ThkLoad 8Qdi TUKKWWF**sf tiae i Tss:Tisllw�rlrftwslkamm paall,arac�t r�� •.;.�s„�wM�'ap�ra "logo Tiar'�tp1lHt aiarasuavaaaHwaaasrcut�.,-��rattr-711 RICK SCOT1i GOVERNOR KEN LAWSON. SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CACo2643t The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the proftforks of Ghapta 489 FS.. Expiration date. AUG 31, 241$ JENSEN, JOHN DEPPE AIRGUIDE AIR CONDITIONING CO 4262 SW 73RD AVE MIAMI FL 33155 This combination qualifies for a Federal Energy Efficiency Taut Credit when placed in service between Feb 17, 2009 and Dec 31, 2013. Certificate of Product Ratinas AHRI Certified Reference Number: 5501681 Date: 3/1/2015 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: XC17-030-230-** Indoor Unit Model Number: CBX32MV-036"+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: DAVE LENNOX SIGNATURE Series name: XC17 SERIES Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, 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 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 unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.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, AM personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERA71ON INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, dick on 'Verify Certificate' link we make life better - 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 ©2014 Air -Conditioning, Heating, and Refrigeration Institute AIRGU-1 OP ID: DF 14 �NL' CERTIFICATE OF LIABILITY INSURANCE D0310212ATE 0 1 W) 0310212015 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: 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 Brown 8r Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 CONTACT NAME: PHONE FAX AIC No Ext): AIC No E-MAIL ADDRESS: P.O. BOX 5727 Ft. Lauderdale, FL 33310-5727 SBU/Commercial House Account INSURER(S) AFFORDING COVERAGE NA IC IM INSURERA:*FCCI Insurance Com an + 10178 INSURED Airguide Air Conditioning Co Attn: John Jensen INSURER B:Bridgefield Employers Ins. Co+ 10701 X COMMERCIAL GENERAL LIABILITY 4262 S.W. 73rd Ave INSURER C: INSURER D: Miami, FL 33155 INSURER E : DAMAGE TO REN I E7_ PREMISES Ea occurrence $ 100,00 INSURER F: CLAIMS -MADE I—XI OCCUR COVERAGES 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSR 5ui WVD POLICY NUMBER MMIAi DDIYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPP000352611 04101!2014 04101!2015 DAMAGE TO REN I E7_ PREMISES Ea occurrence $ 100,00 CLAIMS -MADE I—XI OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMP/OP AGG $ 2,000,00 POLICYP- JECROT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ PER ACCIDENT HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N I A 83008133 0410112014 04/01/2015 WC STATU- OTH- TORY LIMITS R EL EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 5500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CACO26431 CFRTIFICATF HOl DFR CANCFI I ATIii MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami ShoresVilla a Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD