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MC-15-396Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-228829 Permit Number: MC -2-15-396 Scheduled Inspection Date: May 13, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Owner: RUARK, JOHN Job Address: 9909 NE 4 Avenue Road Miami Shores, FL Project: <NONE> Contractor: C&R AIR CONDITIONING CO Building Department Comments Inspection Type: Final Work Classification: A/C Replacement Phone Number (410)610-2148 Parcel Number 1132060171310 Phone: 305-685-6394 EXACT REPLACEMENT OF 3 TON SPLIT SYSTEM. Infractio Passed Comments INSPECTOR COMMENTS False May 12, 2015 For Inspections please call: (305)762-4949 Page 5 of 30 Inspector Comments Passed ko Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 12, 2015 For Inspections please call: (305)762-4949 Page 5 of 30 aJ2sli s \,,. M 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 FS ) 4 2095 FBC 20 r o Master Permit No. M C.— (SZaL - Sub Permit No. ❑ REVISION ❑ EXTENSION []RENEWAL ❑PLUMBING MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: 9q 09 H i e 1 1 j.e Q J ❑ CANCELLATION ❑ SHOP IC:L\ri 101 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load OWNER: Name (Fee Simple Titleholder):_ `7 Address: 010 9 fAv '1 Avg Construction Type: Flood Zone: BFE: FFE: . 610.,21y9 City: MIM; I m; s h0 Pts State: FI Zip: 3313 e Tenant/Lessee Name: Phone#: ss Email: .1 Q U A K 10 0 % Vh u, 1 . C. 0 `y' CONTRACTOR: Company Name: c * R AI,,.. !' c—O hJ . co • Phone#: :301f 4kS bel 9 1 Address: 4 01 ``i /J� 16 7 "I T C• Lq City: / 111 1 Cl �''I'(n1�I �j- State: El. . Zip: 0 I J Qualifier Name: 1`e0�'C� ` �I'1Pw J ( Phone#: State Certification or Registration #: 0 A C o 16 L41 LI Certificate of Competency #: i'i � � ® 2 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ ( 8q5 • Square/Linear Fo tage of Work: Type of Work: ❑ Addition [:1 Alteration El New Repair/Replace Description of Work: Specify color of color thru tile: Zip: ❑ Demolition �e Submittal Fee $ Ski • W Permit Fee $ t'3 -?d --CCF $ co/cc$:-" Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 218-14 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 ap and a reinspection fee will be charged. Signature Signature Qk U19 -- OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of FE ua rr 20 P , by J Ok^ r`/�c(et ?" r , who i personallyknow o me or who has produced The foregoing instrument was acknowledged before me this da of Fe64AP q 20 I by !� «� IV who i ersonally know as me or who has produced identification and who did take an oath. identification and who did take an bath. NOTARY PUBLIC: NOTARY PUBLIC: 4wt vm�—qff Sign: P� Sign: ^� Print: Ode J _ l,G•�USt Print: Qn erid n Z Seal: """"' Seal: re k0 ` JANET WANZ ROBERT J. CHRYST'_ Commission # EE 091937 Commission # FF 088447 Expires May 9, 2015 A Expires May 24, 2018 � %lJfp • •' SMWThuheyfthW W"8&M18 � • &u1 nvu hoy Fah h mnm 80o, JAPPROVED BY 1 �f - I Plans Examiner Structural Review (ReAsed02/24/2014) as Zoning 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 arre� not acceptable. gld Job Address (where the work is being done): `,1 ® 9 V It 4th /�V-e- City: Miami Shores Village County: Miami Dade Zip Code: 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 dNO ❑ Contract Attached: YESE2( UNIT BEING REPLACED DATA NEW UNIT Ti- a 1A c MANUFACTURER ®i' h `T w L ®J( AHU or PKG. UNIT MODEL # _rTe 0 21C COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU :3,(FKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU KG PKG UNIT / / PKG UNIT EER/SEER _15 YES NO REPLACING DUCTS YES O YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB &D NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES O 1. Minimum Circuit Ampacity (Wire Size): 10 2. Maximum Overcurrent Protection (Fuse/Breaker Size): :3s- Co hc1 o ® 414 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: 'j- "i U Contractor's Company Name: C `t' R A c e Conj. &0 Phone: �3a g g,, 6 0? 9 Ll State Certificalle r R ist tn o. G C, O 6 1 Certificate of Competency No. 4lot Signature Date: �'®° (Quail e s signature) (Revised02/24/2014) Prepared by and Return to: Richard A. Golden, Esq. Kramer & Golden, P.A. 1175 NE 125 STREET Suite 512 North Miami FL 33161 KGPA File #173-14R Parcel ID Number. 11-3206-017-1310 Warranty Deed OR Ok 29496 P5s 435E - 43600 (3p9s) RECORDED 02/10/2015 15:24:14 DEED DTIC I'AX &e lr10.01) HARVEY RUVIN, CLERK OF COURT MIAMI-DADE COUNTY► FLORIDA This Indenture, Made this j-3 day of January , 2015 A.D. , Between JOSEPH OBERMEYER and JULIE OBERMEYER, husband and wife of the County of Sarasota , State of Florida , mentors, and JOHN W. RUARK, an unmarried :Dan and SERGIO B. PAPA, an unmarried man, as joint tenants with right of survivorship whose address is: 9909 NE 4 AVENUE ROAD, MIAMI SHORES, FL 33138 of the County of MIAMI-DADE , State of Florida , grantees. Witnesseth that the GRANTORS, for and inconsideration of the sum of ------------------------TEN DOLLARS ($10) -- ---- - - - -... --- DOLLARS, and other good and valuable consideration to GRANTORS in hand paid by GRANTEES, the receipt whereof is hereby acknowledged, have granted, bargained and sold to the said GRANTEES and GRANTEES' heirs, successors and assigns forever, the following des =bed land, situate, lying and being in the County of MIAMI -DADE State of Florida to wit: Lots 17 and 18, Block 96, AMENDED PLAT OF MIAMI SHORES SECTION NO. 4, according to the Plat thereof, recorded in Plat Book 15, at Page 14, of the Public Records of Miami -Dade County, Florida. and the grantors do hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoever, laser Generated by 0 Display Systema, I=, 2015 (863) 763-5555 Form FLwD-2 Warranty Deed- Page 2 Pareel ID Number. 11-3206-017-1310 In Witness Whereof, thegrantors. we hereunto set their hands and seals the day and year first above written. Signed, sealed and delivered in our Pace: 3 - ._, (Seal) Pri EP Wi tfies a Address:1321 SOUTHBAYDRIVE, Osprey, FL 34229 A (Seal) Pr' ted sane IE OBERMEYER Wi the S s P.O. Address:1321 SOUTHBAY DRIVE, Osprey, FL 34229 STATE OF Florida COUNTY OF Miami -Dade The foregoing instrument was acknowledged before me this day JOSEPH OBERMEYER and JULIE OBERMEMM, husb4 who are personally known to me or who have produced their Florida dr January wife e a ideet i Printed X re"i Notary Public My Commission Expires: P.WMYDIAZ s ). W tX)ApaNSSION it PF0160 EXPIRES: ,pros 17.2017 .� BMW Thro POD Uedeee R= 173-14R Lsser Gmmted bye n130ay Symms, In, 2015 (863) 763-5555 Form FLWD-2 2015 by r OR SK 29496 PG 4360 L-A ST PAGE MIAMI SHORES VILLAGE Building Department 10050 NE 2 Ave, Miami Shores FI, 33138 Tel: 305-795-2204• Fax: 305-756-8972 Permit No. REOC-1-15-22 Certificate of Re -Occupancy Address: 9909 NE 4 Avenue Road City: Miami Shores State: FL Zip: This certificate verifies that the reference property has been inspected by Miami Shores Village and has been determined to presently comply with schedule of regulations of Miami Shores Land and Development Code pertaining solely to the requirement that each one -family dwelling is used and intended to be used for a one -family dwelling purpose only; however, this certificate does not constitute any representation or warranty as to the condition of the dwelling or other structures on the premises described herein, or any aspect of such condition, and interested persons are advised and encouraged to make their own inspections of the premises in order to determine the condition thereof. Iding Approval: c l'� 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: 7020878 Date: 2/20/2015 Product: Split System: Alr-Cooled Condensing Unit, Coll with Blower Outdoor Unit Madel Number: CZH03612 Indoor Unit Model Number: AHV36C+TXV Manufacturer. YORK BY JOHNSON CONTROLS Trade/Brand name: AFFINITY Series name: Manufacturer responsible for the rating of this system combination Is YORK BY JOHNSON CONTROLS 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:' • Rage followed by an asterisk (*) Indicate a voluntary rerate of previousiy published data, unless a=rnpanied with a WAS, which Indy an Involuntary rete. 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 ltability for damages of any kind arising out of the use or performance of the produet(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.ahridlrectory.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 INSTrruTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org, dick on "Verify Certificate' link vm 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 13068ii36g1�)219W ©2014 Air -Conditioning, Heating, and Refrigeration Institute Ct-RTIFiCATE NO.: