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MC-15-872Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 C" nspection Number: INSP-234951 Permit Number: MC -4-15-872 Inspection Date: May 18, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: PRADO, IGNACIO AND MARTA Work Classification: A/C Replacement Job Address: 424 NE 105 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1122310150050 Project: <NONE> Contractor: IGLOO AIR CONDITIONING INC Phone: 305-554-8988 Buildina Denartment Comments AC REPLACEMENT Infractio Passed Comments INSPECTOR COMMENTS False L(le2 Passed Inspector Comments Failed Correction Needed Zt 7 + Re -Inspection Fee ❑ No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 May 18, 2015 Page 1 of 1 r Miami Shores Village CCF 10050 N.E. 2nd Avenue NE DBPR Fee Miami Shores, FL 33138-0000 DCA Fee Phone: (305)795-2204 Project Address Parcel Number Applicant 424 NE 105 Street 1122310150050 IGNACIO AND MARTA PRADO Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell IGNACIO AND MARTA PRADO 424 NE 105 Street MIAMI SHORES FL 33138-2043 424 NE 105 Street MIAMI SHORES FL 33138-2043 Contractor(s) Phone Cell Phone IGLOO AIR CONDITIONING INC 305-554-8988 (305)970-4516 Info: ion: Residential In Review Denied: ping: 3 Fees Due Amount CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $122.80 Date Approved:: In Review Type of Work: Valuation: $ 2,200.00 i Total Sq Feet: 00 Pay Date Pay Type Amt Paid Amt Due I Invoice # MC -4-15-55194 04/15/2015 Credit Card 04/16/2015 Credit Card $ 50.00 $ 72.80 $ 72.80 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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 ening. FuthermoreraLo6orize the above-named contractor to do the work stated. 16, 2015 Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 16, 2015 1 Miami Shores Village APR I S 2015 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 3313 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 1� BUILDING Master Permit No. 'Ca � PERMIT APPLICATION Sub Permit No. ❑BUILDING [:] ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING XMECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Al 9^ /40f Sr City: Miami Shores Countv: Miami Dade Zip: 3 3 / 3 t% Folio/Parcel#. Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): /4v,#C/6'� e*09;r/f Ak .h 4 Phone#: f yof 7J_9 — 24 Z Address: cel Y A)4E /e7x- s r City: $4014es State: Zip: 793 139 Tenant/Lessee Name: Phone#: Email: / �i5''.*.�o O.V 91. CONTRACTOR: Company Name: ®® �� /�( Phone#: aS ' z1—/ Address: �� 4q u5 2 Z/ City: r�G State: , Zip: �� l Qualifier Name: 5 00 I t,14 Phone#: 3 6 OLO State Certification or Registration #: C YjC of Competency #: DESIGNER: Architect/Engineer: Phone#: Address City: State: Zip: Value of Work for this Permit: $ 2-7==0 Q_- Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: 120,049 G 49 C 49:'A,) rOl!�4 L. ,r91,0Z' C 10 /r/.O l Tic9AJ ✓itJ17-- Specify %' Specify color of color thru tile: Submittal Fee $ Permit Fee $ WU a9�L)CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 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 charge Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of20• %i , by who is personally known to me or who has produced ZE X—i-/ y identification and who did take an oath. NOTARY PUBLIC: d. Signature C The foregoing instrume as ck� ledged before me this day of 20 . by If who is personally known to me or who has produced identification and o did take an oath. NOTARY PUB Sign: 711 as Sta e ° otPav r LUIS FERNANDEZ oyperSeal: Seal: 1803 <•,. ssm"o a * * E%PRES: November 7, 2016 Jr9rf0FF��P\O� BwMThmBudgeWSems Tns APPROVED BY xaminer 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): *41Z `f N,6' 100r S 7_ City: Miami Shores Village County: Miami Dade Zip Code: 3S /3C6 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 [!I ARHI Sheet Attached: YES u NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER �. L5 N L AHU or PKG. UNIT MODEL# R i 4 1 SMA COND. UNIT MODEL # t (0 Aa to %L W KW HEAT jo y V3 -i-C_ NOM TONS AHUA 0 CU PKG 1)M.C.A AHU Uy® G AHU CU's roPKG 'Z 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT 17- EER/SEER i 3- / e cx iy YES NO REPLACING DUCTS YES co YES NO REPLACING THERMOSTAT NO YES NO NEW eCONCRETE SLAB NO YES NO NEW ROOF STAND YES N YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity (Wire Size):.�G 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 50 Actz? 3. Voltage of Circuit (208/240/480): °Z�t v-0 L- 4. Size Disconnecting Means:61,,%AP,,5 ®`�- Contractor's Company Name: �' �� �' bAY►-W-�Phone: State Certificate or Registration . Ci\k `7-� Certificate of Competency No. _ Signature /40-7 Date: OG (Q er's s This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2014. AHRI Certified Reference Number: 7943535 Date:. 4/14/2015 Product: Split System: Air -Cooled Condensing Unit, Coll with'Blower Outdoor Unit Model Number: RAI 848AJ1 Indoor Unit Model Number: RH1T4821STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Series name: . Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompaniedwith 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 referenceu p rposes. 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 www.ahridirectoiy.org, click 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 1307350963341744: ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) - ® IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 90050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: ICI -00 41A COW,01 %ioA/rry 6 IA-IC- BUSINESS A✓CBUSINESS ADDRESS: /.22-y/ SIV Z 2n .S7' CITY / -Z�/ STATE E4. ZIP 33/70 BUSINESS PHONE: ®-r) 4TV- 8 998 FAX NUMBER (—_) CELL PHONE L ---j QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: CHC fZ V 9'9rg A STATE OF FLORIDA JDEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 RIVAS, SERGIO A IGLOO AIRCONDITIONING INC 12241 SW 221 ST MIAMI FL 33170 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers, from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. ..," PROFESSIONAL -REGULATION Every day we work to improve the way we do business in order to CMC 1249458 ISSUED: 06/29/2014 serve you better. For information about our services, please log onto w vrw.myfiorldalicense.com. There you can find more information CERTIFIED,MECNA�P ICAL,, C 3NTI ACTOR about our divisions and the regulations that impact you, subscribe RIVAS, SERGE` A`. to department newsletters and learn more about the Department's IGLOO AIRCON[?CFIONING,11C initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFS CONSTRUCTION INDUSTRY LICEI CMC1249468 IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2016 L1406280001653 KEN LAWSON, SECRETARY ISSUED* 06/29/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406290001653 ACOM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I PRODUCER THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION A&D ALL—LINES INS ASSOC INC 5600 SW 135 Ave Ste 106 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFLQBQg= THE POLICI ELOW. Miami, FL 33183 POLICY NUMBER 463-6781 INSURERSAFFORDING COVERAGE NAIC # INSURED IGLOO AIR CONDITIONING, INC. INSURERA INSURER B INSURER C: FLm'mA ermro, Bosamss c nwasnms sorra 12241 S.W. 221 ST. INSURER D: MIAMI , FL. 33170 I INSURER E i195-554—gggg COVERAGES 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 SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR =Q1 POLICY NUMBER POLI EFF CTIVE POLICY P ATl N UMTS GENERAL LIABILITY EACH OCCURRENCE $ -1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES tEa_o=wenom $ 50,000 CLAIMS MADE 10 OCCUR MED EXP onepermn $ 5,000 PERSONAL &ADV INJURY S 1.000,000 A GL0511047004 01/19/15 01/19/16 GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOPAGo POLICY 171 PRO- M LOC AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT $ (Ee amMent) BODILY INJURY $ (Per Pe—) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Peracdde�rt) $ HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE $ (Peraoddent) GARAGELIABWTY AUTO ONLY -EAACCIDENT OTHERTHAN EA ACC $ ANYAUTO AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE III OCCUR 171 CLAIMSMADE DEDUCTIBLE RETENTION $ WORKERSCOMPENSATIONAND EMPLOYERS' UABIUTY ANY PROPRIETORtPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 000, 000 E.LDISEASE- EAEMPLOYEE `. OFFlCERIMEMBEREXCLUDED? 10644100 04/01/15 04/01/16 I dela UMSer babN E.L.IONS DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS AIR CONDITIONING SYSTEMS SERVICE, REPAIRS, AND INSTALLATIONS. MIAMI SHORES VILLAS BUILDING DEPARTMENT 10050 N.E. 2 AVE. MIAMI SHORES, FL. 33138 SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT AILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF allr'IDIOD-WWN T NSURER, ITS AGENTS OR AUTHORIZED ACORD 25 (2001108) WC AOORD CORPORATION 1988