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MC-15-1013Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (3051756-8872_ INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING FB�C21D j()/� Master Permit No. M0__ 6— 101:5 Sub Permit No. ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING DIMECHANICAL [:]PUBLICWORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: CIei'bS 'P"C CA V -9-- City: Miami Shores County: Miami Dade Zip: 3312,$ Folio/Parcel#: 1 I - -6'1 6 (O - c> I y - 12 4o Is the Building Historically Designated: Yes NO Occupancy Type:& -m ll Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholde:� Titleholder) r t q�oes2s yr�oH�eri" CAJ(-Cl. Phone#: Address: 60QZ g6sr11" City: l'�7a� State: IDR Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: CompanyName:Nlame: kkA__e-c,A • /k\c ' �� �� �� �^� - Phone#: L" D.SSI'; ?_ -� g O Address: �SD� NW Ss� S�_ l City: -t),'r-a` • State: f \ r _ Zip: 3 I loco . Qualifier Name- Yt+'_t Phone#: State Certification or Registration #: CMC 12.991-12.. Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: State: Value of Work for this Permit: $ `L2 , bo • oG Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ID New [Repair/Replace Description of Work: V& c-Ie.Agk, U VV14, Specify color of color thru tile: Submittal Fee $ • Permit Fee•$ Scanning Fee $ Technology Fee Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $ DBPR $ Zip: ❑ Demolition CO/CC $ Notary Double Fee $ Bond $ /''' TOTAL FEE NOW DUE $ b 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 0 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 ) OWNER or AGENT The foregoing instrument was acknowledged before me this c2 `CA& day of/� � f"" 20�_, by Davi'd ki-nG%eA-,ho is personally known o me r who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: �V/V/iA- /10 CO The foregoing instrument was ac l nowledged before me this 24, day of 20 S by .who 'pally— k w o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ OF FLORIDA Print: Seal: _' ^Commission # EE098053 Seal: PATRICIA LOURDES LLORENTE '•,,,������,' Expires: JUNE 08, 2015 MY COMMISSION 9 FF203490 BONDED THRU ATLANTIC BONDING CO., INQ • EXPIRES February 25, 2019 APPROVED BY v Plans Examiner Structural Review (Revised02/24/2014) 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 are not acceptable. Job Address (where the work is being done):tel`} b City: Miami Shores Village County: Miami Dade Zip Code: 33138 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 Z ARHI Sheet Attached: YES ❑ NOR] Contract Attached: YES X 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse Breake Size): o"b0 3. Voltage of Circuit (208Y240/480): 4. Size Disconnecting Means: '7'0o Contractor's Company Name: _4 &I't'CA C' Phone: (1,D '5) S State Certificate or Registration No. 0 4 L.' 24'9�1 Z - Certificate of Competency No. Signature Date: 03 1 9,-il U 15 ( Iffle s st e (Revised02/24/2014) UNIT BEING REPLACED DATA NEW UNIT MANUFACTURERejZiC?i►4 0 ;?S-A AHU o KG UNIT MODEL# 00 60,40000 COND. 01qrT MODEL # KW HEAT 2fio/ j NOM TONS AHU CU KG 1) M.C.A , '; AHU CU PKG AHU CU K 2) M.O.P J AHU CU KG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS Mt o i�cTT� YES NO YES NO REPLACING THERMOSTAT YE NO YES NO NEW 4"CONCRETE SLAB VES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES N 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse Breake Size): o"b0 3. Voltage of Circuit (208Y240/480): 4. Size Disconnecting Means: '7'0o Contractor's Company Name: _4 &I't'CA C' Phone: (1,D '5) S State Certificate or Registration No. 0 4 L.' 24'9�1 Z - Certificate of Competency No. Signature Date: 03 1 9,-il U 15 ( Iffle s st e (Revised02/24/2014) IKtN LAWSUN, StUKt1AKY 4 STATE: OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CMC1249772 Fbe MECHANICAL CONTRACTOR Named below. IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 L TRUONG, KIET HUYa . AIRTECH.AIR CONDITIONING 7805 -NW 55TH -ST DORAL FL 33166-4113 ISSUED: 07/03/2014 DISPLAYAS REQUIRED BY LAW ❑ - i SEQ# L1407030001190 )06671 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA 8LL — DO NOTPAY 6183271 -L�BT BUSINESS NAME&OCATION RECEIPT NO. EXPIRES AIRTECH AIR CONDITIONING RENEWAL SEPTEGMABERG3a70, 2015 7805 NW 55 ST 6447734 Must be displayed at place of business DORALFL33166 Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS MIAMI AIR MECHANICAL INC 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED CMC1249772 ev Tax cot:LEcroR Worker(s) 10 $45.00 08/07/2014 CHECK21-14-046472 This Local Business Tax Receipt only, cmljirms payment of the Local Business Tax The Receipt is not a licens rnme, permit or a;certification of the holders qualifications, to do business. Holder must comply with a!ry govenanental or nongoveental regulatory laws and requirements which apply to the business. The RECEIPT NO.. above must be displayed on all commercial vehicles— Miami -Dade Code Sec Be -276. For more Information, visit www.mimnIdade ooV&xcollector SEE OTHER SIDE _ 19bs METTRUONG, LEED AP VP of Construction e- roil! AtRCONDMONtNG State License #CMC1249772 ltW9606 "J 6 .a CF;9AdlpQ910{! ' SAFE DRIVER 8•_= •e"•: •+ 07 a mcnm ae�lr icz�.�u+ab rcm.e�u rn .aq S clay: ty tz 7 wcpuutl by 7.e Apr, 29. 2015 9: 54AM No. 3837 P, 1 ACORtIr CERTIFICATE OF LIABILITY INSURANCE �i DATE(MMMDNMJ 4/29/2015 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 130ES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE WOLb>_It. IMPORTANT: It the cenlficats holder Is an ADDITIONAL INSURED, the policy(iee) must be endorried, If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certaln policies may require an andorsement A statement on thl6 Certificate does not Confer rlghte to the Certificate holder In Ileu of such endorsement(s). PRODUCERCONT 8sitlin, A Marsh&Mcbennan Agency LLC Co. 9050 NPT 471st Street, $te. 100 NAWCT Patricia Castellanos PHONE (305) 591-0090 FA ,(7E6) 662-6827 POLICY EXP rM Miami FL 33178 1S COtNbNERCU►LGENERAL LU181LnY CLAIM84AADF ❑X OCCUR INSURERIS) AFFORDING COVERAGE MAIC 0 INSURFRA: &ibsVtV Mutual Fire Insurance 23035 9/20/2014 INSURED (305) 592-5700 Miami Air mechanical. InC, dbe Aittooh Air Conditioning 7005 N.W. 55th Street msuRERB:Bri.d efield 8m Yo ers Insurance 10701 INSURER C: INSURER D: INSUaERE: Miami FL 33166 INSURER P COVERAGES CERTIFICATE NUMBER: cert ID 46022 RFVLSIAm m"murR• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR NSR TYPE Of INSURANCE SUERPOLICY POuGYNUMBER EFF POLICY EXP UNIT$ A 1S COtNbNERCU►LGENERAL LU181LnY CLAIM84AADF ❑X OCCUR TH2-291-459981-024 9/20/2014 9/20/2015 EACH OCCURRENCE $ 1,000,000 pgE&NES jFq DOMMSM61S 300,000 MED EXP mme ..on 3 10,00 PERSONAL B ADV INJURY 6 110001000 CEMLAGeREGATELIMIT APPUESPER. POLICY L2[j JJECT ❑ LOC x 0TK&-C3PDed at $15lu4 GENERAL AGGREGATE 3 2,000,000 PRODUCTS -COMPTOPAGO $ 2.000;000 llmpl benefits Liab $ 11000,000 A AUTOMOBILE x LIABILITY ANYAUTO ALL OWNED SCFIFDULED AUTOS AUTOS HIRED AUTOSUUTNO- SWNED A$7-991-459981-014 8/20/3014 9/20/x015 BWEDSINGL,"MIT $ 1,000 000 WOILYff4MY(PwPgr an) $ RODILYIMMY(PerauWAI) S PROPERTY DAMAGE S S A X UMRRELLAU" EXCESBLIAb 7L UR CLAIMS -MADE TH7-Z91-459981-034 9/20/2014 9/20/2015 EACHOCCURRENCE $ 3409400 AGGREGATE $ 5 000 000 DED I X I MWION$ 10,00 WORKr'AS COMPENSATION AND EMPLOYERS*LIABILITYYIN ANYP:sOPRl-VOR1PARTNERIEXECUTIVE OFFIC0KgA 9R EXCLUDED? (Marwlilvry In u oEscRl ON O� n OPERATIONS oelow $ R B NIA 830-48962 9/20/2014 9/20/3015 ELEAC,HACCI NT S l 000 0 00 E.L DISEASE- FAwkOYE S 1,000,000 E1, DISEASE- POLICYU&AT S 1., 000, 000 OE3GRIPTION OP OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Add100aal ReTAfhs Soheduk, MAY be allaehed 11 more apace IS requhed) R8, License@, CXC 1249772 Proof of Insurance Only NC�YIdAATC I,n, ,.,+r. Miami Shore Village Building Department 10050 NE 2nd Avenue Miami shores $L 33138 ACORO 28 (2014101) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI R REPRESENTATIVE W IVUH-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233617 Permit Number: MC -4-15-1013 Scheduled Inspection Date: May 20, 2015 Permit Type: Mechanical - Commercial Inspector: Perez, JanPierre Inspection Type: Final Owner: CHURCH, MIAMI SHORES Work Classification: A/C Replacement DOPOYMIAAI Job Address: 9405-33 PARK Drive Miami Shores, FL Phone Number (305)751-5917 Parcel Number 1132060141270 Project: <NONE> Contractor: AIRTECH AIR CONDITIONING Phone: (305)592-5780 Building Department Comments PACKAGE UNIT REPLACEMENT Infractio Passed Comments INSPECTOR COMMENTS False P Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 19, 2015 For Inspections please call: (305)762-4949 Page 20 of 40 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 rroject Aaaress Parcel Number Applicant 9405-33 PARK Drive 1132060141270 MIAMI SHORES PRESBYTERIAL Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MIAMI SHORES PRESBYTERIAN 601 NE 96 ST (305)751-5917 —• •• •.... MIAMI 38 FL 33138-2741 Contractor(s) Phone Cell Phone AIRTECH AIR CONDITIONING (305)592-5780 Tons: 25 Additional Info: PACKAGE UNIT REPLACEMENT Classification: Commercial Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Scanning: 3 Fees Due Amount CCF $13.80 DBPR Fee $10.22 DCA Fee $10.22 Education Surcharge $4.60 Permit Fee $681.00 Scanning Fee $9.00 Technology Fee $18.40 Total: $747.24 Valuation: $ 22,700.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -4-15-55366 05/05/2015 Check #: 056893 $ 697.24 $ 50.00 04/29/2015 Credit Card $ 50.00 $ 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 informationi a rate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-nameccp tr ctor to do the work stated. May 05, 2015 Authorized Signature: Owner / Applicant / Cot o tra T r / Agent Date Building Department Copy May 05, 2015 1 ! 4. 1 7805 NW 55 Street Miami, M 33166 Ph: 305-592-5780 Fax: 305463-7608 SUBMITTED TO: David Kinche11 DATE: April 22, 2015 Miami Shores Presbyterian PROJECT: Preschool- 25 -Ton. 6021VE 96 St SUBMITTED BY: Gil Rodriguez Miami Shores, F1 Email. (ficinchenkLit spe.net Ph: (305) 754-9541 Fax. (303) 758-95'97 MAT ERU LS & SERVICES: The following quote is for the replacement of (1) deteriorated 25 -ton ]York Package Unit serving Preschool with (1) new American Standard Rooftop unit. �F4c3rx�xT�x7jxp9eDY�Y��+px�xx�Yxxxxxxxx�xx�Yxxxx�Y3exx�YAe3r�xxxxxx��Yxxxrxxxxxxxxxxxxxtrxxx�xxxxx�xxxx o Shut down and electrical lockout of roof top unit o Remove and discard existing 25 -Ton Fork roof top unit o Install (1) new American Standard RTI MN EAC'300 with Motorized ]Fresh Air Damper and Electric Bleat. o Set and install new unit on existing Steel I ]beam Stand o Reconnect to existing sheet metal supply and return air duct system. Install sheet metal transitional duct pieces to connect new unit to existing duct Veal all new duct pieces for with weather resistant mastic duct sealer: o Reconnect unit to existing electrical supply voltage and controls. o Install new Smoke Detector with stand alone visual & Audio device as required for life safety. floes not include any tie into existing fire alarm or panel. o Reconnect to existing condensate drain line system. o Start --up and check for proper operation. o Warranty: One year on parts, S years on compressor and I year on labor: © Includes Crane and Mechanical Permit NOT I7VCL UDED OR TO BE DONE BY 077IERS ® Any work not specified in the included section of this proposal. o Does not include any additional requirements by Building & Zoning Department. • Structural or Mechanical Drawings if requested by the Building Department. o Roofing work of any kind or upgrades to existing electrical wiring or panel. o Overtime if job is scheduled after hours or during the weekend Nk Price to perform, the above scope of work ............................... � S21,950" 00 Coil Coating g optiom �Jfo' 3 'E`° ;JfVma "/§R! C011, (10 : F':° fO(Eor !Z'dded py`olevi'9, n.."° u7. -G°€ 0 Payment terms. 50% Deposit rre0uirred upon acceptance & Balance clue upon completion. Price vcalld fon• 30 days. DD�F7 F3�OF7Of7��❑DDF3D®Ot7��©[300090©OFe�[30l!30�©D��I3O0®®Ot9mB®Q���®BOt7O®B®0®0®®t9®�®�®®®®®ta TERMS AND CONDITIONS OF THIS CONTRACT: It is expressly understood and agreed that title to the above described property is retained by Airtech Air Conditioning and same shall not pass or become vested in the purchaser until the entire purchase price has been paid. Said property shall be and remain personal property and retain its character as such and purchaser shall not attach or affix said property to any realty so that it loses its character as personal property nor shall purchaser resell said property until purchase price therefore has been paid. The purchase price shall be due and payable as provided under "terms, above, and upon the failure of the purchaser to make any on the due date the seller, at its option, may declare the entire balance of the purchase price due and payable, in case of default, purchaser shall pay all cost and damages, including a reasonable attorney's fee incurred by seller in collection this account or repossessing the described property, whether suit be brought or not. Purchaser hereby waives presentments, demands and all other prerequisites required to make it liable. No warranties, representations, or promises, not appearing in writing in this contract will be recognized. This agreement shall not be considered executed or binding to the seller until duly accepted by an authorized officer ofthe seller. The execution by the seller of this agreement is subject to force majeure and is contingent upon strikes, accidents, acts of God, weather conditions, regulations, or other restrictions imposed by any Government or Governmental agency or other delays beyond sellers control ACCEPTED BY: WORKORDERk uwner - •.nncnaser Airtech Air Conditioning