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MC-15-749�AMiami Shores Village ,f, - \ Building Departmenti APR 0 2 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 3313E Tel: (305) 795.2204 Fax: (305) 756.8972 [BY: INSPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20 I� BUILDING F Permit No. PERMIT APPLICATION Master Permit No. Permit Type: MECHANICAL JOB ADDRESS: 1234 NE 96 ST MIAMI SHORES FL 33138 City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-014-3930 Is the Building Historically Designated: Yes - _- NO `� - - -- Flood Zone: - OWNER: Name (Fee Simple Titleholder): CHARLES ALLEN Phone#: (305) 751-5888 1234 NE 96 ST City: N1XrAm.% 514CVZS— State: FL Zip; 33138 Tenant/Lessee Name: CONTRACTOR: Company Name: SO ARB AR SERVICES Phone#: (305)863-1830 Address: 10125 NW 116 WAY #10 City: MEDLEY State: FI QR DA Zip: 33178 Qualifier Name: M AlLiz L.(,EU5f Phone#: ; &6-3. I tm State Certification or Registration #: CAC1817134 Certificate of Competency #: Contact Phone#: 3ME&I • 1 APQ i 1 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 COMNVIENCEMENT 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 IL day of MARCI4 , 201,x., by 0h1qui ga (ILLay who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My APPROVED BY =lI01MISSION,# FF142531 EXPIRE: Sept 15, 2018 WWW.AARONNOTAky.com Signature 1/� Contractor The foregoing instrument was acknowledged before me this' day of Magelk 20 , by Ir►-Aasext 1AA4 who is ersonally kno o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Examiner ® ION # FF142531 Sept 15, 2018 www.AARONNOTARY.CON! Zoning Structural Review Clerk Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) ,",, Aim r• ' I W—"! �I 10125 IVW 116 Way, Suite 10, Miami, FL 33178 Phone 305-863-1830 FAX 305-863-1885 www.SolarBearFLcorn FL Reg. CAC 1817134 81 .Ao al Phone: �c-1 E-mail: equipment to be installed: A/C or Heat Pump Air Handler Coil Additional accessories: Thermostat ? (^ -7 r a:-µ f., W Light Zoning HEPA Filter 5"Media Dehumidifiers Other Additional services: Duct Cleaning Annual Service Agreement Scope of work: - o anal materials: System 1 2 3 system 1 2 3 Disconnect box ❑ ❑ ❑ . New return plenum 000 High voltage wiring ❑ ❑ ❑ Insulate ductwork ❑ Q ❑ Low voltage wiring 01,00 Old equipment removal 0,00 New outdoor pad p ❑ ❑ New supply ducts ❑ ❑ ❑ Vibration pad ❑ ❑ ❑ New return ducts 000 Line set 000 New registers/grilles ❑ ❑ ❑ Refrigerant filter dryer ❑ .❑ ❑ New condensate piping ❑ ❑ ❑ Recover refrigerant 0 ❑ ❑ Condensate pump (sft. switch) ❑ ❑ ❑ Mastic seal plenums 130 ❑ Drain pan with overflow switch ❑ ❑ ❑ New supply plenum 000 1" filter rack 000 Mastic and seal supply/return 4 feet ❑ ❑ ❑ FPL Completed ❑ ❑ ❑ Load Calculation ❑ ❑ ❑ Payment terms: Sale Price - $ Credit Card Type Customer Cash Card $ Name on CC Discounts/Coupons $ C Credit Card # $ FPL Rebates $ � / 00 p Exp: Date Total Investment o 00 Check # To o ense after rebates, discounts an Its Balance due to Solar Bear $ Notes: (Labor portion plus permit fees) Balance due to Costco $ (Total Investment minus Balance due to Solar Bear) All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra cost 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/owners to carry all necessary insurance. Our worker's are covered by Workman's Compensation Insurance. The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Any payment not made as speclgd shall be subjectito 189o' annual interest plus filling ch rg ,court costs and attorney fees. Price subject to change if not accepted within 15 days. JA '' —a 115 Company authorized signature C nat Date of 1cceptance r' i ff / Compressor ,ff') yrs, Coil yam, t Parts yrs. Labor '' yrs- - Zoning yrs. Extended Warranty yrs. Other yrs" r Payment terms: Sale Price - $ Credit Card Type Customer Cash Card $ Name on CC Discounts/Coupons $ C Credit Card # $ FPL Rebates $ � / 00 p Exp: Date Total Investment o 00 Check # To o ense after rebates, discounts an Its Balance due to Solar Bear $ Notes: (Labor portion plus permit fees) Balance due to Costco $ (Total Investment minus Balance due to Solar Bear) All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra cost 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/owners to carry all necessary insurance. Our worker's are covered by Workman's Compensation Insurance. The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Any payment not made as speclgd shall be subjectito 189o' annual interest plus filling ch rg ,court costs and attorney fees. Price subject to change if not accepted within 15 days. JA '' —a 115 Company authorized signature C nat Date of 1cceptance v C G W7 _ Miami Shores Village Building Department 10050 N.E.2nd Avenue L r ' Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC y 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): 1234 NE 96 STREET 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 ❑■ ARHI Sheet Attached: YES 9 NO ❑ Contract Attached: YES 0 UNIT BEING REPLACED DATA NEW UNIT GOODMAN MANUFACTURER LENNOX AR61-1 AHU or PKG. UNIT MODEL # CBx32Mv-060 CKJ60-1C COND. UNIT MODEL# XP21-060 9 KW HEAT 9 5 NOM TONS 5 AHU 60 CU b0 PKG 1) M.C.A AHU 6Q CU bo PKG KI AHU — CU - PKG 2) M.O.P AHU CU PKG AHU00CU0ePKG 3) VOLTS AHUI&CU226PKG PKG UNIT PKG UNIT / / EER/SEER 12.50 / 16.50 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES _ NO YES NO NEW ROOF STAND YES NO YES NO r NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 6 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: 230 Phone: 305-863-1830 State Certificate or Registration No. CAC1817134 Certificate of Competency No. _ Signature Date: 3/28/2015 (Qualifier's signature) (Revised02/24/2014) This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17, 2009 and Dec 31, 2014. Certificate of Product Ratings AHRI Certified Reference Number: 5272316 Date: 3/30/2015 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: XP21-060-230-** Indoor Unit Model Number: CBX32MV-060-230*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: DAVE LENNOX SIGNATURE Series name: XP21 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: Cooling Capacity (Btuh): 56500 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 16.50 Heating Capacity(Btuh) @ 47 F: 53500 Region IV'HSPF Rating (Heating): 9.20 Heating Capacity(Btuh) @ 17 F: 33400 FootNote 11 - The AHRI 210/240 certified EER ratings are calculated under the same methodology as the EER ratings at T1 conditions of ISO 5151:2010 and ISO 13253:2011. * 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 products) 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 AM 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 INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.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 130722114416387582, ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: t 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 1LL air conditioning replacement permit applications. Each unit change -opt must ltiple units on single sheets are not acceptable. Job Address (where the work is being done) -1234 NE 96 STREET 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 0 ARHI Sheet Attached: YES 0 NO ❑ Contract Attached: YES ❑® UNIT BEING REPLACED DATA NEW UNIT GOODMAN MANUFACTURER LENNox AR61-1 AHU or PKG. UNIT MODEL# cBx32MV-060 ciw60-1c COND. UNIT MODEL# xP21-060 9 KW HEAT 9 5 NOM TONS 5 AHU 60 CU bO PKG 1) M.C.A AHU CU 6Q PKG AHU — CU — PKG 2) M.O.P AHU CULI PKG AH CU PKG 3) VOLTS AHU CU 315PKG 14 PKG UNIT PKG UNIT / / EER/SEER 12.50 / 16.50 YES NO REPLACING DUCTS YES NO YESk NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES _ NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Site): I 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 60 3. Voltage of Circuit (208/240/480): 230 4. Size Disconnecting Means: Contractor's Company Name: SOLAR BEAR Phone: 305-863-1830 State Certificate or Registration No. CAC 1817134 Certificate of Competency No. Signature, Date: 3/28/2015 (Qualifier's signature) (Revised02/24/2014) p This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2014. Certificate of Product Ratings AHRI Certified Reference Number: 5272316 Date: 3/30/2015 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: XP21-060-230 ** Indoor Unit Model Number: CBX32MV-060-230*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: DAVE LENNOX SIGNATURE Series name: XP21 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: SEER Rating (Cooling Heating Capacity(Btuh 16.50 ), 47 F: 53500 Heating Capacity(Btuh) @ 17 F: 33400 FootNote 11 - The AHRI 210/240 certified EER ratings are calculated under the same methodology as the EER ratings at T1 conditions of ISO 5151:2010 and ISO 13253:2011. * 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 9M 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 INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.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 130722114416387582 ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 0 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234953 Permit Number: MC -4-15-749 Scheduled Inspection Date: May 20, 2015 Permit Type: Mechanical - Residential Inspector: Perez, JanPierre Inspection Type: Final Owner: ALLEN, CHARLES Work Classification: A/C Replacement Job Address: 1234 NE 96 Street Miami Shores, FL Project: <NONE> Phone Number Parcel Number 1132060143930 Contractor: SOLAR BEAR SERVICES Phone: (305)863-1830 tsuuming ueparEmem comments AC CHANGE OUT 4 TON Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid INSPECTOR COMMENTS False Inspector Comments CREATED AS REINSPECTION FOR INSP-231478. c/u must meet min flood elevation May 19, 2016 For Inspections please call: (305)762-4949 Page 32 of 40 Miami Shores Village 10050 N.E. 2nd Avenue NE * Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Applicant 1234 NE 96 Street 1132060143930 CHARLES ALLEN Miami Shores, FL Block: Lot: Owner Information Address Phone Cell CHARLES ALLEN 1234 NE 96 ST MIAMI SHORES FL 33138-2554 Contractor(s) Phone Cell Phone SOLAR BEAR SERVICES (305)863-1830 4 Info: AC CHANGE OUT 4 TON ion: Residential In Review Denied: ping: 1 Fees Due Amount CCF $4.80 DBPR Fee $4.22 DCA Fee $4.22 Education Surcharge $1.60 Permit Fee $281.01 Scanning Fee $3.00 Technology Fee $6.40 Total: $305.25 Date Approved:: In Review Type of Work: Valuation: $ 7,047.00 TotaIS q Feet: 0 Pay Date Pay Type Amt Paid Amt Due I Invoice # MC -4-15-55031 04/02/2015 Check #: 11570 04/07/2015 Check #: 11615 $ 50.00 $ 255.25 $ 255.25 $ 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 1 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 zoning. Futhermore, I authorize the above-named contractor to do the work stated. April 07, 2015 Authorized Signature: Owner / Building Department Copy April 07, 2015 1