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MC-15-670Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-230975 Scheduled Inspection Date: June 15, 2015 Inspector: Perez, JanPierre Owner: ORTEGA, JUAN Job Address: 173 NE 106 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: JAG AIR MECHANICAL INC Building Department Comments A/C CHANGE OUT C / Permit Number: MC -3-15-670 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number INSPECTOR COMMENTS False 1121360060390 Phone: (954)752-7825 (9 1" / 1,5 / , June 12, 2015 For Inspections please call: (305)762-4949 Page 3 of 29 Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. June 12, 2015 For Inspections please call: (305)762-4949 Page 3 of 29 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Applicant 173 NE 106 Street 1121360060390 JUAN ORTEGA Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell JUAN ORTEGA 173 NE 106 Street MIAMI SHORES FL 33138- 173 NE 106 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone JAG AIR MECHANICAL INC (954)752-7825 Tons: 3 Additional Info: A/C CHANGE OUT Classification: Residential Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Scanning: 3 Fees Due Amount CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $118.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $137.40 Valuation: $ 3,399.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -3-15-54930 03/30/2015 Credit Card $ 87.40 $ 50.00 03/25/2015 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction ang,�utbermora, I authorize the above-named contractor to do the work stated. March 30, 2015 AuthorIz:6d Slg1WtuW. Owner / Applicant / Contractor / Agent Building Department Copy March 30, 2015 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 MAR 2A NiS FBC 20 ( O Master Permit No.� Sub Permit No. ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING TgMECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: O'7 2) 1\1 t"-- d () (P S � g� City: Miami Shores County: Cts a Miami Dade Zip: 3-3/3 Folio/Parcel#: l I ® a G 3� - 006 m (2-3 50 Is the Building Historically Designated: Yes NO X— Occupancy Type: Re 5 Load: Construction Type: C le SFlood Zone: ' BFE: FFE: OWNER: Name (Fee Simple Titleholder):C' Phone#: /.51® cl Address: D 1 .3 6/F� City: W d G9yo l s �r� State: L- Zip: 3 315'p Tenant/Lessee Name: �� Phone#: Email: CONTRACTOR: Company Name: Address: City: Qualifier Name: WNW= PL. Zip: 3 "�o 7( Phone#: (ov Rlaq State Certification or Registration #: ��. ��2 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1 � Square/Linear Footage of Work: Jy a Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ —NI CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ CC,, TOTAL FEE NOW DUE Bonding Company's Name (if applicable) ly Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State 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. Signatur Signature OWN AGENT CONTRA OR The foregoing instrument wass acknowledged before me this The foregoing in nt was knowledged before me this day of / �%+%C/T '20 /� , by 2, day of 2015 , by A19 -',Qs , who is personally known to who is personally known to me or who has produced baii,Se as me or ho has produced �- L— as identification and who did take an oath. NOTARY PU/_� Sign: Print: ��A Seal: moo ffiffiffiffi*ffiffiffiffi ffiffiffiffiffiffiffi8 APPROVED BY _ (Revised02/24/2014) MANESHROOPWINE Notary Public, State of Florida Commisslog EE 169991 identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Examiner Structural Review LO!S BUCHANAN Notary Public - State of Florida r My Comm. Expires Jul 4, 2015 ffiffiffiffiffiffiffiffiffi Zoning Clerk Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr� COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: � A BUSINESS ADDRESS: 119'N L S L4 CITY ln .5 STATE F (o ZIP CODE BUSINESS PHONE: - 1 ) ?,2- �) ?D FAX NUMBER ( 1 CELL PHONE (_) 15q vy -e QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: -C-MC-_7_723 f �l °l E-MAIL ADDRESS (IF APPLICABLE): lie l+f i `f (?0 4P, 64(ma'IL c aA Created on 3119109 BY NILOV I RV 3126(09 NBAV JAGAT, HARRY HARDEO JAG AIR MECHANICAL INC 11878 WILES ROAD POMPANO BEACH FL 33076-2216 Congratulations! ;Ar'ith 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantlystri►ve 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 DEPARTAdENT,OF BtISI SS,A . : CO{�S�tt1�Ti _f111�DUS JA 'RX ROW .�C n LAImPA1ci1/YAI KEN LA FLORIDA.*"-.-'- D mO E"0110 R GILL ptT10N Y IICIrNSINI IDAR WS ON, SECRETARY ISSUED_ 07/03/2014 DISPLAYAS REQUIRED BY LAW SEQ# L1407030001177 S � ID �- v=`ae'9ti1 .-;''•i$°�"ana�e�. 93c� ^'_, C_/ ��,s�+4 -�i' BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-1 00, Ft. Lauderdale, FL 33301-1895 — 954831-4000 VAUD OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 i DBA: JAG AIR MECHANICAL INC Receipt# ATING/AIRCONDITION CONTRA Business Name: Business Type: (MECHANICAL CONTRACTOR) ; Owner Name: HARRY JAGAT/QUAL BusinessOpened:03/01/1996 Business Location: 11878 WILES RD State/County/Cert/Reg:CMC1249332 CORAL SPRINGS Exemption Code: Business Phone: 9S4-978-2220 Rooms Seats Employees Machines Professionals 4 For Vending Business Only M�unhnr of IU{swhinne• Vandine Tvna_ Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid ;a 0.00 1 0.00 0.00 1 0.00 27.00 � ID �- v=`ae'9ti1 .-;''•i$°�"ana�e�. 93c� ^'_, C_/ ��,s�+4 -�i' BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-1 00, Ft. Lauderdale, FL 33301-1895 — 954831-4000 VAUD OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 i DBA: JAG AIR MECHANICAL INC Receipt# ATING/AIRCONDITION CONTRA Business Name: Business Type: (MECHANICAL CONTRACTOR) ; Owner Name: HARRY JAGAT/QUAL BusinessOpened:03/01/1996 Business Location: 11878 WILES RD State/County/Cert/Reg:CMC1249332 CORAL SPRINGS Exemption Code: Business Phone: 9S4-978-2220 Rooms Seats Employees Machines Professionals 4 For Vending Business Only M�unhnr of IU{swhinne• Vandine Tvna_ Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 1 0.00 0.00 1 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Recelpt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that - — -- - -- it is in -compliance with State or local laws -and regulations. - Mailing Address: HARRY JAGAT/QUAL 11878 WILES RD CORAL SPRINGS, FL 33076 2014 -2015 Receipt: #ICP -13-00007968 Paid 07/21/2014 27.00 rom:Danielle Tabino FaxID: Date:3/25/2015 10:38 AM ` ' __"1. : 2 of 2 ,aia._ o CERTIFICATE OF LIABILITY INSURANCE 25/201DATE /DD/YIYYJ 3/25/2015 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 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(les) 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 BB -Insurance Marketing Inc 10167 W Sunrise Blvd, 3rd Floor Plantation FL 33322 NAMNT E: Andrea Lopez ext 314 PHONE FAx Arc No Ext:954-452-49WC.No:9 - 52-0450 A DREss: re INSURERS) AFFORDING COVERAGE MAIC S GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X�MISES INSURER A:BUSineSS.FirSt Ins Co 11697 INSURED JAGAI-1 Jag Air Mechanical, Inc DBA Arcon AC INSURERB-0h*o Security Insurance Co 24074 INSURER C: INSURERD: 11878 Wiles Rd Coral Springs FL 33076 INSURER E: INSURER F : 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. INSRPOLICY LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER EFF MM/DD/YYYY POLICY EXP MM/DOIYYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X�MISES BKS66680191 1/30/2014 1/30/2015 EACH OCCURRENCE $1,000,000 DAMAGE IQ RENTEIT- PRE (Ea occurrence) $300,000 MED EXP (Any one person) $15,000 CLAIMS -MADE OCCUR PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,D00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC PRODUCTS -COMP/OP AGG $2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDSCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BAS56680191 1/30/2014 1/30/2015 Ea accident -000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE Is DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F_� (Mandatory In NH) A N / A 37910 /16/2014 /16/2015 X WC STATU- OH - TORY LIMTS ER E.L. EACH ACCIDENT $500.000 B DMes describe under DESCRIPTION OF OPERATIONS below AUTOMOBILE LIABILITY CONTINUED BAS56880191 1/30/2014 1/30/2015 E.L. DISEASE . EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $60D,000 UNINSURED MOTORISTS $20,000 PIP W1$0 DEDUCTIBLE $10,000 COMP/COLLISION $500/$500 DEDUCT DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace 1s required) HVAC/Mechanical Contractor. Scheduled Auto: 2002 Ford Econoline Van VIN# 1 FTRE14242HB12948. Re: License # CMC1249332 CERTIFICATE Wni n=P__- Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores FL 33138 ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE v Iststs-cul V At.VKU t..VKNVKATION. All rights reserved. The ACORD name and logo are registered marks of ACORD —`" A w Miami Shores Village Ma 2015 Building Department 10050 N.E.2nd Avenue BY: Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC 4��-�5 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): -73 hl E 10 City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 41NCH 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[]NOD\ ARHI Sheet Attached: YES NO ❑ Contract Attached: YES i 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): � 5 3. Voltage of Circuit (208/240/480): D 4. Size Disconnecting Means: Contractor's Company Name: IA Phone: _ State Certificate or Registration No. 2Certificate of Competency No. Signature (Revised02/24/2014) -T - Aer s. UNTr BEING REPLACED DATA NEW UNIT MANUFACTURER (J CA (, a AHU or PKG. UNIT MODEL # d 3 COND. UNIT MODEL # d L KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU U 000KG 3) VOLTS AH CUA KG PKG UNIT / / PKG UNIT EER/SEER D Vj 5 - YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT Y S NO YES NO NEW eCONCRETE SLAB S YES NO NEW ROOF STAND YES N YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): � 5 3. Voltage of Circuit (208/240/480): D 4. Size Disconnecting Means: Contractor's Company Name: IA Phone: _ State Certificate or Registration No. 2Certificate of Competency No. Signature (Revised02/24/2014) -T - Aer s. MAR 2815 AHRI Certified Reference Number: 3799196 Date: 3/17/2015 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 14AJM36 Indoor Unit Model Number: RHAL-FR36P Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD; WEATHERKING Series name: Manufacturer responsible for the rating of this system combination Is RHEEM SALES COMPANY, 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): 36000 EER Rating (Cooling): 12.20* SEER Rating (Cooling): 14.00'` IEER Rating (Cooling): . Ratings followed by an asterisk (•) indicate a voluntary rerate of previously published data, union accompanied with a WAS, which indicates an involuntary rerace. 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 unauthorlmd alteration of data Elated 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 tort or manner or by any means, except for the user's Individual, AM 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, 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 Ilated at bottom right. 130710894051203E ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 0 2750 NE 183rd St. # 2605 0 GO 0 @ .( ENERGY SOLUTIONS Averdura, FL 33160 OF MIAAH 786-768-7184 N: Air Conditioning •Heating • QentUatioa keith4004@hotmail.com .Imraice we JUD hlatne -"'"�i x , Chang to Address l r' 12k -c. it:� City ZIP 1 Cust. P.O. No. Phone 1 Account'No. Trouble Rep. 0 Mon p The p Wed Q Thu WEATHER ❑ CLEAR- ❑ FOGGY ❑ RAIN ❑ NOT ❑ MODERATE ❑ COOL 0 COLD REFERENCE Make. Made! and swkd Numlm of Fadure or hem on which part was repaired. PARTS WARRANTY AA parts as recorded are laebr a apachflt r . LABOR GUARANTY The fabor charge' as recorded hers reiattveta the equipmera serviced as note, to guaranteed tow a•perlad of 3tf days We d0 not, of course, guaranty other parts than tbMwe InstelL. It repeilm later become jaury due to other detective parls, they Will W charged separately. p Sat p sun STORE °F %RH ���.`� attlt�ntL�LttlltitLrL��tltl� on the reverse.side of ft agraGMSM. we has— sa0�torify coffq*M and hours worked are caveat. Fnergy utim is a JAG Air Company. io TOTAL6ABOR TOTAL AMOUNT DUE W4= r TEF& S NETON RECEIPT t1F I W*GE PAYMENT•IS DUE WLTHIN'30 DAYS OF DATE WOAiGW d PERFOAIII m