Loading...
MC-15-1993 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240911 Permit Number: MC-8-15-1993 Scheduled Inspection Date: August 24, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: CARROLL, LAURENCE & HERMINE Work Classification: A/C Replacement Job Address:53 NE 106 Street Miami Shores, FL Phone Number Parcel Number 1121360060290 Project: <NONE> Contractor: PREMIER AIR COND& REFRIGERATION INC Phone: (305)888-3826 Building Department Comments EXACT A/C CHANGE OUT 3.5 TON Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 21, 2015 For Inspections please call: (305)762-4949 Page 23 of 39 b No SIG- -'I 5'* sNO1 S L,� Miami Shores Village Chat1lca1-Rest de 10050 N.E.2nd Avenue NE 12 flit k�,. MY `f!VW .! lft AlC Re*cem t . Miami Shores, FL 33138-0000 Phone: (305)795-2204 B n A E'Nigg RNs i,. '...��.. 121 Expiration: 02/08/2016 Project Address Parcel Number Applicant 5=106Street 1121360060290LAURENCE&HERMINE CARRO MBlock: Lot: Owner Information Address Phone Cell LAURENCE&HERMINE CARROLL 53 NE 106 Street MIAMI SHORES FL 33138- 53 NE 106 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,549.00 PREMIER AIR COND&REFRIGERATII (305)888-3826 Total Sq Feet: 0 Tons:3.5 Available Inspections: Additional Info:EXACT A/C CHANGE OUT 3.5 TON Inspection Type: Classification:Residential Final Approved: In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# MC-8-15-56646 DBPR Fee $2.00 08/12/2015 Check#: 1979 $ 143.62 $0.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $124.22 Scanning Fee $9.00 Technology Fee $3.20 Total: $143.62 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 a oing info ation is accurate and that all work will be done in compliance with all applicable laws regulating d zo ' construction ang. Puther orize t amed contractor to do the work stated. August 12, 2015 uth ure:Owner / cant / Contractor / Agent Date Building Department Copy August 12, 2015 1 Miami Shores Village Building Department r� - �r�r� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 AUG b 7015 Tel: (305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 =---- FBC 20jy `' BUILDING Master Permit No. Hc- 8' MQ-3 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING Z MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: S3 ti l06 Strep+ City: Miami Shores Countv: Miami Dade Zip: Folio/Parcel#: I I— ZO 3(a — 006 —02gL) Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): ijerZni'h e QiLfCe++S Phone#: Address: 5 3 /V E /06 S frL-e t City: 51:,04e< State: FL Zip: 3 313 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Pr8m ier A& Phone#(305) AC583826 Address/:`,16s uyez t- I v /port City: l ( 1 Clle4h State: EL Zip:'33 Qualifier Name: T05e H6rnG„de2 Phone#( D 21e?-- 'SIA 8 b State Certification or Registration#:(;4Gp5 74 7 / Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �,� 5 LI4,00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ElNew ❑ Repair/Replace ❑ Demolition Description of Work:5)CQC+ AIC (JrCl r)0P 01/1 3,5 tL)h Specify color of color thru tile: (� Submittal Fee$ Permit Fee$ l CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ II TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address 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. p PP P f 9 Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of All q�3+ 20 19- by �_day of akgysf 120 IS by ..rm in.c 2 i 1t c- whoi personal_ ly kr10Wn t o s� Lrn a.1�c z who i ersonally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: 2g,,.� -"•�oso Print:��yrn� Seal: Seal: Notary Public State of Florida Ld Notary Public State of Florida M Raul M CardosoRaul M Cardoso My Commission EE 218158 My Commission EE 218158" Expires 08/1312016a ti Expires 08/13/2016* * * * * **** ***************** ************ APPROVED BY X/IPlans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 7/29/2015 Property Search Application-Miami-Dade County . OFFICE F THE PAPPRAISER Summary Report Generated On:7/29/2015 Property Information Folio: 11-2136-006-0290 NE 107TH ST Property Address: 53 NE 106 ST Owner LAURENCE T CARROLL&W HERMINE Mailing Address 53 NE 106 ST MIAMI SHORES,FL 33138-2034 Primary Zone 1000 SGL FAMILY-2101-2300 SQ 0101 RESIDENTIAL-SINGLE oar Primary Land Use FAMILY:1 UNIT Beds/Baths/Half 3/2/0 N E Floors 1 Living Units 1 Actual Area 1,928 Sq.Ft Living Area 1,880 Sq.Ft Adjusted Area 1,820 Sq.Ft Lot Size 9,225 Sq.Ft Taxable Value Information Year Built 1940 2015 2014 2013 County Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2015 2014 2013 Taxable Value 1 $95,730 $94,574 $92,438 Land Value $163,894 $154,253 $87,509 School Board Building Value $112,460 $109,486 $109,486 Exemption Value $25,000 $25,000 $25,000 XF Value $19,919 $20,167 $20,416 Taxable Value 1 $120,730 $119,574 $117,438 Market Value $296,273 $283,906 $217,411 City Assessed Value $145,730 $144,574 $142,438 Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $95,730 $94,574 $92,438 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $50,000 $50,000 $50,000 Save Our Homes Cap Assessment Reduction $150,543 $139,332 $74,973 Taxable Value 1 $95,730 $94,574 $92,438 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Sales Information Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Previous OR Book- Board,City,Regional). Sale Price Page Qualification Description 2008 and prior year sales;Qual by exam 02/01/1993 $94,000 15826-2866 Short Legal Description of deed 36 52 41 PB 41-78 11/01/1978 $57,500 10220-1265 2008 and prior year sales;Qual by exam DUNNINGS MIAMI SHORES EXT NO 2 of deed LOT 13 BLK 207 LOT SIZE 75.000 X 123 09/01/1975 $41,500 00000- 12008 and prior year sales;Qual by exam 00000 of deed OR 15826-2866 0293 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disciaimer.asp Version: CR O. y Miami Shores Village Building Department �... .....� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 j� Tel: (305) 795.2204 �ORiDp' 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): 5 3 0 E 16 6 S+r-<e-+ City: Miami Shores Village County: Miami Dade Zip Code: 3 313 Y 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 NO ❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT tarn MANUFACTURER Akeem C 2 FJ4 D AHU r PKG. UNIT MODEL# 21 S1,4 12-A, qq-j-A 2 COND. UNIT MODEL# y.2 IF KW HEAT -3_ S NOM TONS 3 S AHU CU PKG 1) M.C.A AHU'3a CU zs PKG AHU 55 CU PKG 2)M.O.P AHU_.-5 CU 1)PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT 2 E NO YES NO NEW 4"CONCRETE SLAB E NO YES NO NEW ROOF STAND YES O YES NO NEW RETURN PLENUM BOX ES NO 1. Minimum Circuit Ampacity(Wire Size): '? 2. Maximum Overcurrent Protection (Fuse/Breaker Size): d 3. Voltage of Circuit(208/240/480!):b d 4 4. Size Disconnecting Means: �j D _ Contractor's Company Name: Phone: 3 8 8 8-3132 State Certificate or Registration No. If H-05s7'1'7I Certificate of Competency No. Signature fir' � _ Date: -4'7/2 9/2- OS- (Qualifier's signature) This combination qualifies for a Federal Energy CERTIFIED Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2014. Certificate of Product Ratings AHRI Certified Reference Number: 7942888 Date: 7/24/2015 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1642AJ1 Indoor Unit Model Number: RH1T4821STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: Region Note: Central air conditioners manufactured prior to January 1,2015,are eligible to be installed in all regions until June 30,2016. Beginning July 1, 2016, central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. 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 test filing Capacity(Btuh): 41500 EER Rating(Cooling): 13.00 SEER Rating(Cooling): 16.00 IEER Rating(Cooling): 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.abridirectory.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, AM-41 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 eke life bcucr 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 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 130822280783920804 5t1oREs Gi soon .....e1 � � " Miami shores Village Building Department ���RIDA 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. v `COPY OF LOCAL BUSINESS TAX RECEIPT C. `COPY OF LIABILITY INSURANCE* D. y COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE 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. —�/7—COPY OF LIABILITY INSURACE* E. y COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: BUSINESS ADDRESS: CITY STATE_ZIP 3-30)0_ BUSINESS PHONE: ( s ) 8 8 i3 3 B2 6 FAX NUMBER(3`s ) 8.FS– 1221 CELL PHONE( 3a 1- QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: L R C o s--)cj] STATE OF FLORID DEPARTMENT OF WSINESS AND PROFESSIONAL R=GULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HERNANDEZ, JOSE LUIS PREMIER AIR COND& REFRIGERATION INC 2165 W 10 CT HIALEAH FL 33010 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 CAC057971 ISSUED: 08/2112014 serve you better_ For information about our services,please log onto www.myfloridalicerne.com. There you can find more information CERTIFIED AIR GOND CONTR about our divisions and the regulations that impact you,subscribe HERNANDEZ,JOSE LUIS to department newsletters and learn more about the Department's PREMIER AIR GOND&REFRIGERATION I 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, IS CERTIFIED under the provisions of Ch 489 FS and congratulations on your new license! E s ALOG 31 2016 L140821000115e DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ERMU OEM CAC057971 The CLASS AAIR CONDITIONING CONTRACTOR ." Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 HERNANDEZ, JOSE LUIS '❑ �'•❑ PREMIER AIR GOND&REFRIGERATION INC 2165W10CT -% .c HIALEAH FL 333010 ISSUED: 0&21/2014 DISPLAY AS REQUIRED BY LAW SEQ* L1408210001158 SS x�rGfcf,ky;�iht)°tr�'�,'�'ts x t1 ft " rti 7 wR- � ! �' r r ga $ h ry�Mr�n e�`�XS.�ti Lv w`�'"`.�1F^z`R�f�a � j.. � x a���x� aPa s'�x� ♦ ae 9t.i rf+`;Gl��t��d��y C� � 5 a Jc JJ a� x, r.l u�� 5. '•hf 1 5 NY ' h* s � l�� f AC�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)8/10/2015 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(ies) 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 CONTACT Greta Nielsen NAME: Corporate Insurance Advisors PHONnE o. t: (954)315-5000 A/C NO: (954)315-5050 1401 E Broward Blvd E-MAIL ADDRESS:gnielsen@ciafl.net Suite 103 INSURER(S)AFFORDING COVERAGE NAIC# Ft. Lauderdale FL 33301 INSURER ADe ositors Insurance Company 00035 INSURED INSURER B:Philadel hia Indemnity Ins Co. 18058 Premier Air Conditioning 6 Refrigeration, Inc. INSURERC:Commerce and Industry Insuranc 19410 2165 W 10th Court INSURER DAssociated Industries Ins Co 23140 INSURER E: Hialeah FL 33010 1 INSURER F COVERAGES CERTIFICATE NUMBER:15-16 REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DDNYYY X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $_ A CLAIMS-MADE OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ ACP5935219511 9/25/2014 9/25/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 X P OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 _B X ANY AUTO BODILY INJURY(Per person) $ _ ALL OWNED SCHEDULED PHPK1213210 8/5/2014 9/25/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS $ Per accident Medical payments $ 5,000 X UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 R DED RETENTION$ 0 EBU064141444 9/25/2014 9/25/2015 g WORKERS COMPENSATIONR OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE TUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT_ _ $ 1,000,000 D Mandato in NH EXCLUDED? NIA AWC1049043 7/18/2015 7/18/2016 (Mandatory ) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: License # CAC057971 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE / 1 Mark Schwartz/ANGELA #re ? 1-fe� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 n01401t T�iUAt w,a&� 2165 W. 10th Court, Hialeah, FL 33010 Ph:305.888.3826 PLem i er Fax:305.888.1221 TrustPremierAC.com OP Air Conditioning Data ;912,212016- State 922 20/S"State Licensed&Insured CAC-057971 yob#: AGREEMENT invoice#- To: ri"'7ii�► /��l5 e-mail Street S`3 �C /067"/"" Sl- l.7 Home Phone 0r / V LWork city l ��• r�5 p o �- We hereby submit specifications and estimates for:X in boxes=yes New Duck System(See Plans) Vertical AM Closet Water Cooled Unit Package Unit Mobile Home Add Now Supply Duct(See Plans) Garage A/H Condenser on Ground Package Unit on Ground Add New Return Duct(See Plans) Altic AM/Coiling Mount Condenser an Roof Package Unit on Roof Reconnect to Existing Ductwork New A/H Support Bracket Condenser Wail Bracket Package Unit on Wail Bracket UV-Light Filter Rack New Concrete Stab New Refrigerant Lines Balance Air Flow New Aluminum A/H Stand New AM Platform(Wood Box) Hurricane Strap to Code Reconnect to Existing Lines Return Air Type RH_RHF_ Insulate Return Air Base Vibration Pads Liquid Line Size_ New Return Grill New 3/4 Plywood Base Top New Roof Stand Suction Line Size_ Replace All Supply Air Grills Smoke Detector to Code Seal Roof Stand Insulate Suction Line(ArmaPiex) Replace Supply Air Riser(Plenum) New Emergency Drain Pan New Steel Wall Bracket New Drain Line Drop Cloths used Reconnect Heat RecoveryNew Unit on Existing Mount Insulate Drain Line(Armahex) Crane Service New Thermostat H_VC New Float Switch KReconnect to Existing Drain Line Permit New Humidistat System Star Up and Test Reconnect to Existing Electrical Remove old Equipment from Premiset New De-Humidistat New_AMP Disconnect at A/H Replacement Permit-$350.00&up Condensate Pump 115V.240V New_AMP Disconnect or Breaker at Condenser New Installation Permit-$750.00 Additional Line Cover ELECTRICAL PERMIT NOT INCLUDED.SEE ELECTRICAL CONTRACTOR. EXISTING CONDITIONS MAKE MODEL DIMENSIONS(H x W x D) Condensing Unit 779 �_ Air Handler OPTION#1 OPTION#2L- OPTION#3 MANUFACTURERInitials "InitialsMANUFACTURSC Initlala TONNAGE ' •s S.E.E.R. / (0Z CONDENSER UNIT 14 V -4 AIR HANDLER UNIT ' ii/5 741/VT r Z� ���!'► PACKAGE UNIT HEATER PRICE 3 T -,/ 2. YEARS OF WARRANTY Labor / C/e--*r Parts Q .Litt/- _ Compressor / ,Q� TO BE INSTALLED. Data. 2 e,,. C-/Olit A.M. 0 P.M. RECOMENDATION /NOTES -- C /C i /sGovn /1 ne-1v 10o a�oo :� S C Wi� t p GOyr! re-,;Soy O ,��` A?d ddewAl %3 TERMS OF PAYMENT rob Prime: a TUNE UP AGR��� E FPL Discount: a Z3 18 POINTS CHECK UP $ TYPE OF PAYMENT Tax: E SAP# S' g CHOM Check# .lob Total: a FINANCING Deposit a /31 SERVICE CALL $ CREo CMD VAdtt,ru ogo r-# Balance Due: $/2' Service&Warranties:All equipment and materials installed by Seller shall be guaranteed by the manufacturer for the period of one year from date of installation unless otherwise specified.Labor required for replacement of defective parts or workmanship shall be furnished by Seller free of charge for a period of one year from the date of installation,unless otherwise specified above.Failures by lack of maintenance is not covered under warranty. Any alteration or deviation from the above specifications involving extra cost will be exec only upon written order and will Include an extra charge over and above this estimate. Acceptance of Proposal:The above prices,specifications.Terms and conditions 1- Reverse Side)are satisfactory and are hereby accepted.You are authorized to do the work as specified.Then payment will be made at outlined ve. "on 501.025 Statutes(Consumer Protection)provides that "...the buyer has the right to a home solicitation sale until the midnight of ird bu Ma day attar day an whi#h th@ WYK§igft§fiH 119MORNO:" man to insure and compliance f au w Zz zo,s ,2Z a /dr Owner's Name(Print) D e ARCO T P R ATIVE