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MC-15-2040 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FIL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241311 Permit Number: MC-8-15-2040 Scheduled Inspection Date: August 24, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: JOUBERT,JEAN-PIERRE LOUIS& Work Classification: A/C Replacement ICQQ1f%A RAnDAI ec Job Address:77 NW 96 Street Miami Shores, FL 33150- Phone Number (305)401-7778 Parcel Number 1131010330390 Project: <NONE> Contractor: STRONG AIR CONDITIONING AND SERVICES INC Phone: (786)360-5051 Building Department Comments REPLACE AN A/C UNIT 3 1/2 TON RHEEM 14 SEERS 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 24 of 39 1`&2040 Ft Miami y Miami Shores Village 4�iri �C�'trxnscall-Residential • �� 10050 N.E.2nd ANW venue _ ....M •" Miami Shores, FL 33138-0000 It sSfe�WPPROVED Phone: (305)795 2204 f� 1 Fiosiid' � x INN �� � 1 �3/2b't6 Expiration: 02/14/2016 Project Address Parcel Number Applicant 77 NW 96 Street 1131010330390 Miami Shores, FL 33150- Block: Lot: JEAN-PIERRE LOUIS&JESSICA Owner Information Address Phone Cell JEAN.PIERRE LOUIS 8�JESSICA 77 NW96 Street (305)401-7778 MIAMI SHORES FL 33150- 77 NW 96 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone _ �. Valuation: $ 3,300.00 STRONG AIR CONDITIONING AND SE (786)360-5051 Total Sq Feet: 00 Tons:3 1/2 Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Approved: In Review Review Mechanical Comments: Date Approved: : In Review Date Denied: Type of Work:REPLACE AN A/C UNIT 3 1/2 TON RF Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# MC-8-15-56698 DBPR Fee $2.00 DCA Fee $2.00 08/18/2015 Credit Card $89.40 $50.00 Education Surcharge $0.80 08/13/2015 Cash $50.00 $0.00 Permit Fee $120.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $139.40 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 AFFI VI - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zoning Futherm I authorize the above-named contractor to do the work stated. August 18, 2015 Authori nature:Owner / Applicant / Contractor / Agent Date Building D partment Copy August 18, 2015 1 Miami Shores Village p - AU6X015 Building Department , j 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 13Y: _ Tel: (305)795-2204 Fax:(305) 756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20/z/ BUILDING Master Permit No. . 1 - .JF. � 'zdL/e9 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING4 MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:] SHOP / CONTRACTOR DRAWINGS JOB ADDRESS: W 6 ST City: Miami Shores County: Miami Dade Zip: 7n Folio/Parcel#: b 1 0_?,__� - 6 A c(h Is the Building Historically Designated:Yes NO Occupancy Type: Load: `` __Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): "" �s1 021- tr104t�eC ,O�b� Phone#: Address: ,-A---A- N W q (o S-V City: r\1( rh\ S6fe.S State: L_ Zip: 33j�r� Tenant/Lessee Name: 1�'� Phone#: Email: yn M q'r�1 Ctl ` . Cowl oSe�rJ CONTRACTOR:Company Name:_zAV-0V1 Ai \r Q I4 t tA' Phone#:�05 cyk68- (� , Address: pp e-44- C <.. City: �`CL.I Q� State: t- l— Zip: 3 Qualifier Name: F f UQ.r'O Phone#: 2 h E 9_2- aq S9 State Certification or Registration#: 0_64 bej I Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: 1111h$ ' C) t. 0 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New EdRe air/Re p p lace El Demolition Description of Work: lac U\ Al C UI/�t 1 �Z. 4C 1 a he yn I �eP D' Specify color of color thru tile: Submittal Fee$_1L0 CZPermit Fee$ /00v' Oy CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ a 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 mus posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the n such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature , I Signature �) NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing in rument was acknowledged before me this day of Z2var .j 20,/� by d of Uqo 4, 20 /rte" , by r)6c/,7I;who is personally known to ho is personally known to me or who has produced '- �_ as me or who has produced L as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: r Sign: Sign: b01Fl Print: Notary Print: DIANA • My Commission c MY COMMISSION#EE835882 Seal: Expires 01112!2018 Seal: a, EXPIRES September 18,2016 OF a 107 J96o1s3 FlondsNob 8arvice.00m �7 I APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �1•,SNOC.193,RES`� Miami Shores Village Building Department 11911"' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 ��oRiDp 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): ST "1Gt W k Sa0fe S V 331 ST--S City: Miami Shores Village County: Miami Dade Zip Code: 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 2/NO ❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL# 1�0 OVIAl St"SWM COND. UNIT MODEL# AI dj d19,rl 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 CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES O YES 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 O 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit(208/240/ 0 - P<Il e 410"-1 4. Size Disconnecting s: Contractor's Comp me* V-\ ` Z (k O-OA S92vAone:3C)5 ` xC -O/7 , State C i icate o r orvN / I `2 Certificate of Competency No. SignaWr - Date: 8f ature) (Revised02/24/2014) i A "IMP . . . Certificate of Product Ratings AHRI Certified Reference Number: 7600509 Date: 8/11/2015 Product: Split System: Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1442AD1 Indoor Unit Model Number: RH1P4221STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD Region: Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT,VT,WA, WV,WI,WY, U.S. Territories) 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; Man uf�acturer:responsible or the rating of this system combination 1s RHEEM SALES COMPANY, INC. Ratedfollows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat f,ir'r�np,Egeiprna acid subject to verification of rating accuracy_,by AHRI-sponsoired, independentr third party testing: x Cooling Capacity(Btuh); 41500 EER Rating;(Cooling): 11.50 SEER Rating (Cooling): 14.00 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.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 form 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,click on"Verify Certificate"link we make life bei ter° 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. 1 X1)837926976183121' ©2014 Air-Conditioning, Heating,and Refrigeration Institute CER't1FICATE NO.: w � t ro n 9 AIR CONDITIONING & SERVICES 7925 W 25 AVE UNIT#4 Hialeah, 17133016 (305) 968-1010 License: CAC041128 For: Jessica Morales jorbert job Address: 77 NW 96 ST,Miami Shores,FL 33150 Date: 8/12/15 Scone Of Work This price includes: o Replacement of a 3.5-ton Rheem split-system (14 SEER) Total Bid Price..................................$3,300.00 Approved by: Owner Strong A/C SHORES G �j o... 1111 iami Shores Village - �� Building Department RtiDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: C er State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of—�-;✓-�L -,20—L� By CC' r _r_4(_}b�e C A who is personally known to me or has produced r as identification. Notary Public State of Florida Notary: ?4 Joanna M Feliciano My Commission FF 082753 SEAL: %and' Expires 01/12/2018 Mal t r o n 9 AIR CONDITIONING & SERVICES 7925 W 25 AVE UNIT#4 Hialeah, F133016 (305) 968-1010 License: CAC041128 I,Emmanuel Rodriguez, as sole proprietor of Strong Air Conditioning&Services, Inc.,will be performing work at 77 NW 96 ST Miami Shores,Fl 33150. I will be the ONLY ONE working on this site as I am the only one covered in the workers exemption. Thank you, I Emmanuel Rodriguez •' DIANA ROSA RODRIGUEZ rl ••: MY COMMISSION 0 EE835882 EXPIRES September 18,2016 107 N"iS3 n FWd*NM Saviu.o0m g��z11s