MC-15-1988 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-241838 Permit Number: MC-8-15-1988
Scheduled Inspection Date:August 31,2015 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre
Inspection Type: Final
Owner: CLIFFORD LE, PAUL Work Classification: A/C Replacement
Job Address:1371 NE 103 Street
Miami Shores, FL 33138-2623
Phone Number
Parcel Number 1132050300170
Project: <NONE>
Contractor: MARVIN'S AIR CONDITIONING CORP Phone: (305)541-8408
Building Department Comments
EXACT CHANGE OUT 5 TONS A/C UNIT Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-240878. NO ACCESS
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 28,2016 For Inspections please call: (305)762-4949 Page 13 of 26
.. .• ,.� � � Stu'.
f
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204
1 �t�lX1120 Expiration: 02110/2016
s.
E
Project Address Parcel Number Applicant
1371 NE 103 Street 1132050300170 PAUL CLIFFORD LE
Miami Shores, FL 33138-2623 Block: Lot:
Owner Information Address Phone Cell
PAUL CLIFFORD LE 1371 NE 103 Street
MIAMI SHORES FL 33138-2623
1371 NE 103 Street
MIAMI SHORES FL 33138-2623
Contractor(s) Phone Cell Phone Valuation: $ 3,931.00
MARVIN'S AIR CONDITIONING CORP (305)541-8408 Total Sq Feet: 0
Tons:5 Available Inspections:
Additional Info:EXACT CHANGE OUT 5 TONS A/C UNIT
Inspection Type:
Classification:Residential
Final
Approved:In Review
Review Mechanical
Comments: Date Approved::In Review
Date Denied: Type of Work:EXACT CHANGE OUT 5 TONS A/C U
Scanning:2
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40
DBPR Fee Invoice# MC-8-16-56640$2'06 08/14/2015 Check*8414 $ 104.11 $50.00
DCA Fee $2.06
Education Surcharge $0.80 08/07/2015 Check#:8394 $50.00 $0.00
Permit Fee $137.59
Scanning Fee $6.00
Technology Fee $3.20
Total: $154.11
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 and zoning. Futhermore,I authorize the above- ed ator to do the or stated.
August 14, 2015
Authorized Signature:Owner / Appli / Contractor Agent ate
Building Department C py
August 14,2015 1
N
�S e`aC Miami Shores Villa� g
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
FBC 20
BUILDING Master Permit No. HC® 1 -- ISI 88
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION r-1 RENEWAL
❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:_ .'.`11 4)F IG a S I
City: Miami Shores County: Miami Dade ZiD: 3313'(6
Folio/Parcel#: 1/^3W 'U3®'®l T® IS the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): �� c\<aiz)CC' Phone#: MG-544-®re�
Address: _.k 3j k "
City: R-%>-YYli 5h0--e5 State: TL Zip: 33\m
Tenant/Lessee Name: Phone#:
Email:
P
CONTRACTOR:Company Name: -ins)i, a A%K- ytikh n®42rA cap- Phone#: 36-'L
Address: 1-76 5L-� I (+`' -I" (G��
City: /Li j a °i' State: Zi -?-3513s-
Qualifier
3-3513s-Qualifier Name: i-1g1n�„� l �c tC Phone#:
State Certification or Registration#: CAL 1 12-s [31 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ � �� p° Square/linear Footage of Work:-
Type
ork:Type of Work: ❑ Addition ❑ Alteration ❑ New [2"'Repair/Replace ❑ Demolition
Description of Work: ..5-N C'I& � l'►°�`r
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$
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.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
T--day of .20 /5 ,by 7� day of ,20 15 ,by
cv ,who is personally known to �.,� ,who i- ersonally Icnnwn
me or who has produced �0q �J� � 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: SFO®
Print k
Print: E:1,,, �\ S5\ 312oe��e
Seal: a�:••••; Y31, a
* E eN Seal: ; .. c ea
Soto
0
APPROVED BY q D Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
sr° Miami Shores Village
Building Department
.... �.. 10050 N.E.2nd Avenue
Miami Shores,Florida 33138
�r Rey Tei:(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): \3`1 \ NE, KY3 S�
City: Miami Shores Village County: Miami Dade Zip Code: 33 4 34�>
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
AH DATA SHEET REQUIRED
Change disconnecting means:YES El NO ARHI Sheet Attached:YES;d O❑ Contract Attached:YES t
UNIT BEING REPLACED DATA NEW UNIT
MANUFACTURER -n.
AHU or PKG.UNIT MODEL# 9A + k K 1
COND.UNIT MODEL# 16G,UA 31
KW HEAT
NOM TONS 1s
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 J / PKG UNIT
EER/SEER
YES NO REPLACING DUCTS YESA-�°
YES NO REPLACING THERMOSTAT NO
YES NO NEW 4"CONCRETE SLAB NO
YES NO NEW ROOF STAND YES =NAL—
YES NO NEW RETURN PLENUM BOX YESiffo—'-71
1. Minimum Circuit Ampacity(Wire Size): B, l Nt2,
2. Maximum Overcurrent Protection(Fuse/Breaker Size): ayn,95
3. Voltage of Circuit(208/240/480):
4. Size Disconnecting Means:
Contractor's Company Name: RC�K-'j�Vl S eA�r Gbrzk' kaG 10 )G'PPhone: 505_-51-1
State Certificate or Registr on No. Certificate of Competency No.
Signature Date: l�11-'S
d (Qualifiers atom)
(Revisedo2/24/2014)
i ® This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed In service
® between Feb 17, 2009 and Dec 31,2014.
Certificatv,aftf 104*(Dduct Ra
AHRI Certified Reference Number: 7943714 Date: 8/6/2015
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number RA1660AJ1
Indoor Unit Model Number: RHITS024STAN
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*00nellililei for the rating oi�system combIrratlon is RHEEM SALE$�IPANIP,INC.
Rated as follows In accordance with Alf Standalyd 2101240- t���yy
for Un Air-C #i log andAifr-Source
Heat Pump Equipment and subject to verification of rating accur y by*Alltoipo nsonKIndependent,third
party tenting.
Cooling CapaCtljf(Stuh): 58000
EER i2atl waling): 13.00
SEERRatio (Cooling): 1Ei.t1€1
LEER Rating(Cooling):
•Ratings followed by an asterisk(')indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an Involuntary cerate.
DISCLAIMER
AHRI does not endorse the product(s)listed on this CerNflcate and num 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
LLnand
ory at www.ahrldirectory.org.
MS AND CONDITIONS
Certificate and Its contents are proprietary products of AHRL This Certificate shall only be used for individual,personal andAM
dential reference purposes.The contents of this certificate may not,in whole or in part,be reproduced;copied;disseminated;
ed Into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual,
onal and confidential reference. AIR-CONDITIONING,HEATING,
TIFICATE VERIFICATION &REFRIGERATION INSTnUTE
nformation for the model cited on this certificate can be verified at rimu.ahridireetory.org,dick on'Verify Certificate"link we make life better,
enter the AHRI Certified Reference Number and the date on which the certificate was issued,
h is listed above,and the Certificate No.,which is listed at bottom right 1��014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.:
Marvn's Air Conditioning Carp
License CAC1816314
1761 SW 11 Terrace-Miami,FL 33135
Off Ph:(305)541-8408-Fax: (305)441-1856-Cell: (786)487.0801
PROPOSAL
July 3,2015
To: Paul Clifford
Address of Work:
1371 NE 103 St
Miami Shores,FL
Scone of Wark
1. Remove the existing split A/C system unit
2. Supply and installation of 5 tons split system(IuwW )
a. C/U:AUB969F3 PA*r,,O A 31
b. AM:
c. Seers: 16
d. Heater: 10 KW
3. Supply and installation of pvc switch
4. Supply and installation of digital thermostat
5. Supply and installation of concrete base for condensing unit
6. Supply and installation of metal stand for condensing unit
7. Process and pull out permit
Warranty: 10 years Compressor and Parts; 12 months of labor(this job only)
Value of this job: $4,275.00 -3qq co
FPL Rebate Discount: (9,jO6-80)
New Value of job: -,�pPj a1,C10
Of rnanng0 00ontl -
Payments:
'let i
Payment in advance....................................................... $2069-.w
At the end of installation ................................................ $ 1,000.00
We accept credit cards
Scope of Work
1. Remove the existm' split condens' g unit
2. Supply and installatio of 5 tons ondensing unit
a. C/U:TCJF60S41
3. Supply end installation of a ion valve for air handler
4. Supply and installation o 'gi thermostat
5. Supply and installatio concret for condensing unit
6. Supply and installati of metal star r condensing unit
Warranty: 10 years Co r and Parts; 12 months f labor(this job only)
Aug 0715 01:02p Marvin's A/C Corp. 3055411856 p,1
CER`"F1CATE OF u"jU Y INSURANCE a �
1712/2015
i1p3.G ICA7519 1$Bf1®f ABA YI'A7YERt]eK tNiOW MMM N.Y AM CONF MMM NKi M upoN TW C6AYY MAYNNpt,DM TM
t T1P7CJ►'18DOSS NOT AiF1FALW ILVat!!Et{A aV,,%WMk WOMOR At MTM COWWAORAFl=ORe»SY-am POUF
AR-OW THIS W a19OAANCEODESNOT OONSTVM^ODUuUwr TfN{'�g10UAi AtJtiNOW�D
RP?iZ T M4 -R PSI®7.A1i0 7N8 CE�FICA•IFJNrL05R.
MPOW&M WON orbae AoarnpllAlJlgNp�Am.aQn4vl�ue�mme a9UeNOGA'eObBW
Ipeorarouucoeeu AIDGasvWettb
AeNefFe2WpYdciePegr�gp}� .A ��01 cnwq+dahtstoeq
COgiGo�10H10t1olAiogl eegbrmdpnpaewAp(�• ,
PRDD•A`.e -
BRACON INSf3RAM= GRCCTP INC P�
8567 Coral %8y X307 (305)266-9706 ""'I X305}q68-6503
-tmi, FL 333.5. 5@.7Ltsurer.cpm
Anormwo wawa
Roane uaaus>Ben•� GRPMADA IITStJRANCE CO.RQ:f1�TS A.IR CdNdIT30NYYdC3 CORP
1761 sw IITg TER tea:
N r PL 33135
ulsu�te:
COVER&OMCQt7fFiCAT� N ER
•iF93.I$10C trIFYT1W7n�AOUCMCFaMMAW;eLWmeagwrlegrgsF1ft19811FD'ioTFle E1AS1 FtU BER•
9O)ECJtYF�. NOSµy •,�OR IiVa1NID�EOABO�FOR M'POULY RB74Q
LEtYfEFiCATE AfleY B&>6$IIED OR itAY -rye ANT!CMRptAf„-�pR pTHgt DOC1kVftTOT VMB7i REQ TO yy�i'�11NJS
�yO'mEO av nos M$CEB O HERR s Gle,f,"�TO ALL IM TWO^
C°�`^'+nF.a.G�I.tJI�$S11tAMrEVW HAVHBF8tRB7tICW 6YPAtp C1A4J8
net
�r rVPflOFikWW= r
PGUCV women a 1.PRT9
X. D�A�tL ft"
gA�196N01= rXI .000
OCf1R BPLtI DDCt 8 Q 1Q0
airs. •marreie s
A 0185FL000S1143 7 '"�� aeptira l s 5 000
AMM pa-
.0 PBe:-0.c wo o u " � 0 2.000,000
o� -coisnnaAoa s T D00 OOa
AlnoNwaeuasanY s
AWVW o wan $
PAL' aCHODULM 900iLYK6fftY�Nl9e®S $
RUMS AUTM
"No*U= rAufte
BOOAYa(nnmr(Praa>�p g
a
PAGffis lWB SUN OCCURRB= s
ear �»naa a Aoc�txAzs s
.�*l�unffiury s
symm vim t1a4
LR
dO°OfO• NIA
*4 6A PN.Y ACopla7r 8
Ma.OBkA6sv+Pi
ampn ovonetL0.zraeie avow •i �' E-FA EAtPIbYB'i t
Ba. -PAI timer t
DEMPItONOP Ct8iA7EDkaIt0rR7sygry Qi00i70106AO�Otif iiumuie SYe t/e�eelt�.a aeaa maeapre h
IR COMITIONnt6+1 L'oNTR&CT_
CAMS16314
CE'RYIFlcArE w
EMMORMWII.S.M,
k .
MIAML SHCFM VILLAGE BLDG DEPT
10050 NE 2ND AVE F7W pcL=WeecAr+e
M74ML SHORES,FL 333 , Nonce tau, Be. IN
ACCOFAV4e4 MINEPOt1t.YPl004 .
rrAnvE.
h40RD25(2df3fQ41 A�868••a013 AOOgp CDRPiDrtATtOPI. Ah rl�laaeited.
'rhe ACaRO none and 100 Bre wed malts of AMM