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MC-15-2094 V_ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241647 Permit Number: MC-8-15-2094 Scheduled Inspection Date: September 02,2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: HURLEY,JAMES Work Classification: A/C Replacement Job Address:685 GRAND CONCOURSE Miami Shores, FL 33138- Phone Number Parcel Number 1132060172180 Project: <NONE> Contractor: AIR Q INC Phone: (786)486-7810 Building Department Comments REPLACEMENT OF AC SYSTEM 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. September 01,2015 For Inspections please call: (305)762-4949 Page 24 of 47 `� 1 �� N 4/ � �1 � � v ,E�i � �� � 3 24 i �>�� W� M.,� t 3� E E E EEE�E Miami Shores Village 10050 N.E.2nd Avenue 01 [•. Miami Shores FL 33138-0000 Phone: (305)795-2204 p Ex iration: 02/16/2016 � Project Address Parcel Number Applicant 685 GRAND CONCOURSE 1132060172180 JAMES HURLEY Miami Shores, FL 33138- Block: Lot: Owner Informatlon Address Phone Cell JAMES HURLEY 685 GRAND CONC MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone Valuation: $ 3,319.00 AIR Q INC (786)486-7810 Total Sq Feet: 0 Tons:2.5 Available inspections: Additional Info:REPLACEMENT OF AC SYSTEM 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-8-15-56757 DBPR Fee $2.00 08/20/2015 Check#:7193 $89.40 $50.00 DCA Fee $2.00 Education Surcharge $0.80 08/18/2015 Check#:7215 $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 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 d 'the work stated. August 20, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 20,2015 1 Miami Shores Village AG815 ® , wilding 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 201 BUILDING Master Permit N4\A�•, � PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION []RENEWAL ❑PLUMBING ®MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:6Grand Concourse City: Miami Shores County. Miami Dade Zip: 'Isa. 13 Folio/Parcel#: 11- 32Q 2Q b -Q I-) —?A'�O Is the Building Historically Designated:Yes NO X Occupancy Type: Res Load: Construction Type: Flood Zone; BFE: FFE: OWNER:Name(Fee Simple Mtleholder):Jim&Kathy Hurley Phone#:305-310-5892 Address:658 Grand Concourse Cit.. Miami Shores State: FL Zip.33138 Tenant/Lessee Name: Phone#: Email:limandkathyhuriey@o atLnet CONTRACTOR:Company Name-Air-Q, Inc. Phone# 786-486-7810 Address: 9010 SW 32 St City: Miami State: FL Zip:33165 Qualifier Name: ROdolfo Alonso Phone#: 786-486-7810 State Certification or Registration#: CMC1249976 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address., City: State: Zip: Value of Work for this Permit:$3,319 Square/Linear Footage of Work: 1,000 sf Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: Replacement of AC System Specify color of color athru tile: Submittal Fee J Permit Fee ' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 09. 1 `' (Revlsedo2/24/7-014) i r ,a 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 low brochure will be delivered to the person whose property is subject to attachment. Also,ra 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 thg absence of such posted notice, the inspection wall not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The fore sing instrum nt was acknowledged before me this The foregoing instrument was acknowledged before me this day of .20 by day of _ ,20 ,by ��z personally known to &o{ Al o is personally known to me or who has produced as me or who has produced as identification and who did tak n oath. identification and who did o th. NOTA PUBLIC: NOTAR UB S SiCn- ul ',� LL Print: 0,-A"rMl v1. Print: r CARMIN TILLIT ,� CARMIN TILLIT Seal: MY COMMISSION#FF 98617 Seal: ; MY COMMISSION ii FF 98817 EXPIRES:June 28,2018 ,a. EXPIRES:June 28,2018 8ondad Thm Nolm Public Underorritere �'.q� �yq;' Bonded Thru Notary Public Undere bm 76 APPROVED BYZ�;P//V/,O�Y_Plans Examiner Zoning Structural Review Clerk {Reuisexi02i24i2014) E .4 �' CERTIFICATE OF LIABILITY INSURANCE 5/DATE(MM/DD/YYYY) 18/2015 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 CONTACT A&D ALL-LINES INS ASSOC INC PHONE (305)463-6781 FAXAIC •(305)387-2918 5600 SW 135 Ave Ste 106 E-MAIL ADDRE­3aI[l8 or a south.net Miami, FL 33183 INSURER(S) AFFORDING COVERAGE NAIC0 INSURERAJ%XIELIA UNDERWRITER INSURED AIR-Q, INC. INSURERB: LLOYDS OF LONDON 9010 SW 32ND STREET MIAMI, FL 33165 INSURER D: 786-486-7810 INSURER F, INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSLTR TYPE OF INSURANCE UL OVUM POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY $ 100,000 CLAIMS-MADE ■ --.OCCUR MED EXP(Anv one rson 5 000 B Y CIBFL0006487 09/23/1409/23/15 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG 2,000,000 PRO- M LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY AUTOS DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ WORKERS COMPENSATION X I WC STATU- I OTH- AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE FLA 106-52223 05/08/1505/08/16 E.LEACH ACCIDENT $ 100/��0 A OFFICER/MEMBER EXCLUDED? U NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ r "Was Pc1be under D RI PERATIONSbelow E-L.DIS LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additonal Remarks Schedule,if more space is required) License# CMC1249976, Mechanical Contrator FICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORMIN. g s reserve . ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD sHO1s Miami Shores Village ttic tv9a ABuilding Department ones Roeser R 10050 N.E.2nd Avenue mi Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA �p PERMIT NUMBER: MC `�—DG I 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):685 Grand Concourse 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 Q NO❑ Contract Attached:YES Q UNIT BEING REPLACED DATA NEW UNIT Carrier MANUFACTURER Rheem 40YA024300 AHU or PKG. UNIT MODEL# RMT36211VITANJA 38TMO2430ODL COND.UNIT MODEL# RA1430AJlNA 5 KW HEAT 5 2 NOM TONS 2.5 AHU 32 CU 15 PKG 1)M.C.A AHU 31 CU 17 PKG AHU 35 CU 25 PKG 2)M.O.P AHU35 CU 25 PKG AHU2 4 OCU2 4 0 PKG 3)VOLTS AHL2 4 OCU2 4 OPKG PKG UNIT / / PKG UNIT EER/SEER 13/16 YES REPLACING DUCTS YES QD (0 NO REPLACING THERMOSTAT In) NO YESVt�O NEW 4"CONCRETE SLAB YES ( YESIED NEW ROOF STAND YES O YES O NEW RETURN PLENUM BOX YES 66) 1. Minimum Circuit Ampacity(Wire Size): AH (8), CU (10) 2. Maximum Overcurrent Protection (Fuse/Breaker Size): AH (35), CU (25) 3. Voltage of Circuit(208/240/480): 24Ov 4. Size Disconnecting Means: AH (35), CU (25) Contractor's Company Name: Air-Q, Inc. Phone: 786-486-7810 State Certificate or Registration No.CMC 12 76 Certificate of Competency No. Signature Date: 2015-01-17 (QuaUflees 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. e Certificate AHRI Certified Reference Number: 7491227 Date: 8/17/2015 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1430AJ1 Indoor Unit Model Number: RH1T3621MTAN 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 reglon(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 testing: Cooling Capacity(Bfuh): 31600 EER Rating(Cooling)-.-­_ 13.00 SEER Rating (Cooling): 16.00 " JEER 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, 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. 130843205651516082 02014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: f Y Air-Q, Inc. Estimate 9010 S.W. 32nd Street Date Estimate# Miami,FL 33165 8/5/2015 3207 Air-Q, Inc. Name/Address Ship To Jim&Kathy Hurley Jim&Kathy Hurley 685 Grand Concourse 685 Grand Concourse Miami Shores,FL 33138 Miami Shores,FL 33138 Project Description Qty Cost Total Subtotal 385.00 Notes: This estimate is good for 30 days. AC Closet patch and seal,by others,excluded from this estimate. Heat Load Calcs excluded from this estimate,if Heat Load Calcs are requested by the City,please add$175.00 Miami-Dade County Sales Tax 7.00% 0.00 Thank you for your business. Tota $3,319.00 Phone# Fax# E-mail 786-486-7810 786-363-8810 airginc@yahoo.com Air-Q, Inc. Estimate 9010 S.W. 32nd Street Date Estimate# Miami, FL 33165 8/5/2015 3207 Air-Q, Inc. Name/Address Ship To Jim&Kathy Hurley Jim&Kathy Hurley 685 Grand Concourse 685 Grand Concourse Miami Shores,FL 33138 Miami Shores,FL 33138 Project Description Qty Cost Total CONTRACT/ESTIMATE 2.5 TONS SYSTEM(31,600 Btu/h),RHEEM, 16 SEER,AHRI# 7491227 10 YEARS WARRANTY ON COMPRESSOR AFTER OWNER'S REGISTRATION 1 YEAR WARRANTY ON PARTS AND LABOR Demolition.Removal and disposal of existing Air Handler and 1 0.00 0.00 Condensing Unit,removal of Return Plenum (after removal of AH the AC Closet must be finished:patched, sealed and painted) 2.5 Tons Air-Handler.Rheem,Model#RH1T3621MTANJA, 1 895.00 895.00 Dimensions:H:50-1/2"x W:21"D:21-11/16",S/N: Air Handler Heater,5 kW.Rheem,Model#RXBH-1724C05J 1 85.00 85.00 2.5 Tons Condensing Unit.Rheem,Model#RA1430AJ1NA, 1 1,095.00 1,095.00 Dimensions:H:27"x W:29.75"D:29.75",S/N: Replacement of Air-Handling Unit,reconnect fiberglass supply 1 400.00 400.00 plenum,drain line,refrigerant lines,high and low voltage wiring Replacement of External Condensing Unit,reconnect refrigerant 1 300.00 300.00 lines,low and high voltage wiring Digital Programmable Thermostat,Honeywell 8000 1 175.00 175.00 Safety T Switch,SDSS3 2 25.00 50.00 22"x 23"x 1.5"Drain Pan for underneath Air Handler. 1 55.00 55.00 Air Handler Units Stands, 18" 1 50.00 50.00 Subtotal 3,105.00 FPL REBATE FPL Rebate(a 1 year or older account must be open for more than a -171.00 -171.00 year to apply for Rebate) Subtotal 2,934.00 PERMITTING City Fees for Permit and Inspections(this amount may vary) 1 135.00 135.00 Fees for Permits and Inspections 1 250.00 250.00 Thank you for your business. 11 Total Phone# Fax# E-mail 786-486-7810 786-363-8810 airginc@yahoo.com