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MC-15-2074 r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241506 Permit Number: MC-8-15-2074 Scheduled Inspection Date: October 07, 2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: PONTON, RONALD Work Classification: A/C Replacement Job Address:552 NW 112 Street Miami Shores, FL 33168-3318 Phone Number Parcel Number 3021360210640 Project: <NONE> Contractor: NEW SERVICE COMPANY Phone: (305)324-754_ Building Department Comments EXACT REPLACEMENT OF 2.5 TON CENTRAL WITH IINNSPECSPEC Passed Comments 8.OKW HEATER. TOR COMMENTS False l wo l Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 06, 2015 For Inspections please call: (305)762-4949 Page 16 of 60 0, ,yo";P h Miami Shores Village t�t� t 10050 N.E.2nd Avenue NW "• "'"`" Miami Shores,FL 33138 0000 r �Ei t18 s f ' ' . . 4�`�0Ri"ot�y Phone: (305)795-2204 r ; xpir E at'on• 02/15/2016 .. raj. ':'. t ,..;�,.•.. Project Address Parcel Number Applicant 552 NW 112 Street 3021360210640 RONALD PONTON Miami Shores, FL 33168-3318 Block: Lot: Owner Information Address Phone Cell RONALD PONTON 552 NW 112 Street MIAMI SHORES FL 33168-3318 552 NW 112 Street MIAMI SHORES FL 33168-3318 Contractor(s) Phone Cell Phone Valuation: $ 4,200.00 NEW SERVICE COMPANY (305)324-754_ (305)798-7383 Total Sq Feet: 0 Tons:2.5 Available Inspections: Additional Info:EXACT REPLACEMENT OF 2.5 TON CENTRA 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 $3.00 Invoice# MC-8-15-56736 DBPR Fee $2.21 DCA Fee $2.21 08/17/2015 Check#: 1156 $50.00 $ 118.42 Education Surcharge $1.00 08/19/2015 Check* 1162 $ 118.42 $0.00 Permit Fee $147.00 Scanning Fee $9.00 Technology Fee $4.00 Total: $168.42 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 informal io 's ccurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-na tractor to do the work stated. August 19, 2015 Authorized Signature:Owner / Applicant / C ntr or / Agent Date Building Department Copy August 19,2015 1 Miami ShoresVillage g Building Department AUG 7 2015 g p � 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 (. INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 2aq BUILDING Master Permit No. �4 c� Un�� PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 5 2 A) ISI / / 2 S'/2 L L City: Miami Shores County: Miami Dade Zip: 3-31 Folio/Parcel#: I I 1 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Ronald V. Ponton Phone#:(305) 751- 2 32 Address: S 5 Z /Y JA/. // 2 S REE i City: AI/A A4 i Sh O k e S State: F—L A Zip: 3 3! 68 Tenant/Lessee Name: Phone#: Email: ?0N.pp1yt-c1v rRd AeL . Ce5/yl CONTRACTOR:Company Name: N L-,\AJ S e Y y C e ftM P A Al Phone#: 2& - 31 N '? 504 Address: 5o 1 SW � Si Vt*-e 302 City: A,M' State: Zip: 3 3 3D Qualifier Name: Phone#: 3 OS- 20 2- ? State Certification or Registration#: C A C I is 1 N N 2 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ , Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: 6 X 6 F PC C CTri e rl tO2, S 1 0 N C 13ry 'E't L wi'�1R K W 1 Specify color of color thru tile: Submittal Fee$ Permit Fee$ l /• 19CCF$ 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 V. 4,", Signatur OWNER or AGENT CONTCTO The foregoing instrume was acknowledged before me this The foregoing instrument was acknowledged before me this /S day of �(� 20 ,by 3 day of 20 � ' ,by I/who is personally known to who is personally known to me or who has produced f j F� as me or who has produced Y KJ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: EA., Print: allETH PLUM �'V 1 Seal: n 7E Seal: r� 'r Ikt1,c T EX•5 of .41 s***s**************** s ^*s********s**sss***s**s***sss**s***********ss**********s*ss*s**s*s*s********s*s APPROVED B S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) From:New Services Fax:(305)256-8248 To: Fax: +1 (305)756-8972 Page 1 of 1 08/17/2015 9:12 AM ` '`" ' 08/07/207/201155 CERTIFICATE OF LIABILITY INSURANCE DATE / 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 staterrent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Best Option Insurance Brokers,Inc PHONE (305)859-7303 (FAX,/ No): (866)9100983 3400 Coral Way Suite 500E-MAILD ludys@bestoptioninsurance.net Coral Gables,FL 33145 INSURERS AFFORDING COVERAGE NAIC# Phone (305)859-7303 Fax (866)910-0983 INSURER A: Granada Insurance INSURED INSURER B: INFINITY New Service Company INSURER C: 501 SW 1st ST#302 INSURER D: NORMANDY HARBOR INSURANCE COMPANY INSURER E MIAMI,FL 33130 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADD SUB POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM D/YYW MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 O COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrrence) $ 100,000.00 F-] ❑ CLAIMS-MADE Q OCCUR MED EXP(Any one person $ 5,000.00 A F-1PERSONALN 45121784 05 08/03/2015 08✓03/2016 PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 1,000,000.00 ❑ POLICY ❑ PRO- ❑ LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY INJURY(Per person) $ 25 000.00 B ❑ ALL AUTOSNEO D AUTOSULED N N 509800014081001 12/03/2014 12/03/2015 BODILY INJURY(Per accident) $ 50 000.00 NON-OWNED PROPERTY DAMAGE F-1HIRED AUTOS ❑ AUTOS Per accident $ 25,000.00 F-1 El PIP(NIRR)DED-$1,000 $ 10,000.00 ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ DEO n RETENTION $ WORKERS COMPENSATION ❑SPTERTUTEORE TH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTI E.L.EACH ACCIDENT $ 1,000,000.00 D OFFICER/MEMBEREXCLUDED? N/A N NHFL0032152015 01/08/2015 01/08/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CAC1814442 CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WLL BE DELIVERED IN 10050 NE 2 Ave ACCORDANCE VNTH THE POLICY PROVISIONS Miami Shores Village FL 33138 AUTHORIZED REPRESENTATIVE 305-7952204 Fax 305-756-8972 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)QF The ACORD name and logo are registered marks of ACORD ,5t►oR,ms y� Miami Shores Village Building Department -molls ....m 10050 N.E.2nd Avenue Miami Shores,Florida 33138 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): 552 A/141 //2 S%2EE i City: Miami Shores Village County: Miami Dade Zip Code: 3 3/&9 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[]X NO❑ ARHI Sheet Attached:YES ❑ NO❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER 6k A w AHU or PKG.UNIT MODEL#F N p *0 COND.UNIT MODEL#- � p KW HEAT 1- NOM TONS 2 . 2: - AHU CU PKG 1)M.C.A AHU CU l;i PKG AHU CU PKG 2)M.O.P AHU 'ACU PKG AHU CU PKG 3)VOLTS 0 N0C.1 S AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES O YES NO REPLACING THERMOSTAT 5 ES NO YES NO NEW 4-CONCRETE SLAB V5 yo- NO YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): 2 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 2 b N't Vs"S 4. Size Disconnecting Means: �`jA13 A1ih Q b Lt'Kq= f Contractor's Company Name:_ 1 v e.VV �e V 1V i C e �0 mP 4 t4 Phone:_j b S -3'l.N`-7 S V'7 State Certificate or Registra ion No. C L° kA Certificate of Competency No. Signature Date: 1'7 i per's sig re) (Revised02/24/2014) This combination qualifies for a Federal Energy e , Efficiency Tax Credit when placed in service Al between Feb 17,2009 and Dec 31,2014. www.ah r ire ct or y.or Certificate of Product Ratings AHRI Certified Reference Number: 7657334 Date: 8/15/2015 Product: Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number: CA14NA030"**'kA Indoor Unit Model Number: FX4DN(B,F)037L Manufacturer: BRYANT HEATING AND COOLING SYSTEMS Trade/Brand name: BRYANT HEATING AND COOLING SYSTEMS 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: 14 SEER PURON AC Manufacturer responsible for the rating of this system combination is BRYANT HEATING AND COOLING SYSTEMS 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): 29400 EER Rating (Cooling): 13.50 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 CenMcabL AHRI expressly disclaims all liability for damages of arty 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; Imman entered into a computer database;or otherwise utilized,in any form or manner or by arty means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUrE The Information fo►the model cited on this certificate can be verified at www.ahridlrectory.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 listed at bottom right130841341-- - --------13227402937 ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 2550 NW 72 Ave#113 Office:305-324-7504 Miami,FL 33122 Licensed and Insured tmpaniCAC1814442 PEDRO PEREZ 6i&; 3 RONALD PONTON 552 NW 112 ST MIAMI 33168 Customer Name Adamem____- city&Zip Code Pholmie-gu—M Referred By Equipment Choice Date------ Z OPTION*1 E] OPTION#2 ❑ OPTION#3 Brand CARRIER Tonnage Capacity 2.5 TON S.E.E.R./Efficiency 16 SEER Outdoor Unit/Condenser CA14NA030 Indoor Unit/Air Handier FXDNF037L 10 YRS COMPRESSOR M COMPRESSOR YRS COMPRESSOR Warranty 16- YRS PARTS YRS PARTS YRS PARTS Accessories INSTALLED PRICE PRICE $4,371.00 PRICE PRICE With Tax Included REBATE ($171.00) REBATE REBATE TOTAL $4,200.00 TOTAL TOTAL Accessories Indoor Air Quality Solutions ion System [ZI Thermostat ❑ UV Ught(s) 0 New Air Vents 0 Safety Switch ❑ Whole House Air Purifier Number of Vent(s) Equipment Tie-Down E] Guardian Air/UV Purifier ❑ New Return Air ❑ Air Handier Stand [] Custom Fitter(Frame&12 Pads) Number of Return ❑ Concrete Slab 0 Energy-Efficient Ventilation E] Duct Cleaning ❑ New Refrigerant Lines C] Carbon Monoxcide Alarm Number ofvents) Fresh/Outside Air 0 Installation Package _WarrantyC Your Choice (F) Complete System Start-Up ❑ 90 Days Labor Remove&Recycle existing equipment 1 Year Labor $0.00 1 Choose Option It Fkish Drain Line ❑ 5 Year Labor Q) Charge to Manufacturer's Specs ❑ 10 Year Labor Equipment Cost $4,371.00 (D Protect Home with Drop Cloths ❑ 10 Year Parts&Labor Q) Flush Refrigerant Lines 0 FPL Rebate ($171.00) 0 Permit Fee$ "Comfort at depot price" Down Payment Lowest Price Guarantee BALANCE DUE $4,200.00 , Notes: Acceptance of Proposal/Contract "t,J to,;,)stafiere,it,full In.tall"t"n.i'.'.s a freed and under-t—d Ly the that all equipment and v-, old pursuant her,._shall r,;t fi,tr—or 1.Til �t the r.ai srate 1,01,!y re placed, e,Juy,",!W shall at Al times ret iaT po;sc,.l P-Pelli a111 fllhr ihcrelo shall rwwt-%vtth the_,eller until payment n'uA is r:i; ,Buyer hereb,, tl,.Oend n1", be th,­r,rit ,fryyi and ,V,th,p­nl,ss-loo!rum fA,q,.% entr., t"1'.n.,ov,any equip.....it 4tt�, ins!alLu no"tu­j tvi11 be L"r—', Customer Approval I X __-) 0-Y., I AuthorlmdSigriature