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MC-16-395 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL l/ Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-252737 Permit Number: MC-2-16-395 Scheduled Inspection Date:April 06,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner. ALTMAN, HOLLIE Work Classification: A/C Replacement Job Address:144 NE 101 Street Miami Shores,FL 33138- Phone Number Parcel Number 1132060131990 Project: <NONE> Contractor: FLOW-TECH AIR CONDITIONING CORP Building Department Comments EXACT AC&CHANGE OUT 4 TON. Infractio Passed Comments INSPECTOR COMMENTS False TO CANCEL PERMIT#MC14-1293 Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid For Inspections please call: (305)762-4949 April 05,2016 Page 8 of 45 3 Miami Shores Villageh i 10050 N.E.2nd Avenue N e E Miami Shores,FL 33138-0000 �t Phone: (305)795-2204 Expiration: 08/17/2016 Project Address Parcel Number Applicant 144 NE 101 Street 1132060131990 HOLLIE ALTMAN Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell HOLLIE ALTMAN 144 NE 101 Street MIAMI SHORES FL 33138- 144 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 6,090.00 FLOW-TECH AIR CONDITIONING COF -- Total Sq Feet: 0 Tons:4 Available Inspections: Additional Info:EXACT AC&CHANGE OUT 4 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 $4.20 Invoice# MC-2-16-58670 DBPR Fee $3.20 02/11/2016 Credit Card $50.00 $189.75 DCA Fee $3.20 Education Surcharge $1.40 02/19/2016 Credit Card $ 189.75 $0.00 Permit Fee $213.15 Scanning Fee $9.00 Technology Fee $5.60 Total: $239.75 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 j'o o n in at on is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I autho' tractor to do the work stated. February 19,2016 Authorized Signature:Owner / Applicant / C ntractor / Agent Date Building Department Copy February 19,2016 1 Miami Shores Village g Building Department F B 1 1 2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 S�'t+ FBC 201 BUILDING Master Permit No. 'J PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION CrENEWAL ❑PLUMBING MECHANICAL []PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: l y 1 a 1 S'1" City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 113 a o(0 D 131 C) Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type:I Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): `1 l e 'm �ML.✓1 Phone#: Address: 144 �)F 1Z) ! 49�-- City Hzry-'•.R, State: V�T Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: -ret �v. . A �l 1�axya Phone#: Address: 4e,,r City: � i.f�� State: Zip: 03 1Vv Qualifier Name: K&A O AYr 2- �dAs C —Z> Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: P � City: State: Zip: Value of Work for this Permit:$ �1 0 q- I - Square/Linear Footage of Work:� Type of Work: ❑ Addition ❑ Alteration ❑ New E9 Repair/Replace ❑ Demolition Description of Work: G(Z) a Specify color of color thru We: a , )(� Submittal Fee$ �® lA� Permit Fee$ �9 CCF$ tet' ' �Wn) CO/CC$ Scanning Fee$ 1 . � Radon Fee$ 2" DBPR$ /� Notary$ Technology Fee$ 6® Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 9) TOTAL FEE NOW DUE$ RC4 -':�6 Q (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 SignatureO&tC----, OWNER or AGENT CONTRACTOR The foregoing instruments was acknowledged before me this The fcy,egoing instrument was acknowledged before me this �!�- d of ✓ ,20 by day of 20 by C) tom. Ir��lA�.1rJ !!"personally known to . N `• %1�- (s ersonall known to � ���1L�LJ�IJ P V me or who has produced s t as me or who has produced as identification and who did t6ke an oath. identification and who did take an oath. NOTARY PUBLIC: �t-''1 ..� �(�J� ®NOTARY PUBLIC- sign: / Sign: * v*; \SS\ — Print: �°•" MIRMAPAMNA MY COMM#EE * °oto�:v:�i,� MELISSA RIVERA EXPIRES:February I Q EXPIRES:Febrs-r, :;.: Seal: MY COhIMISSDN#EE SMS �l9 ov vt��OP BMW Th Budget plotary ge�v�F;oag Bonded Thru cudgel:�o a•s:'•'• * * EXPIRES:February 18,2017 `�'4 ��°' Ba�dTfwBNotarYServkes APPROVED BY °' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) /1/V/•V VV/ /I VV t V/ ttV/• iWli Ll1TiVV/t/ViV/\V/I M•/ STATE OF FLORIDA' DEPARTIIIIENT OF BUSINESS AND PROFESSIONAL REGULATION , CONSTRUCTION INDUSTRY LICENSING BOARD CA=4371 ' The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 0• Q PEREZ VEiASCO,MARIQ,t W • FLOW-TECH AIR CONDCO.RP 7023 SW 13 TERRACEu MIAMI FL 33144 e ISSUED: 062014 DISPLAY AS REQUIRED BY LAW SEQ# L1400090000697 00. Local Business Tax Receipt Miami—Dade County, State of Florida -7F�.S IS NOTA IML-00 NOT PAY Nk LBT 2303824 WORMW 10AWWW"TUM EXPIRES FLOW TECH AIR CANDrnONING FNIEvAL SE"EMBER 30, 2016 CORP 2421550 7023 SW 13 TERR btit,st dMant to at ueee of buairtess MIAMI,FL 33144 Chapt to to County code cnatrter aa-Airt.s&Io OW?MR ti@C TV"CNa FLOW TECH ABR CONDRIONM 196 SPEC MECHANICAL By T COLt,HCIM CORP CONTRACTOR 75.00 0VA5 X16 WWWO) 10 CACO24371 CREWCARD-16442247 ibbtac! 11 1 Tu neodo Q* 8 dOeLwW Bohn=Tsps Remo isada fteaw PIVAara dft 10ai0osboWs todbbwftass.t rso'sea*'M-v m boss and I r 1 , , IwhbRaV*toRebodam Nw rft =Wbe ®ep toe11 U -Nbm&4hft Code Set Se-M � s1s6t FLOWT-1 OP ID:LD ACORO® E(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1DATEIMIMN5 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. N SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsemeft A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COKrACT Alfredo Andrial BROWN&BROWN OF FLORIDA INCPHONE 30r.>'-364-7800 FAX No:305-7141401 14900 NW 78th Court Suite#200 Miami Lakes,FL 33016-589 E'aAB Alfredo Andrial INSURERS)AFFORDING COVERAGE NAX:0 INSURER A:Ascendant Commercial Ins Inc 13683 INSURED Flow-Tech Air Conditioning INSURER S:Gemini Insurance Company 10833 Corp. waURERc:Philadelphia lndemn Ins Co 18058 7023 SW 13th Terrace Miami,FL 33144 INSURER D' INSURER E: 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. IN8R AWL SUBR LTR TYPE OFINSURANCE POLICYNUMBER POLICY EFF POLICY EXP LIMITS B X comwERcm GENERAL Lamm EACH OCCURRENCE $ 1,000, CLAIMS-NAOE ❑X OCCUR VGGP001717 10/06/2015 10/8!2016 PREMISES occurrence $ 100Wo MED EXP(Any one person) $ Excludec PERSONAL&ADV INJURY $ 1'0W'= GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2r000r POLICY a JECT LOC PRODUCTS-COMPIOP AGG $ 2,CW,00( OTHER: $ AUTOMOBILE LUU30 Y NED SINGLE LIMIT $ 1000 0� aodderd r r C X ANY AUTO PHPK1403365 10/0612015 10/8/2016 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per ardderrt) $ X HIIRRED AUTOS X AUTOS OS AUTOS NON-OWW NED (Per ac GE $ UMBRELLA LIM OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS•MADE AGGREGATE $ DED RETENTION$ $ WORKERRSCOMPENSATiON X PER ER AND EMPLOYERS•LIABBJTY A ANY PROPRIETORIP,ARTN�CUTNE Y 1 N WC65626 06/29/2015 06/2812016 E.L.EACH ACCIDENT $ 1 r0Wr OFFICERIMEM13ER EXCLUDED? ® N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ V yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT $ 11000100( DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,A"Horad Remarks Schedule,may be attached H more space Is required) Mario Peres Velasco License#CACO24371 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE 00nRAnoN DATE THEREOF, NOTICE WILL BE DELIVEREDN I g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue Miami Shores Village,FL 33138 AUTHOR®REPRESEWATM ©1888-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD td Jw�i� a � ,I'• �� � f; This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17,2009 and Dec 31,2013. Certificate uf Product Ratinus AHRI Certified Reference Number: 5868109 Date: 6/26/2014 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:4TTR6049B1 Indoor Unit Model Number:*AM7AOC42H31 Manufacturer:TRANE Trade/Brand name:XR16 Series name: Manufacturer responsible for the rating of this system combination Is TRANE Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Condltioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, Independent,third party testing: Cooling Capacity(Btuh): 46000 EER Rating(Cooling): 13.00 SEER Rating(Cooling): 16.00 LEER Rating(Cooling): •Ratings followed by an asterisk(h indicate a voluntary cerate of previously published data,unless accompanied with a WAS.which Indicates an involuntary rerste. 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 MM 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 etterand 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 rigid. 02014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 1304829071781770 • oaf Miami Shores Village � ! Building Department 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): 144 0 !✓ 10 1 ST City: Miami Shores Village County: Miami Dade Zip Code: '3 313 8 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:YESK NO❑ ARHI Sheet Attached:YES NO❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT M&NUFACTURER 14 4,2 1,T t 15(-Xr44Z AHU r PKG.UNIT MODEL# T'A-1✓1 40C4Z4 D Ii R 14 50 4 g I"g Z COND.UNIT MODEL# 4TTA(&04q15 I I O Vt^j KW HEAT 10 KAJ 7-CrX5 NOM TONS 4 T-0-A15 AHU CU PKG 1)M.C.A AHU CU ZCaPKG AHU Cu PKG 2)M.O.P AHU S PKG AHU Cu PKG 3)VOLTS 2027-2-0o - I60 HU C PKG PKG UNIT / / PKG UNIT EER/SEER 95 t�' YES NO REPLACING DUCTS YES O YES NO REPLACING THERMOSTAT I YES NO YES NO NEW 4000NCRETE SLAB YES CNO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES O 1. Minimum Circuit Ampacity(Wire Size 0,01 2 fe A t. 44A) 2. Maximum Overcurrent P tection Fuse Breaker Size): Ct) 3. Voltage of Circuit(208 240 0): 4 -Q - 5 J — 404 -*( W/ 4. Size Disconnecting Mea '� - �'o,4- r o_ruv g6 ��,J. ` 0 Contractor's Company Na 'F- ef-d Phone: 3K Q(4 -�5 State Certificate or r tic 4C0-2443)1 Certificate of Competency No. ,t Signature � Date: "t ' ! (Qwuftes sWoture) (ReYised02/24/2014)