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MC-16-1236 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-258430 Permit Number: MC-5-16-1236 Scheduled Inspection Date: May 18,2016 Permit Type: Mechanical - Residential Inspector Perez,JanPlerre Inspection Type: Final Owner. ZACCARDI,GREGORY Work Classification: A1C Replacement Job Address:1621 NE 105 Street 1-3 Miami Shores,FL Phone Number Parcel Number 1122300530700 Project: <NONE> Contractor. RAMA AIR CONDITIONING INC Phone: (305)262-1121 Building Department Comments EXACT REPLACE OF 2.5 TON Infractlo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed IUM Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid r May 17,2016 For Inspections please call: (305)762.4949 Page 28 of 44 Miami Shores Village Building Department MAYO late 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 $Y. INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20111 BUILDING Faster Permit No. 1(Y�Al61 > 2Z�o PERMIT APPLICATION Sub Permit No. ❑BUILDING M ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL []PLUMBING gpMECHANICAL []PUBLIC WORKS [] CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS ,,rr JOB ADDRESS: `�y7/ 105 -5�ReE-� 7 (� City: Miami Shores County Miami Dade Zio"B� 13 Folio/Parcel#: //-a?2 " 31D '- 05=- ' 10-ADO is the Building Historically Designated:Yes NO �✓✓ Occupancy Type: Load: Construction Type: a Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): e O `�"r' C Phone#.,CAAJ - ) 9 -1 �0 7 Address- 114 -11 N°e, )0_5 Sfi� �E City�i-4 M" 590,6E5 State: �L Zip: Tenant/Lessee Name: ��fF Phone# T Email: � CONTRACTOR:Company Name: Givf G Phd e#: 0bp—!19:�-/ Z Address: 9?l�1 City: G/ ` - State: Qualifier Name: r �� I�C l�/��/��' PhoneIK-W--14o- C/; State Certification or Registration#: Z�I�Z Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: Cty: State Zip: Value of Work for this Permit:$ d� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ AIt ration ❑ New ❑ Repair/Replace ❑ Dem lition Description of work: L422!E: zz G 7 c-1, J Specify color of co r ru die.- Submittal. ile:SubmittalFee$ Permit fee$_ 0CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (RevL%ed02J24/2014) 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$25W,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- !Y� Signature OV45WNrT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this P�3 day of ,20 li!::� ,by 3 day of 20 /`� ,by �f�Coo d�J Z 01e.e-01e ,who is personally known to who is personally known to me or who has produced as me or who has produced A,- 4,,,x/6 0?? 3,7,-?'fV as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si �7,/ Sign: Print ' ' loP�i; ,�.�� Print: � 07" 'le '� "p 0`';W!� 0 tto Regalado Seal: ;+ Win Eu S Menlo Seal: -A. •:�31WMMM$10X0EE884576 ��• ,:EXfMRESSI4N#FF!48843 ;',� ,1 XPIM:MAR 17,2017 .� 80NOWTHRU10�e r�erlu�°° W1NYl.AAROMNO?ARYcC t * s****s*********ss*s*sasses*s*sss*ss**s************s**ass APPROVED BY6 ��Lt(�TlaisExaminerZornng Structural Review Clerk (Revised02/24/2014) st►o> s 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. Z(Job Address(where the work Is being done): 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❑ NO2�ARHI Sheet Attached:YES❑ NO❑ Contract Attached:Y UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG.UNIT MODEL# GOND.UNIT MODEL# 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 YES NO REPLACING THERMOSTAT NO YES NO NEW 4"CONCRETE SLAB YES io YES NO NEW ROOF STAND YES -NO YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): b 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 56 3. Voltage of Circuit(20880): 2 qO 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate glstratio o. Certificate of Competency No. Signature Date: (Qusgtler's srgnabo) (RwiseW2/24/2014) This combination qualifies for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17,2009 and Dec 31,2016. Certificate of Product Ratings AHRI Cenifled Reference Number:7941343 Date:5/4/2016 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:RA1630AJ1 Indoor Unit Model Number:RH173617STAN Manufacturer:RHEEM SALES COMPANY,INC. Trade/Brand name:RHEEM;RUUD Region:All(AK,AL,AR,AZ,CA,CO,CT DC,DE, FL,GA,HI,ID,IL,IA,IN, KS KY, LA,MA,MD,ME, MI,MN,MO,MS, MT,NC,NO,NE, NH,WJ, NM, NV,NY,OH,or,OR, PA, RI,S6,SD,TN,TX, UT,VA,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 regions)for which they meet the regional efficiency requirement. Series nam: Manufacturer esponsIbie for the rating of this,man combinatta 'la RN EM SALES COMPANY,INC. Rated as follows in accordance with AHRI Standard 21002404009for Unitary Air-COnditloning and Air-Source Heat Prpt"md and sublet to v ica*m ofhating aocuracy by AHRI-sponst i,Ind tient,third ppartyfi ming Capatclty(Stat►): 2 MA Rating(Chong): 13.gt? SEER Rating(Cooling): 16.00 IEER Rating(Cooling): "Raunps followed by an asterisk(7 Indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which hWicates an lovokmtwy rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no repteaelrtatlorls,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expresely dims all Ilablilty for dam of any kind arising out of the use or performaeae of the product(s),or the unauthorized aNeration of data listed on this Certificate.Certified ratings are velld only for models and configurations Iloted in lite directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shell only be used for individual,personal and , aonfldential reference purposes.The contents of this Certificate may not,in whale or in pert,be reproduced;oopled;diesembeted: entered Into a computer database;or otherstlse utilized,In any form or mnlner or by any means,elwW for the user's Indhrklual, pereolel and confidential reference, AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRMERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,dick on"Verify Certificate"link we make life , and enter the AHRI Certified Reference Number and the date on which the cartiflcate was issued, which is listed above,and the Certificate No,.,which Is listed at bottom right 02014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 1310686$4174+22867 This combination qualities for a Federal Energy Efficiency Tax Credit when placed In service between Feb 17,2009 and Dec 31,2016. „tt , Certificate of Product Rafln AHRI Certified Reference Number:7941343 Date:5/4/2016 Product:Split System:Air-Cooled Condensing Unit,Coll with Slower Outdoor Unit Model Number:RA1630AJ1 Indoor Unit Model Number:RH1T3617STAN Manufacturer:RHEEM SALES COMPANY,INC. Trede/Brand name: RHEEM;RUUD Region:All(AK,AL,AR,AZ,CA,CO,CT DC DE,FL,GA,HI,ID,IL,IA,IN,KS KY LA,MA,MD,ME, MI,_MN,MO,MS,MT, NC, NO,NE,NH,WJ,Nilii, NV, NY,OH,OK,OR, PA, RI,SGS,SIS,TN,TX, UT,VA,VT,WA,WV,VVI,WY,U.S.Territories) Region Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be Installed s �in» 12na,� conditioners can ly be Insulted In reglon(s)forwhich the regional efficiency Series name: Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY,INC. Rated as follows In accordance with AHRI Standard 2101240-2W 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): 29000 EER Rating(Cooling): 13.00 SEER Rating (Cooling): 16.01 IEER Rating(Cooling): •Rathp foibwed by an asterisk(')m ste a voluntary rents of previously pubMed data.orbs,accompanied with a MS,whirr Indicates an hvoturrtwy rerate. DISCLAIMER AHRI does not endorse the products)listed an this Certificate and nukes no r�na,warranties or sara►teas and assumes as to,ano responsibility for, the unauuthorized alteratioonofof data �Cerexpresolytificate.Cert radisclaims OR s are r t int product(s),or the directory at www.ahridirectoryorg. TERMS AND CONDITIONS This Owt(floate and Its contents are proprietary products of AHRI.This Certificate shall only be used for individual,persmrlai and 3 confidential retererw purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered hdo a compute or otherwise utilized,In any tarn or rrt nner or by erq nate,exoW for the usWo brdividwd, AIR-CenDMONINc,HEATING, personal and confider"referelco. &REFRIGERATION INSTITUTE OERTIFICATE VERIFICATION The ikon torthe model cited on this certificate can bsvertw at www.ahridirectory.org,eHck on*Verify Certificate"Unk UT male M better- and etterand enter the AHRI OwNfled Reference Number and the data on which the certiffeWA was issued, which is listed above,and the Certificate No.,which Is listed at bottom right. 1310686841742221367 02D14 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: i OiG ttl'a Tel:(305)262-1121 www.4ama8c.com 310 NW 26 ` t F�rn�:.' +Eo I Miami$ , DATE Ucensed &1i cured Air Cax *)WM JOB.Na. CACO 4319mom , RAMA�cJo�+ 4ad �� Oft ow+dAt�+s n� am MW ,�: Neva 1 a r sYs T �Super ,ESE Heat 8 CooI r Svat # Lam. 'ron __V ile on COMMA" -t Yom LOW opidapunk Air 0UNM Tex`$ • JOB TOTAL $ SUPPLIES: � WAARK.S: o � a D UNG o RETL RN ❑ eATHROD�A D FLORIDA ROS ADWM 0 WATER PUMP [] UVING ROOM ❑BEDNM Q ❑ FAMY ROOM ❑ ❑ oral &IPLwvdmw Lim sir Pedafnr L8�r Equipment Foundation Reft1getwo moring*am Builcilng Pani d Ung Cuftv Holm Of Contrd System BBet woorn E)dla M Now Elechical Servk)e Oft" NOTE: INSTALLATION SCHEDULE We will be nay to begin in;sWadonthy►by :,:::,�trail Expirgdon Date: Owner purchave Acceptarm Dom_ GcW Approval: ikon tia>a• • Gt> . .. ...... RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CAC043192 rhe CLASS B AIR CONDITIONING CONTRACTOR darned below IS CERTIFIED Jnder theprovisions of Chapter 489 FS. Expiration date: AUG 31, 2016 ECHEVARRIA, BERTO S RAMAAIR CONDITIONINI✓ 310 NW 57 COURT W! MIAMI FL 331'28 k Z. 0 112A ISSUED: 06/1512014 DISPLAYAS REQUIRED BY LAW SEQ# L1406150000944 001227 Lfal Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY \ILBTI/ 4356929 BUSINESS NAMEMOCATION RECEIPT NO. EXPIRES RAMA AIR CONDMONING INC SAL SEPTEMBER 30, 2016 310 NW 57 CT 4547429 Must be displayed at place of business MIAMI FL 33126 Pursuant to County Code Chapter 8A-Art.9&10 SEC.TYPE OF BUSINESS OWNER PAYMENT RECEIVED RAMA AIR CONDITIONING INC 196 SPEC MECHANICAL CONTRACTOR BY TAX COLLECTOR welrke*} 3 CAC043192 $45.00 07/16/2015 CHECK21-15-096407 This Local Business Tax Receipt only confines payment of to Local Susiaoss Tax.Us Receipt is act a license, nongovernmental n*ol q lawsof the randrsqui which �b .mod comply with any governmental The RECEIPT NIX above must be displayed on all commweial vehicles—Mlemi-l)sde Code Sec ga-276. For mute information,visit it From:Ingrid Herrera Fax:(306)463-9431 To: Fax: +1(306)766-8972 Page 2 of 2 06MI201611:24 AM Aco CERTIFICATE OF LIABILITY INSURANCE °A / ""'x'' `..,.�/ 05/092009/2016 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 policypes)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 Ileu of such endorsement(s). PRODUCER ALL CITY INSURANCE INC-ACI CONTACT Carmen Rodriguez 275 FONTAINEBLEAU BLVD. PHONE (305)463-9431 FAX (305)436-6797 SUITE 190 E-IAAIL gmaO@allcityins.com MIAMI FL 33172 PRODUCER 200248 A- INSUEtERISI AFFORDING COVERAGE NAIC B INSURED I .NORMANDY INSURANCE COMPANY 13012 RAMAAIR CONDITIONING,INC INSURER S;WESCO INSURANCE COMPANY 310 NW 57TH CT INSURER C: MIAMI FL 33126- , INSURER E: COVERAGES CERTIFICATE NUMBER:16 IF• REVISION NUMBER:00 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 MAYHA VE BEEN REDUCED BY PAID CLAIMS. MR TYPE OF INSURANCE ihm main POLICY R DOL SUER POLICY EFF POLICY EXP LIMITS B GENERAL LIABILITY P1421168 00 1/092015 11109t2016 EACH OCCURRENCE $ 1,000,000 X COMMERaAL GENERAL LIABILITY DAMAGE TO RENTED-PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE M OCCUR MEDone rson $ S,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLI PRO- F7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS PROPERTY DAMAGE $ (Per accident) NON-OWNED AUTOS $ UMBRH LA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE A AM WIS BWLOYERS LIABILITY COMPENSATION AND NHFL0041972015 /122015 9A 22016 WC STATU- OTH- EAMPLO _ d Or-RCCaVMBWABEUDER EXCLANYT Dom? C�I�YIN F-1 NIA E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100,000 -W.ZMEMQN OF OP E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addhlorarl Remarks Scheduler ifmcre q>aco Is required) A/C CONTRACTOR LICENSE#CAC043192 CERTIFICATE HOLDER CANCELLATION Al V.Q.C MIAMI SHORES VI LLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd AVE MIAMI SHORES FL 33138- AUTHORIZEDREPREsENTATIVE O 1999-2009 ACORD CORPORATION. All rights reserved ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Miami Shores Village , a 10050 N.E.2nd Avenue NE 3 Miami Shores,FL 33138-0000 Phone: (305)795-2204 Expiration: 11113/2016 Project Address Parcel Number Applicant 1621 NE 105 Street Number: 1-3 1122300530700 GREGORY ZACCARDI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell GREGORY ZACCARDI 1621 NEI 05 ST UNIT 1-3 MIAMI FL 33138-2117 Contractor(s) Phone Cell Phone Valuation: $ 2,850.00 RAMA AIR CONDITIONING INC (305)262-1121 Total Sq Feet: 0 Tons:2.5 Available Inspections: Additional Info: 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 $1.80 Invoice# MC-5-16-59702 DBPR Fee $2.00 05/172016 Credit Card $117.80 $0.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $117.80 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: ify all th ing information is accurate and that all work will be done in compliance with all applicable laws regulating construction ni F r o' e above-named contractor to do the work stated. May 17,2016 Autho Sig er / / Agent Date Buildin epa fent Copy May 17,2016 1