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MC-16-1961 3 1 Shores VillageI P tttt 7"Ae � ,* it-W— Miami RItia1 10050 N.E.2nd Avenue NE £ INSrqssl T- 0 �E �& nt ep MOO Miami Shores,FL 33138-0000 Phone: (305)795-2204 Expiration: 01/15/2017 issue©ate 7119120 i6 .. p� Project Address Parcel Number Applicant 478 NE 92 Street 1132060140020 Miami Shores, FL Block: Lot: THOMAS ROGER&CHRISTINA' Owner Information Address Phone Cell THOMAS ROGER&CHRISTINA WHITE 478 NE 92 Street (305)546-1030 (305)439-2855 MIAMI SHORES FL 33138- 478 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 5,100.00 EDD HELMS AIR CONDITIONING AND (305)653-2530 N......._-------- Total Sq Feet: 0 Tons:4 Available Inspections: Additional Info:REPLACE EXISTING A/C SYSTEM 4 TONS. 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 $3.60 Invoice# MC-7-16-60591 DBPR Fee $2.68 07/14/2016 Check#:6346 $50.00 $152.46 DCA Fee $2.68 Education Surcharge $1.20 07/19/2016 Check#:7502 $ 152.46 $0.00 Permit Fee $178.50 Scanning Fee $9.00 Technology Fee $4.80 Total: $202.46 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in complia ce with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the prop@r authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. 1 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 i cc and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-nam on o the work stated. July 19, 2016 Authorized Signature:Owner / Applicant / Con ractor / Agent Date Building Department Copy July 19,2016 1 E,C�T_N71F I� Miami Shores Village J 4201 i i ? Building Department BY. _► �V �°y 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 f , INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2001 BUILDING Master Permit No.MC PERMIT APPLICATION Sub Permit No. BUILDING F-1 ELECTRIC F-] ROOFING REVISION EXTENSION FM-]RENEWAL ❑PLUMBING FN_j MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION El SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 478 N.E. 92 STREET City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-014-0020 Is the Building Historically Designated:Yes NO X Occupancy Type: R Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):CHRISTINA WHITE Phone#:305-546-1030 Address:478 N.E. 92 STREET City. MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: EDD HELMS AIR CONDITIONING Phone#: 305-653-2520 Address: 17850 N.E. 5 AVENUE City: MIAMI State: FL Zip: 33162 Qualifier Name: NORMAN LARRABEE Phone#: State Certification or Registration#: CACO21309 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$_ i ( 00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 0"Repair/Replace ❑ Demolition v� ( l C_ ,Description of Work: _ -f?1 i -� -�ffi. 2 , Specify color of color thru tile: GO I NS Submittal Fee$ Permit Fee$ 1 CCF$ CO/CC$ Scanning Fee$— o l�°l�� Radon Fee$ 2 12 �i� DBPR$ n� (U Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ o (Rev1sed02/24/2014) 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 �f4 r ( 1� OkLkv Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before/me this The foregoing instrument was acknowledged before me this H' day of (A1 20 W , by _day of 20 by +,,who is personally known to (l�`IY�G�1� LO-II who' personally known �o�ho has roduce 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: ad2Ind! Print: Print: =ie} ; STACY CUSANO STA Y CUSANO ' /•F Seal: MY COMMISSION#FF126960 Seal: I, a MY COMMISSION#FF126960 oa a�oP EXPIRES August 30,2018 ++�` o Of` EXPIRES August 30,2018 (407)398-0153 FloridallotaryService.com (407)398-0153 FloridallotaryService.com APPROVED BY s Examiner Zoning Structural Review Clerk (Revised02/24/2014) ORFs y� Miami Shores Village Building Department N•.• ou.M 10050 N.E.2nd Avenue �e.,. Miami Shores, Florida 33138 Rlpp► Tel: (305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC f I`15-cpcRe This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on(siinglee sheets are^�nott acceptable. Job Address(where the work is being done): I�O go( D -G� 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❑ NO[B"'ARHI Sheet Attached:YES VNO ❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER fwe 009 AHU or PKG.UNIT MODEL# COND. UNIT MODEL# -roU l7 KW HEAT 10 NOM TONS �- AHU oCU PKG 1) M.C.A AHU CU qSPKG AHU CU (95 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 600 YES NO REPLACING THERMOSTAT YES YES NO NEW 4"CONCRETE SLAB YES N YES NO NEW ROOF STAND YES fiw YES NO NEW RETURN PLENUM BOX YES INO 1. Minimum Circuit Ampacity(Wire Size): to 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): /_�d� 4. Size Disconnecting Means: X00 AI Contractor's Company Name: 6Z MMS /'{ I�dQe;aAj Zl(') Phone:31Z66575Z State Certificate or Registration No. Certificate of Competency No. Signature - Z:) �s Date: oil I (Qualifier's signature) (Revised02/24/2014) Edd Helms CAC 021309 EC 13001830 Air Conditioning Elockxx ic A Name You Can Trust Slnco 1975 rr October 29,20% ----`-�-`- r�� Roger White X178 NP 02"'Street Miami Shores,Fl.33138 305.439-2865 , Ladd hsbi}s Air Conditioning is pleased to provide Hilo proposal to replace the air conditioning In your home. Y Permit a Removal and disposal of the existing equipment o Install 4 ton Trane 16 Seer Split system e Condenser Model:4TTR604QC1000A,Variable Speed Air Handier Model:TFM6AOD48H418A e install new overflow switch o Install new shoe box return Y Install new Hurricane dips . a install now-l0kw Heater a Rouses existing thermostat C Reconnect to the duct work,Copper,drainage system and electrical.No changes Included • All materials and labor Warranty:One Year labor and Ten Years all Parts.Customer must register system with to 45 days of the installation at%wnv.trane.corn or parts warranty will revert to five years. Warranty on new Thermostat Five(6)Year Parts and Labor.Warranty hours are Monday through Friday Sam to Spot excluding holidays. Total for the system above:$5,617-$267.00 Fi'L Rebate -$250.00 Trano rebato=$5,100.00 Torms:$2,550.00 down and$2,660.00 upon completion Edd Helms Air Corrdillonfng is authorized to perform the above work and services at the prices and terms specified heroin. All payments shelf be duo in accordance vdth the torus described above.Customer agrees to pay all court costs and attorneys fees should legal mean be necessary(of collection. The RVAC system included In this proposal is designed according to industry standards to provide comfort cooling to occupied areas.This proposal does not include the responsibility by EDD HELMS for any procedures to Identify,control,eliminate or remove mold In oocupled or unoccupied spaces.if you suspect mold to ba a problem,or If you have construction conditions that support the grovdh of mold,we recommend the CUSTOMER take remedial actions outside of this proposal to eliminate the problem,remove the mold,and insure a mold free environment Edd Holms Air Condillonfng shall not be responsible for dryviall repalre,painting,concrete repairs,or Code violations outside of the scope of work.All cencoliatlons must be submitted in wiling direct to Edd Helms Group,Ino.three business days before verbal schedule Installation date. j If you have any questions concerning this proposal, please do not hesitate to contact us at your convenlenco. j i We thank you for this opportunity to be of service. Sincerely, 77z __ Ron Thompson Cotnfort Specialist omorSignafur Cell: 306-970.411 s ; rthomusongaddhehns.coin Dare _.._--._....---.t7850iV:C 5th Avenure �Vitamr Florida 33162 Tet 305=853 2f330:Toll,Free—(800)-32T-263TTFax:(305)•653=7933 wwvi Prlrihalma��m, • P. 1 x x Communication Result Report ( Jul- 14. 2016 11 :55AME ) 2 2 Date/Time: Ju1. 14, 2016 11 :53AM File Page No. Mode Destination Pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 0535 Memory TX 913057568972 P. 1 4K ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang uo or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—mail size E. 6) Destination does not support )P—Fax Q(#r1: RCtRk�tis fgd Helms. c4c Wik rC IWIM C �a�.aiucareaeQ+aa�eenm.n.ee.r��mre�min,�mae�ra�mo�eaea. I" dim + M69�W 7mt u'assr9lu+M� k4w �FbOWplt0.ki'aSNd►e�..tagltFdyaa56tTi1167gf)4UNj35. • r1i+AtiAo.Itp�wicrAl � �- Remh'lodmttcO�a0.?a:b4lA7SA'�'itr�(JadAatl lbP.vp.tlKhWG- /.ItfYaididdlaw Yktrq!MtrYu(1abxE47a.YHtlabi�dp, �Lt►13epnP++tOy�Cdry .W.N{i rglefM3xSArYcd pfAoR4exeen ' alba ww.VrOanrtatu - ... YtmYgtha�reAbraegaSgwflA�Tsa PW ev'4decYda�7y-0ve.tii FkeNyertvplPlAgZAb.[pn��°9 _ Y�eos�l;atA[6eG.n�mHi� 4��-is�ou+rodb�ai0.wlm i 611 ++�40RwrWYIHWfq!>i�R4i}.ICVIIYM' Mv;�c.aMs!al.trdraa�¢kN+hHW.ev�.Mr.aark earax..o,aa.d+mberrtav d s wwa.t•uf'Nra+aa.IM rE1 M+i+aayayxmna'ce . _ PMea'hJddranp�mraad�dw.msrq bi ai.6,e as w�lapt�pa.,otba.d.VA Qvtbtbd•Nlio6id�hM�4lporilu[af�pyHw�Bi.ea'R•S. SidM,'th.�HYdee�dh%b•MbA}•'fiit�'af �eeapa.dlole. •ctrwen.ae.Mt6w,..au�orcrgy�o174♦ 1�.o,w ix C.onro7ablQ.+D�ld PJisred7�dRbMV�Ydi.414h1sD�A.aw Imid4.oftaa<swea�gFmp.t WHnaf/s0 �ilYgbs e!jstValbfkyiirpliP•�1d4.d•MlYA9Nr.0y�iRM41MtALt4At2i0Y./AY.da!>alb4lkPif.9$0Na]diY deWbatl lglaQ,q•11Caa.brnn6yt Wp WM W�t04 ttdS(tne Y. . K19Pt�eI+MQ�7 ? 9�Ir004sB1D�d3t1C+:_-1'c.�4tf7o0.�t�Abt pUtOotsaB• Yh4�ftfowbre+io[�a!a�rto-bea.pxvta. �1� I ��� g`. 70- Ifon�h@@6m��jidpp4H Cv �gOfi/�f � wa . . • ® DATE(MM/DD/YM) ACORN CERTIFICATE OF LIABILITY INSURANCE 6/22/2016 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 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 NAME: Bateman Gordon and SandsPHONE FAX 3050 North Federal Hwy E-MAIL - -0900 AIC No): - - 2006 Lighthouse Point FL 33064 ADDRESS INSURERS AFFORDING COVERAGE NAIC# INSURER A-Amerisure Insurance Co. 1948a INSURED EDDHE1 INSURER B;Amerisure Mutual Insurance Co. 23396 Edd Helms Group, Inc. INSURERC: Edd Helms Electric LLC INSURER D: Edd Helms Air Conditioning 17850 NE 5 Avenue INSURERE: Miami FL 33162-1008 1 INSURER F: COVERAGES CERTIFICATE NUMBER:1171223807 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. INSR TYPE OF INSURANCE D B POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY Y Y GL20119261401 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMDAMAGE TO RENTED PREMISES ERoNTED ce $100,000 CLAIMS-MADE OCCUR MED EXP(Any oneperson) $5,000 XCU/Contractual PERSONAL&ADV INJURY $1,000,000 Broad Form PD GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ T F A AUTOMOBILE LIABILITY Y YCA20011461501 7/1/2016 7/1/2017 COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROP RTY DAMAGE $ AUTOS Per a 'dent B X UMBRELLA LIAB X OCCUR Y CU20011491502 7/1/2016 7/1/2017 EACH OCCURRENCE $5,000,000 EXCESS LUIB CLAIMS-MADE AGGREGATE $5,000,000 DED X I RETENTION$0 $ A WORKERS COMPENSATION WC20025011601 7/1/2016 7/1/2017 X I WC STATULIMIT- OTH- DRYAND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Rented&Leased Equipment IM20832950402 7/1/2016 7/1/2017 Limit$265,000 Ded:$1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Document is not complete unless accompanied by the Acord 101. General Liability:Additional Insured, Primary&Non-Contributory, Ongoing and Completed Operations, as required by written contract, per CG7048 1015./Waiver of Subrogation as required by written contract,per CG7049 1109. 30 Days Notice of Cancellation other than non-payment of premium per Notice per Form IL 70 45 05/07 Auto Liability:Additional Insured, and Waiver of Subrogation, as required by written contract, per CA7171 0508. Workers'Compensation:Waiver of Subrogation as required by written contract, per WC000313. See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF] NOTICE WILL BE DELIVERED IN 10050 NE 2 Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: EDDHE1 _ LOC#: ACC)RO® ADDITIONAL REMARKS SCHEDULE Pagel of 1 AGENCY NAMED INSURED Bateman Gordon and Sands Edd Helms Group, Inc. Edd Helms Electric LLC POLICY NUMBER Edd Helms Air Conditioning 17850 NE 5 Avenue CARRIER NAIL CODE Miami FL 33162-1008 EFFECTNE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Umbrella Liability: Extends coverage to underlying General Liability(excludes the general liability per project aggregate),Auto Liability and Workers Compensation coverages. General Information:The General Liability policy contains no specific residential exclusions./Independent Contractors Liability is included in the General Liability. ALL COVERAGE IS SUBJECT TO THE POLICY TERMS,CONDITIONS AND EXCLUSIONS QUALIFIER: NORMAN LARRABEE LICENSE#CACO21309 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ®© This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31, 2014. 1 1 1 Certificate ®f Product Ratings AHRI Certified Reference Number: 7567557 Date: 10/29/2015 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4TTR6049B1 Indoor Unit Model Number: TEM6AOD48H41+TDR Manufacturer: TRANE Trade/Brand name:TRANE 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, ND, NE, NH, NJ, NM, NV, NY,OH,OK,OR, PA, RI, SC,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 region(s)for which they meet the regional efficiency requirement. Series name:XR16 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-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 46500 EER Rating (Cooling): 13.00 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 Indicate an Involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,an I 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 per ormance 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 th directory at www.ahridlrectory.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, AM 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.ahrid[rectory.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. ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 130906128328109784 ,yNoREs y Miami Shores Village Building Department "" fl ""'m NO 2 2015 10050 N.E.2nd Avenue Miami Shores, Florida 33138 yn .F RiDp' 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. L Job Address(where the work is being done): `�T 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[—] NO[ RHI Sheet Attached:YESNO ❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER ICA eq e," AHU or PKG. UNIT MODEL# COND. UNIT MODEL# y KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU&0 CU.VS PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU' PKG 3)VOLTS AHU CU PKG PKG UNIT I / / PKG UNIT EER/SEER I YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT YES N YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit (208/240/480): ?S 4. Size Disconnecting Means: ti Contractor's Company Name: ja)b O�eW5 Phon : (Q ZS�Z) State Certificate or Registration No. ®� Certificate of Competency o. Signature Date: (Qualifier's signature) (Revised02/24/2014) Y "© This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2014. Certificate of Product Ratings AHRI Certified Reference Number: 7567557 Date: 10/29/2015 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:4TTR6049B1 Indoor Unit Model Number:TEM6AOD48H41+TDR Manufacturer:TRANE Trade/Brand name:TRANE Region:All(AK,AL,AR,AZ, CA,CO, CT, DC, DE, FL, GA, Hl, ID,IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY,OH,OK,OR, PA, RI,SC,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 region(s)for which they meet the regional efficiency requirement. Series name:XR16 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-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 46500 EER Rating(Cooling): 13.00 SEER Rating(Cooling): 16.00 IEER Rating (Cooling): Ratings followed by an asterisk r)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 umes 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 AHRL 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, twig 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.ahrldirectory.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 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE N ,; 130906128328109784