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MC-15-1835 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-266761 Permit Number: MC-7-15-1835 Scheduled Inspection Date: September 07, 2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: ROSE, CHARLES Work Classificption: A/C Replacement Job Address:150 NW 108 Street Miami Shores, FL 33138- Phone Number 954-882-3338 Parcel Number 1121360090050 Project: <NONE> Contractor: KINGDOM AIR CONDITIONG INC Phone: (305)986-0423 Building Department Comments INSTALLATION OF DUCTLESS AIR CONDITIONING Infractio Passed Comments UNITS. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-23962' . Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 06,2016 For Inspections please call: (305)762-4949 Page 33 of 40 3 Pm Iva err Miami Shores Village ;�17t7I� ? ��an�� ti�r. S� 10050 N.E.2nd Avenue NW ... Werk Ci ssrfic the C temadelment Miami Shores,FL 33138-0000 Phone: (305)79x2204 Petr1 Status APPLI Volip . Issue lie 5141201° Expiration: 10/31/2016 Project Address Parcel Number Applicant 150 NW 108 Street 1121360090050 CHARLES ROSE Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Celt CHARLES ROSE 150 NW 108 ST 954-882-3338 Miami Shores 33138 Contractor(s) Phone Cell Phone Valuation: $ 9,037.20 KINGDOM AIR CONDITIONG INC (305)986-0423 __.. Total Sq Feet: 1576 Tons:4 Available Inspections: Additional Info:INSTALLATION OF DUCTLESS AIR CONDIT Inspection Type: Classification:Residential Final Approved:In Review Review Electrical Comments: Date Approved::In Review Review Electrical Date Denied: Type of Work: Review Electrical Scanning:3 Review Mechanical Review Mechanical Review Mechanical Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $6.00 DBPR Fee Invoice# MC-7-15-56430 $4.74 07/22/2015 Check#:1302 $50.00 $300.78 DCA Fee $4.74 Education Surcharge $2.00 05/04/2016 Credit Card $300.78 $0.00 Permit Fee $316.30 Scanning Fee $9.00 Technology Fee $8.00 Total $350.78 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 the above-named contractor to do the work stated. May 04, 2016 Authoewoa,—Snature:Owner / Applicant ! Contractor / Agent Date Building Department Copy May 04,2016 1 Miami Shores Village JUL in� Build e artment g Department ix 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 (A1\ INSPECTION LINE PHONE NUMBER.(305)762-4949 FBC 201 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING KMECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP log DRAWINGS JOB ADDRESS: ,So � I ag 51 City: Miami Shores County: Miami Dade Zip: 1(oX X Folio/Parcel#: 1 I- t 13 6 -®(o -cz)So Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 0A1-(4J (Lpq Phone#: �Sll- U7. -33))!r Address: 155 t'"` 1()& S'T City: State: Zip: Tenant/Lessee Name: Phon #: s&-L-.333 R Email: �/ '71 to CONTRACTOR:Company Name: P�kNt- �t�- (SDs '�" hone#: 3 ° ' Liq`' J - I1 Address: (0(0� ) 6nil S'f '�✓� City: State: f L Zip: ©I Qualifier Name: Phon #:'S_1f_ y�� x729 L State Certification or Registration#: C/a' 191 Cpl(D 1 Certificate of Competency# DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ®�1- �� Square/Linear Footage of Work: )�1 Type of Work: ❑ Addition ' ❑ Alteration [ f New ❑ Repair/Replace ❑ Demolition Description of Work: !HS7v►L ®F Pvu"53 ��""0^' pdc�'yW4 UAIT 17, Specify color of color thru tile; Submittal Fee Permit Fee$ CCF$ COICC$�0 Scanning Fee$ Radon Fee$ 7 DBPRR$ / ' -1 Notary$ 0 Technology Fee$ 1J.0z) Training/Education Fee$ 2' `� Double Fee$ 0( Structural Reviews$ Bond$ 0 TOTAL FEE NOW DUE$ .98 (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. Signaturecz,.6, x�� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 11 day of J�JO ,20 ( V ,by titi day of 7'°�" 120 1- by blAVV) 1.03 who is personally known to f�46(.,4 S ht"tJa"'t who is personally known to me or who has producedSfpL klDt) -i `K-'�L3'as me or who has produced S01' identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: \\\I1i1111111N, NOTARY PUBLIC: `��\N111111WIN, Sign: A �:v0� 3s'?NEjA.FcS' Sign:- 1Zl U �. 19 • s Print: ��F'tZ S_ u';+= Print: �F�� g.ate � a' Seal: S� #EE 079561 ;o` Seal: * oq'.• �� Q #EE 079581 Q=7- 2 �a a0 • O` wo gT •... �***************�*�*t�(#��i!'111'��1�i.**�*�•********�*****.***.************��i, �' ��**.�*�******�***** � �N111111111\\\1 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 4 Miami Shores Village Building Department Ivan 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA ' PERMIT NU BER: 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): PS 0 Pj W I ® 1 City: Miami Shores Village County: Miami Dade Zip Code: 3 3 (y s 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❑ ARHI Sheet Attached:YES ❑ NO ❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL# COND.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 NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registrati o. Certificate of Competency No. Signature � XDate: (Qualil lees signature) (Revised02/24/2014) ,SNORES Gil 'SINE milli" Miami shores Village Building Department ��oRIDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. V COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: '1tjC11D0/%, BUSINESS ADDRESS: I UV!�( PL-' a7 L S1 CITY STATE_ l- ZIP 3 3 "18 BUSINESS PHONE: 3(_�; ) 440 `3-01 FAX NUMBER Civ) Wq�® .5-6(pS CELL PHONE (1 W )44; -�0WCI Q QUALIFIER'S NAME: GzA 6--l- QUALIFIER'S -^7QUALIFIER'S LIC NUMBER: CAt, I $k C®�o ip j 07/21/2015 09:17 3054805665 KINGDOMAIRMIAMI.COM PAGE 01 PAY" •NEfl"A:'SIL"1 t IF K1NiC3tYIG1 ' (?l�li !'i`I{5111+1 (�1C' ' ': �Cn: y'< i`: `: Musfl�a tl;s61.80tl itoli < --bf rid*, H1: kF1'GIkRE31 ` oIs; t .tra�aecv�i + to ,ty:r. . �Ckti�ptibr�6�!i'=:Xttt.:�':$i�,7R� is i,'• .. OWNERsr;c.TV"OF 1i17st1q1�SS.i;::'.:i ;`• '•':' PAYMEN1fgECEN :''t KINCb6k{'7UR CONOMMNlN�;INC .196 SPED MECiiiPil�ILAL CLIP �C I i31 gY 7Ax Uazi TdiFt'.. rAC18t.rMl ;`:$ 5,00 U7/l 3/26 �W�rli�r(s) i , • '. '�;L,•HECK21�15--090631 . Ti+ts`Logiil BusiRoss 1 Cht Ancaip�oefj�i nomas iusYot _ilt.&ktlt i awne6 Tcx.Tho Receipt is cot a li'eonso. p6tfMltioi'RcnrtifiMiHoh•bfttmiroldbf'sgUeAticatiallsfhttl0titi§Mikts HoidhFm08tccmpiy.UPid1AcYBovfYno++etrtA) ,.�*iNrA�ttiammo�itigp6ta�myl�5•��d'tcgn+ra►"+ `'�iiP�ayinu;jtothei�9ee�:•�,.•;::::�• . •''I�ii'g1E mfl.Nb�bma4e bo ihrs�l�td ee atl�aNmnotetai veh�i�iae—Miis►itT:�ib�'>CdiTe�e es-�e.; • rbr'diiHe'iiva�nnncnrvt�t� mia�.�sa�•e►�rlit•�: �' :. . . KEN LAWSON,SECRETARY RICK SCOTT;GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REOULATION CONSTRUCTION INDUSTRY LICENSING BOARD J _ CAC4816661 The CLASS B ALR CONDITIONING CONTRACTOR"' Named below IS CERTIFIED Under the provisions of Chapter 489'FS. Expiration date- AUG 31, 2016 SARDUY, ROBERT J KINGDOM AIR:CONDITItS`l� ,G;_IdVC 4021.-SW 1.53.60URT:=•'.. . �--*�4 :~<4 '::; if.'...... •••=r.,",r'� µ`tier.''`,`,`°'.�i.'•'`•_ w 14- L1407010Uoo9a2 SQty ISSUED: 07101/2014 DISPLAY AS REQUIRED BY LAW 7/22/2015 12:50 PM FROM: Fax M _M FAMILY INS LTD TO: 305 756 8972 PAGE: 001 OF 001 + ' ,,p...� CERTIFICATE OF LIABILITY INSURANCE DAT (M MID O7Y22D/YYW) 0722/15 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 terns 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(leu of such endorsement(s). PRODUCER CONTACT M&M Family Insurance,Ltd. PHONE 5)554-5282 FAx (305)552-8970 12260 S.W.8th St.#228 E-MAIL mdhins(8prodigy.net No Miami,FL 33184 INSURER(S) AFFORDING COVERAGE MAIC O Phone (305)554-5282 Fax (305)552-8970 INSURERA: ASCENDANT COMMERCIAL INSURANCE INSURED INSURER B: KINGDOM AIR CONDITIONING INC INSURER C: 10651 N W 132 ST BAY#4 INSURER D: MIAMI, FL 33018 (305)986-0424 INSURER E: COVERAGES CERTIFICATE NUMBER: INSURER F 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 App SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY Po�DY MOM%DD%YXW LIMITS GENERAL LIABILITY INSR EACH OC URRENCE $ 1,000,000.00 © COMMERCIAL GENERAL LIABILITY PREM SE 0'RENTED NT D nce $ 1.000,000.00 A ❑ ❑ CLAIMS-MADE ❑ OCCUR GL-38120-3 MED EXP Any one person $ 5,000.00 ❑ 09/07/2014 09/07!2015 ❑ PERSON &ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000.00 El POLICY [:] PRO- ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadeM F-1ANYAUTO BODILY INJURY(Per person) $ ❑ AUTOS OWNED ❑ AAUUTOEDULED ❑ HIREDAUTOS NON-OWNED BODILY INJURY(Peracadent $ ❑ AUTOS PeraccidentDAMAGE $ $ ❑ UMBRELLA LIAB ❑OCCUR ❑ EXCESS LIAR EACH OCCURRENCE $ ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY ❑WC STA'^U- ❑OTH- ANYPROPRIETOR/PARTNER/EXECUTIVE /NER OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory,d)scrbeun E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICYLIMR $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) AIR CONDITIONING INSTALLATION,SERVICES/REPAIRS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE A13OVE DESCRIBED POLICIES BE MIAMI SHORES VILLAGE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELI REDLINE BEFORE 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHOARES FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25(2010/05)QF ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 07/21/2015 09:17 3054805665 KINGDOMAIRMIAMI.COM PAGE 02 .TEFF ATWATER STATE OF FLORIDA CHIEF IFINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This Certifies that the individual listed below has elected to be exempt from 51oride Workers'Compensation law. EFFECTIVE DATE: 12/12/2014 EXPIRATION DATE: 12/1112016 PERSON: SARDUY ROBERT FEIN: 650701641 BUSINESS NAME AND ADDRESS: KINGDOM AIR CONDITIONING INC 10651 NW 132 ST HIALEAH GARDENS FL 33018 SCOPES OF BUSINESS OR'TRADE: CERTIFIED AC HEATING,VENTILATION, CONTRACTOR AIR-COND Pureuant to Chapter 440,06(141,F,S.,an officer of a corporation who elects exemption from thls chapter by filing a oett cyte of oieedon under this rection may not recover benefits or oompon"untion under this th:ipter.Pursuant t0 ChspMr 440.05(17),F.S.,Certificatos of election to be exempt...apply only within the scope of ft business or trade listed en the name of election to be exer"A Pursuant to Chapter 140.05(73),F.S.,Notices of election to be exempt and cermcatea of Plectlon to be exempt sheil be subject to revocation fP,at any time after the filing of the notice or the issuance of the certificate, the parson named on the notice or othtft to no purger meets the requirements of thir section for Issuance of a ccrmc:ate.The department shag revokr-a DFS•F2-IWC-25?.CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413.1609 a KINGDOM AIR CONDITIONING INC Date: 31I 2420 0 State of LW(DR County of 1-R M Before me this day personally appeared t �U J �uY who, being dul sworn, deposes and says: That he or she will be the only person working on the project located at:�� N�h� loo J1 Sworn to(or affirmed)and subscribed before me this 1Z2-day of L 20 by Personally know OR Produced Identification Sh (o G9 b Type of Identification Produced V- - PEI�k- lorE oe Notary Public State of Florida r Sindia Alvarez e*qMyCommission FF 156750 �o� Expires 0910312016 Print,Type or Stalmp Name of Notary ♦SIi 1932, Dr N,,, 11112E Miami shores Village Building Department �LpR{pp► 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insura ce Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or!in the case of an LLC,a statement attesting to the minimum 10 percent ownership; I 2. The officer is listed as an officer of the corporation in the records bf the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-rime employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: CL-C6,, J,�_Ad 40-�_ Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this 1 1�1-- day of J_ULL) ,20L5�_. By M ��'�' �uu�'� l who is personally known to me or has produced S OI —I,►'�,�` '� , F��'��i as identification. ff 00. Notary: Ate- so A�u,SF L4 SEAL: ,y, #EE 079561 a jK V I;Z�q c;- , E3 c> i%a 1 IL- (C7_ C) 1�_J L)> I _F I C�) 1!T I .N C3 10651 NW 132 St,#4 Hialeah Gardens, FL 33018 Tel:305-440-3292 Fax: 305-480-5665 E-mail: Robert@DuctlessMiami.com 12 Mar 2015 Dear Charles,thank you for the opportunity to work on the following project with you. In order to facilitate communications and meet deadlines,we suggest appointing one person in your office to whom we will report.This person will have the authority to immediately respond to our submittals and should give immediate approval or changes no later than 30 days following receipt of this proposal. Location: 150 NW 108 ST. Miami Shores, FL 33168 Equipment: Ductless Mini Split Air Conditioning System Environmentally friendly R-410A Freon. Digital Remote Control Reusable Air Filter Hurricane Tie down to meet Florida Building Code Aluminum air hander wall bracket Freon line set 9' Thermo line insulation Low voltage communicating wire 12' Work Details: Installation of new high efficiency system. Seal all walls and ceiling penetrations created to prevent unwanted infiltration. Install drain line connections and add traps as required for correct drainage. Dry nitrogen fill to verify seals hold pressure. Removal and Disposal of old equipment and materials. Start up procedures in accordance with manufacture. Customer training and familiarization. *System is installed to Energy Stars standards to maximize efficiency and life span. Start date: We are able to start work on this project immediately upon acceptance of this proposal and will schedule an exact date and time once a signed copy is received by our office. Time line: Once the (Replacement,system upgrade, Installation).is started it will take approximately 2-4 weeks for engineering drawings and city approval. 1 working day per unit for installation. Warranty: An implied factory warranty of 7 years on compressor, 5 years on the coils and parts,and 1 year for labor. Work quote: The following project requested can be completed for:$9037.20 Fujitsu Units Page 1 of 2 Living Room: 18,000 BTU 19 SEER$3033.08—FPL$195=$2838.08 Master: 9,000 BTU 33 SEER $2795.54—FPL$195=$2600.54 Guest Room 1: 9,000 BTU 16 SEER $1903.29—FPL$104=$179— Guest Room 2: 9,000 BTU 16 SEER $1903.29—FPL$104=$ Also Available: t t 13D-6 Engineering plans with heat load calculations$2300.00 for the whole house % bo (13ms- Plus city permit Fees approximately$134.00 Per unit Payments: 20%deposit is required to commence the work. Balance due upon final inspection. Payments must be made in full within 24 hours of completion and inspection of work. We accept checks payable to Kingdom Air.We only accept the following credit cards,Visa, Master card,American Express. If work is financed by third party all pertinent documents must be signed and approved within the same time frame as stated above. In order to meet your deadlines and the above delivery schedule, this proposal must be accepted on or before 30 days. The above quote is only valid for 30 days from the date above.A signed faxed copy will be sufficient authority to begin the work with a signed hard copy to follow. Upon agreement the client is accepting all work terms stated above with no other work or warranty implied. Contract r: W.Robert J. Sarduy Kingdom Air Conditioning '2 Q Date: �ILI ql os- ,i-u �. D ? 6 I accept the terms stated herein. Client: ✓. Charles 954-882-3338 CRMIAMIC�YAHOO.COM .;� Date: '' ` t6 i i Page 2 of 2 f ♦ ORE' Gi � Miami shores Village Building Department OR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT -f SIT PERMIT#: I DATE: �y /�Vt (Name) '�a Contractor ❑ Owner ❑Architect Picked up 2 sets of plans and (other) Address: cI "�� kf W —Y1 l 7 9 From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Depai t to continue permitting process. Signature: ATURE) PERMIT CLERK INITIA f RESUBMITTED DATE: I PERMIT CLERK INITIAL: ,