MC-16-362 WKSg Miami Shores Villages
10050 N.E.2nd Avenue NE " `Y
Miami Shores,FL 33138-0000
Phone: (305)795-2204
, Expiration:06/28/2016
Project Address Parcel Number Applicant
600 NE 101 Street 1132060172131
Miami Shores, FL 33138- Block: Lot: LEONARD MARINELLO
Owner Information Address Phone Cell
LEONARD MARINELLO 600 NE 101 ST
MIAMI SHORES FL 33138-2468
Contractors) Phone Cell Phone Valuation: $ 6,382.00
SERVICE EXPERTS HEATING&AIR C(305)264-2020 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 $4.20
DBPR Fee $3.35 Invoice# MC-2-16-58632
DCA Fee $3.35 02/092016 Credit Card $50.00 $200.27
Education Surcharge $1.40 03/012016 Credit Card $200.27 $0.00
Permit Fee $223.37
Scanning Fee $9.00
Technology Fee $5.60
Total: $250.27
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: Irt' that all the for oing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. F h rffI
autho' the above-named contractor to do the work stated.
March 01,2016
Authorized Sigture Owner / Applicant / Contractor / Agent Date
Building Depa went Copy
March 01,2016 1
Miami Shores Village
B pyo ^61
%
Building
•ng epartment
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 -
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)7624949
FBC 201 4
BUILDING Master Permit No. r'1.CGI (n-
PERMIT
oPERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING AMECHANICAL ❑PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑SHOP
,A� `� c CONTRACTOR DRAWINGS
JOB ADDRESS: O 00 I V� y 'e'/f-
City: Miami Shores County: Miami Dade Zip:
FoNo/Parcel#: �20 V•
0 I �• 2 J 19 the Building Hstorkally :Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: SFE: FF/E:
OWNER:Name(Fee Simple Titleholder): ` 80' '� • G - f,1 Q Phone#: *?)045, q O Z' '76 32,
Address 6 Q O me
Q' tut
City: M L� S
( lno`ye} State: I-- Zip: 3
Tenant/Lessee Name: +VTC Phone#•
Email: _ `�/
CONTRACTOR:Company Name: C.. /tr Il{ exiee Phone#: 3 o r"7° GA'C• Z•D 20
Address: ��- 1\�w
City: State: 'I"®ls Zip:33 1 t7 2.
Qualifier Name: Q Phone#: 34 •0 Z �4Jz-
O-
State Certification or Registration#: 0, 121 12,,,lCertificate of Competency#:
DESIGNER-Architect/Engineer. Phone#:
Address City: State: Zip:
Value of Work for this Permit:$ (-3 2- Square/Linear Footage of Work:
Type of Wm*: ❑ Addition ❑ Alteration ❑ New ;xRepair/Replace ❑Demolition
Description of Work: '1 • i c+Tl44(ce QyLe44
Specify color of color thru tile:
Submittal Fee$ " Permit Fee$ CCF$ COJCC$
Scanning Fee$ �l Radon Fee$ DBP/R\$ SS Notary$
Technology Fee$ G •G® _Training/Education Fee$ U Double Fee$
Structural Reviews$ Bond$ 0
TOTAL FEE NOW DUE$
IWmedO2/24/2m4i
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Trp
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. 1 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$25W,the applicant must
promise in goad faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment: Also,a certified copy of the recorded notice of commencement must be posted at the Job site
for the first inspection which occurs seven (7)days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
r�
Signature L2���`�V Signature
OWNER or AGENT ONTRACTOR
The oing InstrunIptwas acknowledged before me this The f oing instrument was acknowledged before me this
day of 20 by day of 2 3 by
Gho ially known to fgAl wh<P,
Wally kno 0
r�
me or who has producedi"may+ •as me or who las produced as
identifi nand who did take an oath `Ta identifi and wiro did take an oath.
NOTARY UG `T NOTA PUB
Sign: Sign:
Print: Pri
Seal . � ;.=»:; o JESSICAACOSTA I. �°`.•"•,°� JESSICAACOSTA
s * MY COMMISSION Ii FF 010901 * MY COMMISSION#FF 010901
\o� EXPIRES:May 13,2017N-IF 110 4' .� N��
rf��,� 13,2017
S=dedTlwBud�tNoWySevk=
ssssssssssssssssssssssssssssssss asses assess ss sssssssssssssasssssssssssss•ssssssssess$sssssssssssss
APPROVED BY Pla Examiner Zoning
Structural Review Clerk
(i ewbedO 24/20 )
Miami Shores Village
Building Department
..,, 10050 N.E.2nd Avenue
Miami Shores,Florida 33138
tsR ► 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): (006 IDI10
City: Miami shores VAlage County. Miami Dade Zip Code: 33 J 3
ALL CONDENSING UNITS MUST BE ON A 41NCH 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,K ARM Sheet Attached:YES ONO❑ Contract Attached:YES
UNIT BEING REPLACED DATA NEW UNIT
MANUFACTURER
AHU#PKG.UNIT MODEL# �-
D.UNIT MODEL#
KW HEAT
NOM TONS
AHU CU PKG 1)M.CA AHU CU PKG
AHU CU PKG 2)M.O.P AHU CU PKG
AHU CU PKG 3)VOLTS AHU CU PKG
PKG UNIT I I PKG UNIT
EER/SEER
YES NO REPLACING DUCTS YES NO
YES NO REPLAONG THERMOSTAT NO
YES NO NEW 4"CONCRETE SLAB YES
YES NO NEW ROOF STAND YES
YES NO NEW RETURN PLENUM BOX NO
1. Minimum Circuit Ampaaty(Wire Size): e
2. Maximum Overcurrent Protection(Fuse/Breaker Sae): 15 O
3. Voltage of Circuit(208/240/480): 208
4. Size Disconnecting Means:
' Contractor's Company Narrm• L4 C21 Phone: 366,
2Z ,2420
State Certificate or R n No. Cate of Competency No.
Signature Date: 10
ss ,rel
This combination qualWoes;for a Federal Energy
® Ef6dency Tax Credit when placed in service
between Feb 17,2009 and Dec 31,2016.
Certificate of Product Ratings
Mill Certs W Reference Number.7940903 Date:2/5/2016
Produces Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:RA163CAJ1
Indoor Unit Model Number:RBHP21
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,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SD,TN,TX,
UT,VA,VT,WA,WV,WI,WY,U.S.Territories)
Reeggion Note:Central air c onditiorers manufactured prior to January 1,2015,are eligible to be
In led in ail regions until June 30,2016. Beginning July 1,2016,central air conditioners
can only be Installed In reglon(s)for which they met the regional efficiency requbennoL
Series name:
Manufacturer responsible for the rafting of this system cwd*w& r Is RHEEM SALES COMPANY,INC.
Rated as follows in accordance with AHRI Standard 210240-2008 for Unitary Air-Conditioning and Air-Source
Beat Pump Equipment mW subject to tib of rating accuracy by AHR4osixnsored,Independent,third
Icy testing:
Cooling Capacity(Btuh): 28OW
EER Ralin g(Cooling): fi3.00
SEER Rating(Cooling). 16.00'
IEER Rating(Cooling):
'Rat'W folkwed by an asterisk(1)indicate a voluntary rare*of previously published data,unless acoernparried vrAh a WAS,vOdch indicates an hwoluntary cerate.
DiSCtAIMER
Alfitl does not andorse Nre product(s)wed on this Certificate and makes no representations,wamvinties or guarantees as to,and assumes no responsibility for,
the product(a)Iiid on this Certificate.AHRI expressly dime all liability for damages of any kind arising out of the Less or performance of the product(sl or the
unauthorized alteration of data Med on this Certificate.Certified ratings are valid orlyfor models and configurations lei In the
directory at www.shvidirectery.org.
TERMS AND CONDITIONS
This Certifx-a and its contents are proprietary products of AHRI.This Certificate shall only be used for individuat personal and r:,,_4;
confidential nderanos purp The finis of this Cwt raft may not,in whole or in part,be reoopled;dissamlivated; H
entered hdo a cue database:or otherwhe utI fzed,in any form or mamw or by any means,except for the use's Individual,
personal aid confidential reference. Al"ONORIONiNG,HEAnNG.
CERTIFICATE VERIFICATION &REFRIGERAnON INSTI IM
The information for the model cried on this mate can be verified at www ahrtdirectory.org,dirt on"Verity Certificate"link we make life better"
and enter the AHRI Certified Reference Number and the date on which the oertitk ate was Issued,
which is listed above.and the Certificate No.,which Is hated at beftm right
1 1 41
02014 Air-Conditioning,Heating,and Refrigeration Institute CERI7 =TE NO.:
1521 NVit 83 Ct.
m
ServiceExperts Mia}`S'ii_FL 33172 SeiwtceExpgWs•cnm
HEATING d AIR CONDITIONING P,U -IV675
Street Address
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