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MC-16-2639 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267963 Permit Number: MC-9-16-2639 Scheduled Inspection Date: October 26, 2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: , Work Classification: A/C Replacement Job Address:975 NE 94 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060350020 Project: <NONE> Contractor: PROTOCOOL COOLING SOLUTIONS,INC. Phone: 9541776-2665 Building Department Comments EXACT REPLACE 1.5 TON SPLIT SYSTEM. Infractio Passed Comments INSPECTOR COMMENTS False I � Inspector Comments Passed Failed Correction ❑ Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 25,2016 For Inspections please call: (305)762-4949 Page 17 of 37 ttosfIY tib � t8111[� Miami Shores Village 10050 N.E.2nd Avenue NE r "'• Miami Shores,FL 33138-0000 �« ` 56 � oWA a ov Phone: (305)795-2204 Expiration: 04/021 17 �1d/20t : Project Address Parcel Number Applicant 975 NE 94 Street 1132060350020 BLACKWELL ESTATES LLC Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell BLACKWELL ESTATES LLC 2425 N CENTER Street HICKORY NC 28601- 2425 N CENTER Street HICKORY NC 28601- Contractor(s) Phone Cell Phone Valuation: $ 3,647.00 PROTOCOOL COOLING SOLUTIONS, 954/776-2665 _..__.. ... _.... _ _N:_. .. __._ ..... ..._.,.: __ _....._... Total Sq Feet: 0 Tons:1.5 Available Inspections: Additional Info:EXACT REPLACE 1.5 TON SPLIT SYSTEM. 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 $2.40 Invoice# MC-9-16-61464 DBPR Fee $2.00 10/04/2016 Credit Card $97.04 $50.00 DCA Fee $2.00 Education Surcharge $0.80 09/26/2016 Credit Card $50.00 $0.00 Permit Fee $127.64 Scanning Fee $9.00 Technology Fee $3.20 Total: $147.04 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 A IDAVIT: �Futhe ify th a oregoin ' formation is accurate and that all work will be done in compliance with all applicable laws regulating constru n an zo . u orize a ve-named contractor to do the work stated. October 04,2016 Au orize ignature: ner / Applicant / Contractor / Agent Date Building Department Copy October 04,2016 1 I, Miami Shores Village BY' ----r Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)79S-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 s FBC 20 ly BUILDING Master Permit No. M0-1 PERMIT APPLICATION Sub Permit No. " BUILDING ❑ELECTRIC 7 ROOFING REVISION EXTENSION (RENEWAL ❑PLUMBINGMECHANICAL PUBLIC WORKS CHANGE OF ❑CANCELLATION SHOP 39 CONTRACTOR DRAWINGS JOB ADDRESS:975 NE 94 Street City Miami Shores County: Miami Dade Zio: Folio/Parcel#:11-3206-035-0020 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):BLACKWELL ESTATES LLC Phone#: Address:2425 N CENTER ST#348 City: HICKORY State: NC Zip: 28601 Tenant/Lessee Name: VANESSA MAGGIE Phone#: Email: CONTRACTOR:Company Name: PROTOCOOL COOLING SOLUTIONS, INC Phone#: 954-776-2665 Address: 1669 NW 144 TER, SUITE#203 City: SUNRISE State: FL Zip:33323 Qualifier Name: CHRISTOPHER POMPILIO Phone#: 954-776.2665 State Certification or Registration#: CA0058577 Certificate of Competency#: DESIGNER:Architect/Engineer: N/A Phone#: Address: City: State: Zip: Value of Work for this Permit:$3647.00 Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration IQ New ® Repair/Replace ❑ Demolition Description of Wort. (,.��. . s civ spI-IT s"YSi M Specify colorlor thru tile: Submittal Fee$ Permit Fee$ CCF$ � ® COICC$ Scanning Fee$ l �) Radon Fee$ DBPR$ Notary Technology Fee SS- 20 Training/Education Fee$ ® _Double Fee$ fCJ Structural Reviews$ to Bond$ o � TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) N/A 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 falth 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 appr ve nd a reinspection fee will be charged. Signature - Signature _6,,-,2 92=1:t O NER or AGENT CONTRACTOR The fo agoing in rumen was acknowledged before me this The foregoing Instrument was acknowledged before a this day of by �_day of ___ _ by JAMES HOLT who i rsonally known CHRISTOPHER POMPILIO who is orally know o me or who has produced 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: Print: COLE FERGUSO Print: ICOLE FERG SON YP Seal: a°t. PUt E1gR10NE1TEF Seal: ?°t.R"�.e`'� N �EFmr MY COMMISSION 6 FF 1594 * MY COMMISSION t FF 159004 EXPIRES:September 11,2018 EXPIRES:September 11.2018 +rBOFI°P° Bonded ThruBudgetNatarySerrkesBond�ThruBudgetNateryServim APPROVE*:Y ♦rrrrrrrrrr �` rrrrww rrrrrrrrr rRrrsy�••rrrrrrrrrrrrrrrrrrrrrrrrrwrrrrrrrrrrrrrrrrrrrrrrrrr rrrrr rrrrr♦ land Examiner Zoning Structural Review Clerk (Revised02/24/2014) M Miami Shores Village Building Department ..., nays N.E.2nd Avenue y� Miami Shores, Florida 33138 N4' 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 arenotacceptable. (�-�- Job Address(where the work is being done): Q� ►V E �/+ S-FKfj -° RO-0 5313,R 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❑ N6,4 ARHI Sheet Attached:YES NO❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER UG0'4J'nC1P 1 AHU or PKG.UNIT MODEL# V TC J o -71,1,4 COND. UNIT MODEL# S a7 N0,03 01 KW HEAT NOM TONS AHU CU PKG 1)M.C.A AHU A CUA PKG — AHU CU PKG 2)M.O.P AHU CU� ,5'PKG AHU CU PKG 3)VOLTS AHII,"OCUZ2-,&KG PKG UNIT / / PKG UNIT EER/90 14P YES REPLACING DUCTS YES N YES REPLACING THERMOSTAT YES 4& YES NEW 4"CONCRETE SLAB YES , YES 2 0; NEW ROOF STAND YES 40 YES NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): NO 0 C,0 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 14�M, L) s- co, 3. Voltage of Circuit(208/240/480): = � 4. Size Disconnecting Means: /-I, rsA-No :2 Contractor's Company Name: Phone:491O .7-1 State Certificate or Re ' ration Certificate of Competency No. Signature L Date: uaAee signal (Revised02/24/2014) 21.11 Wilson Boulevard Suite 500 Arlington VA 2220.1-3001. USA A- n- Phone 703 524 8800 I Fax 703 562 1942 w.ahrinet.org A!R-CONDMONING,HEATING, e REFRIGERATION INStY UTE we make life better- Date: 5/3/2016 To Whom It May Concern: This letter is issued to confirm that the product identified below was once certified by AHRI with the following efficiency ratings. The product is no longer certified by AHRI because the manufacturer has ceased production of the model(s). AHRI Reference Number: 4431254 Outdoor Unit Model Number: SSX160301A* Indoor Unit Model Number:AVPTC313714A* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN,JANITROL,AMANA DISTINCTIONS, EVERREST,ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Region: 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. Cooling Capacity(Btuh): 29000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): 131067807575848825 i Cooling Solutions, Inc_ 1669 NW 144 'Terr.#203 Sunrise,Fl.33323 Ph.954-776-2665 *Fax.954-252-0080 State License#CAC058577 September 2,2016 Dear Mr. Pierre, We performed a residential replacement at the address listed on the attached permit application. Our work was found to be code worthy however,the inspector recognized another system that had been replaced previously. We recently began taking care of all the HVAC work for the owner who lives out of the country. He has asked us to help resolve this situation. The non-permitted Goodman system is no longer made. We were able to research the combination with AFRI and had them provide a letter showing the discontinued combination and the old AFRI number. Since there is no tie down detail available,we intend to use generic heavy duty tie down clips with Tapcons into the concrete slab and#14 screws into the unit for this ground mounted application. If you need any further information to approve this application,please let us know. Vice-President Qualifying Agent rIi-r-/istopher Pompilio "Progressive Cooling...Exceeding Your Expectations .►" =�-- .._F-- ::.,-___^?,��_ _":.�:". _ -�_,.._mom..;,.. .��....... ..a_.. -.,-� ..-.-t_ ;,,,,.:,. �� •�..."4.:�.�`'.�"*��' .;.�. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 f VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 I i DBA: Receipt N:18 3-1719 Business Name:PROTOCOOL COOLING SOLUTIONS INC Business Type: CONTP TR ype:(AIRcoNDITION CONTR'AM) Owner Name:CHRISTOPHER J POMPILIO BusinessOpened:04/01/2002 Business Location: 1669 NW 144 TER 203 StatefCounty/CertlRsg:CAC 058577 ' SUNRISE Exemption Code: Business Phone: Rooms Seats t M00yses Machines Professionals 2 For Vending Business Only ` Number of Machines: Vending Ty Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27,00 h THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS i THIS BECOMES A TAX RECEIPT This tax i8 levied for the privilege of doing business within BrowatQ County and is � non-regulatory in nature. You must meet all County and/or Municipality planning and zoningrequirements. This Business Tax Receipt must be transferred when ;a WHEN VALIDATED the business is sold, business name has changed or you have moved the business location This receipt does not indicate that the business is legai or that If It is in compliance with State or kmal laws and regulations, Mailing Address: CHRISTOPHER J POMPILIO Receipt #ICP-15-00417728 1669 NW 144 TERRACE #203 Paid 08/05/8016 87.00 SUNRISE, FL 33323 N 2015 . 2017 ' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION � CONSTRUCTION INDUSTRY LICENSING BOARD CACQ58577 � , The CLASS AAIR CONDITIONING CONTRACTOR. Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 rol POMPILIO,CHRISTOPHER_ U.. PROTOCOOL COOLINs�- NS INC 1659 NW 144THSUNRISE F3:393 3 a ISSUED aMtr1016 DISPLAY AS REQUIRED BY LAW SE0# LIGM10DETM DATE CERTIFICATE OF LIABILITY INSURANCE 08/01P1016(MMIDDNYYY) 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 lieu of such endorsement(s). PRODUCER CONTACT C&C Insurance,Inc. PHONE(Atc No 431-2M FAX yy) 704-0507 1921 NW 150 Ave. -MAIL nnRFSS. info andcinsurance.com Ste.101 INSURER(S) AFFORDING COVERAGE NAIC# Pembroke Pines FL 33028 INSURER A:Montgomery Insurance INSURED INSURER B:Technology Insurance Company PROTOCOOL COOLING SOLUTIONS INC INSURER C:Ohio C8SUBI 1669 NW 144 TERR#203 INSURER D: SUNRISE FL 33323 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $10 A X COMMERCIAL GENERAL LIABILITY PREMISES (Fa occurrence) RENTED 30= CLAIMS-MADE X�OCCUR x X BLS1755706369 08/26/2016 08/26/2017 MED EXP(Any oneperson) $15000 x Blanket Additional Insured PERSONAL&ADV INJURY $1000000 X Blanket Waiver of Subrogation GENERAL AGGREGATE $200 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $20000 POLICY FX I PROIT F1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED HIREDAUTOS AUTOS $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $1000000 C X EXCESS uaB CLAIMS-MADE X X US01755706369 08126/2016 08/26/2017 AGGREGATE $1000000 DED I X I RETENTION 100W $ WORKERS COMPENSATIONX WC STAT+- T.- AND EMPLOYERS'LIABILITY YIN B OFFICERIMEM ER PEXCLUD D?ECUTIVE NIA TWC3461946 03/17/2016 03/17/2017 E.L.EACH ACCIDENT $1000000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $10000 If yyes,describe under DESCRIPTI N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $10000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Certificate holders are additional insured for liability as respects Insured operations and as required by contract RE:CAC058577 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BLDG DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE / G! ©1988-2010 ACORD CORPORATION. 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