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MC-15-1138 (2)
Miami Shores Village D I i Building Department DEC 2 1.2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No.zy-,C /bt— /z:� ❑BUILDING ❑ ELECTRIC ❑ ROOFING VISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 101 20 n G /®1 S T City: Miami Shores County: Miami Dade Zip: .30f•3� Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 'I0 4W) SU_. 44 a0 Address: Fo �11 �. /0 �S p City: �ic.t�� �n ( S State: ��- Zip: �3 (3 6 Tenant/Lessee Name, Phone#: Email: T" CONTRACTOR:Company Name: ���®,�7�� � �y/ Phone#: Address:�4!2 1 7 o9U2 City: 'l) I e m I State: Zip: / Qualifier Name: 1 � — 26n'), j� e--y- Phone#: 4/p State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ Newn ❑ Repair/Replace ❑ Demolition Description of Work: lov Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if ap licable) 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 on 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. Signatur Signature r` OWNER or AGENTCONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this II '' ''�, day of � ""< ,20 Z-0I'�,by tel_day of DeO PI)�,Vd� ,20 I S— .by lam' ("i A-,. 2 -'('Z-:-Trw`1ho is personally known to L=-� hc, 2L,who is personally known to me or who has produced C� C--f-2 -'AR S as me or who has produced qp(SCy)W(T/ (L,t)Q as identification and who did take an oath. identification and who did take an oath. `"\\\\`11S1ll/lll�i, NOTARY PUBLIC: Sil ��` 8n yeNOTARY PUBLIC:r� 16 r Sign: = Sign: Print: •. C0mmISS100 # Print ta% U' of Florida �,9 0 ��� Meana Rodriguez Seal: ''�, )E'OF F1.��\�\\`� Seal: J�o() My commission EE 882474 / \ Expires 03/11/2017 APPROVED BY K�4Ins Examiner Zoning J. Structural Review Clerk (Revised02/24/2014) s ZE7 Edwin Cerna,PE 1595 Sw 154M Court Miami FL 33194 Tet.786-2454851•Fax 305-397-0354 SHOP DRAWING REVIEW PROD.NO: 14-027 i REVIEWER: Edwin Cerra DATE RECEIVED:08/12/15 PROJECT NAME: ROY KELLEY RESIDENCE DATE RETURNED:08/14115 EaummENTIMATERIAL DESCRIPTION Ductwork Layout Revisions Review is limited to verifying general conformance with the design concept as presented by the contract documents. Notations do not constitute a contract modification and do not relieve and contractor from compliance with contract documents,governing codes and regulations. No detailed check of quantities or dimensions was made. The general contractfconstruction manager is solely responsible for confirming all quantities,dimensions,fabrication techniques,coordinating work with other trades and ensuring that work is performed in a safe and satisfactory manner. Date: 08/14/15 BY: EDWIN CERNA�PE 69808 ❑ SUBSTANTIALLY CONFORMS TO DESIGN CONCEPT....ACCEPTED AS SUBMITTED SUBSTANTIALLY CONFORMS TO DESIGN CONCEPT....ACCEPTED As NOTED ❑ DOES NOT CONFORM TO DESIGN CONCEPT....REVISE AS NOTED AND RESUBMIT ❑ UNRESPONSIVE SUBMITTAL As NOTED....REJECTED,REVISE AS NOTED AND RESUBMIT REVIEWED AND RETAINED FOR INFORMATION ONLY , NO. COMMENTS 1 Provided ductwork layout revisions are consistent with design intent. Acceptable and needed due to existing structural layout conflicts. add ��.. a; •: `� ��� FIELD ,m+®�.,• ;,;a r� •tee ",.. 00Adffilk .�y.Ig s ; »uji •00000 00.00. OPY 0 00 000*00 00 • •••• i 0000 •.... 00.00• • • 90.00 • • 0000•• •• •• • 0000•• • •••••• • • N • • • • •0000• 0000•• ON 0'th E V • • • 0000•0ISION • 0000 0 • • • . . ... . . . ... .. .. . . . .. .. . . . . . . . . . . . . . ... . . . . ... .. . . . . .. .. . •• • • • •• • • •• •• • • • • • • • •• 4 i: tv . . 1.0 . . ... .. . . . .. .. .•• • • • • • • • • . • too 00 . . • .... .. . • f ' � l . . ... . . . ... .. .. . . . .. .. . . . . . . . . . . . . . ... . . . . ... .......... �r tt- w e n a , s K: �.r vvGi�lIIS a',e00, I I i� z t r c _ s x ••• • • • • ••• • • • • • • • • • • • • ••• • • • ••• • • DEC .g 1 2015 Edwin Cerna,PES. 1595 SW 154'Court Miami FL 33194 Tet.786-2464651•Fax 306-397-0354 SHOP DRAWING REVIEW PROD.NO: 14-027 REVIEWER: Edwin Coma DATE RECEIVED:08/12195 PROJECT NAME: ROY KELLEY RESIDENCE DATE RETURNED:08/14/15 EflurMENTIMATERIAL DESCRIPTION Ductwork Layout Revisions Review is limited to verifying general conformance with the design concept as presented by the contract documents. Notations do not constitute a contract modification and do not relieve and contractor from compliance with contract documents,governing codes and regulations. No detailed check of quantities or dimensions was made. The general contractleonstruction manager is solely responsible for confirming all quantities,dimensions,fabrication techniques,coordinating work with other trades and ensuring that work is performed in a safe and satisfactory manner. Date:08114/15 BY: EDWIN CERNA,PE 89808 ❑ SUBSTANTIALLY CONFORMS TO DESIGN CONCEPT....ACCEPTED AS SUBMITTED SUBSTANTIALLY CONFORMS TO DESIGN CONCEPT....ACCEPTED AS NOTED ❑ DOES NOT CONFORM TO DESIGN CONCEPT....REVISE AS{VOTED AND RESUBMIT ❑ UNRESPONSIVE SUBMITTAL AS NOTED....REJECTED.REVISE AS NOTED AND REsuamrr REVIEWED AND RETAINED FOR INFORMATION ONLY t No. COMMENTS 1 Provided ductwork layout revisions are consistent with design intent. Acceptable and needed due to existing structural layout conflicts. i .• � ii�ifi� i • O1614-15 L J .�r p cc ft :r�SLLI sjl�•i T �L of: '0C �► e e ,irk,rtt e• �f Q'• '',Q :SSSS• •SSSS• dam, e•••LJ•••• 5 �• �• ♦�grllroxnr 1..... . SSSS.. SSSSSe SSSS . ..ON SSSS. V1S1 %jE R SSSS.. SSSS . SSSS.. =EC = SSSS.. . 6.. SSSS :. . . Sees% SSSS.. S . sees . . . • .•. . • . ••• .. .. . . . .. .. . . . . . . . . . . . . . ..• . • . • ••. • . . . ... .. *00 000 ..• .. :00 r . • • •. • .•• • • • . •• • 0 000 00 t me • r i l 4k •• •• • • • •• •• • • • ••• • • • • ••• 00 •• • • • •• •• • Jr • • • • • • • •• • • • • • • • ••• • • ••• ••• ••• • :00 4es ,�.... x114 , .� .. .. . . . .. .. . . . . . . . . . . . nt.a' • • • • • 2 ;a S + z �r y. f a y b �'���$'"v'z�h'a✓`�� �'" ` �� ��,��,',.� � alk W ': �, :. y. <2 N ��M�a�.:..r�e� �9E�:. � #�� - h��cq� `St t �'.ul SS � ^.� .�. }•�d ��r _: .t.wp�vn�?�J'.��-.a�1' ./"Y��� T �b -.;� �� � 2-iPO�� s �r 6 - zfoZe Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-258373 Permit Number: MC-5-15-1138 Scheduled Inspection Date: May 09,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: ROY,WILLIAM Work Classification: Addition/Alteration Job Address: 1280 NE 101 Street Miami Shores, FL Phone Number Parcel Number 1132050210010 Project: <NONE> Contractor: METROPOLITAN AIR CONDITIONING INC Phone: 305-264-4646 Building Department Comments REPLACE 1 ST FLOOR HVAC AND ADD ADDITIONAL infractio Passed Comments UNIT(3RD) SYTEM TO ONE STORY WIRING OF HOUSE. INSPECTOR COMMENTS False l� Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid May 06,2016 For Inspections please call: (305)762-4949 Page 37 of 45 ME Miami Shores Village 60 Rpt 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Itl�tl Phone: (305)795-2204a��� V Expiration: 02/13/2016 Project Address Parcel Number Applicant 1280 NE 101 Street 1132050210010 Miami Shores, FL Block: Lot: WILLIAM ROY Owner Information Address Phone Cell WILLIAM ROY 1280 NE 101 Street (305)793-5050 MIAMI SHORES FL 33138- 1280 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 17,750.00 METROPOLITAN AIR CONDITIONING 305-264-4646 ...... :: _.. ::.._ . _.., .,._...� _....0 Total Sq Feet: 0 Tons:5 AND 2 Available Inspections: Additional Info:REPLACE 1 ST FLOOR HVAC AND ADD ADD Inspection Type: Classification:Residential Rough Duct Approved:In Review Rough Duct Comments: Date Approved::In Review Final Date Denied: Type of Work: Review Mechanical Scanning:1 Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $10.80 Invoice# MC-11-15-57818 Change of Contractor Fee $75.00 11/23/2015 Check#:5053 $75.00 $3.00 DBPR Fee $9.32 DCA Fee $9.32 11/23/2015 Cash $3.00 $0.00 Education Surcharge $3.60 Permit P� $621.25 Invoice# MC-5-15-55547 Scanning Pee $3.00 05/14/2015 Cash $50.00 $621.69 Scanning Fee $3.00 Technology Fee $14.40 05/21/2015 Check#:1114 $621.69 $0.00 Total: $749.69 1.1 7f In consoration 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 acceptirl Ahis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required4gr ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNE136 AFFIDAVIT: I certify t the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construatlbn and ning. Futhe thorize the above-named contractor to do the work stated. November 23, 2015 Authorized Signature: n Applicant / Contractor / Agent Date Building Department Copy Novomber 23,2015 1 Miami Shores Village - ,,1 Buildin g Dep artment Dov NIS 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 f�z��ls— �►`''� FBC ZO I O BUILDING Master Permit No.k PERMIT APPLICATION Sub Permit No.rnGl 5 — 1 : s ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING (MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: is the Building Historically Designated:Yes NO_ Occupancy Type: Load: // Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):� l L iQ ji= S(j-s f4<ff ne#: 96 70 a Address: U 8-d W,0 /}0 / City:T✓ yj �/r::R Q S State: Zip: Tenant/Lessee Name: Phone#: Email: AF C11-11JOIC4-i CONTRACTOR:Company Name: I"�� V i'y3_n aje_a=-n Phone#:3C)�S7-Z&4""LY4.LKP Address: COP(n r)ly Sz City: 'Y�',C�rrI State: Zip:3 3 I(p(p Qualifier Name: 1p,�\Cq-)teC-1'O nC,n7a Phone#: State Certification or Registration#: Q � l'��IGl Certificate of Competency#: DESIGNER:Architect/ERgiReer: 9 /1 C I o 2 Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1,06D.Gp Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: '7 Submittal Fee$ Permit Fee$ f CCF$ CO/CC$ Scanning Fee$��. (p Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 0Z > (ReAsed02/24/2014) 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 Signature OWNER or AG NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this l day of ,20 tby a day of 020 f 5 ,by LU vim,t�'r''2- y20-1 who is personally known to R►qQ 1Xc 0 who is personally known to me or who has produced "` ' as me or who has produced D�(" x'xh,l Iy as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: \\���►►►► Sign: \Sign 7ZJ-�-� ?X� Print: — jrint: tate of Florida WHY Seal: Commission # ;Seal: Meana Rodriquez %� af'j; .,EE113059. Q off` MY commission EE 882474 �'. Q\\ of Expires 03/11/2017 OF E o 1\\\ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) .,v,♦vvv, ,,vv vim.,♦,.v,. MAN{d'\Y Y41V1 v,V%-%J'1 .IMI%I r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION-INDUSTRY LICENSING BOARD Elm CAC043919 b The CLASS BAIR CONDITIONING CONTRACTOR Named below IS CERTIFIED a Dawe Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 GONZALEZ, RIGOBERTO 0 . W11 METROPOLITAN AIR COND INC 6917 NW 50TH STREET �• MIAMI FL 33166 L • • ISSUED: 06/23/2014 DISPLAY AS REQUIRED BY LAW SEDT# L1406230000414 01=17 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY 1568519 LBT �/ BUSINESS NAMEILOCAATION RECEIPT NO. EXPIRES MEfROPOUTAN AIR CONDITIONING INC RENO►AL SEPTEMBER 30, 2016 6917 NW 50 ST 1568519 Must be displayed at place of business MIAMI 8.33,1&6 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS METROPOLITAN AIR CONDITIONING INC 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED CAC043919 BY TAX COLLECTOR Worker(s) 10 $75.00 07/09/2015 CHECK21-15-083068 This Local Business tax Receipt only confirms;payment of flie Local Business tax The Receipt is not a license, permi4 or a aerdRcetiwn of the holder's qualiRcadons.to do bainass:Holder must comply with any govermaeutal or aongovemm 11 regmlatory laws and requirements which apply to the business. The RECEIPT N0.shove must be displayed on all commercial vehicles-Miami-Dade Code Seo Ba-VIL For more information,visit y tt;�nidade aavHeucollectar it ... DRIVER LICENSE CLASS E n '*70 G524-720.43-340-0 RIGOSERTO r; G NdZALEZ 13870 SW 108TH ST HAAS,FL 53186-3183 DOB:09-20-1943 SF-x-M° .o .,. 88 '0b*2914 "PUMS 09-U-2M SA tmvF—R Opermwn of a moles vnitleb coralw us cone to anv sobnoov Nat r*Mw*d by taw BRIGHTSTAR ► , GLOBAL SUMMIT Creating the Future of Brightstar Together brig htstarcorp.com 0 SNizc 2 soon nonce MiamishoresV'ffillage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 CONTRACTORS' REGISTRATION Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. 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. ■■eeegeegeeqeeeseeeeeeeeeeeeeeeeeeeeeeeqeseqeeeqeeesqeeqqqee■■eeeegeeeeeeeeeeeseeeeeesoeee BUSINESS NAME: tWo . BUSINESS ADDRESS: (cq 11 rel I-) Sz'D srt-- CITY rn'lc(rYa STATE fl. ZIP 33 (&-Xo BUSINESS PHONE: ( 1 20-\ y(00ko FAX NUMBER CELL PHONE(_—j QUALIFIER'S NAME: �` +O (2?onQ .� QUALIFIER'S LIC NUMBER: r' THE CO IA LAW GROUP, P.A. 215 NE 98 STREE MIAMI SHORES, FLORIDA 33138 TELEPHONE: 305.891.7595 FACSIMILE: 305.891.1961 gcoia@coialawgroup.com November 13, 2015 HAND DELIVERED Mr. Ismael Naranjo The Village of Miami Shores Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 RE: William Roy, Ph.D. Residence: 1280 NE 101 Street, Miami Shores, FL. 33138 Contracts Dated: 9/26/2014 and 3/20/2015 Dear Mr. Naranjo: The undersigned represents the interests of William Roy with respect to his contract(s) with One-Hour Air Conditioning. Dr. Roy is seeking a charge in contractors from One-Hour to Metropolitan A1C. To this end, Dr. Roy, through the undersigned, has complied with the Miami Shores Village requirement of sending a certified letter to the previous contractor and waiting for the passage of ten (10) business days prior to submitting a Change of Contractor form. I have enclosed a copy of the October 28, 2015 letter to the previous contractor. As of the date of this letter, my office has not received the signed receipt certificate nor has the letter been returned for any deficiencies. Since it has been more than ten (10) business days and no response has been received and no contact has been made by One Hour, Dr. Roy would like to proceed with the change of contractor. Enclosed, please find the appropriate documents to effectuate the change. Thank you for your prompt attention to this matter. VWadys yours, G . Coia cc: Dr. William Roy Miami Shores Village Mgr: Tom Benton: THE COIA LAW GROUP, P.A. 215 NE 98 STREE MIAMI SHORES, FLORIDA 33138 TELEPHONE:305.891.7595 FACSIMILE:305.891.1961 gcoia@coialawgroup.com October 27, 2015 Via Certified Mail Return Receipt Requested One Hour Air Conditioning & Heating, #156 655 NW 118 Street Miami, Florida 33168 Attention: Matias Torroja, Chris Reynolds and "Kevin" RE: William Roy,Ph.D. Residence: 1280 NE 101 Street, Miami Shores, FL. 33138 Contracts Dated: 9/26/2014 and 3/20/2015 Dear Sirs: The undersigned represents the interests of William Roy with respect to two contracts with One Hour A/C as referenced above. It is our position these contracts have been breached by One Hour. Accordingly, this letter serves to advise that a new AC contractor has been retained to complete the work One Hour has failed to perform. Dr. Roy contracted with One Hour on September 26, 2014, for the purchase and complete installation of an Amana/Goodman AC Unit for the second floor of the Roy residence. The amount of the contract, $11,220.00, has been paid in full. There nevertheless remains an issue with the functionality of the AC unit as installed by One Hour. In the meantime, on or about March 20, 2015, Dr. Roy contracted with One Hour for the purchase and complete installation of two additional AC units. The Village of Miami Shores has combined all three units under one permit. The permit remains open. The AC handler that was installed on the second floor of the Roy residence (contract dated 9/26/15) has had an ongoing issue since approximately August 10, 2015. One Hour was called out on no less than five occasions to diagnose, repair and/or replace the malfunctioning part under the existing Amana/Goodman warranty. The last attempt to repair occurred on August 14, 2015. Since that date , Dr. Roy repeatedly attempted to contact Mr. Torroja by phone and by email. Mr. Torroja finally responded at the end of August and promised to have the issues resolved to Dr. Roy's satisfaction. After not hearing back from Mr. Torroja despite his promises to fix the issues, Dr. Roy contacted One Hour on September 2, 2015, and was advised that Mr. Torroja was no longer running the company. Between September 2, 2015 and September 17, 2015, Dr. Roy repeatedly called and left phone messages for whomever was running One Hour that the AC unit in the second floor continued to shut-off in the middle of the night. Moreover, no one from One Hour was working on the installation of the additional two units. Finally, on September 17, 2015, Dr. Roy received a voice mail message from "Kevin" at One Hour, requesting to meet with Dr. Roy in order to introduce the "new guy"they hired who will "definitely take care of your [Dr.Roy] situation". On Tuesday, September 22, 2015, "Kevin"and Chris Reynolds met with Dr. Roy at his residence and assured him that all would be taken care of and that Mr. Reynolds would be at the residence the next morning. Mr Reynolds never appeared and Dr. Roy has not heard from One Hour since September 22, 2017.. Not only has One Hour not repaired nor replaced the malfunctioning AC handler covered under the first contract, despite full payment by Dr. Roy, they have abandoned the second contract altogether leaving the residence without the completed additional AC units and leaving the pending permit open. Dr. Roy has been left with no choice but to consider these contracts in breach and to hire another AC contractor to repair the second floor AC unit and to complete the installation of the additional two AC units. Please consider this letter as a formal discharge of One Hour as the AC contractor on this project. Very truly yours, Gladys L. Coia st , � � • N �• d . e .• . . . C3 r`u Palag3. C3 g Cl ru Certified Fee $I C„ffl l C3 Retum Receipt Fee Postmark M (Endorsement Required) «• r_ Here O .-: ResMcted DelNery Fee C3 (Endorsement Required) r. so 49 cO Tota!Postage&Fees $6.7;-- M 6. Sent o (�,, ,, a_t [ t r-3 Street, ptP``iva lb!Y'� .�t Q.�!!r !!� �. ------ J`��-- n— or PO Box No. S g CP 5 ...-N-F---.-------- �>�;ate.� --�---------------------- i L 33 PS F6rii)38007 Auq List 2006 f 'l (Expected Delivery Day) (Friday 10/30/2015) Certified 1 $3.45 41USPS Certified Mail #) (70101870000202654029) Return 1 $2.80 Receipt (MUSPS Return Receipt #) (9590952106150129347725) Total $6.74 Debit Card Remit'd $6.74 (Card Name:Debit Card) (Account #:XXXXXXXXXXXX4649) (Approval #:122697) (Transaction #:209) (Receipt #:001267) (Debit Card Purchase:$6.74) (Cash Back:$0.00) For tracking or inquiries go to USPS.com or call 1-800-222-1811. After delivery, use this tracking number to track your Return Receipt. Order- stamps at usps.com/shop or call 1-800-Stamp24. Go to usps.com/clicknship to print shipping labels with postage. For other information call 1-800-ASK-USPS. Get your mail when and where you want it with a secure Post Office Box. Sign up for a box online at usps.com/poboxes. xrc�ct�rw�crcrx>rrc�c�crrrcrxxrcr�cx*xrcrrc>Yx�crcxxxtcx� All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business HELP US SERVE YOU BETTER TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE Go-,ta;- https://pos experience.com/Pos or.scan this code with /your mobile device: r F • ~ ACORO0 DATE(MM/DDNYYY) AC40 CERTIFICATE OF LIABILITY INSURANCE 11/5/2015 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 CON NAMTAE: T Maria Nelson G. David Harris Insurance PHONE (305)885-2055 F No):(305)885-2005 688 South Drive ��Ls:maria@gdhinsurance.com INSURER AFFORDING COVERAGE NAIC d MIAMI SPRINGS FL 33166 INSURERAGRANADA INSURANCE COMPANY INSURED INSURER B SUMMIT CONSULTING Metropolitan Air Conditioning, Inc. INSURER C: 6917 NW 50 Street INSURER D: INSURER E: Miami FL 33166 INSURER F: COVERAGES CERTIFICATE NUMBER-CLI511501117 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 SU R POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER D R COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR PREMISES EaDAMAGE TO ENTED occu encs $ 100,000 0185FL00064373-1 11/4/2015 11/4/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY D JECT F] LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: HAUTL $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'UABILnY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N/A E.L.EACH ACCIDENT $ 100,000 B OFFICER/MEMBER ryIH)EXCLUDED? 52109048 8/3/2015 8/3/2016 E.L.DISEASE-EA EMPLOYE $ 100,000 If yas,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) LIC# CAC043919 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 Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Maria Nelson/CS ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 tpnwif • R g� Miami shores Village loss� o nasM Building Department I� Rnjp�► 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. M(2-.1S ® 113'6 Owner's Name (Fee Simple Title Holder): /J,), L.0 r �us i i*. � A-3 .305-' 63V—g700 Owner's Address: -a$p City: Mme, Slrhtxrg.' State: wr-k . Zip Code: ?x----Si 3� Job Address (Of where work is being done): City: Miami Shores State:_,_Plorida Zip Code: X13 Contractor's Company Name: 1-k±XJ2011 An At 1°1-1,Q- Phone Address:�(D OL l ) ri W a4 City: l CJI State: ` . Zip Code: (o(v Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name: Phone#: Address: Cit): State: Zip Code: Describe Work al t Ant 1 4� 1 hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Mi i Sh less of all legal involvement. O Signature Signature Owner or Agent ctor or Architect The foregoing instrument was aknowledged before a The foregoing instrument was aknowledged before me / this A day of 1U0'ep)lkr,2015,by this 17 day of �ember .201�y iLi ' er ko G)'4111%_ Who is personally known to me or who has produced who is personally known to me or who has produced Qf C'S 1Oj k I/ VXL%AX-) as indentification. i ( 4-pc.A-qn as Indentification. Notary Public: Notary Pu lic: Sign: Sign: ��. °�s�� Notary Public State of Florida L sG Notary Public State of Florida Q Ileana Rodriguez Seal ' Ileana Rodriguez `� o My Commission EE 882474 v My Commission EE 882474 �� Expires 03,11/2017 Expires 03/11/2017 Miami Shores Village _ Building Department -� l10050 N.E.2nd Avenue,Miami Shores,Florida 33138 MAY 205 . `l Tel:� .(305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 BY: FBCp20 1C)20 BUILDING Permit No. ° � �C�I Q 3 PERMIT APPLICATION Master Permit No.--d C Permit Type: MECHANICAL JOB ADDRESS: Aa eO Al E / ,a / City: Miami Shores County: Miami Dade Zip: -3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: �S OWNER:Name(Fee Simple Titleholder):L L r !�,o /'0' o v "'15" /f�one#: as-Z2 3,--rd -6 Address: rz> /�_I /�/S`F City: ,Zg& � S/he �S State: Zip: Tenant/Lessee Name: .('/o ec/4 Phone#: Email: 09r 4 to. c: A-sk. 71,st-/, eN CONTRACTOR:Company Name: ?'j6.Z I f tQ Phone#:30s IA a O Address: City: /'Y/c/ 11 State: f=-f, Zip: zCV/�Q Qualifier Name: kA P%t1 A S 1 ®W®i 1 A • Phone#: 3flS 2 G S 111Z70- State 1220State Certification or Registration#: CA,C 40'1 -5 T 9 a Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: t4'7-_-x0_ „342 a c '41,4 Phone#: OS'_ � /� - s6 40 Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑Address uAlteration.- 14rNew .*epair/Replace ❑Demolition Description of Work: z PC dK�-. �c T �c �p� /�t/�C y¢ RD_b A)Z1V _di/�C 44?U S_Fp �- xx x xx x xxxxxxx *****Fe1�� xxx�xxxxxxxxx�xx�xxx��xxx�xxxxx�xmxx�x�x Submittal Fee `� Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$_ C Bonding Gompany's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) A V 6 (� 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 ` Signature -��d Owner or ent Contractor The foregoing instrument was acknowledged before me this_ The fore oing instrument was acknowledged before me this/lot day of ,20�,by j� J ®o�, day of ,20 &by l • /u ice'o/ T',4 who is personally known to me or who has produc ' who is personally known to me or who has produced q0,5e-J &E c)%s identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: A 14111 �CUNp''�i Si I:` Sic \ OM 0 ; S r gn: Print: a�� p�a�r oanna M Feliciano Print: $ MY Commission My Commis 01112120 My Commission E fat p G �.�X/7 °GBS%•:....•.•�0%�� TATE OF e\�e� APPROVED BY Examiner Zoning Structural Review Clerk Revised 3/12/2012)(Revised(Y7/10/07)(Revised 06/10/2009)(Revised 3/15/09) DBPR- TORROIJA, MATIAS JOSE; Doing Business As: ONEHOUR AIR CONDITIO... Page 1 of 1 12:50.'29 PM 511412015 Licensee Details Licensee Information Name: TORROIJ , MATIAS JOSE (Primary Name) NEHOUR AIR CONDITIONING (DBA Name) Main Address: 540 W 83RD ST HIALEAH Florida 33014 County: DADE License Mailing: Licensel-ocation: License Information License Type: Certified Air Conditioning Contractor Rank: Cert Air License Number: CACIS13298 Status: Current,Active Licensure Date: 06/24/2002 Expires: 08/31/2016 Special Qualifications Qualification Effective Class A 06/24/2002 Construction Business 03/02/2011 Alternate Names View Related License Information View License Complaint 1940 North Monroe Street,Tallahassee FL 32399 :: Email: customer Contact Center :: custcrner Contact Center: 850.187.1395 The State of Florida is an AA/EEO employer.Coovriaht 20!2Z-2010 State of Florida,Priyacv Statement Under Florida law,email addresses are public records. If you do not want your email address released inrr-:pons to n public-rec rds request,do not send electronic mail to this entity. Instead,contact the office by phone or by traditional maO. if yc-u have air; questions,please contact 850.487.1395.'Pursuant to Section 455.275(1),Florida Statutes,effective October I, 4012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one. f'I:< onw,il s provided may be used for official communication with the licensee. However email addresses are i whiic record.If you do no,;,VP---h t,Supply a personal address,please provide the Department with an email address which can be made available to the public NeasF see our Chapter 455 page to determine if you are affected by this change https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=F53F77E9958F21 DF043... 5/14/2015 k Miami Shores Village • �C��� -D 2` Building Department E - 02014 �p� s 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 to BUILDING Master Permit No.W - ��-'��20 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLICWORKS [:] CHANGE ❑CANCELLATION [:] SHOP 12-Sp �j ` CONTRACTOR DRAWINGS { JOB ADDRESS: 2 tS p NE, I� 15T OO City: Miami Shores //�� County: Miami Dade Zip: c� Folio/Parcel#: [1. 32D5 . 02-1 . Vo u Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple �SSimpll�e Titleholder): Vy I I Iyt.r r i ®l.� Phone#:305• � 57 3 L0 Address: 12 CICO I\ i I ®I nFF City:_EI am ( �C� _`� Stater— Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �l , �C�LX ( -' Phone#: (c�J- Address: CC55 Iy VV ST � c� City: Owl State: � Zip: _331 �C� GG//"" Qualifier Name: lam. 1 r-D IIF' Phone#: --rib a s a ° iy_356 State Certification or Registration M Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/linear Footage of Work: Type of Work: ❑Addition ❑ Alteration ❑New Repair/Replace ❑Demolition Description of Work: �,'�N A'/ e_ yM T V n"A4 k C3 cJ CA— w ,. Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ n• CO/CC //$�� Scanning Fee$ -03Radon Fee$ DBPRR$ S• P�Bond$ /SCJ Notary$ Training/Education Fee$ _ 140 Technology Fee$ – l •�PIJ Double Fee$ rA Structural Review$ TOTAL FEE NOW DUE$ 5d2 . �� d Bonding Company's Name(if applicable) Bonding Company's Address i City I 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 ELECTRICAL WORK, PLUMBING,SIGNS,WELLS,POOLS, FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certifyhat 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 sev n(7)days after the building permit is issued. In the absence of such post d notice,the inspection will not be approved and a reinspectionee will be charged. Signature Signature Owner or Agent J C tractor The foregoing instrument was acknowledged before me this The foregoing instrument fwaa ,�7 /,s acknowledged before me this day of 20 °�,by v ay of / 20/`7 by �S who is personally known to me or who has produced ' who is personally known to me or who has produced'�� As identification and who did take anath. .,. as identification and who did take an oath. NOTARY PUBLIC: A/ , NOTAR ELIC: Sign: Sign: Print: Print: E-Mll . Emik,e Van h Van Den Bergh My Commission Expires: My Gommiasion EE195282 My CommissionffR,.,,;jE mmission EE 199262 o� Expos 05J0 M18 OS/Oy2016 a APPROVED BY �4� �' Plans Examiner Zoning Structural Review Clerk Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Miami Shores Village Building Department y 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. Job Address(where the work is being done): 1 HC- A City: Miami Shores Village County: Miami Dade Zip Code:5N 30 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 ARI(AHRI)DATA SHEET REQUIRED Change Disconnecting means:YES ❑ NO X ARHI Sheet Attached:YES,9 NO❑ Contract Attached:YES;Z UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER -rwt_ oLth AHU or PKG.UNIT MODEL# COND.UNIT MODEL# KW HEAT to Lt Tals NOM TONS q Tbr-T AHU jo CU 35 PKG 1 M.C.A AHU Ljq CU 1,CPKG AHU Go CU 5D PKG 2 M.O.P AHU bo CU 'SpPKG AHU CU PKG 3 VOLTS ROW AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER t� YES NO REPLACING DUCTS — 9- E NO S NO REPLACING THERMOSTAT ni NO YES NO NEW 4-CONCRETE SLAB YES 0 YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM YES NO 1. Minimum Circuit Ampacity(Wire Size): 40 2. Maximum Overcurrent Protection(Fuse/Breaker Size): brJ 3. Voltage of Circuit 208/240 80): 4. Size Disconnecting Means: (a 0 Atlx Contractor's Company Name: ZiP_ ®AC (kv/L Phone: 301 1120 State Certificate or Registration N.(2U_ 11;1, 32-x}i3 Certificate of Competency N. Signature Date: 0'9 -IZq 2® [/ e sign tore only)