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MC-16-1285 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-271034 Permit Number: MC-5-16-1285 Scheduled Inspection Date: November 16,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: KNUTT,JAMES&MARI Work Classification: A/C Replacement Job Address:321 NE 100 Street Miami Shores,FL Phone Number Parcel Number 1132060135350 Project: <NONE> Contractor: NEW SERVICE COMPANY Phone: (305)324-754 Building Department Comments REPLACEMENT OF 2 CCOMPLETE AIC SYSTEM. 1 =4 Infractio Passed Comments TONS 1=2.5 TONS. INSPECTOR COMMENTS False Inspector Comments Passed ® CREATED AS REINSPECTION FOR INSP-258730. Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 15,2016 For Inspections please call: (305)762-4949 Page 23 of 34 MC4 46 i, Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 h� Phone: (305)795-2204F Pefrr :a�i�31S:` ��I . 7- 4 .� W, Expiration: 111161 p� Project Address Parcel Number Applicant 321 NE 100 Street 1132060135350 Miami Shores, FL Block: Lot: JAMES&MARI KNUTT Owner Information Address Phone Cell JAMES&MARI KNUTT 321 NE 100 Street MIAMI SHORES FL 33138-2420 Contractor(s) Phone Cell Phone Valuation: $ 6,000.00 NEW SERVICE COMPANY (305)324754 (305)798-7383 _,.. Total Sq Feet: 0 Tons:7.5 Available Inspections: Additional Info:REPLACEMENT OF 2 CCOMPLETE A/C SYST Inspection Type: Classification:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 DBPR Fee InVOICe# MC-5-16-59750 $3.15 05/18/2016 Check#:1371 $ 184.90 $50.00 DCA Fee $3.15 Education Surcharge $1.20 05/12/2016 Check#:1368 $50.00 $0.00 Permit Fee $210.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $234.90 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 rmity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I ass a resp sibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRI L UMBING, ECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAV rti that all he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a d zo mg. uth ore,I orize the above-named contractor to do the work stated. May 18, 2016 Autho Sig re: n / Applicant / Contractor / Agent Date Building apartment Copy May 18,2016 1 11VED Midl l ll al IUl Cb V Ilidge AY 12 2696 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 -� Tel:(305)795-2204 Fan:(305)756-8972 qq 11 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2® _ BUILDING Master Permit No. VA 1 (6- 1-2 8� PERMIT APPLICATION sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING /MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP / �/0 �s� CONTRACTOR DRAWINGS JOB ADDRESS: �t /Y `�O g f - C' : Miami Shores Coun : Miami Dade zip: 3 3r 3 Fold/Parcel#: — ® Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: 4V om^ OWNER:Name(Fee Simple Tleholder): Phone#: --30� *5 �Y?�j Address: City: ju State: t L= Zip: �7 Tenant/Lessee Name: Phone#: Email: ,�" -7 CONTRACTOR:Company Name:_��Uy � OCP Phone#: Address: -501 rS' w / St s u i + 6 3 a Z City: K i P,»V1 i State: F 1 Zip: 33 / 3 C) Qualifier Name: Te—8'w U ?Cr P -7 Phone#• 3 o S-.3 2 Y ?5-0 State Certification or Registration#: C-14 C (R11 Lf t4 C4 2 Certificate of Competency#: DESIGNER:Architect/Engineer: y Phone#: Address: II ((�� City: State: Zip: Value of Work for this Permit:$ l Q d O V 1, Square/Unear Footage of Work: Type of Work: ❑ Addition El Alteration F1 New Repair/Replace ❑ Demolition Description of Work: LS i�- PjU c P_yA e nT of 4TO Ij d 2-S To"V S Specify color of color thru tile: Submittal Fee$ 50 ° OZ.) Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ 0 Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE S 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. t Signature ASigna e R A E C RACTOR The foregoing instrument was acknowledged before me this The foregoing instrument wa owledged before me this 1 day of S 20 by yy/of Ct 20 by mWr who is personally known toVtd l o is personally known to me or who has produced ft., l as me or who has produced d as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLI NOTARY PUB Sign: ( /l Sign: Print: V l/u JQ, Print: Seal: Ftars M: P Yic Sa Seal poPY:P&6'° EUBH FijO �AES nPYPS oa a° n Notary P k-Sax�67 MY Comm.Exp!res Th-o06 Corrmwimt.FF2 Bordo h Aaai Noiy 9F �-� Horded;hro;p Aaran kotay V APPROVED BY Plans Examiner Zoning Structural Review Clerk C"R IF `'A CERTIFICATE OF LIABILITY INSURANCE DAT / 055J12/2/12/201166 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 poiicypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Best Option Insurance Brokers,Inc PH NE (305)859-7303 F'C.No): (866)910-0983 3400 Coral Way Suite 500ADDRESSe MAIL ludys@bestoptioninsurance.net Coral Gables,FL 33145 INSURERS AFFORDING COVERAGE NAIC# Phone (305)859-7303 Fax (866)910-0983 INSURER A: Granada Insurance INSURED INSURER B: INFINITY New Service Company INSURER C: 501 SW 1st ST#302 INSURER D: NORMANDY HARBOR INSURANCE COMPANY INSURER E: MIAMI,FL 33130 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 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. ILTR TYPE OF INSURANCE ADD UBR POLICY NUMBER POLICY EFF POLICYMEXP LIMITS 0 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 A AGE TO RENTED ❑ CLAIMS-MADE Q OCCUR PREM SES Ea occurrence) $ 100,000.00 ❑ MED EXP(Any one person $ 5,000.00 AN N 0185FL00073289 08/04/2015 08/04/2016 ❑ PERSONAL&ADV INJURY $ 1,000,000.00 GEN'LAGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE $ 1,000,000.00 ❑ POLICY ❑ JEC❑ LOC PRODUCTS-COMP/OP AGG $ 1,000,000.00 ❑ OTHER $ AUTOMOBILE LIABILITY OMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY INJURY(Per person) $ 25,000.00 B E] ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ 50,000.00 AUTOS © AUTOS N N 509800014081001 12/03/2015 12/03/2016 HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ 25,000.00 F-1 HIRED AUTOS Per accident ❑ ❑ PIP(NIRR)DED-$1,000 $ 10,000.00 ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS UAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N LITE ANY PROPRIETOR/PARTNER/DCECUT E.L.EACH ACCIDENT $ 1,000,000.00 D OFFICER/MEMBEREXCLUDED? � N/A N NHFL0032152015 01/08/2016 01/08/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) License#CAC 1814442 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 N.E.2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,Florida 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)OF The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department unit" 10050 N.E.2nd Avenue Miami Shores, Florida 33138 R 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):. NP 16,A) City: Miami Shores Village County: Miami Dade Zip Code- 3-N ALL CONDENSING UNITS MUST BE ON A4 INCHS L!D 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 F] NO[] ARHI Sheet Attached:YES 0❑ Contract Attached:YES UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER V o AHU or PKG.UNIT MODEL# COND.UNIT MODEL# 1(4 A) KW HEAT ­=tQ1 NOM TONS AHU IC4 PKG 1)M.C.A AHU 1;0 CU PKG AHU VCU PKG 2)M.O.P AHU 410CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT PKG UNIT EER/SEER YES NO REPLACING DUCTS YES YES NO REPLACING THERMOSTAT M2 UQ YES NO NEW 4"CONCRETE SLAB YES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES N 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection(Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 34 0 4. Size Disconnecting Means: Contractor's Company Name: bu Phone: State Certif' e or Registr !on NB� Certificate of Cimpetency, 0 Signat e Dal 5; (Qual is si store (Revised02/24/2014) This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service - between Feb 17,2009 and Dec 31,2016. Certificate of Product Ratings AHRI Certified Reference Number: 6946487 Date: 5/12/2016 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 116BNA0301A Indoor Unit Model Number: FX4DN(B,F)037L Manufacturer: BRYANT HEATING AND COOLING SYSTEMS Trade/Brand name: BRYANT HEATING AND COOLING SYSTEMS Region: Southeast and North(AL,AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC,TN,TX,VA AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY,OH, OR, PA, RI,SD, UT,VT,WA,WV,WI,WY, U.S.Territories) Region Note: Central air conditioners manufactured prior to January 1,2015, are eligible to be installed in all regions until June 30,2016. Beginning July 1,2016, central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. Series name: LEGACY LINE PURON AC Manufacturer responsible for the rating of this system combination is BRYANT HEATING AND COOLING SYSTEMS Rated as follows In accordance with AHRI Standard 2101240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(Btuh): 28800 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): Ratings followed by an asterisk(')indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered Into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The Information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link he make life better" and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which Is listed above,and the Certificate No.,which is listed at bottom right. ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 131075327628496848 h Miami Shores Village Building Department mai 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 beim done): �.�t - ( 4Z6ve.S City: Miami Shores Village County: Miami Dade Zip Code: 3 31 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 Dnr AHU or PKG. UNIT MODEL# f 0 6A) Cffj COND.UNIT MODEL# A) KW HEAT iff 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 ES YES NO NEW 4"CONCRETE SLAB ES YES NO NEW ROOF STAND YES YES NO NEW RETURN PLENUM BOX YES 1. Minimum Circuit Ampacity(Wire Size): jr Y 2. Maximum Overcurrent Protection (Fuse/Breake Size): 3. Voltage of Circuit(208/240/480): 4. Size Disconnecting Means: (� 2 Contractor's Company Name: Vffi Phone: J State Certificat ration IN -4uqur*' Certificate f Competency N . Signatu Date: 1Quas - ® This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2016. Certificate ®f ProductRatings AHRI Certified Reference Number: 6946519 Date: 5/12/2016 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 116BNA048****B Indoor Unit Model Number: FX4DN(B,F)049L Manufacturer: BRYANT HEATING AND COOLING SYSTEMS Trade/Brand name: BRYANT HEATING AND COOLING SYSTEMS Region: Southeast and North(AL,AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK,SC,TN,TX,VA AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI,SD, UT,VT,WA,WV,WI,WY, U.S.Territories) Region Note: Central air conditioners manufactured prior to January 1,2015,are eligible to be installed in all regions until June 30,2016. Beginning July 1,2016, central air conditioners can only be installed in regions)for which they meet the regional efficiency requirement. Series name: LEGACY LINE PURON AC Manufacturer responsible for the rating of this system combination Is BRYANT HEATING AND COOLING SYSTEMS Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, Independent,third party testing: Cooling Capacity(Btuh): 46500 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 IEER Rating (Cooling): Ratings followed by an asterisk(')indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certifloate and Its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered Into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verify Certificate"link we make life better- and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which is listed above,and the Certificate No.,which is listed at bottom right. 131075327182010538 ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: