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MC-13-241Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 164 NC'3 5r' Inspection Number: INSP - 185840 Permit Number: MC -2 -13 -241 Scheduled Inspection Date: February 13, 2013 Inspector: Perez, JanPierre Owner: MAJETSCHAK, MATHIAS Job Address: 41 NW 107 Street Miami Shores, FL 33138 -4306 Project <NONE> Contractor: SUSHINE AIR INC Permit Type: Mechanical - Residential Inspection Type• Work Classification: Addition /Alteration Phone Number (305)757 -3963 Parcel Number 1121360070450 Phone: (786)488 -1200 Building Department Comments REPLACE CENTRAL AIR CONDITIONING Infractlo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 12, 2013 For Inspections please call: (305)762 -4949 Page 26 of 30 BUILDING Miami Shores Village Building Department B 10050 N E 2nd Avenue, MW Shores, Florida 33138 Tel: (305) 795.E Fan: (305) 756.8072 INSPECTION'S PRONE NUNIRERt 76.2.4949 ER 0 7 Itnuit� WC) I M4 I PERMIT APPLICATION Master Permit Ne. Permit MECHANICAL JOB ADDRESS: 41 NW 107th Street Shoo County: Wand Dade zip: 33165 Polio/Parcetit Is the Banding IfisturiesilYD le4: Yes 140 d Zee: OWNER: N Simple T );Matthiaa and Michaels Majetecphont_ 786 338 539.8 Add . 22 W 530 Burr Oak Drive City- Glen Ellyn suite: IL Tenannasmn Na= Stephanie Di Bianco Email: mmaj etschakeluiuc . edu CONTRACTOR: Company rye: Adder I ©°l® City; y(Y) i &Lm stag Qualifier Name; .S +0 c y cu n &ennG.- H- asp Certification f: CA c contact phone* 70, 6 - Li ao mall Addrom 60137 //7//i 7o6-1/68--/a00 .7* '3319 -7 x:786 -- 913(3 -laoo C:110 aoofCompc: ucy#: I►9 �� �UhSI� %ne -CA1 CO, DESIGNER: MdzitecliEaginear: Value of Work ibrtldspes $ M, Q o 0 S uarelL l eofWorla Type of Work DAddress OAltelatioa Dhow air/Rcgiace (dittos Deceriiptionofwork IS e_4 Lin c �a 1,-) -{This L ��� C.ev� c� ► "-',`a f), So- )1/-1 IFS_ Permit Fee $ Scanning Fee $ Radon Fee$ Notary $ Tralmng/Edaaea1on Fee $ DeublePtes 9t. Structural Review $ TOTAL FEE NOW DUES tIVO CC F$ COICC $ DBEU Jima $ TeduaotogyF $ Bonding Company's Name (if applicable) ✓°` Bonding Company's Address City State 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 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 is, ue ; In the absence of such posted notice, the inspection will not be ppprov and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this / 7 M day of —'a. 20 ,, by who personally known 0 IP �l me or who has produced As identification and who did take an oath. NOTARY P I LIC: Sign: Print o Y L.. s: etoitkr.R : MY COMMISSION # EE082242 • EXPIRES April 10, 2015 Otatia**** APPROVED BY 0 12o!5 Signatur Contractor The foregoing instrument was acknowledged before me this / day of -Zav+ . c , 20 /3, by 5+Qt cr &1,m ���C who is personally known to me or who has produced i"Yyy*230— k 0 as identification and who did take an oath. NOTARY PUBLIC: * * * * * * *A. * *** * * * * * * * * * * * **** lA VIA I Plans Examiner Structural Review Revised 3 /1212012)(Revised 07/10/07)(Revised O5/10/2009)(Revised 3/15/09) Sign: ssi cONNALiti U LE ." MY COMMISSION a Men 4Z EXPIRES April 10. 2010 * 01 3 F*Rio.ra c..:... +F*qI *'l'******** * *** ** *** Zoning Clerk r 'VI Eiz, . 1.,'...,_....,—efi:-62..V.',,,,,I•gl'i,ilt'g,;.!",:,,,,,:',„,:.1, ',,-/ ..1,....,!.1,,,,,,,,,. . 4,.-"1.:j',''. ,,,..‘...i KO E-.:.,...j fil 1--:1--i-':,,,,,r,),,,Yj,", )21.7.11 1x31.1,',Figig,';,-t., .,,,,i,,,,t-,/,„,7,,,,,,.,„..„.:,„„,,.:.,,,.„,..:,„„.,,„;,_.,...,.:,:..,,:,:..,,.....,...i..i:„... ,,,, *f*AiA;Y4.',:i!"1:40;;,01PY-44.ig'''.. • This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service, between Feb 17, 2009 and Dec 31, 2013. r• ',,?; ',4•"li t AHRI Certified Reference Number 3849913 Date: 2/4/2013 Product: Split System: Air-Cooled Condensing Unft, Coil with Blower Outdoor Unit Model Number 14AJM36 Indoor Unit Model Number RHLL-HM3821+RCSL-H*3821 Manufacturer RUUD AIR CONDITIONING DMSION Trade/Brand name: RUUD 14AJM SERIES Manufacturer responsible for the rating of this system combination is RUUD AIR CONDITIONING DMSION 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): 37600 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 * 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 endome the product(s) listed on this Certificate and makes no repntsentations, warranties or guarantees as to, and assumes no responsibMty for, the product(s) listed on this Certificate. AHRI expressly disclaims all [lability 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 CestMcate. Certified ratings are valid only for models and configurations listed in the dkectory at www.ahridirecir.,, Ty.arg. 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 A51 P form or manner or by any means, except for the user's Individual, personal and confidential reference. • CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at W", ch; click on "Verify Certificate" link 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 kselovi. VAN and Refrigeration Institute ©2012 Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130044554646149998 01/18/2013 10:01 FAX 2396932522 EDISON INSURANCE GROUP 1_j 001 OP ID: HH A4 CV: CERTIFICATE OF LIABILITY INSURANCE °" 01„x'' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL Y AND CONFER NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ANEW , EXTEND t►R ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITL TE 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 pollcyp s) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an 1.ndorsemenl. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 239493 -04011 Edison Insurance Agency, Inc. 3835 Palm Beach Boulevard 6A 239- 593 -25Z . Fort Myers, FL 33916 can - P • : E FAX . , . , , 1 WC, No): AR x l' .'1 ,,aSUNSH -9 INSURERS) AFFORDING COVERAGE NAIL $ INSURED Sunshine Air Inc. 45 NW 193rd Terrace Mimmi, FL 33169 INSuRER A :Old Dominion Insurance Company 40231 INSURER a: INSURER C: 02127112 INSURER D : EACH OCCURRENCE INSURER E : 1,000,000 L:, n F: • pligasTUENTED h COVERAGES CERTIFICATE NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HI VE BEEN IS:IIED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmO■ OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORI ZED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVI i BEEN RE011. :ED BY PAID CLAIMS. TYPE OF INSURANCE ADDL man SUMO Nmn AY RIMER -.1 YI NDDtYtL LIMITS 1050 N.E. 2nd Avenue A GENERAL LIABILITY COMMERCIAL GENERAL u oiure MP02998A 02127112 02127/13 EACH OCCURRENCE $ 1,000,000 X pligasTUENTED h s 500,000 CLAIMS -MADE X OCCUR MEO EXP (sly one Person) S 10,000 PERSONALS ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENT. AGGREGATE LIMIT APPLIES PER: POLICY n n ioc PRODUCTS - COMP/OP AGO S 2,000,000 il S AUTOMOBILE LIABWNTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS XXXXX XXXXX XXXXX )0000( XXXXX COMBINED SINGLE LIMIT (Ea e $ XXXXX - BODILY INJURY (Per Parson) S XXXXX BODILY INJURY (Per accident) S XXXXX (Per accident) DAMAGE S XXXXX — — S S UMBRELLA UAB H OCCUR EXCESS UAB CLAIMS-MAD E XXXXX EACH OCCURRENCE S XXXXX AGGREGATE S XXXIDI DEDUCTIBLE RETENTION S S S AND ANY EMPLOYERS' LIABILITY Y! N N / A XXXXX XXXXX yiC I TOW YM S 1 LER EL EACH ACCIDENT S XXXXX PAOPRIETOMPART CUTIVE OFFICER (Y� MEMBER EXCLUDED? EL. DISEASE -EA EMPLOYEE S XXXXX y In NH) describe IONN OPERATIONS below E.L. DISEASE -POLICY LIMIT S XXXXX X70(XX 70000( XXX)OI X 000( DESORPTION OF OPERATIONS! LOCATIONS I VEHICLES (Muth ACORD 101, AddltlOna1 Remarks Schedule. B mom space Is required) Air conditioning systems or equipment CERTIFICATE HO MIAM021 SHOULD AMY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL- BE DELIVERED IN Village of Miami Shores BIIIIdIne Department ACCORDANCE WITH THE POLICY PROVISIONS. Fax: 305.756 -8972 IUTHORB'EDIMPGE8ENTATWE 1050 N.E. 2nd Avenue Qt,� 5. (�,)„Q/ ,. Miami Shores. FL 33138 ��'�� -. 'y ACORD 26 (2009109) ID 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo a m registered marks of ACORD 305 -255 -7337 MIAMI-DADE COUNTY TAX COLLECTOR 1401X FLAGLER $T. 1st FLOOR 33130 NAME.. - .LOCAL BUSINESS TAX RECEIPT 2013 14' 1 PADE Co U ' STATE OF.'FLORIDA EXPIRES SEPT. 30, 2013 :MUST.•@E,;gISPLAY.ED AT PLACE OF BUSINESS P RSU , TO...CQPN, POPE CHAPTER SA - ART. 9 & 10 639903 -4 aU SUt SHINE AIR INC 10904 SW 155 TERR FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT N0.231 THIS IS NOT A BILL — 00 MOT PAY RENEWAL RECEIPT NO. 666710-0 STATE* CAC1816158 33157 UNIN DADE COUNTY OWJNSHINE AIR INC secl.TJgE I TY BUILDING gYUSSWEESS ONLY X RECEIP. LOCAL DOES NOT PERMIT ME HOLDER TO VIOLATE ANY EXISTING REGULATORY OR OP THE r�O�ORGA . NOR DOES TT EXEMPT THE HOLIER FROM ANY OTHER PERMIT OR LICENSE REQUIRED SY LAW. THIS IS NOT A CERTIPICATIOR OP THE HOLDERS OUALIPICA• PAYMENT RECEIVED COL .DAD TM COUNTY T 09/20/2012 09010080001 000075.00 SEE OTHER SIDE Feb 121311:54a CONTRACTOR WORKER /S 1 DO NOT FORWARD SUNSHINE AIR INC STACYANN BENNETT PRES 10904 SW 155 MIAMI FL 33157ERR 111111111111I111111111111111111 I 1111111111111111J111`11111)° Feb 12 13 11:54a Sunshine Air, Inc 305-255-7337 p.4 AC#6251902 IS DOCUrEfrrHASA CbL0RED BKcROUrfD 41;:1:41CRO91RIWTING.,LINEM;kRiO!'"F.xrk-NTED,.PA0,E13:-.,:',, STATE OF FLORIDA • DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L120807015 DATE BATCH NUMBER LICENSE NBR 08/07/2012 128032697 CAC1816158 The CLASS B AIR CONDITIONING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 BENNETT STACYANN MONIQUE • SUNSHINE AIR. INC 10904 NW 155TH TERR MIAMI FL 33157 RICK'SCOTT ' GOVERNOR KEN LAWSON • SECRETARY =PLAY AS REQUIRED...BXLMY________ Feb 121311:54a Sunshine Air, Inc 305 -255 -7337 p.3 03 -16 -2011 JEFF ATWATER STATE OF FLORIDA CHEF FINANCIAL 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 Florida Workers' Compensation law. EFFECTIVE DATE: 03/16/2011 PERSON: BENNETT FEIN: 300528459 BUSINESS NAME AND ADDRESS: SUNSHINE AIR INC 45 NW 193RD TERRACE MIAMI FL 33189 EXPIRATION DATE: 03/15/2013 STACYANN SCOPES OF BUSINESS OR TRADE: 1- AIR CONDITIONING 2- DUCTS - HTG & A/C IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer el a corporation who elects exemption from this chapter by Tiling a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05f12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the entice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shali be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice ar certificate no longer meets the requirements of this section for issuance of a certificate. The department shell revoke a certificate at nay time for failure of the person named on the certificate to meet the requirements of this section. Q OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 QUESTIONS? (850) 4i3- Feb 121311:53a Sunshine Air, Inc 305- 255 -7337 CERTIFICATE OF LIABILITY INSURANCE HOLDER. IS CER THis TES IFICAT DOE IS OSt1Et? RS A AAA YEOR NEGATIVELY MEND, EXTEND O TER THE OVERAGE A� ORRDEDA$ THE ES CERTIFICATE DOES NOT AE OF INSURANCE THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS }. AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Tc must be endorsed. If SUBROGATION IS WANED, subject to IMPORTANT: terms and if the certificate holder is rt RDO policies may require INSURED, the policy/ es) the terrrts and conditions of the policy, certain policies may retlui an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s p.1 OP ID: JK DATE(MWD1NrYYY) 02/12113 PRODUCER Inc. Edison Insurance Agency, 3035 Palm Beach Boulevard #A Fort Myers, FL 33916 INSURED Sunshine Air Inc. 45 NW 193rd Terrace Miami, FL 33169 INSURER S AFFORDING COVERAGE INSURER A :Old Dominion Insurance Cam • n REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: FOR THE POLICY PERIOD WTV FOR THE PO ICY P IOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTFA BELOW HAVE BEEN ISSUED TO THE INSURED NAMED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT CERTIFICATE AND CONDITIONS OF SUCH POLICIES, LIMITINSURANCE HOWN MAY AFFORDED BY THE POLICIES BEEN REDUCED BY PAID DESCRIBED IS SUBJECT TO ALL THE TERMS, EXCLUSIONS POLICY EPF { POLICY EXP ,.R, I..:►•u, I;. a .A :b INSR TYPE OF INSURANCE GENERAL LIABILITY 71 COMMERCIAL GENERAL LIABILITY CLAIMSMAOE 1 X 1 OCCUR GEN'L AGGREGATE LIMIT G APPLIES PER 1 PRO- 1 1 LOC X I PODY .IR^T AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AD SUBRI MPG2998A 022/27/13 02/27114 XXXXX XXXXX XxxXX xxxXx XXXXX XXXXX UMBRELLA LAB EXCESS UAB OCCUR CLAINIS.MADE 1 DEDUCTIBLE 1 RETENTION 5 LIMITS EACH OCCURRENCE OPRREMGc18 TED 5 nee 5 500,000 MEO SIP (Anyone person) 5 10,000 PERSONAL RAM INJURY 5 1,000,000 GENERAL AGGREGATE S 2,000,001 PRODUCTS • COMP/OP AGO 5 2,000,004 5 1.000,000 COMETNEO SINGLE LIMIT (Ea accident) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) xXxx: EACH OCCURRENCE AGGREGATE s XxXx $ XXXX XXxx 5 $ $ xxxr XXX) 5 5 WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRfETORIPARTNEiJEXECuTIVE OFFtCERIMEMBER EXCLUDED", (Mandatory In NH) If yes. �descnlxrunder OIScR IPTF01•I Or OPERATIONS Delnw E Y/ NIA XXXXX xxxxx 1 WC STATU- 0TH. TORY (NITS ER EL. EACH ACCIDE..NT s E.L. DISEASE • EA EMPLOYEE S E.L DISEASE - POLICY LIMIT S XXXXX XXXXX DESCRIPTION OP OPERATIONS 1 LOCATIONS! VEHICLES (Attach ACORD tat, Additional Remarks Scnedule, Ft more space 1s rerluulIed) Air conditioning systems or equipment xxx: XXX: XXX xxx XXX CERTIFICATE HOLDER CANCELLATION City of Miami Shores Village Fax # 305 -255 -7337 10050 2nd Ave. !.� Miami Shares, FL 33138 ACORD 25 (2009/09) MIAM024 THE EXPIRATION�DATE ABOVE THEREOF NOTICE WILL BE DL X DELIVERED 11 ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORI2ED REPRESENTAT1V E ©19882008 ACORD CORPORATION. Alt rights reserved. The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department 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): 4 1 n I,.1 ) 0 City: Miami Shores Village County: Miami Dade Zip Code: 3 3 % 6 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 ARHI Sheet Attached: YES NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT 1,,V-Ifn MANUFACTURER fkeern AHU or PKG. UNIT MODEL # jJ i, L. - Yi irY13 8ai# 11csL COND. UNIT MODEL # l LI -3 -s6 0 KW HEAT 16 I` i 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 I 16 _ YES NO REPLACING DUCTS YES • (NC1 ) � YES NO REPLACING THERMOSTAT 0ES ) NO . YES NO NEW 4 °CONCRETE SLAB YES NO YES NO NEW ROOF STAND 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: / kin s 11174. i4; v , e.. Phone: 7 S6 -9Y/1 State Certificate or Registration N. 6 ,b 15 A Certificate of Competency N. Signature (Qualifier's signature only) Date: -u11 ?0 /Z (3/3 AGREEMENT Date: January 16, 2013 Go -Green Duct & Insulation, Inc Sunshine Air, Inc P.O. Box 972166 Miami, FL 33197 786 -449 -7900 Fax 305 - 255 -7337 t MINE Am a'c. tu6t41MULAffl TO Matthias Majetschak 41NW107St Miami Shores -33168 786 - 338 -5318 SQUARE FEET L;- TION Ductwork Check for leaks in duct system and r air if necessary. Insulation Install ceiling insulation in attic. "I C1 years labor warranty. ,Air Cork/it/OM/v. install 3 ton Rheem- 16 Seer Air Conditioning Unit. New thermostat, new air handler, new condenser, new concrete slab, float switch. 10 year manufacture warranty. 1 year labor warranty. Total cost of $3,709 includes insulation and new air conditioning. Price includes all FPL discounts. Deposit of $1,854.50 to be paid prior to start of job. Remaining balance of $1,854.50 pus cost of permit to be paid at time permit is closed by Miami Shores. Matthias Majetschak JOB Ceiling] insulation, replace air conditioning.