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MC-16-3477Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. MC -12-16-3477 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: APPROVED Issue Date: 12/29/2016 Expiration: 06/27/2017 Parcel Number Applicant 960 NE 95 Street Miami Shores, FL 1132050070130 Block: Lot: FRANK AND MARY HENRY Owner Information Address Phone Cell FRANK AND MARY HENRY 960 N. E. 95 ST. (305)754-7451 Contractor(s) LORD'S A/C CORP Phone (786)260-4783 CeII Phone Valuation: Total Sq Feet: $ 3,000.00 0 Tons: 1 Additional Info: 3TONtCHANG Classification: Rt! ivae Approved: In Revie Comments: Date Denied: Scanning: 1 ST , tom ' h AT 1 E D i roved:: In Revi Ty — Work: 3 TON CHANGE OUT ECT Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.00 $2.00 $0.60 $5.00 $105.00 $3.00 $2.40 $121.80 Pay Date Pay Type Invoice # MC -12-16-62481 12/28/2016 Credit Card 12/29/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 71.80 $ 71.80 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: ce •fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni rmore, I auth. •- - above-named contractor to do the work stated. December 29, 2016 Authorized Signat Owner / Applicant / Contractor / Agent Building Department Copy Date December 29, 2016 1 BUILDING PERMIT APPLICATION 0BUILDING ❑ ELECTRIC El PLUMBING MECHANICAL JOB ADDRESS: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEIVED DEC 28 2016 BY• 111 FBC 2014 5 Master Permit No. �C 12_---(6 —3411 Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR ct cat)vet✓ S S"� DRAWINGS City: Miami Shores County: Miami Dade Folio/Parcel#: l` 3 2-65-06" —0V-30 Occupancy Type: Load: Construction Type: Zip: '33I3a Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): c apt -to ld Address: c1(.00 nem _l J �� t City: MtPci Si/1oRe_ State: BFE: FFE: Phone#: 50S —q DS Zip: 33 1 3 a' • Tenant/Lessee Name: Phone#: weAll i-ke-hitztl , 01(.1=}5 N �T CONTRACTOR: Company Name: LoR l5 Address: ��2(o' 9 u) 1 c` Email: Phone#: r7g40 VOO 2g3 C City: R\l�, 6 State:'']]E � Zip: 3//� 3 �+S• �` Qualifier Name: n „ h 1414V Phone#: 7ccoZl 7 d� 3 State Certification or Registration #: C►�C.lFsIlA--\ gd ' Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 3600 !la Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace b Description of Work: 17911 a ict-oc-,e., ❑ Demolition Specify color of color thru tile: Submittal Fee $ �t 1 Permit Fee $ a 1i ¶ U CCF $ .$a Scanning Fee $ �J r Radon Fee $ Z DBPR $ ` Technology Fee $ • utO Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) V/V CO/CC $ Notary $ 5 Double Fee $ Bond $ �.----- TOTAL FEE NOW DUE $_9"i ASO 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 The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ith day of 1) e c e 6 ? .r/ 20 % om by `B day of J! ,Y'Cke1M N -e Y , 20 1( , by Fra.,, it /60 W&' o/ NPn ry , who is personally known to D _ c -_ AJ _ ' ho is personally known to me or who has produced IL b, '; ye r L% CeA SP as me or who has produced l)r N V (1 C -t vVS`& as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Tse colo, 11 0 • APPROVED BY (Revised02/24/2014) JOSE CEDANO Notary Public - State of Florida • = My Comm. Expires Feb 20, 2018 einda roughNational otary Assn identification and who did take an NOTARY PU Sign: Print: Seal: ******************** aminer Structural Review OPlj-•,, YANA'Y PRIETO � MY COMMISSION # FF 214031 _ ' EXPIRES: March 25, 2019 •� pF n.°.•• Bonded Thru Notary Public Underwriters *************** Zoning Clerk 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): (Qo i-°(� s� City: Miami Shores Village County: Miami Dade Zip Code: 33 t 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 121A—RHI Sheet Attached: YES O ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NIT C P r3 D , MANUFACTURER R,/�eEW f��UJl/), 'GIN- \\ \( AHU or PKG. UNIT MODEL # . 4'� , 14'§c:.61/-7 ��'�@jQ'-jjp COND. UNIT MODEL # K � WO - KW HEAT .%4( , `- .- NOM TONS '`C ) AHU CU PKG 1) M.C.A AHU clS CU -3. PKG AHU CU PKG 2) M.O.P AHU i6CU 7�jPKG AHU CU PKG 3) VOLTS AHU2 CU 210 PKG PKG UNIT / / PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES 40 YES NO REPLACING THERMOSTAT YES • YES NO NEW 4"CONCRETE SLAB YES • YES NO NEW ROOF STAND YES ► 0 YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): rt -44.(*) 4. Size Disconnecting Means: 'Co LL 0 tyr- ?ig-tue,L Contractor's Company Name: Phone: 79 2/ 00 7 -3 , , State Certificate or Registration No. 1�c�g Certificate of Competency No. Signature —y Date: / 2,/7 (760 Qu. ' s signature) 3. Voltage of Circuit (208/240/480): (Revised02/24/2014) Notice to Owner Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Depaitulent of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signatur State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of "D , 20 \ ByfYon w ttcfr\( .5'�- I4 -'# / Not SEAL: who is personally known to me or has produced s identification. , 101:, , MAHARAI K, GONZALEZ iMY COMMISSION # GG 044602 EXPIRES: November 2, 2020 ,,o i;?," Bonded Pell Notary Public Underwriters Ir LORD'S A/C Date: December 29, 2016 State of Florida County of Miami -Dade Before me this day personally appeared Edgar Greenhauff who, being duty sworn, deposes and says: That he or she will be the only person working on the project located at: 960 NE 95th Street. Sworn t (or affirmed) and subscribed e me this 29th day of December 2016 by Personally know Or Produced Identification -6 Type of Identification Produced ;;wsY?yam YANADYPRIETO *, MY COMMISSION # FF 214031 ..�.:ag EXPIRES: March 25, 2019 1,;g: p' Bonded Thru Notary Public Underwbkrs yecik ?1-40 Print, Type of Stamp Name of Notary 13261 SW 7th Court • Davie, FL 33325 • 786.260.4783 • edgargsr(CD.yahoo.com nn In ....e.l f A f 1 01 LAC0 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD t` CNC1816488. -Tfie:Ci ASS,.:B AIR 'CONDITIONING CONTRACTOR. Namedibelow IS.,CERTIFIED Ut d r the'provisions.. of CI apter 489 FS. - '``• Expiratiori..date: AUG 31,-2018 >' - _ ,,res,, y -.° REENHAUFF, EDGAR` .e _._,,,,,~ '� ' ��' 32,SYY/T` .... •+a_ - W �... ... t tar N \ _ .3332841 ,• .Le 4 1 S 1 5 ` — .47.2.4.4....A. 56.42‘.4*.♦ \ —'\ \ 1, .;...*.l. 'i\ s - ISSUED: 06/12/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1606120000831 LORDS -1 OP ID: DMA ,4�URO CERTIFICATE OF LIABILITY INSURANCE DAT2/27/D/YVYY) 12/27/2016 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(ies) 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 Premier Protection Insurance 409 SE 7th St Fort Lauderdale, FL 33301 Gerald Katz NAME: Gerald Katz HONE Ax (AJCC. No, Ext): 954467-8738 (A/C, NO 954-9441881 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Maxum Indemnity Co COMMERCIAL GENERAL LIABILITY INSURED Lord's A/C Corp. Edgar Greenhauff 13261 SW 7th Ct Davie, FL 33325 INSURER B: National General Insurance BDG0061391-05 INSURER C : 01/16/2017 INSURER D : $ 1,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYV1� POLICY EXP (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY BDG0061391-05 01/16/2016 01/16/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE RENrED PREMISESS((Ea occurrence) 100000 $ , MED EXP (Any one person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NONOSWNED 03875678-0 08/08/2016 08/08/2017 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 50,000 BODILY INJURY (Per accident)$ 100,000 PROPERTY DAMAGE (Per accident) $ 25,000 s Medical Payment $ 5,000 UMBRELLA LIAB_ EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ¥ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Lord's A/C Corporation: License Number- 1816488. AC Installation and Repair. CERTIFICATE HOLDER CANCELLATION City of Miami Shores Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ��:p � •.�..,���.� ems. . BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2016 THROUGH SEPTEMBER 30, 2017 DBA: Business Name: LORDS AC CORP Owner Name: EDGAR GREENHAUFF Business Location: 13261 SW 7 CT DAVIE Business Phone: 786-260-4783 Rooms Seats Employees 1 Receipt #'HEAT NG/AIRCONDITION CO Business Type: (A/C CONTRACTOR) Business Opened:02/10/2012 State/CountylCert/Reg:CAC18164 88 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vendino Tvoe: 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 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: LORDS AC CORP 13261 SW 7 CT DAVIE, FL 33325 U.S.A. Receipt #04B-15-00007222 Paid 07/29/2016 27.00 2016 - 2017 ImIT • /, loitran.„{if f.,7,7.74777-17:11, ,7,770 117;ty ; p • .44 4, t., ' 4 4 W-4,10.1,„.1,1qtili, ' ; r-li ' 1 - ,,I•t':71 4 e . '.• "4, ! . iii1,40,.•,i, .,.'v , 4.,,- ,,..,.‘„tr!gi, r. .ELcm, ENs , I t '11.•, P..):. '4, if 'V-I.,i;•it:ifil"itili-t' . TivEVAIE' , 414i1612 •,..,,,, ,... ,,;,.•.• , 4- :- 17 . .....- . . . - ,..'1*,=1. •;„ 1, ` i PER, S014. 7, 1 tr' G-64Antripi ''-, „„. .. 2,... ..., .., . 4 .4, , 8 1. FEt • 1 r D/it:A, , .;,::•"t!.273o2 ett • "tlit4 • \. '''' P . ' BUSINESS - NAMEAN• • •„ .._. .,, . . ,,, , • ,Ii-,.. LORIY'S A3C-C , • , t • - . , :: ; ,•,. ", .;•,‘, , ‘6,;it r, . 1 . ; •11 • f i f 4 • re, ' 1 , 7 Fq, 1,, •tri ,,,11 , ' ,,,,,,,i. i , • 9 • i 4 ' .1 '4 r- -, '4+4,, ."'3. • • .. ,f - , >;-1,. • I 13261 SW t i I . ' 4° '? ; : 1 DAVI g „ ' Ft. ' f , 33325 . . ,w •_$:;, 5 , 4 • .. 1 SCOPES ,OF 'El1ilis08 OR TRA 1 , — .,,, 1 IHEATING, VENTILATION, 'AIR—COND .4 04... .'4••'•4 44.4•44.4.:44S 4.74 44.1.44; 4 44,1, 14...1.14:;44,1•Jt • ,•••••• .4•••-•••••:‘,.......,•••,,t• •• • i • *44 *V'a;••os•••••••' "*V,atea!••••• :As : -sire.'" •-• •a•••••••* rt.. ."'41.0.,•('•• '''1•1 V.A.,'..4.•••••"*.y.. ••••••:::;4!:••••••' • '....tt • ,%V4,474•Iset.r, sl '..".n., 4.4* „14.•••• • *•'''.:1.4 ••••••.t ........,A4..f „:1, ...... , . _ s 4,.....'„i,„-*-• . 1 , -,--„Ii......$ ....t,,o„' ,..4,... , 1.........•..;....,,...* , .....,,, 4 , . ...,-4 ;,•. Ir.... • ..OrkS .1 , • • - . ,. ",, - ' t': ' ,t,' ,t, ' ;,'" ‘at:1:`:* .‘k P.' ,{0... `!. • `1,Z :" -c-' 4, , . ' ".." ). -..,--tr- 1/4,.....1....47,.,..--. . -0. •. , . , . ., , , . 4,.. . .... , , . , t,,, gt 4 -4) , rr 1 , 4. . u9.i CERTIFIED® www.ahridirectory.org Certificate of Product Ratings._, t ...... AHRI Certified Reference Number: 7491807 Date: 12/28/2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RA1436AJ1 Indoor Unit Model Number: RH1T3617STAN Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM; RUUD ,•. ... • •. •• .• . ..... • • •••. •• • •• • ••.•s • ••••• • • . • • • •O . • . 1 •• • • • OOOOO •• •.• • . • •••, ••• • • • • • i •• 1 • • • • • ...... • •..• • .• 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: • •••oo • Manufacturer responsible for the rating of this,system combination is RHEEM SALES COMPANY, INC. 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: \\, 1 r I I I L) Cooling Capacity (Btuh): EER Rating (Cooling): 'SEER Rating (Cooling-- - IEER Rating 35600\ ,i 4 12.50 � / + 2 15:00 i i I'LL r #:TIA," IC ` �Q 3477 111 _ti, ,. �'I M ami Shcres Village hDFROVED BY DATE 'ONING DEPT �O '7EPT 'T 0 St ^,'PI NCE WITH ALL FEDERAL t C 1 i�, / .. 1 tIP�C? RF��I'LATr`N�S * Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanie with a WAS, whit indica es'an involun ary 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.ahridlrectory.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. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahrldirectory.org, 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 at bottom right. ©2014 Air -Conditioning, Heating, and Refrigeration Institute AIR-CONDITIONING, HEATING, & REFRIGERATION INSTITUTE we make life better'" CERTIFICATE NO.: 131274067494562729 MIAMI -DADS COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 3317-2474 T (786) l5-2590 F( tJ?*2599 ••••• NOTICE OF ACCEPTANCE (NOA) wwv63niaRudade.v/economy• Rheem Sales Company, Inc. • •• ..... 5600 Old Greenwood Rd. • ••.•• �� . •..... Fort Smith, AR 72917•....••••� • SCOPE: This NOA is being issued under the applicable rules and regulations governtrt$ tI?P� use of.. . construction materials. The documentation submitted has been reviewed and accept edrbi Miami-Dafe• • . •, County RER-Product Control Section to be used in Miami Dade County and other areas �tiirere allowed by . • the Authority Having Jurisdiction (AHJ). •• • This NOA shall not be valid after the expiration date stated below. The Miami-Dade.Qtutity Product, Control • Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) rest the right • to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone. DESCRIPTION: Mechanical Unit Steel and Aluminum Tie -Down CIips for Grade and Rooftop Applications APPROVAL DOCUMENT: Drawing No. 15-2543GA and 15-2564RE, titled "Wind Load Certification of Mechanical Unit Cabinetry and Steel/Aluminum Tie -Down Clips: At Grade and Roof Mounted Applications", sheets 1 through 7 of 7, dated 05/14/2015, revised on 11/20/2015, prepared by Engineering Express, signed and sealed by Frank L. Bennardo, P.E., bearing the Miami -Dade County Product Control revision stamp with the Notice of Acceptance number and expiration date by the Miami -Dade County Product Control Section. MISSILE IMPACT RATING: None LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state, model/series, and following statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein. RENEWAL adds NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA # 15-0903.08 and consists of this page 1 and evidence page E-1, as well as approval document mentioned above. The submitted documentation was reviewed by Carlos M. Utrera, P.E. MIAMI•DADE COUNTY APPROVED NOA No. 16-0712.07 Expiration Date: February 25, 2021 Approval Date: July 28, 2016 Page 1 Rheem Sales Company, Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS "Submitted under NOA # 15-0903.08" • 1. Drawing No. 15-2543GA and 15-2564RE, titled "Wind Load Certific'�tion ct ••: • •• Mechanical Unit Cabinetry and Steel/Aluminum Tie -Down Clipt' Vtt Tirade and•Roof • • • • • • ••...• • • . • •• • •....• •• • • •....• • • • • • • •• • •..•.• •..••• Mounted Applications", sheets 1 through 7 of 7, dated 05/14/201 i 8vised on•'•' 11/20/2015, prepared by Engineering Express, signed and sealed bylrank L. • • Bennardo, P.E.•...... . . • • •• • • .•. • • . . • • • ...... • • ..•.•. • • B. TESTS "Submitted under NOA # 15-0903.08" 1. Test report on Uniform Static Air Pressure Test per FBC, TAS 202-94 along with marked -up drawings and installation diagram of Rheem RA Series Mechanical Units, prepared by American Test Lab of South Florida, Test Report No. 0323.01-15, dated 05/18/2015, signed and sealed by Stephen W. Warter, P.E. C. CALCULATIONS "Submitted under NDA # 15-0903.08" 1. Anchorage calculations prepared by Engineering Express, dated 11/20/2015, signed and sealed by Frank L. Bennardo, P.E. D. QUALITY ASSURANCE 1. Miami -Dade Department of Regulatory and Economic Resources (RER) E. MATERIAL CERTIFICATIONS 1. None. F. STATEMENT "Submitted under NOA # 15-0903.08" 1. Statement letter of code conformance to the 5th edition (2014) FBC issued by Engineering Express, dated 08/24/2015, signed and sealed by Frank L. Bennardo, P.E. 2. Statement letter of no financial interest issued by Engineering Express, dated 11/20/2015, signed and sealed by Frank L. Bennardo, P.E. 3. Distributor agreement dated 11/12/2015. Carlos M. Utrera, P.E. Product Control Examiner NOA No. 16-0712.07 Expiration Date: February 25, 2021 Approval Date: July 28, 2016 E -1 RHEEM SALES COMPANY, INC. WIND LOAD CERTIFICATION OF MECHANICAL UNIT CABINETRY AND STEEL/ALUMINUM TIE -DOWN CLIPS: AT GRADE MOUNTED APPLICA CONCRETE SUPPORTING STRUCTURE BY OTHERS, TYP. 18 -GA ASTM A653 PAINTED STEEL p CABINETRY w SIM. YD (C) BUT a, ON OPP. FACE M CONC SUPPORTING STRUCTURE BY OTHERS, TYP. CONTROL BOX W1D�Y 0 is C VN4, SIM. TO (A) BU1 ON OPP. FACE (ID MECHANICAL UNIT 1 MECHANICAL UNIT N.T.S. FRONT ISOMETRIC N.T.S. BACK ISOMETRIC (2)-#10 SMS PER CUP FOR UNITS Up TO 35' TALL (3)-#10 SMS PER CLIP FOR UNITS UP TO 39" TALL (ONLY (2) SMS SHOWN BELOW) ANCHOR PER SCHEDULE 3000 PSI MIN CONCRETE BY OTHERS, TYP. THESE ISOMETRICS ARE INTENDED FOR DIAGRAMMATICAL PURPOSES ONLY; ALTERNATE RHEEM UNITS LISTED HEREIN MAY VARY IN APPEARANCE INTERNAL POST ADJACENT TO CONTROL BOX ® & Q ARE SIM AND OCCUR ON OPP. FACES 1 O TIE -DOWN CLIPS N.T.S. aEVATION SUBSTRATE DESCRIPTION CONCRETE: (4" THICK MIN, 3000 PSI 1419.) (1)-1/498 ITW BUILDEX TAPCON ATT CARBON STEEL 1W" FULL EMBED TO CONCRETE, 3" MIN. EDGE DISTANCE, 3" MIN. SPACING TO ANY ADJACENT ANCHOR. +-41.000- 0.313" 1.250 0.750' 7-1 0.000" TIE -DOWN CLIP MIAMI TECH CLIP: 1459 (0.07") ASTM A653 Fu.. -90 KSI STEEL (CUTD8) OR 0.080' 5052.032 ALUMINUM (CUTDAB), MIAMI TECH KIT Y RRCUTDSMK OR RRCUTDASMK CLIP OFFSET DIMENSION SHALL OO TAKEN FtSOTT TTiI�S 5`IDE ONLY DATUM FACE OTIE-DOWN CLIP LAYOUT N.T.S. PLAN TIE -DOWN CLIP OFFSETS: 0114 1 4.50' MAX OFFSET FROM DATUM FACE 0114. 2 28.00" MIN OFFSET FROM DATUM 19CE DIM. 3 29.00" MIN OFFSET H2014 DATUM FACE DIM. 4 13.00" MAX OFFSET 15014 DATUM FACE APPLICABLE MODELS: RA1348, RA1438, RA144213, RA1624, RA16368, RA16428. RP1336, RPI348, RP1436, RP1442, RPI448, RP1530, RD1430, RP1536, 501436, RP1542, RD1442, RAUA1724, RARJA2038, RAAJA2024 RPIUP1724, RPAJP1738, RAAJA1738, RPJUP2024 FLANK BENNAROO, P.E. 1111, 5 RHEEM SALES COMPANY, INC. 6g� 6 •1.1 12 • •'1:t ••: : • • • • • • PROMICT iIiWSE' .... • WWII as complying %Ma the on • d Building Code D_ ;266/ 44 NOA-No. 16-0712.07 E 6r=5510 is Mit& i+. I. •.• vitt n• • 02/25/2027 J • I. dy • • • MOWN- • Protipctsn4o1 • • • • •••• • • a • • • • . •• • ••• • •• •• •• • •• •• • • • •• • • • • • • •• • • ••• •• •• • • • • • • • • • ••• •• •• • • • • WpS00>FPAN(L AEId.UDOPL 15-2543GA SCALE; N.TB, ( pAaE BEBT71IPTT04t 3P TALL HITS 0075 xSIM FOOTPRINT J CAC -1816488 Z( 13261 SW 7th Court Davie, FL 33325 786-260-4783 SALES • SERVICE • INSTALLATION RESIDENTIAL COMMERCIAL CUSTOMER'S ORDER NO. DATE /Z, Z74 ' NAME ` ff ke A?tC ADDRESS - q // ! Ctsn `' q CITY/STATE/ZIP p/rnt(/ S6o,e_es F --( SOLD BY CASH CHECK rCHARGE C. O. D. MDSE. RETD. PAID OUT QUAN. DESCRIPTION PRICE AMOUNT i 3.1&-r, 1ss.et.)L htbrpt Si -re A/t 4-)7rAisr-liZZ .1',v 4f72 G - Ty r(pie_ /1.-46.0,e___. Jo ye C 9-n ARTS ,k 12r /US 1Q,Clifr 'ee/s Tax TOTAL 11-3 otter --6 RECEIVED BY: