Loading...
REV-16-878J 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 BUILDING PERMIT APPLICATION d ❑BUILDING ❑ ELECTRIC ROOFING 7MAR 31 2016 BY: FBC 2014 Master Permit No. RC I Sub Permit No. TjEv CO— iti. ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 51-f b 6-:2R� Q C0tx(0 V RZ` City: Miami Shores County: Miami Dade Zip: '33 /It Folio/Parcel#: Is the Building Historically Designated: Yes NO - Occupancy Type: Fz) Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): (,'_I✓V(kK4U_c--R_QsrtPhone#:2I i Address:5 y6 (2:?2-AM0 COO COy (QSC City: jam{ (-LVAI State: Zip: Tenant/Lessee Name: Email ry Phone#: 7/7 & �-7 0 7/ 3 CONTRACTOR: Company Name: 1 r1 It ? e C. I Phone#: a'S -z (' 2 vS30 Address: h �' 7 I✓I-c� �'� /iy� City: YJ44, Qualifier Name: Zip: 33/ Gs Phone#: (3 )_) 2 4 Z State Certification or Registration #: CIAO 1 11 a a -0 Certificate of Competency #: DESIGNER: Architect/Engineer: ezha1�I, QAAwJ 4-ks�' aC Q-A Phone#: S (� Address: :�,?,oa g.A 1 2 (1; Q IQ �.1 CityPrymd A �,�� st ate: zip:- Value of Work for this Permit: $ -7 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace / ❑ Demolition Description of Work:. �'nt!4 P U �� �� ���J G/?i �� • Ca^12i Specify color of color thru tile: • ..... = c Submittal Fee $ Permit Fee $ i cJ CCF $ CO/CC $ Scanning Fee $ 3 V Radon Fee $ DBPR $ 3 ' Notary $ Technology Fee $ (p- 4 c) Training/Education Fee $ Structural Reviews $ 30 d Double Fee $ 0 Bond $ 11 P TOTAL FEE NOW DUE $ o_E36 ' I (- (Revised02/24/2014) 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 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. Signature Signature WNER or AGE CONTRACTOR The foregoing instrument was acknowledged before me this ,/ day of r j �-�rcl\ 20 / (D by rh lei 0.4114%e Ahess who is personally known to me or who has roduc &"L. lw130993-0 as identification and who did take an oath. NOTARY PUBLIC: Sign:✓" Print: 1w Seal: The foregoing instrument was acknowledged before me this Q I day of t4-4'A 20 j y , by �i/c„s..� /��-✓� who is personally known to me)r who has produced as identification and who did take an oath. NOTARY PUBLIC: i 0 . ���^�' Sign D4 C_:! V2 / A/ Prinl COMMISSION # EE829921 Seal EXPIRES: AUG. 23, 2016 WWW.AARONNOTARY.com *********************************************************************************************************** APPROVED BY QV A,�Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 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): 671i g 410V 17/617 461111 �/p City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES F3 NO ❑ ARHI Sheet Attached: YES 0 NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT LJa �Q ireCOND. MANUFACTURER AHU or PKG. UNIT MODEL # UNIT MODEL # ✓ O.Z HT C/ , KW HEAT AHU w/n/715. CU 65 PKG NOM TONS 1) M.C.A _ Gl / AHUro-5 U STUN PKG 41 AHU AHU CU Cu PKG PKG 2) M.O.P 3) VOLTS AHUSo-(4U AHU CU W PKG PKG Q ;1 PKG UNIT / / EER/SEER PKG UNIT / 'd19 / / YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT ES NO YES NO NEW 4"CONCRETE SLAB E - NO YES NO NEW ROOF STAND YES -NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): a & u%11Z `50e- 2. Maximum Overcurrent Protection (Fuse/Breaker. Size): r�O'�% �1 �i SO _E7 3. Voltage of circuit 208/240 80): 4. Size Disconnecting Means: Contractor's t State Certifics Signature 5 9 Phone: -3<95 2kZ — Z530 ;ency No. a1gil/� Certificate of Product Ratings AHRI Certified Reference Number: 7434474 Date: 3/31 /2016 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: RASL-060JEC Indoor Unit Model Number: RH2V6024HTAC Manufacturer: RHEEM SALES COMPANY, INC. Trade/Brand name: RHEEM Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, 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: Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC. 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): 57000 EER Rating (Cooling): 12.00 SEER Rating (Cooling): 18.00 IEER Rating (Cooling): " Ratings followed by an asterisk (7 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.abridirectory.org. TERMS AND CONDITIONS n This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and ",apamn confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; �7 entered Into a computer database; or otherwise utilized, in any form or manner or by arty 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, dick on "Verify Certificate" link iv 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. 131039094932985388 ©2014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: