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MC-19-1929Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 09/28/2019 Parcel Number 365 GRAND CONC, Miami Shores, FL 33138 1132060135950 Contacts PermtNo.: MC -08-19-1929 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: Approved Expiration: 02/24/2020 Description: AC CHANGE OUT Valuation: $ 5,900.Inspection Requests: 00 305-762-494 Total Sq Feet: 0.00 Fees FERNANDO & MARTHA PADILLA Owner Other: 7862698313 DIRECT AIR CONDITIONING INC Contractor JUAN SOTOLONGO Business: 3055962666 JUAN @ DI RECTAC123.COM $50.00 CCF $3.60 Description: AC CHANGE OUT Valuation: $ 5,900.Inspection Requests: 00 305-762-494 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $3.60 DBPR Fee $3.10 DCA Fee $2.07 Education Surcharge $1.20 Permit Fee $156.50 Scanning Fee $9.00 Technology Fee $5.16 Total: $230.63 Payments Date Paid Amt Paid Total Fees $230.63 Check # 3221 08/21/2019 $50.00 Check # 3226 08/28/2019 $180.63 Amount Due: $0.00 Building Department Copy 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: 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. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent <,--/ S 4/ Date August 28, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION 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 AUG 2 2019 BY: — E_ FBC 20 Master Permit No. MG' 013—Iq " iq aq Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBINGMECHANICAL [:]PUBLICWORKS E]CHANGE OF ❑ CANCELLATION [—]SHOP / ^ CONTRACTOR DRAWINGS 2JOB ADDRESS: J �� " `COA W V I S� Folio/Parcel#: _11-9 OA -6 ` 5_9 S-0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: /� BFE: FFE: OWNER: Na a le Titlehold Simple ) /% (Fee Sim r 0 ��4�� hone#: Address: C6Y\ Co\ -w City: I w6kO_kk State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name:�Y� Address: WOO SyJ n 1� t City:y � � \ `ti `Ak k State: Qualifier Name: \j 2- V11\_ State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: Type of Work: ❑ Addition f Description of Work: Zip: w /9 r ` L Phone#: �U��' S7 6 6 6• Certificate of Competency #: Phone#: City: State: Zip: Square/Linear Footage of Work: W ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ 50 Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ RM , t 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 Zi 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 co encement m t be posted at the job site for the first inspection which occurs seven (7) days after the building permit is iss ed. In t ab a of such posted notice, the inspection will not be approved and a reinspection fee will be charged. z7 Signature ' Signature - g OWNER or AGENT The foregoing instrument was acknowledged before me this ThejforegoingLstrjumentday of ✓S f 20 by 1 da Q� taj cy l who • pe anally k o me or who has produced as me or who has produced identification and who did take an oath. NOTARY Sign: Print Seal: JOSE GONZ;�t "Z Notary Public - S:a'e of F' r da 2`�'^• commission .,3 • e: My Comm. Exoires Oct 22.2021 •••q'F ov ;?P Boded tMuch t,atcral Mtary Ass,. ############# # # APPROVED BY (Revised02/24/2014) R knov4ledged before me this V7 20 15- by who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal:-.; JOSEGONZA' Z Notary Public - State of Florida a Commission =CC- 153539 ' y ` My Comm. Exoires Oc 22.2021 Plans Examiner Structural Review as ############# Zoning Clerk 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: 10259480 Date: 11-23-2018 Model Status : Active AHRI Type: RCU-A-CB Series: MERIT 14ACX SERIES RECEIVEI Outdoor Unit Brand Name: LENNOX A U G a 9 Outdoor Unit Model Number (Condenser or Single Package) : 14ACXS036-230A"• BY: Indoor Unit Model Number (Evaporator and/or Air Handier): CBA27UHE-036-230'+TDR ."". Region : Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, vii*Aft, d0, CT, IgJL,. IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, VT, WA!Wy!WI, WY, UtS. • • Territories) Region Note: Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed in allregions• • • •••••• • until June 30, 2016. Beginning July 1, 2016 central air conditioners can only be installed in rep (rsj fbr • • • pti• • • which they meet the regional efficiency requirement. • • • • • • • • The manufacturer of this LENNOX product is responsible for the rating of this system combination. • • • Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda -land _ 2, Performance Rating of Unitary I � r I _ - /I .� /., "r 1 � _ t ' h I �� -t Air -Conditioning &Air Source Heat, Pump Equipment and sdb)ect to rating accuracy byAHRI-sponsored, independeint,,third party testing: =`! I I I IMI Cooling Capacity (A2) = Single or High Stage (95F), btuh : 34600 ��,) SEER: 16.00 k"A M EER (A2) - Single or High Stage (95F) . 13'.00 ' A �'lL�li'rLI�IU � r7 "-PROVED BY DATE ---- �_._ ZONIN P G DEP�f 3L DG DEPT SJFJECT I'O C(-,MPI.IANCE VVI FH All. FEDERAL • •• ••• • • • • ISTAIE ANL) C( UN,Y HULAS AND REGULATyONS t"Active" Model Status are those that an AHRI-Certification•Program Participant is,cuRent y prdducing[ ND selling or offering for sale; OR new models that are being marketed but are not yet being produced "Production Stopped" Model Status are those that an AFiRr Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratinas that are accomDanied by WAS indicate_anin_voluntary re -rate. The new published rating is shown alona with the previous (i.e. WAS) rating. 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; AM 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. ©2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: (31874755862017242 • 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 s'ngle sheets are not acceptable. ,� Job Address (where the work is being done): 6 S_ &Z, n& C&�\(i1X/ t City: Miami Shores Village County: Miami Dade Zip Codt: • • • • • • • •� • • 00.00. .. 0••000 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CGiV�RETE SLA.B 0000.. ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION. V. ' A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITA!LS * * � � AHRI DATA SHEET REQUIRED • • • • • • .. .00000 . •. Change disconnecting means: YES ❑ NO ARHI Sheet Attached: YES NO ❑ Cintracl Attaohed:.YES...:. +� •00000 0000.. UNIT BEING REPLACED DATA 0 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 5 0 3. Voltage of Circuit (208/240/480): 0 4. Size Disconne ing Mean . �SC�NN� (�,,,,, (`L //' Contractor's Comp ny Name: l y \W/�flone: �� J (�' �U l'i L State Certificate or R ist do 40. U 5Y Certificate of Competency N:). t q Signature Date: 45 I I ( ualifl s signs ure (Revised02/24/2014) 1VEW UNIT; .'•. MANUFACTURER �Q O L4..A -Msg -Mslife AHU or PKG. UNIT MODEL # G A- Z COND. UNIT MODEL # ' 03 Aia KW HEAT NOM TONS AHU (9 CU 3 o PKG 1) M.C.A AH CU f&IPKG AHU 0 CU PKG 2) M.O.P AHU,40CU,30 PKG AHU216 CU 23o PKG 3) VOLTS AHU ZTVC1 1?,3o PKG PKG UNIT / / PKG UNIT EER/SEER lb YES NO REPLACING DUCTS YES NO 5 NO REPLACING THERMOSTAT NO NN NO 4"CONCRETE SLAB NEW ROOF STAND YES'` YES NO N YES NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 5 0 3. Voltage of Circuit (208/240/480): 0 4. Size Disconne ing Mean . �SC�NN� (�,,,,, (`L //' Contractor's Comp ny Name: l y \W/�flone: �� J (�' �U l'i L State Certificate or R ist do 40. U 5Y Certificate of Competency N:). t q Signature Date: 45 I I ( ualifl s signs ure (Revised02/24/2014)