MC-12-552Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 171759
Permit Number: MC -4 -12 -552
Scheduled Inspection Date: May 02, 2012
Inspector: Perez, JanPierre
Owner: HURTAK, JEROME
Job Address: 533 GRAND CONCOURSE
Miami Shores, FL 33138 -2464
Project: <NONE>
Contractor: TSE AIR CONDITIONER CORP
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060171350
Phone: (786)536 -8517
Building Department Comments
INSTALLATION OF NC MINI SPLIT UNIT 1800 BTN /HR
s/
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 01, 2012
For Inspections please call: (305)7624949
Page 14 of 25
' 2012 -03-16 16:44 TSE Air Conditioner 3055595364 » 3058926798
41616-kdri
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 3313S
Tel: (305) 795.2204 Pax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit Type: MECHANIC
JOB ADDRESS:
City.
Miami Shores
County:
P 2/4
FBC2010 .
Permit No. 12+�c��J2-
Muter Permit No.
Miami Dade
Folio/Parcel #:
Zip: 33112
Is the Building Historically Designated: Yes
NO
OWNER` Name (Fee Simple Titl a older)r./E rOev■e_ thkrtGt.fr
Addre •:
City:
Tenant/Lessee Name:
Email:
Flood Zone:
Phone #:
Phone #:
CONTRACTOR: Company Name: / • S • E ry / I 41&fl Phone#: 061 i3 . RC 11
Address:
3 to tr
City: l /id State: F. Zip: 33/7,2.
QualifierName: kt•Rt / t'/,11d/ Phone #: g ?b 6.3& s. 11
State Certification or Registration 1 I: e,Oe.. IN i'% a Certificate of Competency #:
Contact Phone #: Emil Address: Pp w i `)Ah 010 yAHt. tvit
DESIGNER Architect/Engineer: Phone #:
•
Value of Work for this Permit: $ t>7 7 F? ' 56 Square/Linear Footage of Work:
Type of Work: ClAddress O Iteration Dew ORepair ` • la a litioa
De ription of Work: 1-� / ril / i `O)'') D
r _ ,,1'/ /� rob i1/ Y.
**** *************tee,****** * * I * **rwt **** fit** *+pgrie*t*ii.,I * *** ***
Submittal Fee S Permit Fee S I ilig-
t CCF $
Scanning Fee $ Radon Fee $
Notary $ TraininglEdueation Fee 1
Double Fee $ Structural Review $
CO /CC $
DBPR S `Bond $
Technology Fee $
TOTAL FEE NOW DUE $
*
M1�
2012 -03-16 16:44 TSE Mr Conditioner 3055595364 » 3058926798
Bonding Company's Name Of applicable)
Bonding Company's Address
City
P 3/4
State _ Zip
Mortgage Lender's Name Of applicable)
Mortgage Lender's Address
City
State
ZiP
Application is hereby made to obtain a permit to do the work and installations as indicated, 1 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: 1 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
promisee in good faith that a copy oldie notice of commencetne+nt and construction lien law brochure will he delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of mmencement must be posted at the job site
far the first ins an which occurs seven (7) days of 'r the building permit is is In the absence of such posted notice, the
inspection not be ' pro • and a r * ' ctio 1 he charged
Signature
Owner or Agent
• The f ing instrument was acknowledged before me this The fore in t , , -nt wa cknoo ed cd before „ this
•.
day of , 20 by , day of , 20 "bY ,. • /VI
Contractor
who is personally known to me or who has produced
As identification and who did take an oath.
• NOTARY PUBLIC:
Sign:
Print:
who is natty k wn ' me or who has produced
' 60'101 tifiication and who did take an oath.
TAR
Sign:
LIC: - •
My Commission Ex
* * * *** ***•***,
APPROVED BY
des Sep 23, 2015
o Commission # EE 128810
, Bonded Through National Notary Assn.
4 **
l- Plans Examiner
Structural Review
(Revised 3/12r2012 )(Revised 07/10/07X Remised 06/10/2009)(Revised 3/15/69)
Zoning
Clerk
2012 -03-16 16:44
T5E Air Conditioner
3055595364 a» 3056926798
P 4/4
Miami Shores Village
Building Department
10050 N. E.2rtd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 7568972
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): 5 v � ✓�� W WY6
City: Miami Shores Village County: Miami Dade Zip Code: 33 13-F
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 (AHRt) DATA SHEET REQUIRED
Change Disconnecting means: YES 0 NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES
UNIT BEING REPLACED
DATA
MANUFACTURER
AHU or PKG. UNIT MODEL #
COND, UNIT MODEL #
KW HEAT
AHU CU PKG
AHU CU PKG
AHUa PKG
PKG UNIT 1 I
YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
EER/SEER
REPLACING DUCTS
REPLACING THERMOSTAT
NEW 4'CONCRETE SLAB
NEW ROOF STAND
NEW RETURN PLENUM BOX
AHU CU PKG
AHUssi CU 1MPKG
PKG UNIT?2a) 1
1. Minimum Circuit Ampacity (Wire Size):
2. Maximum Overcurrent Protection (Fuse/Breaker Size): 16 fa Aa
3. Voltage of Circuit (20812401480): PAC
4. Size Disconnecting Means: _
Contractor's Com am: v • 3,/ l'aholf Phone: 'F 2
State Certificate or Regis .ion'(' C& i21 &O (o Certificate of Competency N.
YES st NO
YES NO
YES NO
Signature
Date: 044
Apr 021211:18a Hurtak Law Offices 3058926798 p.2
April 2, 2012
TSE AIR CONDITIONERS
786 - 277 -9475
To Whom It May Concern
1 hereby certify that the information contained herein is true and accurate.
The cost of the air conditioner mini split unit, plus installation.
• 18,000 BTU Mitsubishi Unit With Heat Pump 19.2 Seer
Model # MSZ- GE18NA, MUZ- GE18NA $1888.55 (tax included)
• Installation by TSE Air- conditioners $600.00
TOTAL
$2488.55
Sincerely,
TSE Air-Conditioners Jeronemo Hu rta k
4
.... s. r v • �.VtVYM
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
TSEIA RP CONDITIONER
5726 RIDOESTONE DRIVE
FL 33625
Congratulations! With this license you become one of the nearly licensed. by the Department of Business and 'Profess' gr�af' Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restaurants, and they keep Florida's' economy strong. _'
Every day we work to improve the way we do business in order to serve you better.-
information about our services, please log onto ww.w.myyflfloridalicense.com: � 4$
There
you can find more information about our divisions and the regulations that ,,
Impact you, subsaibe to department newsletters and team more about the
Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank .you for doing business in Florida. and congratulations on yournew license!
11>
1. }4 ;
slit- �b��4.r 2 r �GI
4: „¢� ie`C;s.•s °d[, L�'P�tF }`�`.{°",(�; ri'xd,.4t: �.,- •;""":� _«7
*rtr
DATE
ntItt
C7.
673638 -4
BUTtOWONER CORP
1163 NW 125 CT
33182 UNIN DADE COUNTY
FIRST -CLASS
U.S. POSTAGE
PAID.
MUSA FL
PERIIST NO: 231
THIS IS NOT A BILL — DO NOT PAY DUPLICATE
700994-7
STATEI16686
"TR AIR CONDITIONER CORP
See 1 I� CHANICAL CONTRACTOR
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
NOIDER TO VIOLATE
REGULATORY THE
COUNTY LAWS NOR
OWES tr EXEMPT 'e
HOLDEN FROM ANY OTHER
PERMIT
REGUIRED BYLAW. TIES IS
NOT A CERTIFICATION OF
THE HOLDER'S QUAUFICA-
T1ON
Nwmalommul
awmmoscommnuc
coaECrm
08/22/2011
09010063001
000000.00
SEE OTHER SIDE
WORKER /S
.1
DO NOT FORWARD
TSE AIR CONDITIONER CORP
PEDRO MILIAN
1163 NW 125 CT
MIAMI FL 33182
Llif��,lf�111ili11 11111111111 ,lll1�ll„1l111iftfl,>,1,ff3151f
12 -30 -2010
ALEX SINK STATE OF FLORIDA
CHIEF 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: 12/30/2010 EXPIRATION DATE 12/29/2012
PERSON:
FEIN:
MILIAN - PRIETO PEDRO
273630682
BUSINESS NAME AND ADDRESS:
TSE AIR CONDITIONER CORP
570 NW 99TH PLACE
MIAMI FL 33172
SCOPES OF BUSINESS OR TRADE:
1- CERTIFIED AC CONTRACTOR
*
IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election elder this
section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the
scope of the business or trade listed on the notice 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 shall 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 or
certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person
named on the certificate to meet the requirements of this section.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
QUESTIONS? (850) 413-1609
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DMSION OF WORKERS COMPENSATION
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE 12/30/2010 EXPIRATION DATE: 12/29/2012
PERSON: PEDRO MILIAN - PRIETO
FEIN: 273830882
BUSINESS NAME AND ADDRESS:
TSE AIR CONDITIONER CORP
570 NW 99TH PLACE
MIAMI, FL 33172
SCOPE OF BUSINESS OR TRADE
1- CERTIFIED AC CONTRACTOR
IMPORTANT
F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who
elects exemption from this chapter by filing a certificate of election
L under this section may not recover benefits or compensation under this
D chapter.
Pursuant to Chapter 440.05(12), F.S., Certificates of election to be
H exempt.. apply only within the scope of the business or trade listed on
Rthe notice of election to be exempt
E Pursuant to Chapter 440.05(13), F.&, Notices of election to be exempt
and certificates of election to be exempt shall 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 or certificate no longer meets
the requirements of this section for issuance of a certificate. The
department shall revoke a certificate at any time for failure of the
person named on the certificate to meet the requirements of this
section.
QUESTIONS? (850) 413 -1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
„Mar. 30. 2012 11:13AM THE FIRST INS. GROUP CORP No. 2490 P. 1
ACORTY
CERTIFICATE. OF LIABILITY INSURANCE DATE
maw 2
THIS CERTI IUEMJp NiOA N�NLY .CONF fp�mo THIS AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, F.XTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
aEL,OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED •
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANTi-ir ft:Wiles-1e Qom-its
the terrns and condition at the POIISY. mettle Psficie$ may "%Mr* en endorsereeet. A statement en this certificate does tug solder rights to the
certificate ttdfln lies of such endorse/nein*
PRODUCER
First Insurance Group
10967 SW 40 St '
Witami, FL 33165
Phone (395)221-7878
Mums
UtAifig; . MIRIAM MESA
-1141 14
0: 1305)5547090
INSaRBRISIAFP01301/40 covERAGE NAM'
uReri A • AMERIGAN VEHICLE INSRANCE COMPANY
• --- -- • • • --- . • ---- ,
TSE AIR CONDITIONING CORP
LiklEVRERc
- • --- ...•• .
5726 Rdgestons Or, .
I .
TAMPA, FL 33602-6 305 ; INSURER E s
•-• • ....... • • .••• •..... • • •••••••• ........ • • ......_• • .....• . ......•• • . ...,. . . ... . • • . .
C.OVERAI3k8 --- CER-TIFICATEHiliiiiiii: -- - - - ... ut--1----f-L----------'—ff,C----v --'IsION ISINU DER: -------
THIS ISTO CERTIFY il4AfTliEknklatiii iliftiRkid CitittiedbiN RAVE ilt EiWisikli fo-ftiiiiffuiitti iiiiRin WadVERiii iiii. FititICY PERIOD ” •
INDICATED. NOTWITHsTANDINO ANY REQUIREMEN)'. TERA1OR COMMON OF ANY CONTRAcToR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
° CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE msoRANGE AFFORDED BY THE FoUGIES DEscRIsF_D HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLOgiONS ANO CONDITIONS OF SAJCH RoUcIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAO CIAIM6
" • • • • • • • • ••
Mt: 1WE Of ma/RANCE num Nuragee iiWryjiestigaviosvoi;41— --- --- - - • -
serreSAL LIABWITY - 31111R ':v411°.:'" •
• to covAIERCIAL GENERAL MINIM ! .
•
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,
I 1 isit N.oc.%),12% ,. ....,,,, ! $ imit,600.00 ,
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- 0 01/11/2012 i 01/114013 l'-Ptf"-7.aPV1"11--i $1 &WM).
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ANY AUTO . . I BOMLY INJURY (Per palm) • $
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, 1 Et DISEASE - EA EMPLOYEE- .: $
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DESCRIPTION OPERATIONS LOCATIONS / VEL001,Es putan$ AGO$D 101, /01$1110.- .;$1-Reasulte- $00c$170,--11 rif010 Biltaaa1-5-reautredi•—• • • • • -
AIR CONDITIONING INSTALLTION AND SERVICES LIABILITY
CERTIFICATE HOLDER
. . .
MIAMI SHORES VILLAGE BUILDING
DEPARTMENT
10060 NE 2ND AVE
MIAMI SHORES, FLORIDA 33138
ACORD 28(2010105) CIF
2012-03-30 10:17
3055547090
305 554 7090
CANCEU.ATION
tit FiRar iNSiii?A
cOp NCE
10987 Bird Rd
iss
SHOULD ANY OF THE ABM MOWED POLICIES BE CANC$LLED BEFORE
THE EXPIRATIEW DATE WICREOF, TICS WILL BE DEUVENED IN
ACCORDANCE WITH THE POLICY $IONS.
Auntekszen Remarry/ma
(
1988-2010 ACORD C
The ACORD name and t
•
. . .
AU rtghte reserved.
A.‘
marks of ACORD .
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Location:
Street Address
Latitude,
Lmgitude
House Square 436 sq. 8
Footage:
DesignStar Load Calculation
Results are intended for use with Rheem heating and cooling systems only
Customer information
533 GRAND CONCOURSE, MMMMI SHORES, FL , MIAMI.
DADS, FL 33138
25.7791 °, - 80.1978°
Name:
Phone:
Email:
JEROME HURTAK
786.636-8517
Outdoor
Dry bulb .(°F)
Daily range
Relative humidity
Mdsture difference
Indoor
Indoor temperature ( °F)
Design temperature di ference(°F)
Desi n Conditions
Heating Cooling
50 90
L y
50%
58
Heating Cooling
70 75
20 15
Heatin• Loads
Area
Wall
Floc
Gelling
Windaws
Infiltration
System Efficiency Loss
Total:
Btuh
840
10568
462
1360
1070
1430
15730
% of load
5.3
67.2
2.9
8.6
6.8
9.1
Floor
Heati ng Loads
15,730 BTU /hr
Ceiling
Wall
Infiltration
Windows
`--- System Efficiency
II
— Hourly Loads — Average )
Coo lin. Loads
Area
Wall
Ceiling
lituksus
Sensible Infiltration
Latent Infiltration
System Efficiency Galn
Internal
Sensible People Load
Latent People Load
Total:
Stull % of load
630 3.7
347 2
11857 68.7
602 3.5
1439 8.3
1487 8.6
489 2.8
201 1.2
201 1.2
17252
Sensible load 15613
Latent load 1640
SHR 0.9
Capacity at .75 SHR 1.73 Tons
windows
Cooling Loads
17,252 BTU/hr
r Sensible People Load
Latent People Load
Internal
Infiltration
Wall
Latent infiltration
System Eflicienc)
Adequate Exposure Diversi
20000
15000
10000
5000
0
AED Graph
8am 9am 10am llam 12pm
1pm
2pm
3pm
4pm 5pm 6pm 7pm 8pm
ACCA Marlitai
System equipment selection will be made using the Miming Manual S derived values.
Summer OW= 90°F
Summer VVet Bulb 77°F
Summer Mar 75°F
Summer Design Grains 50°10'
Winter Outdoor 50 °F
Winter Indoor 70 °F
Sensible Coding 15,613 Btuh
Latent Coding 1,640 Btuh
Required Coding Airflow 710 CFM
Sensible Heating 15,730 Btuh
Required Heaing Airflow 204 CFM
All calculations based m the ACCA Manual J 8th Edition. All computed results are Estimates. Product provided by Energy
Design Systems and Idea Tree