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MC-13-278Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 185715 Scheduled Inspection Date: February 27, 2013 Inspector: Perez, JanPierre Owner: GOLOFARB, IGHAL Job Address: 8833 BISCAYNE Boulevard Miami Shores, FL 33138 Project <NONE> Permit Number: MC -2 -13 -278 Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: A/C Replacement Contractor: JOSE C YANE AIR CONDITIONING & APPLIANCES SERV INC Phone Number (305)868 -8203 Parcel Number PARC2003 -18 Building Department Comments AC4TON Infractio Passed Comments INSPECTOR COMMENTS Passed Faded Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments False 3 February 26, 2013 For Inspections please call: (305)762 -4949 Page 10 of 25 B D G B D G PERMIT APPLICATION FBC 201E D Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: MECHANICAL �1 O WNER: Name (F ee Simple teholder ) : I Address - City:,1-v f Tenant/Lessee Name:y( Email: IVo FEB 112013 Q, Permit No. Master Permit No. (.o I '3- ®21 Y rra.ce o S ne #: �C �FIU O �-�J3 Zip: Phone#: )S it °=4 µS 420 0_ JOB ADDRESS. City: Miami Shores Folio/Parcel#: County: Miami Dade Zip: Is the Building Historically Designated: Yes CONTRA • Company Name: Ocie. C Address e I ST:" Y City: Qualifier Name: State Certification or Contact Phone#: DESIGNER: Architect/Engineer: NO Flood Zone: / Certificate of Competenek a Email Address: �/ 1'7 . C, V f ' 1 /o Phon Valve of Work for this Permit: $ 5 tom®• Square/Linear Footage of Work: Type of Work: ❑Address e Iteration „ 17Ne'' O ('j R air/Replace Description of Work: �!� '! DDemolition ********* * * * * * * * * * * * * * * * * * * * * * ** * * * * * * *F ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $50 l" Permit Fee $ t VL. t D CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 0/7t40—' 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S A}VIl)AVIT: 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 subjec to attachment. Also, a certified copy of the recorded notice of commencement must be posted al the job site for the first inspection '•hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be , roved nd a reinsp ction fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before q� e this _'5 day of` ' fir/ , 20 e 3 , by V•O4 Gob who is personally known_tp me or who has produced As identification and who did take an oath. NOTARY PUBLIC: tub ilk Sign: Print: t 9kkar\-Ck 7eirM a °t► '.i�% BIBMM SARMI jJi'0 * MY COMMISSION) EE842217 EXPIRES: October 111, 2016 _ My Commission Expires: 14,0 04) Beaded Tleulkdget Notary Contractor The foregoing instrument was acknowledged before me this S. day of / �, , , 20 L by VO.S'e C � �1_Q,.S , who i ersonall kno o me or w has produced as identification and who did take an oath. NOTARY PUBLIC: Sign. Print: Wait /Cm My Commission MY COMMISSION # EE022532 *Fit, 's EXPIRES September 01, 2014 (407) 388 -0193 FlorldallotaryService.cam * * ** k** * **** **** R ** ** *** ** k ******** M** **** k* * ** k* k ***** ** kN** ******** ******* k* * ********* **** k kf * *** *N**** *** --A APPROVED BY Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) 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): cpres 3 cfiirc y`ils AeL //_.d 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 ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO Yr ARHI Sheet Attached: YES LJ NO ❑ Contract Attached: YES UNIT BEING REPLACED DATA NEW UNIT ,1j, /G,,mt C MANUFACTURER (yam 4J.4LAf �- — AHU or PKG. UNIT MODEL #6; P 13d1477� ' i? . COND. UNIT MODEL # KW HEAT _ 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 YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES .. U/ NO YES NO NEW 4 °CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO _ 1. Minimum Circuit Ampacity (Wire Size): R V 2. Maximum Overcurrent Protection (Fuse/Breaker Size). . r—C' 3. Voltage of Circuit (208/240/480): a 4. Size Disconnecting Means: 17 Contractor's Company Name: (SIa C )41 e /1i Phone: -71k (-4' ' c7 State Certificate or Registration N. Certificate of Competency N. Signature./ Date: c:›1/9 / w.ahrigitectory.or Certificate of Product Ratings AHRI Certified Reference Number: 4635461 Date: 2/1/2013 Product: Single- Package Air - Conditioner, Air - Cooled Model Number: GPC1349H41AB Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade /Brand name: GOODMAN, JANITROL, AMANA DISTINCTIONS, EVERREST, ONE HOUR AIR CONDITIONING AND HEATING, ENERGI AIR Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 45500 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 * 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 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 Certfficate. 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; 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.ahridirectory.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 below. ©2012 Air- Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 130042061432244318 ®o Air-Conditioning, Heating, RN A/ and Refrigeration Institute JOSE C. YANES AIR CONDITIONING & APPLIANCES SERVICES, INC. 1021 NE 132nd STREET, NORTH MIAMI, FL 33161 LICENSED & INSURED CELL: 786.683.9345 FAX: 305.895.3565 CONTRACT IV PROPOSAL 0 WORK TO BE PERFORMED AT: DATE NAME (®® vi„ 1_ _ ADDRESS I ADDRESS CITY, STATE a , pTY.STATE PHONE NO. AttriiCT r We h y propose to furnish the materials and perform the labor necessary for the completion of lam' Pice E ' ,� u i9 c Prtg4 fr"`- fhv f - ad % /L I�Ta- C7`y'.7' % ---- e h,V7 i2 ,c-%''h1 /L Ali-C4t -,k ,1 d /6//52:/- /�' /e. /1/..5� AZ AG) All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and s• : tions itted for above work and completed in a substantial workmanlike manner for the sum of: - L; Dollars {s-s......—‘0 /-: ;- °' dL s with payments to be as follows Any aka or deviation tore above speedroations revoking exlta mete Respectfully submitted we be exeated Wel upon **ton order, and wr4 beware at extra dove met ad above ere OSAMAIL AA agreernenm mdbtgem upon atdkea. aaetdaon, or delays beyaffi our contra Note —. Per - This proposal may be withdrawn by us if not accepted within days. CJ ACCEPTANCE OF CONTRACT accepted. You are authorized to do the work = ' -., - . °- • • , ° is ifl ACCEPTANCE OF PROPOSAL The above prices, speolficatiop and conditions are satisfactory and are hereby be made as outlined above. DATE SIGPIATURE4111 � Ar ... SICdNATU'