ELC-10-253Inspection Number: INSP - 135889 Permit Number: ELC -2 -10 -253
Scheduled Inspection Date: June 30, 2010
Inspector: Devaney, Michael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Fine Arts Quad
Miami Shores, FL 33138 -0000
Project: <NONE>
Contractor: JULIANA ENTERPRISE, INC DBA POWER PRO
Building Department Comments
June 29, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Electrical - Commercial
Inspection Type: Final
Work Classification: Generator
Phone Number
Parcel Number 1121360010160 -06
Phone: (305)687 -7080
100 AMPS GAS GENERATOR 100 AMPS MANUAL
TRANSFER SWITCH
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
/0
Page 2 of 19
Project Address
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
11300 2 Avenue Number: Fine Arts Quad 1121360010160 -06
Miami Shores, FL 33138 -0000 Block: Lot:
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$7.80
$2.60
$780.00
$24.00
$10.40
$824.80
Address
Parcel Number
Contractor(s) Phone CeII Phone
JULIANA ENTERPRISE, INC DBA POVI (305)687 -7080 (786)208 -3493
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
PRO
Expiration: 1 I 2010
Phone
Applicant
BARRY UNIVERSITY INC
11300 2 Avenue
MIAMI SHORES FL 33161 -6628
Valuation: $ 13,000.00
Total Sq Feet:
Type of Work: ELECTRICAL
Additional Info: GENERATOR
Classification: Commercial
Pay Date Pay Type Amt Paid Amt Due
Invoice # ELC -2 -10 -37078
04/13/2010 Check #: 2211 $ 824.80 $ 0.00
Date
BARRY UNIVERSITY INC
CeII
Available Inspections:
0
Inspection Type:
Final
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.
April 13, 2010
April 13, 2010 1
Value of Work For this Permit $
Type of Work: ❑Addition
Desc
Notary $
Scanning $ Q4
Double Fee $
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ 79D./
Radon $
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
BUILDING Permit No. 0010
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) &ff.P / / pi f, a , Phone tfraac, � fP 3 7 '�J
Owner's Address /.3 B
City ffd az / ed State
Tenant/Lessee Name ,/p/ /,,.
Email
Job Address (where the work is being done
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
❑Alteration
Training/Education Fee $ Q
Violation date:
DPBR $
Zip
Phone #
Is Building Historically Designated YES NO, !/
/ Jh - .
Contractor's Company Name ; ,- i < cP _ , / > Phone 6° f7 - 70 /O
Contractor's Address /,. ff/ S / V Lc ) '4 -J ,9 V
City /77 !lw / �'
Qualifier Name ja , ' /me 7Y ,3 Ph) eh e
State Certificate or Registration No. EG— GOD / 9 03
Contact Phone0e J 6 /' 7.. 70 rf O E -mail
Zip 3J0v -
Phone # e -6 >9�67 AP -344. ffJ
Certificate of Competency No.
sow-
Architect/Engineer's Name (if applicable) /2// /-- Phone #
,square / Linear Footage Of Work:
ew ❑ Repair/Replace
Zip
Flood Zone
❑ Demolition
S/�JYYL
SITS ,Cr 3s + 911gn3 mrTi90
. q
solo fjsttll!Si liti$ rtiltuff C3L'5:.7e 4, ios� ° '
r 1►� «<
.°' -- � . /.t lam+ or-
i '.
1t';, , ;; Fyiii /g" i r r J
i to6a8 04 noa? ntrivo ) lill
,i 4 vist id tEntsli 'Vora G9Unt3 ", ii,eSFo
to s
************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ go
Structural Review. $ Total Fee Now Due $
CO /CC $
Technology Fee $
Bond $
o.40
See Reverse side ->
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 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 approv.. a' . a re- inspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this J 7
day of Febr4441, 201 RruC w r s ,
who is ‘ personally known me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
•
Sign: Vpl1
Print:
My Commission Expires:
* * * * * * * * * * * * * * * *
APPROVED B
•
* * * * * * * * *,
(Revised 07 /10 /07)(Revised 06/10/2009)
4//4-A
�,r• a 4s,� LINDA S. MITTS
° ` o. Notary Public - State of Florida
1 My Gomm. Expires Jun I6, 2013
s T z Commission # OD 863031
Bonded Through National Nomry Assn.
' /O Plans Examiner
Engineer
Contractor
The foregoing instrument was acknowledged before me this f )e
day of F� b , 20 Jv , by 1C ,�edl`?ef &rl a.2•�
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Comm
. tary(9obUc - �tivdda
s My Comm. Wires Dec 17, 2012
s: Commission I OD 846355
Banded Through National Notary Assn.
********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Zoning
Clerk checked
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 2136-000 -005
STATE OF FLORIDA
COUNTY OF MIAMI -DADS
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street /address: 11300 NE 2 AVE MIAMI SHORES
3652 4140 AC SE1 /4 OF NE1 /4 LESS E35FT & LESS W4OFT LOT SIZE 1740400 SQUARE FEET
2. Description of improvement: 100 AmPs gas Pam= and 100 AmPs manual transfer switch
3. Owner(s) name and address: BARRY UNIVERSITY, INC. 11300 NE 2ND AVE MIAMI FL 33181
Interest in property:
Name and address of fee simple titleholder.
4. Contractor's name, address and phone number. JULIANA ENTERPRISES INC•
12815 NW45 AVENUE MIAMI FLORIDA 33054
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number. NA
Amount of bond $
6. Lender's name and address: NA
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(x)7., Florida Statutes,
Name, address and phone number: NA
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided In Section
713.13(1)(b), Florida Statutes.
Name, address and phone number. NA
•
9. Expiration date of this Notice of Commencement:
(the expiration date is 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU 1 D TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK 1
OR RECORDING YOUR aj ' - • F COMMENCEMENT.
• s)' Authorized Officer /Director/PartfpFlgk
B f FirtykE13 EE TIFF if ct fia6 A
S Print '* { ,t a IJ! F
Tdie/Officer
hAm
'Fir TN
Signature(s) of
By
Print Name
Title/Office - /hfSS '4e10'°
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The forgoing instrument was acknowledged before me this ,_(_Z d
By a
❑ 101lridually, or Was 1l4 • 1i -- - for
Personally known, or L1 produced the following type of identific atjon:
Signature of Notary Public:
Signature(s) of
BY
123.01-52 PACES 11@7
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92525. FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated . true, to the best of my knowledge and belief.
s)'s Authorized Officer/Director/Partner/Manager who si
BY
1111111111111111111111 1 1111111111111111111111
s i:-s
i
1'
CFH 2010R01 14366
OR Bk 27188 Ps 2458; Ups)
RECORDED 02/19/2010 13:13:51
HARVEY RUVIH► CLERY. OF COURT
I'IIAIII —DARE 'COUNTY, FLORIDA
LAST PAGE
Space above reserved for use of recording office
DE
9
1 130t) NP
✓n. 'ohm; S /i o.heJ
•
LINDA S. MITTS
Notary Public • State of Florida
My Comm. Expires Jun 18, 2013
Commission # DD 863031
Rue* flatland Noisy Assn.
istrzik
�G�
Mar 25 2010 2 :20PM HP LASERJET FAX
Permit Noe 09= -"Co -2
Job Name: " 1/Zo ');', /W01 -'67. Atz iFIVA
2009 Page 1 of 1
ELECTRIC Critique Sheet
/.f° / - 1% /'e' - A r C .W #n
fp ? d3 / cam ,if``iee°' P , f Wh. .G+.7��.*
3 - £i c
M iami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
p.2
42-vt - ("ref jzA9f-g ,93.
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Mike Devaney
305- 795 -2204
Permit No: 99- 4 _
Job Name: `� #lZ12y X/ ° kizi'S /cl�
, 2009
ELECTRIC Critique Sheet
/6 ih p kwA SPC_A�y)_
p e- ed a-,e3/'/ cev�Y22. /� r
Mike Devaney
305 - 795 -2204
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
/ P /✓eon /®
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Apr 13 2010 12:13PM
990003165
UNTIL SEPTEMBER 30, 2010
FORCE. NOTE: THIS LICENS
OCCUPATION SPECIFIED H
CITY OF OPA -LOCKA
CITY MANAGER
HP LASERJET FAX
Cy of Opa -Iocka
Deparanent of Business and Miming
JULIANA ENT RISESsINC D/B/A
12816 NW 48 AVENUE UNIT* 1
OPA- I.00KA, FL 33054
LICENSE FEE $60.00
18 HER -! : ED TO ENGAGE IN THE BUSINESS. PROFESSION OR OCCUPATION OF
K PROFESSIONAL SERVICES
OPA L.00KA, WITH THE ”.ILO WING REST TIONS:
ti ) .' r
/
DISPLAY AS REQUIRED BY LAW
BY:
LICENSE CLERK
p.1
2010
NTY REGULATIONS NOW IN
THE BUSINESS OR
Mar 25 2010 2:20PM HP LASERJET FAX
JUL NA. ENTERPRISES INC D/B /A
POWER PRO
Facsimile
To: Miami Shores Village From: Bennet Berhane
Fax: 305- 756 -8972 pate: 3/25/2010
Phone: 305 -795 -2204 Pages: (3), pages including this one
Re: Permit Appi. For Generator at Barrycc:
x❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle
Please deliver this to Mike the Electrical Inspector per his request.
P.O. BOX 170328 . HIALEAH. FL 33017 -0328 . PHONE 009 687 -7080 . PAM :305) 687 -9080
p.1
Permit No: 10 -2,Y
Job Name
4)S
, 2010
//
Building Critique Sheet
O leo ute6. Ad.* if jG.ya,T fib j --4 S ■C o 8 U
C))
Norman Bruhn CBO
305 - 795 -2204
M iami Shores 'ivage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Project Address
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Address
Permit
Issue Date: 4/6/2010
Permit NO. PLC -3 -10 -503
Permit Type: Plumbing - Commercial
Work Classification: Gas
Permit Status: APPROVED
Expiration: 10/03/2010
Parcel Number
11300 NE 2 Avenue Number: Fine Arts Quad 1121360010160 -06
Miami Shores, FL 33138 -0000 Block: Lot:
BARRY UNIVERSITY INC
Phone
Applicant
Cell
BARRY UNIVERSITY INC
11300 NE 2 Avenue
MIAMI SHORES FL 33161 -6628
Valuation:
Total Sq Feet:
$ 500.00
Contractor(s) Phone CeII Phone
THE NEW MIAMI SHORES PLUMBING (305)751 - 2446 (786)553 - 5424
Type of Work: GAS GENERATOR
Type of Piping: GAS
Additional Info: PLUMBING
Classification: Commercial
Fees Due
CCF
Education Surcharge
Permit Fee - Additions /Alterations
Scanning Fee
Submittal Fee
Submittal Reversal Fee
Technology Fee
Amount
$0.60
$0.20
$150.00
$3.00
$50.00
($50.00)
$0.80
Total: $154.60
Pay Date
Invoice #
04/27/2010
03/25/2010
Amt Paid Amt Due
Pay Type
PLC -3 -10 -37399
Credit Card $ 104.60 $ 50.00
Check #: 4952 $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Press Test
ROW
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
Building Department Copy
April 27, 2010
Date
April 27, 2010 1
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Is Building Historically Designated YES NO
i MAN ' Mi 011
BY: ..,,
Permit No. VLG 10 - a)5
Master Permit No. EIS- X53
Fi r 1 �-r Q j
Owner's Name (Fee Sim _le Titleholder) Q 1 Uif1 \�(5 1 Phone # OS " 23
OwnerA Address it ico . (st'.Q
City MQk, S hofl , State Zip
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) 113 U 0 ►V g 2 e—
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Contractor's Company Name 2 1Veu. MtClml $t o ies 000A.12119 ZS' 2'14G
Contractor's Address q00 (N.k.X3 14 4 S k
City \Gr') 1 State 1 1 ` Zip 331 to B.
Qualifier Name ✓.e lnls b uc ' \ it
Phone# 3®S - ( 2.446
State Certificate or Registration No.
C c{ ZO S. Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
oJ•
Value of Work For this Permit $ —
Structural Review. $
Square dinar Pon a a Of Work;
Type of Work: ❑Addition ['Alteration ['New [] Repair/Replace
El Demolition
Describe Work: tonvNeC A Co ct G -e cru.40
eY9rdcoY4c*** ******xxxxxx4c***************** eF xx xxxxxx**** ****axmxxxxxxxxx
Submittal FQe $ 5 l.).0 -0 Permit Fee $ / 9U f' • CCF $ Q UJ(J CO /C
Notary $ , t raining /Education Fee $ . / Technology Fee $ 0
Scanning $ Radon $ DPBR $
Bond $ Code Enforcement $ Double Fee $
Total Fee Now Due $ ) (99 - e
See Reverse side --
•
Zoning $
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 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 • a rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be app,. . ,hd reinspection fee will be charged.
Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this C The foregoing instrument was acknowledged before me this 04
day of ire , 20 I C , by f Zvi e t, I' �'a r'A5 , day of H_Ctre./k. , 20 1 0 , by Den n is I — 1 U j In't %. n
who ispersonally known to me or who has produced who is perso . • e� o r who has produced
As identification and who did take an oath. en grila �, � ' „ <-
NOTARY PUBLIC: NOT Y COMMISSION # DD753565
`IL . ,' :.; L ,IRES Mat'
o� sa r , 2012
Sign:
Print:
—
,-
UNDA S. WITS
Olio PO/ 1c • Olds M Raids 13
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
Oalliminion • OD $UO31
Attu.
52
Print: !i, r -e ') rc.A.
My Commission Expires:
***** * x x xxxxx * * * * ** * * * * * ** *x * * * *9e ** tie***** de*.*** wit * ** * *fa ******* * * * * *xx * * * * * * * ** *le *** * ** **
Plans Examiner
Engineer
Zoning
Inspection Number: INSP - 141971 Permit Number: PLC -3 -10 -503
Scheduled Inspection Date: May 05, 2010
Inspector: Hernandez, Rafael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Fine Arts Quad
Project: <NONE>
Contractor: THE NEW MIAMI SHORES PLUMBING
Building Department Comments
CONNECT GAS GENERATOR
Passed
EL_
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 138976. PLUMBER WAS LOST
RH 4/30/2010
May 04, 2010
Miami Shores, FL 33138 -0000
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
(1'
For Inspections please call: (305)762 -4949
EL 1 0 . 1 6 3
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Gas
Phone Number
Parcel Number
1121360010160 -06
Phone: (305)751 -2446
Page 15 of 18
Operating Pressure
Lock -up Pressure
Test Pressure
Minutes
Performed By
.i'°- 4 itte-ti
6 I'nat .
11 o mai
iS
&& lope 2,
Job Name: 'i? & rte OV-4~$.0.A\
Address: 1 /3DD IA. E SLLut_
TELEPHONE:
(305) 751 -2446
24 HOURS
MIAMI SHORES PLUMBING
900 N.W. 144th Street
Miami. FI 33168
CCB CFC019205
Licensed and Insured
DROP TEST
Permit # ?LC. v 3 -10 - Sb 3
City. (AA-1 r3 k try /
FAX:
(305) 754-5402