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PL-11-2144Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 166847 Permit Number: PL -11 -11 -2144 Scheduled Inspection Date: December 09, 2011 Inspector: Hernandez, Rafael Owner: TIERNAY, NANCY Job Address: 1226 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: AFFORDABLE IRRIGATION, INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1132050270170 Phone: 305 -681 -6322 Building Department Comments INSTALL LAWN SPRINKLER SYSTEM CITY WATER. Inspector Comments Passed C�- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 08, 2011 For Inspections please call: (305)762 -4949 Page 8 of 14 RECEIVED 1210812011 19:40 3054610121 Dix 08 2011 20:57 MRC Plbg. & Backflow 305 273 6181 page 2 MIAM COUNTY ADDRESS OFDEVICE122fi NE 93 St MIAMI•DADE WATER & SEWER DEPARTMENT METER OPERTATIONS & MAINTENANCE CROSS - CONNECTION CONTROL UNIT 1001 N.W. 11th STREET, MIAMI, FL 33136 -2209 Phone (305) 547-3046 Fax (786)268 -5485 BA(KFLOW PREVENTION ASSEMBLY TEST REPORT FORM OWNEROFDEVICE; Bianchi FrederdlI OWNER CONTACT, New Installation / Aftc dable Irrigation PHONE:: 305 681 6222 ADDRESS OF OWNER 1226 NE 93 St, 61faw1 Shores, Fl FAX: 305 8816321 ZIP CODE:: 33138 NAME OF TESTER: MARCUS RUCHE CERTIFICATION 11:03100 EXPRATION DATE:: 8/'5112 PHONE:: 3052736100 BUSINESS ADDRESS: PA. BOX833323 MIAMI, FL Z� CODE 33183 TEST KIT MAKE:: MIDWEST MODEL*: 835 SERIAL #: 09091454 MAKE OF ASSEMBLY: WILKINS MODEL No.. 720A DATE LAST CAL 1115111 SMILAX: YES / NO 11 \, ash.:; `` 'lfu +•` >:,.$ iT` sERL'L# T085391 NETERNo• 07406189 INITIAL TEST; X ANNUAL TEST: DATE OF TEST: 1t13012011 METER READING: SHUT OFF VALVE in; SHUT OFF VALVE 8t CLOSED TIGHT: X CLOSED TIGHT: i( _ LEAKED` LEAKED: LINE PRESSURE: 55 PRESSURE STABLE' LEI _ No Closed Tight Leaked: PRESSURE DIFFERENTIAL ACROSS CHECK REMARKS / REASON FOR FAILURE (IF APPARENT): SIGNATURE C¢ E FIE0. DA -- . ,33 ate b t� NOTE: TEST FORM MUST BE COMPLETED IN ITS ENTIRETY. INCOMPLETE TEST FORMS WILL BE RETURNED. I \"/A IL,4\:\i BUILDING PERMIT APPLICATION FB C 20 Miami Shores Village Building Department t 10050 N.E.2ncl Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax; (305) 756.8972 Permit No r RECF,IXI NOV 1 ;2011 Master Permit No. Permit Type (circle): Building Roofing Owner's Name (Fee Simple Titleholder) `7, epeZ/ c 73/Art 44' Phone 00371 3 7f S,ee.-7 Owner's Address City /14.W M1 State �G- Zip 33/ 3d Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 42.02 IP 41/, ( 7.? S7iui 7. City Miami Shores Village County Miami -Dade FOLIO / PARCEL # // - 3 Z O ,S"._ / 7 0 Is Building Historically Designated YES NO zip 3 3 /Q, Flood Zone Contractor's Company Name ,416 ,Xi /71 ','br Phone (-) 40 / 4 32 Contractor's Address / 'J /1 k% /39' St% Z �g City ;�f�'g is j State Pe% Zip. 33 / d Qualifier Name . A4 4 Co 70s4y j Phone # . State Certificate or Registration No. 96 /290 o / ff . Certificate of Competency No. Contact Phone ("3 0 0 3 10 ro /2, E -mail Architect/Engineer's Name (if applicable) Phone Value of Work For Phis Permit 914-ACC) Cu Square / Linear Footage Of Wm-11c Type eff Work: ©Addition NAlteration ©New 0 Repair/Replace Describe Work: Demolition �- Submittal Fee $ Permit Fee $. /CV, ` CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning.$ Radon$ . DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. .$ ' Total Fee Now Due $ 1 \ C' • See Reverse side -* oreding 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 WITII 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 trust 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 reinspectio fee will be charged. Signature 0 or Agent The foregoing instrument was acknowledged before me this of f LJ 20 IL, by _ J2e d4`•G iS�l who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: s 9a &. Sign: Print: ,F4s&s My Commis, f`'.. °. MARCO ROSAS �- MY COMMISSION N EE 115873 EXPIRES: August 18, 2015 Bonded > Notary Public Underwriters Signature .ie Contractor The foregoing instrument was acknowledged before me this day of 17 luau, 2011-' by A 1460 , i 9[ , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: / Pri n My mmission Expires: NOTARY tJBUC-STATE OF FAOMA _� "" Jorge Toledo ,, • Commission #DD815435. ,�.,.�' Expire : AUG. 22,2012 BONl DTHUATLANTICBONDINGCO.,OM- *** ** *** * ***** **** * * * ** * * *'' ****** ****** ***** ** ** ,** ***** * * * ** *************** ************ * * * ***** *** ** * *** ** APPLICATION APPROVED BY - (Revised 07/10/07) / /I; "7 Plans Examiner Engineer Zoning Clerk checked Y_7a69 NOV 1 8 2011 Y: CC# 96P000219 Affordable Irrigation, Inc. 198 NW 139 Street Miami, FL 33168 Tel: (305) 681 -6322 11 I® :4 11S91' Di' Zes;de.i Ce 0' --p /�- Flo N' E 93 57' 1)If4m( 16- M :ami Shores Village APPROVED BY DATE ZONING DEP r BLDG DEPT i, //'/' / / —/ SUB CT (OCC,MPIJANC :' If-I ALL FEDERAL STAT:.i, D CC IAN CY RULES AND REGULATIONS m r ') 3/y 31 / r WIf7:300�I'' p.o.o 5/01lov fLGeti Ze6e4 p -2- 0' %Z o S"7 S�11�d7 fz`Q �S © 2*;,v s : Y'e 207,. / /eenis. ) /L k), Q f c11 j7o cv J2 e(J en 7e/1i £ s S 7rn 5 UJ 0-- 73 s WRY ttfBLIC -STATE OF FLORIDA Jorge Toledo Commission # DD815435 Expires: AUG. 22, 2012 EON& TRRU ATLANITC BONDING CO., INC.