PLC-12-1221Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 175381
Permit Number: PLC -7 -12 -1221
Scheduled Inspection Date: August 31, 2012
Inspector: Hernandez, Rafael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Andreas Buildin
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: TWIN BROTHER
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -21
Phone: (305)332 -1969
Building Department Comments
REPLACE FIXTURES IN RESTROOM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 30, 2012
For Inspections please call: (305)762 -4949
Page 1 of 6
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 APPLICATION
FBC 20
BY:
Permit No. PICAZ� 1221
Master Permit No.0 )2' 9
Permit Type: PLUMBING 1:4) I
OWNER: Name (Fee Simple Titleholder): a i (' U n t vn,c-Sl Phone#:
Address: 11300 N 2 J Ave_
a
City: 1'k earn; Si asre S State: Zip: 334 1
Tenant/Lessee Name' Phone#;,
Email:
JOB ADDRESS: 113 0 0 PE
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: I I ' 1136 000 -005-0
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company N r`4 ,5 64 ghone #: 3 0S" 333 if
Address: 4° 69ari4 Alm
City: ilifiroyi State:- Zip: -3 3 / -5
Qualifier Name: Phone #: i
State Certification or Registration #: ' �° 3.--// Certificate of Co petenc %y# �� r_ v- 9- / 6
Contact Phone#: ?�aS '> 3 3 / 16 % Email Address: !�u��t i7�aa�1 a'y e � 'S` • Co��
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ "a S °v � ° Square/Linear Footage of Work:
Type of Work• °Address OA} ration New epair/Replace ®Demolition
Description of Work: ° I A- —r •icrC P 5 5T ' . ' 1 L renpsoh 14411
*******************************+ s******* Fees******** * *** *** **** * * * ***** *way **************
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1(02:30
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 approved a ;,. reinspection fee will be charged.
1
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 L, by
who is perso known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Exp'
Signature
G
Contractor
The foregoing instrument was acknowledged fore me this LS
day of 1 , 20 .a.; by 73)It
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
_ ♦--
Sign:
Print:
My Com
YUDID RODRIGUEZ
M• a
,x**** ,x**** x,x+x*,xs,s*,x*,x,x*** * ;, ,x+r**** x, x, x*a:, x+ x********* *x x******** a *s,*,x,x,xa,x,xa,a,********* x* ***+ ,x+x,n,aa,s*+x,x **+x******
APPROVED BY
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
•
AU ( MC STATE OF RAMA
OrigiREANCIALOFFICES OB"AREI IT OF ~RCM SWISS
ORM* F INORKERS, apMPEWSAT 1
* O ELEIMIN e0 BE EXEMPT IMIN-RONtil COMP * *
COMPRUCINIti MEW socarnai
this• geeing tot to Wad Ned _ has deed b be CORPROMON 1111L
. BrECTME-DATE: 00/241E91O
PERSON Z
NAME —
TM WINES PIANDINDt0nnCORP
IMO Sit22
NMI - FL SIDIM
- iiXPISATION 0ATEr iiiinwzola
SCOPES OF BUM= OR TIMOR
t- PLUIESINI alt
EOM
IMPOMUM ransean mMier CUM WS. as Wiser sr : .as effects ceofeseas funs erit ~Er rr UMW a crEarkilla a "l r elk
,settas es, es pager ese des as aresoados coder ate adeteet
- mos of Or mss or Sods Med at de tae d dorm le eeee le
eked= to be imp[ sled dr safest le eeaBas 9, at Star
ee coth es logs cede Os reeektesses cd Stiis mem for
• and oe Or eeidnaele ee teat the stafitaases of Ode =dm
a 262 =NOM OFBHaw1D6E EMIT N
rinaast to a d a to swap a d
det 10 OWN, ofttORES . se.afa.ae or
de6�afaa4eBeearasl�a#Oee��e�
d s tectiliale. ie repalie d eeed'reeela ai oe * say ea for Mae d Oa ante
OlN8 413 -16119
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
CISOIFEMSESFELEEMON1DOEBEISWITROMIXSUSI
WDEPEREICONFMENEMMILEST
as/2a/2030 ENPSRAIZON OM: 60/210/2012
AMMER
PIKE 200321rAS7 BUSHIESS NAME AND A
TM BROOMS ISPENIM CON cam
ma Of 22 MIME
A FL 33145
SCOPE OF BUSINESS OR TRACE
1- Eufaula cammcnott
•
•
imiram-Arir
fo 1e Manita ES. a officer Of a trepetetan YAW
� r ar 1
toefer Otis sew e
Dew • Be Panissat 44=1I2L F,S Cfrefirotes it ofection to he
r_ mama— =dr only widen the tempo of :the babas or tomb ffstad on
R •
Erman to Omar mama EL Rakes of eAs ea to -lae eta
-a eadifia as e exempt slitS bo a Via► refoodion
N„ at aty thee after Os Ong of the maw or De stardatate. the paw alsool on Do mate ar -i Nollgr '
foodluneNt of this swim -fer items of a eertMete. The
department sere stool o a tostilitoto at swill= for More of to
poises wooed as too cottifictoo to mow the reoftements et -
s
SUESBOOD 413 -1N9
CLff HERE
• -CauY batman pout sae ' job, teep sipper poraoe AT Mr recants. •
,• .0 .0
,
'
, 4.4.1.: ... „3:-.
-.... . ,1.-,,•,-.- ..:k0--; : g,.. -: '“ --e...-- — u-,..;.,,-
- - - - - ..q % -, .1. ,.,..,,..: ,,,..--,.,.,-,_.k.:, i •-:::-. --,----
• r ..-•,,,g re 0";,,; `',3,14,:'@.7ri-l'ii-z.,-; i'.Q :.1.
, • .• -
TWIN: BROTHERS..PLWIBING:
ratifti:.CONTRACTOR:
IS ONLY
essout:
mt..:Ncry IT ThE.
intwarGuisraw OR
SG CF ThE
Mir ORIM:
ONEffINNWPAy:!
MIT. .� -1101211151ff
1Wl5 BY L*W.1HS 5.
DiEE.OTHED SLOE
DO NOT
TWIN BRO1YHERS PLUMBING
cONTRACTORS CORP I -
2930 SW Z2 TERR
MIAMI FL 33145
111111111111k$ %ha MISS 161111111111.11A18411111111AdM
deetRe
CERTIFICATE OF UANILITY INSURANCE
PRODUBER
VP Insurance
3842 Davie EPS
Fart Laudettade. FI.331112
40+9
TtU1aDin1
THE
CIERTMicAyEmiSEUED AS AMATTEROF INFIMATION
ONLY AND GONFERB HO HIGH=S UPON THE CERTIFICATE
tioLOER. THISCERTIFICATE OQES NOTAMEND. MEND OR
ALTER THE cOvERADEAFFORDED BY THE POLICES B»
HOMERS WORDING COVERAGE
Twfi BMWs PbmiluO CON)
Swaz Te+r
Mist Fl =US
4 k AsOROORUOSSforibm. Lis
INSURER 0
INSURER t
INSURER 4k
INSIMERE
COvERAGES
THE POLICIES OF INSURANCE LISTED Ha= HAVE BEEN ISSUED TOTHE INSURED NAMED A FOR THE POLICY PERIOD INDCCATEO. NOTIMTNWANDING
ANY REQUIREMENT. T MORCONDITIONOFAmcQNT iytCTOROTHER 00CIRIBiT WITHRESpECTTOWFSOWNIN TEOD OR MAY
PERTAK THE AFFORDW BYTIEVO1ri2ER 1 k SUNIECTTO ALL Ti E MIAs. ERMUSONSAND
POLICIES. ANGINICATELNSTS SHOWNSA Y HAW BERN fEEDMat BY Pio GARR —
WSW
TYPE OF INSURANCE
GERERALIUUSLITY
ELAM WOE ® OCCUR
►TE UMW APPLEStOt
POUcY pawl= n LOC
ARTURO= Lyman
MT AUTO
ALL OWNED AUTOS
° SIDIEDULEMUTOS
tine:mums
NOOOVVRED AI OS
POLICY MEM
42.44445-2
EACH OECURRME $
=IT ittigt
a
8.000
1.000.000
WIDEN tAnyo arw41 5
PERI MRAL& WNana $ 1.000,408
CENERM.ASGRESATE 5 V .otro
1.008,440
143,000
PROVO= -SAGO $
Fire Dames umii —
SINGLE MOT
BMW NAM
*ARAM WIRROY
] immure
1
tAUmin
] cc= D cu s MADE
OEDUCTIBLE
OMER
Miming Wort
CERTIFICATE HOLDER
CITI MIAMI SHORES
Bilding Deparment
10050 N.E 2nd Ave
Fl9rida 33138
ACID Ns (2082/1111)
VILLAGE
Miami Shores,
1SPoctltL pau►'tilla
!ONTOONLY-E5ACCIRENT .;
;1 IMACC
Aare i
EA0NOC4awRENCE
$
a
EL EACH MIRDEfir
Et- - EAeantaAR
s
EL. oREASE -POLICY M s
CANCELLATION
A1YOP,RS MORE DE55018191 POW= RE GARREUEO REFORTITOR
30 opYBWIUrf
WOO 1i , SOLL TO MI.
R O M E TOTIA GOITIFEmatiatosRosozo mum us7t,4aurFigB ETOOD50
mown* GMAT= ORLIAI R VOP AIN RIND 0505 TKE WORM 110At, on
auntORORDREPROSESTA
DI>
G AcORD CORpoRATION 1988
DEp O$ AND PROFESSUNIAL REGULATION
CONSTRUCTION INDUSTRZ LICENSING BOARD (850) 487 -1395
1940 HQBTE NORBOE STREET 32399-0783
ALVAREZ BENITO A
TWIN BR6THER8 PLYING
2930 St' 22 TRACE FL 3145
With thls keine you became cne of one million
bythe Department
Our professionals and range from to yacht brokers, from
boxers to Intd3eque restaurads. and they keep economy stums.
Every day we wodcbo bdpraroe the way we do bushman and to serve you bier r
For information ab icier services, N log onto
There you czar find more infOrnalion about our +; , ;.; ; + the mold= that
Impact you, subscrthe to and ; mom about
Department's initiatives.
Our mission at the Department k that you Efficiently. �(:.:ei ICit :. Fairly. We
Thank yoaya� Florida, and 'aongrabrfations on yaw new Himmel
.t d�3Y'z is
acs --t., Xsc.: