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PLC-12-1223Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 it)) -Uzi Inspection Number: INSP - 175398 Scheduled Inspection Date: September 19, 2012 Inspector: Hernandez, Rafael Permit Number: PLC -7 -12 -1223 Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Thompson Hall 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 -02 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 September 18, 2012 For Inspections please call: (305)762 -4949 Page 6 of 27 Miami Shores Village Building Department Value of Work for this Permit: $ / 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762A949 BUILDING PERMIT APPLICATION FBC 20 JUL C► 2iC B Y: sm I - 000� Permit No. 1 12:1 Master Permit No.CC/ Z 92. Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Lt. Uy.w& i y Phone#: Address: 11300 lJ V Avg City: avvve S1,nceS State: SW I Tenant/Lessee Name: Phone#:, Email: JOB ADDRESS: I I O Iei 21.S Le_ City: Miami Shores County: Miami Dade Folio/Parcel #: 11° 2r5 6- boo - o ®6S 0 Is the Building Historically Designated: Yes NO x Flood Zone: Zip: 331( CONTRACTOR: Company Address: City: me: / 4F` °`t iei-‘ /4(4 eau Phone#: S 33.. /16 f ut-L -, e-, Qualifier Name: 6 f to State Certification or Registration #: Cc State: FL Zip: 3,j9 ©7S`7-// Contact Phone#: 30s /76f Email Address: Phone #: 7' 4- 'Y:?? Certificate of Competency ## 4 i0 a 9 / - / u9,07 r -rte- �jHath & 447. DESIGNER: Architect/Engineer: Phone#: goo ` ®� Square/Linear Foo)age of Work: T ipe of Work: OAddress ( teration ONew Description of .Work:., % �� her v/'�� / 4, 360 Demolition *** **>xY **** *******>r+x**********>K****e ***F ****>k *>bYx**>H**>p**Y * *********>k+x **** *** *** * **** Submittal Fee $ Permit Fee $ Fri Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 2 S% 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 /j Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 IL, by j)r r�a. �� e-0913141.6 who is personally known to me or who has produced As identification and who did take an oath. NOTARY ' UBLIC: Sign: Print: My Commission E Signature (/ Contractor The foregoing instrument was acknowledged before me this z8. day of .72)I'?L ,201Z,by ZD1iTIti A t/ar who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ** a*** ****** * *e *a***** * * *e ****** axe+ +x*+x+ + x*+ x+ x* ******+ x*************+ x* *****e*************** **************+x** ** ** APPROVED BY Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk