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PL-13-695Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 188829 Permit Number: PL -4 -13 -695 Scheduled Inspection Date: May 09,2013 Inspector: Hernandez, Rafael Owner: GLINN, MacDAM & DENISE Job Address: 1201 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ROBAINA WELL DRILLING INC Permit Type: Plumbing - Residential Inspection Type: Anal Work Classification: Sprinkler System Phone Number Parcel Number 1132050250160 Phone: (786)683 -7437 Building Department Comments REPLACE EXISTING SPRINKLER PUMP AND IRRIGATION SYSTEM. Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments May 08, 2013 For Inspections please call: (305)762 -4949 Page 5 of 28 1111111 i ill111111111111111111111111111111111 Ft4 5A311735 13855 NOTICE OF COMMENCEMENT O' Bk 28593 P9 1735; (1a9} A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION RECORDED 04/22/2013 13:17 :30 HARVEY RUVIFtr CLERK OF COURT MIAMI -DACE COUNTY FLORIDA PERMIT NO. 91..-4 ' 15- 695 TAX FOLIO NO. !I- 3,165- Qa5 -Own LAST PAGE STATE OF FLORIDA: COUNTY OF MIAMI -DADE: 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: 1 r ( FE 10-J ,SA-. SLores FL 3 t3JQ 2. Description of improvement: ,..� , �e c3e,,,_ e .�. /Re. lock ; o l 3. Owner(s) Dame and address: GV:%^.,... 13.41 SIC I o 1 c +. i Interest in property: e vote_ —El -1 le 1.-,.1( et— Name and address of fee simple titleholder: Ckv-.e 0.S. 4. Contractor's name and ddress: ` et; a..... cc. 3 I `-1 tA 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: Amount of bond $ �J 6. Lender's name and address: Q.L. a t . 4. ( , O 3 k . 9 . / d,t, PC. 3 (3 e 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)(a)7., Florida Statutes. Name and ddress: $+ I d'4Co.v-:. SLare s fFL 3 ?I 3 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 and Address: 9. Expiration date of this Notic,g.gRofnetispe ,. ,, a° � ti e date of recording unless a differen date is specified) I HEREBY CERTIFY that this 1P, I ignature of Owner Print 0 er's Name Sworn to and subscribed before me this Oa Cc+s�s Prepared by Okr`C k , 20 12 Notary Public: Print Notary's Name: My commission expires: day of Address: 5..... 2DLq I Sir dee-e c F� 27 ,00c( ACCORb° CERTIFICATE OF LIABILITY INSURANCE �•�.... -.�'- DATE(MM/DD /YYYY) 4/23/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Blackadar Insurance Agency, Inc. 1436 N Ronald Reagan Blvd Longwood FL 32750 NAME: Patti Tomasso PHONE _ FAX ''' _ Arc No : -: .: - EMAIL ADD RESS:Patti@a blackadar.com INSURER(S) AFFORDING COVERAGE A INSURER A:• • -• S 2,1 " UABIUTY COMMERCIAL GENERAL LIABILITY INSURED ROBAWEL -01 Robaina Well Drilling, Inc. 24401 SW 214th Place Homestead FL 33031 INSURER B : 72030277 INSURER C: 7/27 /2013 INSURER D : $500000 INSURER E: $300000 INSURER F: CERTIFICATE NUMBER: 462971392 REVISION NUMBE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD /YYYY) POLICY EXP (MIWDD /YYYY) LIMITS A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY 72030277 7/27/2012 7/27 /2013 EACH OCCURRENCE $500000 PREMISES RENThD =offence) $300000 CLAIMS - MADE X OCCUR MED EXP (Any one person) $10000 PERSONAL & ADV INJURY $500000 GENERAL AGGREGATE $1000000 GEM_ AGGREGATE POLICY UMIT APPLIES PER: JECT 11 LOC PRODUCTS - COMP/OP AGG $1000000 $ AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS - _ SCHEDULED AUTOS NON-OWNED ( IINW SINGLE LIMI I COM6BODILY $ INJURY (Per person) $ BODLY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB _ CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE UDEEDD?XECUTIVE � (Mandatory In NH) Dyea ESCR ION OFFOOPERATIONS below N / A I WCY A U- I IOER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS, LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) "C OT ILAATL Vs. n-I= P I i ? - (oc . CELLATION Miami Shores Building Department Phone #305- 795 -2207 10050 NE 2nd Avenue Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010/05) AUTHORIZED, )3EPRESENTATIVE ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 FBC 20 tk BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 1201 NE 102 St. A . 3„ 013 Permit No. 1 Master Permit No. P lV " (61 S City: Miami Shores County: Miami Dade zip: 33138 Folio/Parcel #: Is the Building Historically Designated: Yes NO XXx Flood Zone: N ?A Phone #: 312 -882 -8060 OWNER: Name (Fee Simple Titleholder): Macadam Glinn Address: 1201 NE 102 ST. City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: NSA Phone #: Email: glinn @earthlink.net CONTRA T R: Company Name: �� g1.1)Q Giii II pri /l1 J)2 is , Phone #: 7 637 y3) Address:, �� 1 Sk./v, pt � 2 City: h.1 i DA I State: r c Zip: 3 J 0 3,/ Qualifier Name: 3-0 e I <)bci . 4 6 Phone #: N State Certification or Registration #: 0 7 e a G o 6 l e Certificate of Competency #: 07P000“0 Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 2000 Square/Linear Footage of Work: 5000 sqft exterior Type of Work: DAddress ❑Alteration UNew Repair/Replace ODemolition Description of Work: Replace existing sprinkler pump with new one and repair existing irrigation system. Well is existing and electrical is existing ***************************************Fees***************** * xamx*** * *** *xxx*** * * **** Submittal Fee $ J Permit Fee $ it" — CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ i A Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) C a se as co,--?.(,. 0 State Mortgage Lender's Address City 611 tui Zip —5 7 l 3 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 FE :RCTRICAL 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 hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be 'proved a nspection fee will be charged. Owner or Agent °- Contractor The foregoing ' ''..trument was acknowledged before me this The fore s' • in ment was acknow day of Act , 2017 , by /nU,c.4 L 6 (•v` `' , day of ' / , 20 /3, by r�ci who is personally known to me or who has produced ewin i personall y wn to me or who has produced 'eft i » As identification and who did take an oath. 7e✓ /4% identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp. sietumiePen Band ke ON mw, Pepoe �Ib:' • 440?' 4 II* :S3HId)3 690996 CO S NOISSIP WOO AV9 MINA ATM s ,.,411∎ ♦ _ 4 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** : * * * **** ** * ** ** k************** kph** ** k* k**%k*****ffi***** N**Naga .k:is***********:k**** r NOTARY PUBLIC: APPROVED BY -to (3 Plans Examiner Zoning Structural Review (Revised3 /12f2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Clerk 1. Connect new pump to existing well 2. Pump to be installed in same location as existing 3. Connect new pump to existing timer on existing 20 Amp breake 4. Install New Mechanical irrigation index valve 5. Replace Pump with Goulds GT15 BLDG'DEPT SUBJECT l'O.CC:PAPI JF NICE 1 [H All FEDERAL PERFORMANCE RATINGS Model GT15/ GT153 PSI Discharge Pressure 20 Suction Lift in Feet 5 63 10 59 15 54 20 49 30 60 55 51 46 c /7.' ( e , C S 9k, / 40 45 38 33 20 25 39. 37 14 Zone / GPM Calculations Zone 1: 40 Total GPM (3 Sprinkler Heads x 1.5 GPM Zone 2: 21 Total GPM 10 Sprinkler Heads x 1.5 GPM Zone 3: t Total GPM d\ Sprinkler Heads x 1:5 GPM 'at ♦v b a . . b .e r JB.2ir (C) Glinn Residence 1201 NE 102 Street Miami Shores, Fl ia" 'e Notary P{i Iic State of Florida ; t Notery Sierra My !saton 0D904722 fop K.o $05/2013 Legend Electrical Panel Existing Well 0 New Pump location main line lateral line X Sprinkler Head 0 S 'ide)c Alve Irrigation plan