PLC-13-834Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 189794 Permit Number: PLC -4 -13 -834
Scheduled Inspection Date: May 15, 2013
Inspector: Hernandez, Rafael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Health & Sports
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: GRAND PLUMBING CORP
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -23
Phone: (786)337 -9090
Building Department Comments
DISCONNECT EXISTING SERVICE SINK AND INSTALL A
NEW ONE
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 14, 2013
For Inspections please call: (305)762 -4949
Page 21 of 45
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
Permit Types PLUMBING
Permit No.
APR 2 3 2013
B Y:
Master Permit No.
OWNER: Name (Fee Simple Titleholder): BABY cdt4Ivalsify Phone #: 38 87 ?'4h3
OFFtc o F cts f odasS S Hr #-76 A
State: FL.
Address: 116 oo IUD , ° Z f9 IT
City: M per{ Sl.4oPES
Ci1Y# S nt
Zip: 33161
Tenant/Lessee Name: Phone#:
EmaiURESS : : S `%a INti Q /2-00444 it 1z / SARgy
City: Miami Shores County: Miami Dade
Folio/Parcel #:
aaiwti . i/y p.6 lq oos
Zip:
Is the Building Historically Designated: Yes
NO Flood Zone:
714 —22F, 06.2o
Ott
Phone#: 786 „ 13 7
CONTRACTOR: Company Name: Cr2AMD Pft IM.131N4
Address: asi 5- zact 4f//
City: LA I4
Qualifier Name:
State: -
State Certification or Registration #: C:fC /3/0t67,7‘..
Contact Phone #: 7ff 6 ° 337 — Email Address:
DESIGNER: Architect/Engineer: Phone #:
Zip: 33 WO
Phone #: ,/f',C 22 DUX 3
Certificate of Competency #:
Value of Work for this Permit: $ Z5 00 Square/Linear Footage of Work:
DNew epair/Replace % DDemolition
Description of Work: %es e oroi / e_X8 � y ���r�, cc L � .' J, ,„,<.; 4 , ®,�ee�
Type of Work: DAddress DAlteration
4 to i.******** * * *** ** * * ** * ** **** ***** * * * ** *** Fees************* * * *** * *** ** **** ** ****** * * *** ***
Submittal Fee $ O� Permit Fee $ /t 0 CCF $
Scanning Fee $ Radon Fee $ DBPR $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
CO /CC $
Bond $
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 absence of such posted notice, the
inspection will not be appr, and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 1V1/4
day of QJIL , 20 l3, by C6' trAfAitiar
who is personally known toJae or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
Signatur
ontractor -
The fore oing in trument was acknowledged before me this 1:3
day of ,20t3 ,by i' d rbO _ 1
_personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLJC&„
Sign:
Print Ibru�. rt a
My Commission Expires: f? NOT �� , L4
t�lr?°
o• %, Gabri
z `cord
li
a Carder
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Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
* * * * * * **
Zoning
Clerk