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PL-13-2093
F_ Inspection Worksheet � Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-199201 Permit Number: PL-9-13-2093 Scheduled Inspection Date: October 08, 2013 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: , Work Classification: Sprinkler System Job Address:9501 NE 2 Avenue Miami Shores, FL 33138- Phone Number (305)756-3711 Parcel Number 1132060133920 Project: <NONE> Contractor: AFFORDABLE IRRIGATION, INC Phone: 305-681-6322 Building Department Comments IRRIGATION SYSTEM INSTALLATION Infractio Passed Comments INSPECTOR COMMENTS False I I Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 07,2013 For Inspections please call: (305)762-4949 Page 17 of 34 T- 10/08/2013 08:13 3054610121 PAGE 01 RECEIVED 10/06/2013 0Q:77 3054610121 Oct. 08 2013 9:37 MRC Pldxj A Bad.Row 345 273 6181 page 1 IVNAMI-DAWE WATER&SEWER DEPARTMENT METER OPERTATIQNS 8:MAINTENANCE MU M CROWONNECTION CONTROL UNIT 1 001 N.W,lith STREET,MIAMI,FL.331362209 Phone(305)5474M Pax(78q2884015 BACKFLCWIf PREVENTION ASSEMBLY TEST REPORT FORM Anomsopw= 9501 NW 2nd Ave, Miami Shores Fl 0"11R1'F11E1r&F.: NEW Inrtd4&n OWNERCOWACT:NeW hobton f Agxdabie lmgaW Ma.nw PRoNa;3058815922 FAx 3D5 W18321 ADDRMOFOWNM SAYE 7�CQOE:33138 NorzariE3Ta R(tiiERTOCCILIAZ t CERTIMATIGN N:HOM EXP9iAlI0NDATE: 09•w* PHONE.::=37361011 oWNW4 NAA$I=PLUMBING 8 BACiisr OW,INC. "NESSADWASS:P.O.BOX 83=1 MIAMI,Ft Lf'cc>ae X288 3 lTEsr wr MAicL-W DATE LW Ok. N E TUSe 01-29.2013 YES I NO MAtF OF ASSEM3LY:YpILM MdC>Et NQ 7 QA &L ALfE.T187584 O'584 LOGAT(N D:As SiEy South of the Building AIM. MB MID MIALTEri: X— ANNUALTE$T: 13ATEOFlES11111 -203 t ta:urrAruaven• sxurOfsVAlyasr. • CiA6[DT)GHr CLOSE iHT: UNERRESSURE:62 PRESSURE$TA K1;:�-NO a MINIM LFAt(EL1: LEA+�D: CHECK VALVE NO.t CHECIf VJ1111E ND.2 DIFFERENTIAL RELIEF VALVE A NINLET CHECKYALVE g� FMMTOC}PBJ:_ '—.- 1'% R�,+IQSPrCI Tght: Closed Tir�ht: FAILED TddP�N: „ ILU- Leaked: Leaked: OPENED AT: HEM AT; PnESSUR6OIfFBtENTWiACROSSGHECC PRE$suk�0}fFERE;rtr:aLACR453t,I•ECIt PSI �PSI OPENED AT: � 4.6 Psi 3,2 PSI RWBWAO .s 1 ptm"FOR FALURE OF APB RWT} ..:p;�,:e:. .,�. .;;����t:��tP'ai '•r:ITT fix. ,t���1�, r 7,a�'�' i _Gp i:k CIElWE6: CLEANED: CLEANE : CIFIWED; CL R£PJ.ACEU: REPLACED: REPLACED: REPLACED. LU a...n-'LL':'•iu•• l�:=,a" 'i m•:� a��, `� _ r CHECKVALVENO.i CHECK VALVENO.7 AIRjMff UKKVALVE ClowdTight: _-- _ Closed Tight: FAILEDTepPEtt: rA1L�TDOPtN_ LEAKED.— `~ OPENED AT: HELD AT: Leaked; Leaked: _ FF40UFWWFEWPALACR0S8CHWA PRESSURE DWFERENTrALAGR0SSpW-CIC OPENEDAT; P61 Pat PSi PSI PSI �,'T •. SIGMA RE CIF CERTIFIED TESTER: DATE-8-03-2013 NOT TEST FCIRM MUST SE COMPLETED IN ITS ENTIRETY. INCOMPLETE TEST FORMS WILL BE RETURNED. Ravi : 512772010 a-mail: CCC @miamidnde,Sov Web: 'wwW.miamidade.govlwaadtcron connecUon.asp . Miami Shores Village YTVED Building Department SEP 16 2013 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 I INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 BUILDING Permit No.C F1_ o—2 PERMIT APPLICATION Master Permit No G�:"C�/�• � �¢' a Permit Type: PLUMBING C)�A JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes_ NO f Flood Zone: OWNER:Name(Fee Simple Titleholder): Phone#: Address: ty: p: �l E Ci ® -State: Zi _ Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: '` Phone#(33 S Address: g��!/�Gr/ ,�3, City:—^z"0;W State: Zip: Qualifier Name:/OAe;;C J' f Phone#: State Certification or Registration#: Certificate of Competency#: Contact Phone#. ,3&V 4 '/-63 Z Z- Email Address: z"I'aga,1021 d. GG- ..ce,�-r- 7 DESIGNER;,Architect/Engineer: Phone#: .a, value of Work for this Permit:$ Square/Linear Footage of Work: Type of'Work: DAddressAlteration ONew ORepair/Replace ODemolition Description of Work: 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$ I Ll L4 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 inspe 7) days after the building permit is issued. In the absence of such posted notice, the inspect, of be a ed and a reinspec fee will be charged. Signatur Signature O or g t Contractor The fore ing' trument was ac owled ed befo MM"yof s, The foregoing instrument was acknowledged before me this�(p day of ,20 L,by ,20/3,by_�'fo,lrt,. who, ersosaiigown to a or who has produced who is personally known to me or who has produced As identification and who did take an o as identification and who did take an oath. NOTARY IC: �o�\o�,aQ,S N TARYPUB "� JORGE T01EDo n o 2 + N1Y 00aIISStatd#EE 224678 Sign: 1�0 a�Pss° i' � �` amdo 9 2u,201t& Print' My Commission Expires: =C v r o aea My Co -ssion Expires: E S lgTE 'ICQCBC�C1Y7YtYSY�H:iY�C�C�:�:�:k:Y1YeYaY4C&'7Y:t���9c9e 9[dC9enYeY��*eYo4���Yk�:�CtYYC�C�Y�C�G�t�tLY�::Y:Y�YIY�C�'IC'A��G�Y�Y3.'LYR'R'�C�?3C�:�E'�G�::�LF�:F'�.'�:Y�G SY'ICSY�'SF SY�I��C�C�C�F�:�C�C�C�l�' APPROVED BY Val"-13 Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) '4`°R°® CERTIFICATE OF LIABILITY INSURANCE 9//12/12/D 201 3 IDD/Y3 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 CONTACT NAME: Nancy Munoz Brown & Brown of Florida, Inc. PHONE (305)247-5121 o:(305)246-8543 dba T.R. Jones & Co. E-MAIL ApogEss: I' 1780 N Krome Ave INSURER(S) AFFORDING COVERAGE NAIL# Homestead FL 33030 INSURERA:Scottsdale Insurance Company 41297 INSURED INSURER B: Affordable Irrigation, Inc. INSURERC: P.O. Box 601743 INSURER D: INSURER E: No Miami Beach FL 33160-1743 INSURER F: COVERAGES CERTIFICATE NUMBER:2013 Master REVISION NUMBER: 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD M/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 A CLAIMS-MADE Fx-1 OCCUR OPS1819164 9/12/2013 9/12/2014 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMINNE SINGLEuRrr $ (E,accdent)ANY AUTO BODILY INJURY(Per person) $ ALL ED AUTOS SCHEDULED OS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAJMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY Y/N TORYLIMITSIL ANY PROPRIE'rOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ -T DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,I more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2 Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Hamilton Jones/NAM4= Jr i i ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(2olow).ol The ACORD name and logo are registered marks of ACORD