PLC-12-1957 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL 1
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-180222 Permit Number: PLC-10-12-1957
Scheduled Inspection Date:January 14,2013 Permit Type: Plumbing-Commercial
Inspector: Bruhn, Norman Inspection Type: Final
Owner: ,BARRY UNIVERSITY Work Classification: Addition/Alteration
Job Address:11300 NE 2 Avenue Nat&Health Sc
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 1121360010160-08
Project: BARRY UNIVERSITY
Contractor: RINGEMANN PLUMBING SERVICE INC
Building Department Comments
REWORKING COMPRESSED AIR, VACCUM,WATER ANC Infractio Passed Comments
GAS INSPECTOR COMMENTS False
i
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 11,2013 For Inspections please call: (305)762-4949 Page 3 of 33
Miami Shores Village ®CT 8 20,
r
Buildin g Department
artment 4,
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 2 l0 J ii rg
BUILDING Permit No. 1
PERMIT APPLICATION Master Permit No.C-C
Permit Type:PLUMBING
JOB ADDRESS: ii300 WE 2"0
City: Miami Shores
County:__ Miami Dade Zip: 3 31(p l
Folio/Parcel#:
Is the Building Historically Designated:Yen NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): f;otR2'4 VWiVS.t?-SJT{ Phone#:-- 61.'-j00p
Address:- 613®® NE Jq A v eAk4.,.e,
City:_ t tx VU i S4&cr State: - zip: 3 3 t0
TenandLessee Name: Phone#:
Email:
CONTRACTOR:Company Name: #re#:
Address uk-t L---)(-4-
City: is t —State: —tof -ir I L+�-
Qualifier Name: U .........
one
State Certification or Registration# Certificate of Competency#:
Contact Phone#: -Q0--25m— 'k4 5 t CO Email Address:_1�Q(�l ri ae' mcP o o corn
DESIGNER:Architect/Engineer a."tt n.CLLC�/S� �,pC� S Phone#: � °4 1° (o0o&
� G�Ic1
Value of Work for this Permit: 1 Square/Linear Footage of Work: I y o SF
Type of Work: ❑Address OAlteration JdNew ORepair/Replace dDemolition
lDw pQonof work:-- ii ,C-A * 'Kl LOY0 CM, OF 9 emoCezi !kiz"66 La-bs-
-- --- --------i QV l'i C rn rfe554 a i r VaCev-ki t,.q e- q mA a$
a �h 1 a r Q • h r+o �q er /A� S u c.,�
Submittal Fee$ Permit Fee$ 11 �`t1 CCF$ CO/CC$
Scanning Fee$ Radon Fee$2_1
t -5-'DBPR$ Bond$
Notary$ Trabdrig/Education Fee$ Technology Fee$
Doable Fee$ Structural Review$
TOTAL FEE NOW DUE$
10164A I
4
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 ag indicated. I certify that no work or installation has
commenced prior to the is.%uance 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 jab 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 approveda4d a reinspection fee will be charged
Signature kgLL Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this,_ The foregoing instrument was acknowledged before me this
day of�° ?,201 ,by A Ls�-.��� ��° _ day of o by.._ ..Q id?����_.
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
� LEIDA MERCA O
Sign: !'J Sign:
Print: t:
STATE OF FLORID
My Commission Expires: ►+°'"+ 1 �� My Commis ire xpires 1/27/2014
X12014
M
ll
APPROVED BY �i�, `v Plans Examiner Zoning
Structural Review Clerk
(Rcvised3/12/2112)(Revtsed 07/1=7)(Reviscd(W10/M)( *sW 3/151119)
I