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PLC-12-1964 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (306)795-2204 Fax:(305)759.8972 Inspection Number: INSP-192034 Permit Number: PLC-10-12-1964 Scheduled Inspection Date: May 29,2013 Inspector: Hernandez,Rafael Permit Type: Plumbing- Commercial Inspection Type: Final Owner: , BARRY UNIVERSITY .,., k Work Classification: Addition/Alteration Job Address:11300 NE 2 Avenue Wlegand&Annex Miami Shores,FL 33138-0000 Phone Number Project: BARRY UNIVERSITY parcel Number 1121360010160-09 Contractor: RINGEMANN PLUMBING SERVICE INC Building Department Comments ADD NEW CHEMICAL STOCK ROOM NEW PLUMBING Infractio Passed Comments FOR GAS AND COMPRESS AIR EQUIPMENT INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-180256. 1. PROVIDE RPZ CERTIFICATION, 2. PROVIDE GAS DROP TEST. $.CONNECT POWER TO GAS SECOND VALVE. Failed 4. 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'9 4 4 Miami Shores Village - - Building Department OCT 182012 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 _ INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING - " Permit No. ��� I PERMIT APPLICATION Master Permit No.Gc FBC 20 (D Permit Type: PLUMBING OWNER:Name(Fee Simple Titleholder):--J Q P-4 L) g JI; a 1f Phone#:30 Address:_ c)o N c-, 1'.. � k/F- I G�-A)V D y City: h 1 la,Mi S ho A'cs State: t L Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS:_ 113 00 C 2- (A)0 (28 N City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: t'l (1 �VC Phone#:W5-Qo� Address:nd' L.l> City: `4- lam t State: FL— Zip: Qualifier Name: Pa Q • �� +(Z Phone#• State Certification or Registration#: ;:14(dU( Certificate of Competency#: Contact Phone#:'GM��KP Email Address: Muk f-� �1�C��. Corte DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ (Sfusq Footage of Work: 4oy L' Type of Work: ❑Address OAlteration ONew ORepair/Replace ODemolition Description of Work: _ >� Gc°��3,rve�1-+cwt or S 4ed- @ R&WORK O'is T W& 60.19w(- 900M I'S AN,D LU:5Z4e.(.. PC-ty EvM61a60 6.4s.., ARO ConfieTSM AA. Pf Q f!U�Ph i-T (N /UC'w q&)c-0iAJ, 2ND r TDQN Submittal Fee$ Permit Fee$_ � 6�Ya CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ a TOTAL FEE NOW DUE$ 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." i 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. Signature Signature—/� Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me thizo day of ,20/ ,by �, ( � c �4c%>?z. day o 201 L,by`%rd�A'Af-1P W A 4 4, who is person Hy known to mfr 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: a � *0'*'Cr Sign: — Sign:Print rids Print• NOTARY PUBLIC cheryi Saida Gerber My Commission Expires: ® My Commiss an DD96612e My Com D1�S29880 Expires 05108/2014 xpits 1 Z$7Z014 �ksk�ksk�k�kKa�sMsxs�kala�k�bsk�k+kk+k%+*�k�k�c�kx�� �k�kss�k+k�k+k�ksk�ksk�A�k�k+k+k�a�k�k+k�k��k�ksksk+RSa�k�k�Rsk�R�h�k�k+k�k�k�k�ke�ke�ksk�k+&sk�k+k+k�ke�Rdsd��k+k+x#�+k+k�k�k�k�d�d�sk+k�k*� k+k�k+ke�k�k APPROVED BY l' �7' Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)