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PLC-12-2373 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 a � Inspection Number: INSP-187382 Permit Number: PLC-12-12-2373 Scheduled Inspection Date: March 14,2013 Permit Type: Plumbing -Commercial Inspector: Hernandez,Rafael Inspection Type: Final Owner: ,BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address: 11300 NE 2 Avenue Wiegand&Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: RINGEMANN PLUMBING SERVICE INC Building Department Comments INSTALL FIXTURES Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-183027. NEED TCO SIGNATURE CARD Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 13,2013 For Inspections please call: (305)762-4949 Page 30 of 37 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-183027 Permit Number: PLC-12-12-2373 Scheduled Inspection Date: March 06,2013 Permit Type: Plumbing - Commercial Inspector: Hernandez, Rafael Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address:11300 NE 2 Avenue Wiegand&Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: RINGEMANN PLUMBING SERVICE INC Building Department Comments INSTALL FIXTURES Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed ❑ Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 05,2013 For Inspections please call: (305)762-4949 Page 16 of 43 Miami Shores Village yul Building Department ���011 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ' 7-,-- Tel:(305)795.2204 Fax:(305)756.8972 - INSPECTION'S PHONE NUMBER:(305)762.4949 �- - FBC 20 AD BUILDING Permit No. PERMIT APPLICATION Master Permit No.(!!�C Permit Type: PLUMBING JOB ADDRESS: w (n City: Miami Shores County: Miami Dade ----.Zip: r lQ2 1 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): '�wt`'� �``� V g``,+}�a Phone#:Sn - Address:it?)CO, ��; �'�' f�\4,e, City: Stater Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ,+ t'�"Y Ott l�l )` r i Yl�:_ i U rtl�- � Phone#: 5- Address: City: f C,4-YA t State: Zip: ( ° Qualifier Name: PDX- - ed^�� �' C'�i 1 f`+ Phone#: State Certification or Registration#: Certificate of Competency#: Li,Contact Phone#:- =�' )��� �� Email Address: .�1 U 1i 1�1( 'i� �1�l'R • Co-V-1 Architect/Engineer:Vl�Cw'1\.ee-I ���L�`,; �`i �V 6600 LQ+eft Phone#:CF-�LV"'X-`1^ (0%C�0 Value of Work for this Permit:$ Z!0 ac Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration f fNew ❑Repair/Replace ❑Demolition Description of Work: % n't x��x�x�xFees�x�x�x��x��x�x��x�x�x��x�x���x�x�x��x�x��x�x�x�x�x�x�x�xx��x�x��x��x�x�x�x��x 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$ 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 roust 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 and inspection 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 this f�14 day of® � 20 A2,by RQM(� �e4�l0S day of 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: Sign: Sign: -/ Print: a Print: L,i C�e�, a/0 My R �. y M Co MYCOM IISS1oN#EEMR9 M %�PSMERCADO Y PUBLIC ExputEs:November 12,2014 STATE OF FLORIDA m.Na"DbowM o ca Comm#DD929580 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)