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
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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)