MC-13-1286 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-193248 Permit Number: MC-6-13-1286
Inspection Date: August 23,2013 Permit Type: Mechanical- Commercial
Inspector: Perez,JanPierre Inspection Type: gh-Bttet-
Owner: , BARRY UNIVERSITY Work Classification: Addition/A teration
Job Address:11300 NE 2 Avenue Powers Building �kl
Miami Shores, FL 33138-0000
Phone Number
Parcel Number 1121360010160-20
Project: BARRY UNIVERSITY
Contractor: TRIUMPH AC& REFRIGERATION CORP Phone: (786)512-0548
Building Department Comments
DIVIDE EXISTING CONFERENCE ROOM INTO 2 OFFICE Infractio Passed Comments
2 GRILLS AND PIECE OF FLEX INSPECTOR COMMENTS False
v� G
3
Inspector Comments
Passed CANCELLED AS PER INSPECTOR
Failed
Correction
�V v
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
August 26,2013 Page 1 of 1
I
Miami Shores Village _ -- -
Building Department JUN 10 2013
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 20 l-0
BUILDING Permit No.M C y
PERMIT APPLICATION Master Permit No. �
Permit Tnw:MECHANICAL
JOB ADDRESS: 11300 NE 2nd Avenue(Powers Hall Conference Room 147)
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2136-000-0050
Is the Building Historically Designated:Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder):Barry University, Inc. Phone#:305-899-4059
Address;11300 NE 2nd Avenue
City: Miami Shores State: Florida gip; 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Triumph AC&Refrigeration, Inc. phone#; 786-512-0548
Address: 8821 NW 112th Terrace
City: Hialeah Gradens State: Florida Zip; 33018
Qualifier Name: A iel Jimenez Phone#: 786-512-0548
State Certification or Registration#: CAC1816229 Certificate of Competency#:
Contact Phone#: 786-512-0548 Email Address:
DESIGNER:Architect/Engineer: Synalovski, Romanik, Saye Phone#:
Value of Work for this Permit:$,500 Square/Ligear Footage of Work.. 380
Type of Work: DAddress OAlteration ONew ORepair/Replace ODemolition
Description of Work: Divide Existing Conference Room into 2 Offices 0 7 _
Submittal Fee$ Permit Fee$ I CJ 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) NA
Bonding Company's Address
City State zip
Mortgage Lender's Name(if applicable) NA
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 l' law brochure will be delivered to the person
whose properly is subject to attachment. Also, a certified copy of the recorded notice o co encement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issue 1 i he absence of such posted notice, the
inspection will not be approve a reinspection fee will be charged
Signature Signature
Owner or Agent AI�Contractor
The foregoing instrument was acknowledged before me this-�Yd The foregoing instrument was acknowledged More me thi
day of A ,20, ,by l 4AAL/J ° , day of 20 a by
who is personally known to me or who has produced who isep("ally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY UBLIC: NOTARY PUBLIC:
Sign: Sign
Print: JAO Print: f2abyltu, N,
My Commission Expires: E�1800WWARY i� I Y J.YA® My Commission �A Nota a Roir Florida
EXPUtES:Novtogm M 2014 My Commfe Wi E 193489
R r Vista-Asm co. �t��o F�cpires MOWS o0 � 9oa�o1«9999
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APPROVED BY Plans Examiner Zoning
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Structural Review Clerk
Revised 3/1212012)(Revised W/10/07)(Revised 06/10/2009)(Revised 3/15/09)
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CERTIFICATE OF LIABILITY INSURANCE ""'°°""'"'
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THIS CERTIFI TE E=I=AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NOLDER THE
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CERTIFICATE HOLDER CANCELLATION
RIRO A D ANY OF THEAIOVE DESCMM POUCES BE CANOE MO BEFORE
MIAh§SHORES VILLAGE THE W11PIRATIAN DATE 1WERIM,NOTICE W LL BE OELIVERt°JD IN
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MIAMI SHORES,FL 33138
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ACORD 25(20101"OF The ACORD mama and I*"am ra&twW marks of ACORD
AC# 6185496 STATE OF FLORIDA
DEPARTICNT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD §E0#L1207050065'
DATE BATCH NUMBER LTCEI+TSE NS
0-7/05/2012 1727000514 7C7C1816229
The CLASS H AIR CONDITIONING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date.: AUG 31, 2014
JIMENEZ, ARIEL
TRIUMPH AC & REFRIGERATION CORP
88.21 NW 112TH TER
H.I-ALEAH GARDENS FL 33018
RICK SCOTT KEN LAWSON
GOVERNOR SECRETARY
DISPLAY AS REQUIRED BY LAW
'c193 PA!C E .20'92 LOCAL BUSINESS TAX RECEIPT 2093 FIRST-t'LAS
140 W.FLAGLER ST. EXPIRES SEPT.30,2013 PAO
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