PL-13-1564 08-28-'13 06:37 FROM- T-701 P0003/0017 F-970
Inspection Workshsst
014mi.6h.0re.s.Village
10050 NA InO AvAnvo Itiilaraj',lrtoltes,1=1r
pllne:( Q )7821?4 �a(. t {IIS►}7d "$ 7Z
Inspection•Number: INSP='I9646.7 Permit Number: RL-.?.4. 34 504
Scheduled Inspection Date:Au0pst 37,.09
Inspector I�lax,Osvaldo Permit Type: !"luiintiing-Resldsntial
Inspection 'hypes Final
Owner: FRANKILK TRAOY Wor k-Claarp IffC.A.i0R: Cas
.Job Address':17 NE 100$fMeet
Miami Shores,FL 33938-
Phone Number (017)8�4*02
Project: <NONF> Pgrcel Number i13.20$QW430'
Contractor: ORON`I'OPL.VM61140 INC' Ph+ptte:(605).07 =7x55
Muiltling Depart Mi ent Cornmen4s
PLUMBING GAS FOIE GENERATOR af+a tl�' vasse-2 comments
INSRECTOR MMME 5 False
InspOtpr CQmmetft
Passed ®k- �
Failed El 13
Correction
Needed
lie-ln�p�ctiot� ❑
Fee
No Additional inspections,can be scheduled ur it
re-inspection fee Is pold.
Augtjst 26,2048 For Inspeations please call: (305)7624949
Page 16 of 38
08-28-'13 06:38 FROM- T-701 P0004/0017 F-970
i 1 �
BRADFORD PLUNUMNG LLC. (305)871-3094
CFC 041673,LPG 14007$ - :;:y fox(305)876-4254
BACK flow tcskr 0 X.12-983507 .a•
www bradfordpinmbing cem
39$0 North West 64 avenue '
VkOinia gardens,if.33166--6910
Wednesday,August 21,2013
Job=Tracy Zazadae TEL#917 826 6492
77 N.E. 100stmt
Miami Spore!FL,33138
Permit# 7--/3
This gas job was done by Pronto plumbing they passed pressure test I
conducted drop test
Tine it takes to test/hook up each gas fixture pressure test results
30 pound pressure test required for pressure test inspection
start date and date did it hold yes i--�no _ if no was it
fined yes no reason
Did it pass inspection yes r/ no inspection date*Z/0
FOR REPAIR WORK ONLY was the test done on each Second-stage,and or single
stage?
Date_ _ -first stage start time. end time S.prig. Finish
psig W.C. did it pass-yes no
211d stage Pressure Test=Test Date. 17 star#time. i.finish time., _df loth
did it pass-yes_no psig./ In. VVC. :�4fuus ied psig.Or/W.C.
Regulator operation
Date code mfr. model# flow pressure
in WC.Lockup presser: in WC.
Second stage:date code mfr model# flow
DROP TEST WAS DONE ON CONPLETE SYSTEM
.Lock up Pressure in WC. 11W TEST STARTED Date
Time of Day test duration=5 minutes
SAFTY CHECK
Pimfom ,ed gas appliance system check,yes Tito
Clearly explained the operation of the gas appliance system to customer,yes �no
Clearly explained service work to the customer yes ono_
Showed customer how to shut off gas in case of an Emergency yes I,,,"no
Left customer safety information yes r/no
I certify, all above tests have been completed as prescribed
`� -�'twl signed by tech David Bradford
Sighed by customer Date
Miami Shores Village
A
Building Department
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
BUIELI)114G l Permit No. I 1 —15
PERMIT APPLICATION Master Permit No. �
Permit Type: PLUMBING
JOB ADDRESS: -77 N6 I®0
City: Miami Shores County: Miami Dade Zip: 3313.E
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): C �` ®✓ Phone#: J 7
Address: 72 1l/ -e- ry
City: d l �State: Zip: �?3 S
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#:( ® L''7 z J
Address:
City: State: Zip:
i
Qualifier Name: Phone# 0
State Certification or Registration#: & to of Competency#:
Contact Phone#: Email Address:
a—•
DESIGNER:Architect(Engineer: Phone#:
Value of Work for this Permit:$ �� 00 0 o 00 Square/Linear Footage of Work:
Type of Work: OAddress OAlteration ANew ORepair/Replace ODemolition
Description of Work:aD a:: ^ go ejaz6)–
Submittal Fee$ Permit Fee$ '/,S CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ � ' �
� `Y
i � � t Q
Bonding Company's Name(if applicable)
M
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such po d t' e, the
inspection will not be approved and a reinspection fee will be charged
n u
JI
Si Signature
Owner• Contractor
The forego' g instrument was acknowledged before me this�� The fore oinE* n;was ack nowledged before me this L—day of ,20 A3,by Thy 6�I 4 day of 0/1,by
ea ,
who is perso y known to me or who has produced a L— who is o to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: '" Sign:
Print: Print:
My Commission Expire My Commission Ex 4cF, Mille Perms of Florida
-VXf Notary Public State of Florida
Michelle Perez My Commission FF 000321
9 My Commission FF 000321 ov a°� Expires 04/08/2017
Expires 04108/2017
�S�sBsaAdwR�>ia���#84&ak��+�� ��siz�aeae8���ds�ssBs�$i��+���a�Rffi�aRaAB#�NtikIadaHaa4IaaR�ak��a4���IasR9RaR�HaR�tRde�$
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised3/1=012)(Revised 07 1101W)(Rmised 06110/2009)(Revised 3/15/09)