PLC-14-232Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 206789
Scheduled Inspection Date: February 26, 2014
Inspector: Diaz, Osvaldo
Owner: , CHARTER SCHOOL
Job Address: 11301 NW 5 Avenue
Miami Shores, FL 33138-
Project: DOCTORS CHARTER SCHOOL
Contractor:
THE NEW MIAMI SHORES PLUMBING
tsunamg uepanment comments
BACKFLOW INSTALLATION 3"
Permit Number: PLC -2 -14 -232
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number
INSPECTOR COMMENTS False
Inspector Comments
Passed 3 �r
Etc
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
112136000060
Phone: (305)751 -2446
February 25, 2014 For Inspections please call: (305)762 -4949 Page 19 of 28
Miami Shores Village
Buildin g Department
artment
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 APPLICATION
FBC 20
Permit Type: PLUMBING
Permit No.
0A
FEB 002014
Master Permit No. IPL.G 14 -3 Z
Owner's Name (Fee Simple Titleholder) �` l c o, e o M m I 3a)(9ne # 305 -1 q5 - 2-2 c)-+
Owner's Address 1() 0 5() N E 2- n d A�j C
City!j(O�rYI`1 cJ(1C�(� State T10 •ldG zip 33134
Tenant/Lessee Name Phone #
Email , L � CC D fi O V -_Y+�) 10 rn ► sy)�G f C S Y 1 I D G cu e' C Gm
DWO 's cnQ,i+U-. ® ®1
Job Address (where the work is being done) ICA L
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name
Contractor's Address n(
city, Nby-m
Qualifier Name n 1
ell A.
State Certificate or Registration No.
Contact Phoney 5- I -1414U
Certificate of Competency No. Q 1 q ZO
E -mail M S,P V I no �( � � � ° � ryl
Architect/Engineer's Name (if applicable). Phone #
Value of Work For this Permit $ Amp - ® ® Square / Linear Footage Of Work:
Type of Work: ❑Addition Alteration New ❑ Repair/Replace ep ❑ Demolition
Describe Work:
Submittal °° ° T,..-,_ <;°Perntib F' CCF $ CO /CC $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $,
DPBR
Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side ->
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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 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. I the absence of such posted notice, the
inspection will not be approved and reinspection fee will be charged.
Signature ! cY Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of `C' oin, 20 _q, by tC� e ,
who is personally known tome or who has produced
As identification and who did take an oath.
0%J11111 fillq,
.� • •. do''�,
�` 4� ''•. eye :.
My Commission Expires:
Contractor
The foregoing in;*r'ument was acknowledged before me this
day of I U a , 20 14, by QQ11ntS Mc,tal hll I�,
who is personally known to me or who has produced
as identification and who did take an oath.
APPROVED BY L %d'�4! Plans Examiner Zoning
Engineer
(Revised 07 /10 /07)(Revised 06/10/2009)
Clerk checked
/cam
le Model 375
` IN S Reduced Pressure Principle Assembly �r FEB
_ a zoo
Application
Designed for installation on potable water lines to protect
against both backsiphonage and backpressure of contami-
nated water into the potable water supply. The Model 375
provides protection where a potential health hazard exists.
Ideal for use where lead -free* valves are required
Standards Compliance
(Unless Otherwise Noted, Sizes 21/2° Thru 10')
• ASSEO Listed 1013
• IAPMO® Listed
• Certified to NSF /ANSI 372* by IAPMO R &T
• CSA® Certified (21/2" thru 8 ")
• AWWA Compliant C511, and C550
• FM® Approved
• UL® Classified
• C -UL® Classified
• NYC MEA 49 -01 -M Vol 2
• Approved by the Foundation for Cross Connection
Control and Hydraulic Research at the University of
Southern Califomia.
• NSF® Listed- Standard 61, Annex G*
*(0.25% MAX. WEIGHTED AVERAGE LEAD CONTENT)
Materials
Main valve body Ductile Iron ASTM A 536 Grade 4
Access covers Ductile Iron ASTM A 536 Grade 4
Coatings FDA Approved fusion epoxy finish
Internals Stainless steel, 300 Series
NORYLTm, NSF Listed
Fasteners Stainless Steel, 300 Series
Seal rings EPDM (FDA approved)
O -rings Buna Nitrile (FDA approved)
Springs Stainless Steel, 300 Series
Sensing line Stainless Steel, braided hose
Features
Sizes: 21/2 ", 3 ", 4 ", 6 ", 8 ", 10"
Maximum working water pressure 175 PSI
Maximum working water temperature 140 °F
Hydrostatic test pressure 350 PSI
End connections (Grooved for steel pipe) AWWA C606
(Flanged) ANSI 1316.1
Class 125
Relief Valve discharge port:
21/2"-6" - 2.75 sq. in.
8'- 10" - 3.69 sq. in.
Attention: Model 375 (flange body) and Model
375A (grooved body) have different lay lengths.
Dimensions & Weights (do not Include pkg.)
NMI
Options
(Suffixes can be combined)
❑ - with NRS shut -off valves (standard)
❑ FS - with cast iron wye type strainer (flanged only)
❑ FSC - with epoxy coated wyetype strainer(flanged only)
❑ G - with grooved end NRS gate valves
❑ GF - with grooved inlet gate connection and flanged
outlet gate connection
❑ FG - with flanged inlet gate connection and grooved
outlet gate connection
❑ L - less shut -off valves (flanged body connections)
❑ MS - with Integral Relief Valve Monitor Switch
❑ OSY - with OS&Y gate valves
❑ PI - with Post Indicator gate valve (3" -10 ")
❑ DOM - with Clow gate valves, 51 % Buy American
Act Compliant
Accessories
❑ Repair kit (rubber only)
❑ Thermal expansion tank (Model XT)
❑ OS & Y Gate valve tamper switch (OSY 40)
❑ Air gap (Model AG)
❑ Electronic Solenoid Timer (Model EST)
❑ QT-SET Quick Test Fitting Set
""�L 0--j
M
`` in anti,
Zum Industries, LLC I Wiildns
1747 Commerce Way, Paso Robles, CA U.S.A. 93446 Ph. 855 -663 -9876, Fax 805 -238 -5766
In Canada I Zurn Industries Limited
3544 Nashua Drive, Mississauga, Ontario L4V 1L2 Ph. 905 -405 -8272, Fax 905 -405 -1292
Rev. C
Date: 12/13
Document No. BF -375
Patent No. 5, 913, 331
Product No. Model 375
Page 1 of 2
DIMENSION (appro)imate)
WEIGHT
MODEL
375
SIZE
In. I mm
A
in. I mm
B LESS
GATE
VALVES
in. Imm
C
in. mm
D
in. Imm
E
OS&Y
OPEN
in. mm
E
OS&Y
CLOSED
in. Imm
E
NRS
GATE
in. Imm
F
in. Imm
G
in. Imm
H
in. Imm
VIATHOUr
GATE
VALVES
lbs. I kg
WITH
NRS
VALVES
lbs. kg
OSS&Y
ATE
VALVES
lbs. I k
212
65
31
787
157/8403
7114
184
3 3/4
95
16 3/8
416
137/835211
318
289
9 1/2
241
8313
1213
411/41048
60
272
16273.5
170
77.2
3
3
15 7!8
403
7114
184
3/4
95
18 718
479
15 5!8
397
12 3/8
314
91/2
241
.8313
213
42 3!
1086
60
272
184
83.5
190
86.3
4
191!2
495
8
203
1 /2114
22 3/4
578
18 114
464
14 314
375
11
279
9114
235
52 3/41340
98
44.5
278
1
288
130.8
6
t6O
!11'37
231/2
597
10
254
6
152
301!8
765
23 314
603
19
48312
3/8
314
103x4
273
62 314
1594
175
79.5
459
208.
475
2156
8
43
373/4
959
11
279
10
254
37 314
959
29 1/4
743
22 112
57215
3/8
391
163/4
426
85
2159
377
171
829
376.4
853
3873
10
1619
373/4
959
11
279
10
254
5 3/41162
35 3/8
899
26 1 /2
673153/8
391116341426193
114
2369
407
185
1167
530
1225
556
Zum Industries, LLC I Wiildns
1747 Commerce Way, Paso Robles, CA U.S.A. 93446 Ph. 855 -663 -9876, Fax 805 -238 -5766
In Canada I Zurn Industries Limited
3544 Nashua Drive, Mississauga, Ontario L4V 1L2 Ph. 905 -405 -8272, Fax 905 -405 -1292
Rev. C
Date: 12/13
Document No. BF -375
Patent No. 5, 913, 331
Product No. Model 375
Page 1 of 2
t
Flow Characteristics
MODEL 375 2112 ", 3" & 4" (STANDARD & METRIC)
FLOW RATES (Its)
0.0 12.6 25.2 37.9
W 20
15
10
H 5
0
O Rated Flow (established by approval agencies)
50.5
0 200 400 600
FLOW RATES (GPM)
MODEL 375 6 ", 8" & 10" (STANDARD & METRIC)
FLOW RATES p /s)
0.0 63.1 126.2 189.3
m 20
—i 15 ' (150mm) (200mm)
a 10
N v
5
a 0
0 1000 2000
FLOW RATES (GPM)
Typical Installation
Local codes shall govem installation requirements. Unless
otherwise specified, the assembly shall be mounted at a
minimum of 12" (305mm) and a maximum of 30" (762mm)
above adequate drains with sufficient side clearance for test-
ing and maintenance. The installation shall be made so that
no part of the unit can be submerged.
DIRECTION OF FLOW
INDOOR INSTALLATION (375GF)
3000
138 w
104
69
35
0 a.
800
252.4
138 co
104S
69 � a
35
0 a.
4000
Capacity thru Schedule 40 Pipe (GPM)
Pipe size
5 ft/sec
7.5 f tsec
10 ft/sec
15 fVsec
21/2"
75
112
149
224
3"
115
173
230
346
4"
198
298
397
595
6"
450
675
900
1351
8"
780
1169
1559
2339
10"
1229
1843
2458
3687
12"
1763
2644
3525
5288
-- — — — — — — — — — — — — — — — — — —
PROTECTIVE I
OUTDOOR INSTALLATION
Specifications
The Reduced Pressure Principle Backflow Prevention Assembly shall be certified to NSF /ANSI 372, ASSE® Listed 1013, and
supplied with full port gate valves. The main body and access cover shall be epoxy coated ductile iron (ASTM A 536 Grade
4), the seat ring and check valve shall be NORYLTm, the stem shall be stainless steel (ASTM A 276) and the seat disc elasto-
mers shall be EPDM. The checks and the relief valve shall be accessible for maintenance without removing the device from
the line. The Reduced Pressure Principle Backflow Prevention Assembly shall be a ZURN WILKINS Model 375.
Zum Industries, LLC I Willdns
1747 Commerce Way, Paso Robles, CA U.S.A. 93446 Ph. 855 -663 -9876, Fax 805 - 238 -5766
In Canada I Zum Industries Limited
3544 Nashua Drive, Mississauga, Ontario L4V 1 L2 Ph. 905- 405 -8272, Fax 905- 405 -1292
%VVWW.=M.00M
Page 2 of 2
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Approved
Disapproved
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i
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Date: �L ° 9 _ 2.3Z,
Permit No:
Plumbing Critique
Chief Plumbing Inspector -1.54 _ '5'->®z�'
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re- submittal drawings.
�a
ai
q � P�-A
Patty Perez
From: Nathalie [ nathalie @miamishoresplumbing.com]
Sent: Thursday, February 6, 2014 8:35 AM
To: 'Patty Perez'
Subject: FW: Backflow permit
From: Doug Garter [ mailto: GarberD @doctorscharterschool.org1
Sent: Thursday, February 06, 2014 8:33 AM
To: Nathalie
Subject: RE: Backflow permit
Nathalie: The owner of the school is the Village of Miami Shores.
Address -10050 NE 2nd Ave, Miami Shores, FL 33138
Phone — 305 -795 -2207
Email- bentont @miamishoresvillaee.com
D.<7.far"
-7tiferi" prind pae
Doctors O&Wer SeSoaB of AU"d Shores
From: Nathalie rmailto: nathalie @miamishoresplumbing.com]
Sent: Wednesday, February 05, 20141:20 PM
To: Doug Garber
Subject: Backflow permit
Good Afternoon Doug,
We need the following information on the owner of the school's property. Name, address, phone number, &
email.
Thanks,
Nathalie Fernandez
Miami Shores Plumbing, INC.
1