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PLC-15-333Ar Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234386 Permit Number: PLC -2-15-333 Scheduled Inspection Date: June 04, 2015 Permit Type: Plumbing - Commercial Inspector: Diaz, Osvaldo Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138-0000 Project: <NONE> Phone Number Parcel Number 1121360000050 Contractor: MARLIN PLUMBING OF MIAMI INC Phone: 305-652-6108 duuaing uepartment comments REPLACE 2" RPZ BACKFLOW + CERTIFY. Infractio Passed Comments INSPECTOR COMMENTS False NE 11 5S ENTRANCE nspector Comments Passed CREATED AS REINSPECTION FOR INSP-228302. BY CONTRACTOR Failed � J� Correction S' Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. June 03, 2015 For Inspections please call: (305)762-4949 Page 6 of 28 Address: 320 NW 115TH ST Company: BARRY UNIVERSITY Location: Curb NORTHSIDE OF PROPERTY Hazard: Hazard ID: 2032745 Meter #: 09400000 Serial #: 3872435 Backflow Prevention Assembly Test Report Test Confirmation # Unsubmitted Manufacturer: WILKENS Model: 975XL2 Type: RP Size: 2.00 ❑ I certify the above test is accurate and true, to the best of my ability. I also understand that under Miami -Dade ❑County Code, the penalty for submitting a false or fraudulent test report is a fine of $1,000. I understand that improperly completed reports will not be accepted. ❑ I certify the backflow prevention assembly is properly installed. All discrepancies, if any, have been noted. Tester Tester # Test Kit RAUL BRINGAS H03023 491989 Reduced Pressure Principle Assembly PVB/SVB Double Check Valve Assembly Initial Test Check Valve #1 Check Valve #2 Relief Valve AIR INLET 04/09/2015 Did not Open ❑ Leaked ❑ Leaked ❑ Pass Fail Closed Tight ElClosed Tight El Did Did not Open ❑ at PSID ❑ ❑ Held 7.8 Held at 2.4 CHECK VALVE at PSID PSID Opened at 2.2 PSID Leaked ❑ Held at PSID Repairs Comments: ❑ Cleaned ❑ Rubber Kit ❑ Rebuild Final Test Check Valve #1 Check Valve #2 Relief Valve AIR INLET Opened at PSID 04/09/2015 Pass Fail Closed Tight ❑ Closed Tight ❑ CHECK VALVE ❑ ❑ Held at 7.8 PSID Held at 2.4 PSID Opened at 2.2 PSID Held at PSID ❑ I certify the above test is accurate and true, to the best of my ability. I also understand that under Miami -Dade ❑County Code, the penalty for submitting a false or fraudulent test report is a fine of $1,000. I understand that improperly completed reports will not be accepted. ❑ I certify the backflow prevention assembly is properly installed. All discrepancies, if any, have been noted. Tester Tester # Test Kit RAUL BRINGAS H03023 491989 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑BUILDING ❑ ELECTRIC ❑ ROOFING 2015 � FBC 20 1Q Master Permit No. r � iE - Sub Permit No ❑ REVISION ❑ EXTENSION ❑RENEWAL 70PLUMBING ❑ MECHANICAL EJPUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11300 NE 2 AVENUE L' /�� 71;r g:N/7'4e4e City: Miami Shores • County: Miami Dade Zip: Folio/Parcel#:1121360010160-26 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: REPLACE B#FT.VT .ca�ll�ne: BFE: FFE: OWNER: Name (Fee Simple Titleholder): BARRY UNIVERSITY INC Phone#.305-899-3797 Address: 11300 NE 2ND AVE City: MIAMI SHORES -Qmo� I - - — State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: MARLIN PLUMBING OF MIAMI, INC Phone#: 305-652-3031 Address: 20145 NE 16 PLACE City: NORTH MIAMI BEACH State: FL Zip: 925 Ill Qualifier Name: i(el —13� Wy l k of Phone#: 305'069' 310? r State Certification or Registration #: F.�FCocflg ag 3, Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $_' 6 a DD Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ®❑ New D Repair/Replace ❑ Demolition Description of Work: RI`` l a 2-'1�. T � &ck-Pj � + �P 14 Specify color of color thru tile:. Submittal Fee Scanning Fee $ Permit Fee $ P V 1 1-11 CCF $ CO/CC $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. JY1111A SignatureSignatur OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 9 day of 20 4^by 4 day of _ 20 IS by 7i0- q— who is personally known to J")yrcf 3 who is personally known to me or who has produced as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: as Si- Ce i Sign Print: Print: f Seal: = WOOMMSM#11EOM600 Seal: F) MQIE& AWR e' AMG�.•;`►n'r'^iie4 - t o tAw 1. i THERESA MCCREERY $. A Notary Public - State of Florida 3 x�*�*m*�*xw��**�m�x*r�*x**x+�***+x*x�ww�**wm�xw*w**�*�**wr****� * C�>•>�I$�>Q�lii>��7� sx�w�rx*r� ommisWon / FF 070897 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)