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PLC-15-334f e Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234388 Scheduled Inspection Date: June 04, 2015 Inspector: Diaz, Osvaldo Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138-0000 Project: BARRY UNIVERSITY Permit Number: PLC -2-15-334 Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1121360000050 Contractor: MARLIN PLUMBING OF MIAMI INC Phone: 305-652-6108 rswiamg uepanment comments REPLACE 2" PVB BACKFLOW ASSEMBLY INSPECTOR COMMENTS False spector Comments Passed CREATED AS REINSPECTION FOR INSP-228311. Failed Correction � 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 8 of 28 Y Backflow Prevention Assembly Test Report Test Confirmation # Unsubmitted 0 I certify the above test is accurate and true, to the best of my ability. I also understand that under Miami -Dade ElCounty 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 Manufacturer: WATTS Address: 11300 N MIAMI AVE Hazard ID: 2131656 Model: 800M4 QT Company: BARRY UNIVERSITY Meter #: 04421461 Type: PVB Location: Curb center northwest of hydrant 2 Serial #: 026914 Size: 2.00 Hazard: Did not Open ❑ Leaked ❑ 0 I certify the above test is accurate and true, to the best of my ability. I also understand that under Miami -Dade ElCounty 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 04/13/2015 Did not Open ❑ Leaked ❑ Leaked ❑ Closed Tight Closed Tight ❑ Did not Open Opened at 3.2 PSID❑ Pass Fail X❑ ❑ Held at Held at PSID Opened CHECK VALVE PSID at PSID 1:1Leaked Held at 1.8 PSID Repairs Comments: ❑ Cleaned ❑ Rubber Kit ❑ Rebuild Final Test Check Valve #1 Check Valve #2 Relief Valve AIR INLET Opened at 3.2 PSID 04/13/2015 Pass Fail Closed Tight ❑ Closed Tight ❑ CHECK VALVE X❑ ❑ Held at PSID Held at PSID Opened at PSID Held at 1.8 PSID 0 I certify the above test is accurate and true, to the best of my ability. I also understand that under Miami -Dade ElCounty 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 r 4 016 21 to 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 0 FBC 20 ICS Master Permit S39 Sub Permit No ❑ REVISION ❑ EXTENSION ❑RENEWAL OPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11300 NE 2 AVENUE Al W P/.��'�s'T,�/7"`�s1�.�C.; 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"�TTo'o Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): BARRY UNIVERSITY INC Phone#.305-899-3797 Address: 11300 NE 2ND AVE City: MIAMI SHORES 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: 33179 Qualifier Name: EDWARD WALKER Phone#: 305-652-3031 State Certification or Registration #: CFC048292 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 980.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: REPLACE 2" PVB BACKFLOW ASSEMBLY Specify color of color thru tile: Submittal Fee $ Permit Fee $ Id dl yy CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ _ (Revised02/24/2014) 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. JJA1116A &AAt Signature Signature OWNER or AGENT TRACTOR The foregoing instrument was acknowledged before me this day,of 20 /5 , by J`d.34�7 /w(o is personally known to me or who has produced The foregoing instrument was acknowledged before me this 4—dayof l-6rap--zq .201.5 by &Lbx,J T%AtaI Iles who is personally known to 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 •, , , Sign: Print:Print: ark CL - Seal: .� � yY �MT��y#fiF WWW Seal: r a 1Mu XF Nay Pd* LMNXDW o � n s'� THERESA MCCREERY Notary Public • State of Flotklit will NQ.1 -5 Commisabn it FF 070887 APPROVED BY Z '! �/� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)