PLC-15-101 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-226634 Permit Number: PLC-1-15-101
Scheduled Inspection Date: January 22,2015 Permit Type: Plumbing - Commercial
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: , BARRY UNIVERSITY Work Classification: Gas
Job Address: 11300 NE 2 Avenue Thompson Hall
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 1121360010160-02
Project: BARRY UNIVERSITY
Contractor: GO PLUMBING INC Phone: (954)554-1780
Building Department Comments
Infractio Passed Comments
REMEDIAL GAS WORK. INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
22s�
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 21,2015 For Inspections please call: (305)762-4949 Page 17 of 29
Miami Shores Village TZE E �
Building Department JAN 15
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel: (305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20(
BUILDING Master Permit No.0-0—` 1 �-f' �
PERMIT APPLICATION Sub Permit No. `� 4� 0
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP
CONTRACTOR It DRAWINGS
JOB ADDRESS: /V L= z AV 14�t�, .RI 19 �E gta C �S�-
�
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
i
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
i
OWNER: Name(Fee Simple,Titleholder): �w _�;VC-1'r>.J Ty Phone#:
Address: 11 ,300 IAL 2 ,4 [9f--
City: f ` iCLM i 5�® r'ES State: ET, Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#:954-551- G r
(
Address: 912 7 MW 3S_"'3S_"' /�h ( +. I1 �1
City: 'Dn,4 I P_' -State:
Qualifier Name:Mn r) V, Gni-ai Phone#:qnA nnA vi
State Certification or Registration#: :!42 ZZ n Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ `/,c -00- 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition �T Alteration ❑ New�y ❑ Repair/Replace ❑ Demolition
Description of Work: Rc nMEj+ A
Specify color of color,thru 016
Submittal Fee$� ' "-�° Permit Fee$' OK225' ACCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ r
TOTAL FEE NOW DUE$ 2— ' 1p
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City d"a a 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 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 COMMENCEMENVIF ,
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.
ignature gnature
WNERrAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instr �ents acknowledged before me this
1 dayof ,JoIA0V ,20/ ,by day o 20 1 by
r�a� who i ersonally known to h Y"Yz__V ,w is ersonally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: av �� Sign:
Print: �e ��e7s n�jll If l 1�--' Print: - 1C�
Seal: `\`����BARA J CO6���i Seal: MAW RIVAMM
�� �.joss/pH••.��i WCON�JIISSIO ##0180
. Just iS,?p�.o; s ° �EAPIRES:July 2015
•. •
#FF113p
APPROVED BY
W : -+r•'-VS Plans Examiner Zoning
%"14,611111111W,`a
Structural Review Clerk
(Revised02/24/2014)