EL-09-607 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-111321 Permit Number: EL-4-09-607
Scheduled Inspection Date: December 17,2014 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: BUTLER, ROBERT Work Classification: Temp for Construction
Job Address: 123 NE 97 Street
Miami Shores, FL 33138-
Phone Number (786)556-2919
Parcel Number 1132060132440
Project: <NONE>
Contractor: HARVEST TRUST DEVELOPMENT GROUP Phone: (305)720-8517
Building Department Comments
TEMP FOR POLE
Inspector Comments
Passed
Failed
l
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 16,2014 For Inspections please call: (305)762-4949 Page 1 of 45
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDING RECEIVED Permit No. do
-&Oc(
PERMIT APPLICATIO 3 aos Master Permit No. cw-- 13w
FBC 20
®ss
Permit Type: ELECTRICAL /� L n l
Owners Name(Fee Simple Titleholder) Phone# J
Owner's Address 1 ?) 9 /$
City_ hu Id'yh State fi Zip
Tenant/Lessee Name Phone#
Email
Job Address(where the work is being done) �� S t
City Miami Shores Villaize County Miami-Dade Zip
FOLIO/PARCEL# /1- 32G G-- 013- 24 Yo
Is Building Historically Designated YES NO t/ Flood Zone
Contractor's Company Name��„S„ ( . j Phone# �—
Contractor's Address CIO A)
City j) s 1 V State zip_
Qualifier Name Phone#
State Certificate or Registration No. F/;?L9012 020 —Certificate of Competency No. 10100 Df 72
Contact Phone ®j 3 �V-2Q E-mail
Architect/Engineer's Name(if applicable) Mk k � � Phone
v
Value of Work For this Permit$ Square/Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ew ❑ Repair/Replace
� � El Demolition
Describe Work:
Submittal Fee$ Permit Fee$ /a0 coo CCF$ CO/CC
Notary$ Training/Education Fee$ Technology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$
See Reverse side
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mo� �gg Lender's Name if applicable)
Moirtga � Esnds A�dr s�
X41
City State Zip
4
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$2500, the applicant must
promise in good faith.that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature <
Owner or Agent eZ11 Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowled ed befor=ei s
day of�—%206,by ��1- GW�,�/ day of ,20d 1,by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC. NOTARY PUBLIC:
Sign: Sign:
Print: E RO—im-72 Print: GsS
M C Omm1SSlOri i s N �p��tSS10N 19,2010 Cad pg18172
Y �pY ember
1R Nov My C 1, E �tp� 0
�rvtce.00m 'Push. coo peg 19,2 10
;;gg6�, F ricfallot =a4•' "� �jtl � �pVem
";BgvF Flo `'
7-
XP1RS �NtCR.cOm
�407)38�159 m!!iP F1oi'ieNotarY
`gp7�BB-fl
�kokkkk�kkkkk�kkSakk$ekkekk8tkkkkk�:kk3a�CsRkkk�k$sk�dkkkak$k=kkk8arkRkkkBk RkkakekIa=kkekkkRk�S•kik=kkkeksksk:kaksRekkkkRkRskkskkkkkSa�ekkakkkk
APPLICATION APPROVED BY laps Examiner Zoning
Engineer Clerk checked
(Revised 07110/07)