RC-08-1368 (5) IP-1 11,E LOAA
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Miami Shores Village
Building Department
DEC 0 3 2014
10050 N.E.2nd Avenue,Miami Shores,Florida 331380
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. EL-7-11-1349
PERMIT APPLICATION Master Permit No.f
FBC 20
Permit Type: Electrical
OWNER:Name(Fee Simple Titleholder):
Robert Butler Phone#: 305-933-0683
Address: 123 NE 97 Street
City:
Miami Shores State: F1 Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 123 97 Street
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 1132060132440
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR:Company Name:
L S Curtis inc Phone#: 786-486-1961
Address: 20341 NE 30 Ave #108
City: Aventura State: FL Zip: 33180
Qualifier Name: Lewis S Curtis Phone#: 786-486-1961
State Certification or Registration#: EC 0 0 0 317 5 Certificate of Competency#:
Contact Phone#: 786-486-1961 Email Address: asst eve 2 a^' Com
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 10 0 0 . 0 0 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition 1
Description of Work: �. ,o► 1 �X P'�jn—� { 'pp wrl.
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Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE
Bonding Company's Name(if applicable)
Bonding Company's Address
City 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 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---_b
Owner or Agent Contractor
The foregoing instrument was acknowI dged before me this
The foregoing instrument was acknowledged before me this 20
day of t V®V ,20 1�[,by � C't-\- 2)T�4-9!-f, day of November2o 14,by Lewis Curtis ,
ho i personally known to me or who has producedPr,_ who is onally known me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLIC;
Sign: Sign:
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APPROVED BY �L ~ Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-238346 Permit Number: EL-7-11-1349
Scheduled Inspection Date: July 08,2015 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: BUTLER, ROBERT Work Classification: Low Voltage
Job Address:123 NE 97 Street
Miami Shores, FL 33138-
Phone Number (786)556-2919
Parcel Number 1132060132440
Project: <NONE>
Contractor: LS CURTIS INC Phone: 305-892-0115
Building Department Comments
LOW VOLTAGE Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed E�
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 07,2015 For Inspections please call: (305)762-4949 Page 35 of 52