EL-10-1294BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
OWNER: Name (Fee Simple Titleholder):
Address: 1`i, q t.° 51-
City: r CAA"" S State: l_ Zip:
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: 5U2 t3 - 1 VZ S
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: i 1? Z -00 017 1 S L
Is the Building Historically Designated: Yes NO . "- Flood Zone:
CONTRACTOR: Company Name: v\-`t �v tit l Phone #: /C7 t fa'g
Address: 50 9 iU Q * 2_
City: .0 —` i ckAA ek ' 02 - ‘t-e State: EL — Zip: - 5;1L
Qualifier Name: v i a c t+ Phone #:
State Certification or Registration #: C b S- t ' g Certificate of Competency #:
Contact Phone #: & c l `-( D7-3(i) Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ '7 CI I 0 5 ` Square/Linear Footage of Work: - 5 2-0
Type of Work: 94dress ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of'Work: �(ai�n 5 i Sc� C ' - ( .)CL°- f- ,
Lkto .,v.Q
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
TOTAL FEE NOW DUE $ ` •75`�
ZORIVE
JUL - ,,
BY ..
Permit No. EU O 2�
Master Permit No. V\ CA) 2�3
IN\ Phone#: s $ ? c Z3&3
************* * ************ *********x * ** Fees ***x * ** ** * ****** * * ***** *:x*** ***** * **** * *****
Submittal Fee $ 50' t Permit Fee $ / ' 4P " CCF $ CO /CC $
Ptl-t 0
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
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, SIGN,
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
APPROVED BY
Owner o Agent
k
The foregoing instrument was acknowledged before me this ¶.a
day o `s 1.A'( , 20 k , by < Ce;.1'e12 ^ - t)4 C ('F
who is personally known to me or who has produced L..
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*** * * * * * * * * * * * * * * * * * * * * * * * * * * *r.. * * * ** ***fig * * * ** * **
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
2 2 �Zi4y se:' Plans Examiner
Signature
29.,Lt(
Contractor
The foregoing instrument was acknowledged before me this
day of :anr —�t , 20( 0 , by ,' "` 61—( S f�
who is personally known to me or who has produced ]) L_
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: �1's` Q .._
My Commission Expires:
* * *.. ** *** **** * * ** *** � ** ** * ** * *** *** * ** **
Clerk
4
Inspection Number: INSP - 152754 Permit Number: EL -7 -10 -1294
Scheduled Inspection Date: November 01, 2010
Inspector: Devaney, Michael
Owner: BYRD, MICHAEL
Job Address: 567 NE 96 Street
Project: <NONE>
October 29, 2010
Miami Shores, FL
Contractor: GREENTECH SOLAR SOLUTIONS
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
'0-1'1913
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060171580
Phone: (954)463 -9218
DOMESTIC SOLAR WATER HEATER
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
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