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551 NE 102 St (10)ELECTRICAL WORK NEW OFFICE AND GARAGE KAR1 EN Passed Inspector Comments /i/ i / 1,44/ 0 f i . A/air' a'' Failed Z "// 1 /z ,,A . Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 03/12/2007 Inspector: Devaney, Michael Owner: GITTNER, CORY Job Address: 551 102 Street NE Project: <NONE> Contractor: ATLANTIS ELECTRICAL CORP Building Department Comments Friday, March 9, 2007 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: Electric Phone Number (305)754 -3771 Parcel Number 1132060170980 Lot: Phone: (305) 551 -4043 Page 1 of 2 L • Signature of o PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 02 - i o; 99 Job Address .3.5/ E, '02 ,_*-gEEi Tax Folio / / 520 C d / 7 C 4 Pd M iA Sic, Legal De`§cription LOT /9 •j - W eS1s z ,2 (� )1G'GZ' q S11 Hi orically Designated: Yes No Owner/Lessee / Tenant U. 7 R , A 1,e. Master Permit # q 13 i1 Owner's Address 57 .t/. /02 r � Phone 30.5) 7...37 -3 20 2, Contracting Co. ■.gc c/4/E,.-7-. C Address (0 4OO 4_/ / / Qualifier 4:e;„/n.) L/lo6/ SS# Phone (34 X59 - i66,5 State # ooCn 6 2,_5 Municipal # 6000J32_,.1.3_ Competency # C /,3 3 Ins. Co. 0-3 Architect/Engineer A✓ //3 1 /4 Address A/ 4 Mortgagor A//' Address / //� Permit Type (circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION . &A40L /TiD U. 0 7 �•�F y7 /cl�- �A�AG �Tn , /-? ` 5*(DG.c6., -- v 75 e_ 9iGv 61) Square Ft. ,c //6 Estimated Cost (value) -, — 7_5: d d WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 regula g cons Ai tion and zoning. Furthermore, I authorize the above -named contractor to do the work stated. k. Bonding Company Notary o My C 'ssion Expires: .► er and/or Condo President Date FEES: PERMI © RADON 02- /o -9 9 02 -/0 - 99 ident Date C.C.F. Address /r/ / / 9 OZ.-Jo-99 Date ature o Co tra or Owner- Builder Notary s t actor r-Ow er- Builder My C mmission Expires: , 6 o NOTARY - 0 `^ BOND TOTAL DUE e,z /O -99 Date JOHN M. FARQtnHM Notary Public • State ct Flndde My Commission Expires Mar W„`JW Commission # CC 543396 APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS v o CENTRAL HEATING DISHWASHER RECEPTACLES b b A/C (WIND) DISPOSAL SERVICE TEMPORARY 0 0 A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS o O DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE p b REFRIGERATION GREASE TRAP APPLIANCE OUTLETS (;) 0 PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP o C7 UNDERGROUND TANKS LAVATORY OVEN CD 0 ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER 0 O U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP o 0 STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP o o HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP O 0 MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP O O TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP C5 p ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP O O FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP o 6 COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP D Q VIOLATION INDIRECT WASTES A/C WINDOW 65 O REINSPECTION WATER SUPPLY TO: - AIR CONDITIONERS n 6 A/C UNIT STRIP HEATER p FIRE SPRINKLER GENERATORS TRANSFORMERS 0 n • HEATER -NEW INST. GENERATORS TRANSFORMERS /7 0 HEATER- REPLACE GENERATORS TRANSFORMERS 0 0 LAWN SPRINKLER -WELL SPECIAL PURPOSE 0 6 SWIMMING POOL OUTLETS COMMERCIAL D b WATER SERVICE SIGN TUBES 0 0 SEWER CONNECTIONS SIGN TRANSFORMERS 0 0 UTILITY -SEWER SIGN TIME CLOCK 0 C) UTILITY -WATER IP FIXTLRES ® p +► SEPTIC TANK ANTENNA D O RELAY TELEVISION OUTLETS n rj GRAINFIELD, 4' TILE/RES. -- VIOLATION 0 (j PUMP & ABANDON SEPTIC TANK REINSPECTION D ^ Z) SOAKAGE PIT CU. FT. ,+.[DG N /D4) /-(, ),7 1 , CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING • LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING _ ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING MECHANICAL e massa llIIIIII February 10, 1999 Gittner, Mr. and Mrs. Cory 551 North East 102 Street Miami Shores, Florida 33138 Re: Demolition / Electrical Permit. Dear Mr. Gittner; As per our conversation, attached is the permit application. Please fill in the highlighted areas and submit the application to Building & Zoning. When you pickup the permit, please mail or fax me a copy of the permit itself for our records. If you have any difficulty requesting the final inspection, call me. Otherwise good luck with the demolition. Sincerely, Bennett Electric Service co. John M. (Mike Service Manager JMF /ms Attachments: M.S. Permit Application M.S. Fee Sheet ELECTRICAL CONTRACTORS • ESTABLISHED 1958 69C0 NORTHEAST FOURTH COURT MIAMI, FLORIDA 33138 - 5697 DADE (305) 759 -1665 BROWARD (305) 920 -4899 FAX (305) 754187/ RADIO DISPATCHED SERVICE LICENSED • INSURED Page 1 2/10/9910:24 AM Feb 01 99 08:51a Frances Melgaard 305 - 969 -1320 p.1 ABSOLUTE DEMOLITION INC. January 30, 1999 Mr. Cory Gittner 551 NE 102 Street 1VEami Shores, Fl. 33138 RE: 551 NE 102 Street Miami Shores, Fl. We hereby submit specifications and estimate for the sum of: Two Thousand Dollars 00/100 S 2,000.00 Payment to be made as follows: 30% Deposit, remainder full upon completion s Cc4 -edit- od a ll , Total demolition and removal of detached garage structure and rock wall with Bar - B-Que, hauling away all demolition debris. Leaving areas rough graded with dozer. • Scope of work: Submitted by: n J Accep , by: Todd Melgaard, ' j ent Cory ' er Absolute Demolition c. 14740 S.W. 83 Place • Miami, Fl 33155 305/969 -3644 • Fax: 305/969 -1320 CONTRACT 305/ 754-3771 305/757 -4900 305/ 751 -0776 fax (:ii 00# d ad a yye 5arew- Securing demolition permit with Miami Shores. ) Owner to provide: ul U M"' K V l'1 ,s14 e I 1. Property survey to obtain permit. 2. Electrical and plumbing permits with disconnections (to be tied in with master demolition permit). 4/'// have peerr,' a i `nemda y , Affa41 in the event it becomes necessary far Absolute Demolition, Inc. to collect any deficiency from Cory (Miner by legal aaica. Cory Gltsaer agrees to reimburse all of Absolute Demolition Inc. costs and atta neys fees, at the trial and appellate levels, as well as any costs and expenses associated with such anion. Date Legal Description Owner �/ Lessee / Tenant C r 7 Owner's Address Contracting Co. ( -IL 2 c fr Qualifier (11 b. 6 State # Municipal # Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING W DESCRIPTION k-Q- w� t ID O 1 )) .S'i - w�lQ-' / Square Ft. 7 V o rk .\ WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in ompl'ance with all applicable laws regulating construction and zoning. Furthermore, I authorize e a'=ve :med contractor to do the work sta d. Signatu a o owner and /or Condo President Date: APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Zoning Job Address) 5 l NE 102, 1 - S'- Tax Folio /( 320/ I ) 07Z 03 SS( �F= IOZ S/ Notary as to Owner and or Condo President My Comm, $pPI3IxeENbTARY SEAL. O �i SANDRA M IIONTIEL * COMMISSION NUMBER ** * 4 ,11r Q CC4Q1261 C MY COMMISSION EXI OF F\ O � AUG. 171998 FEES: PERMIT :G . RADON Address / Phone G 8( /2 V Competency # /b 0 9-‘ Ins.Co. �gk fti� ELECTRICAL PLUMBING MEC 70)/ ICAL on ROOFING PAVING FENCE SIGN VD S - {7 , 1vs reAt7�.4'�ra.1 Zc� rPcseP !� 4,Fk(e cu, /gi Estimated Cost(value) Sig ature of Contractor or Owner- Builder Dat as to Contractor or Owner- Builder My Commission Expires: * * * * * o c) C.C.F. NOTARY )- Fire Other Building Electrical P) Mechanical Plumbing Engineering Master Permit # ;370; Phone - TT - ) V /0O TOTAL DUE ' Legal Description / 9 I N Owner / Lessee / Tenant PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job A ddress 51C1 '_ ST_ Tax Folio // c%b e`3 ' 1 Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: 7//-9,6eAt G ' er Master Permit #15a 9,-- Owner's Address ( Phone Contracting Co. �4QV1-3,1/L . �`e ±�` Address lys2 1tii't3 I3 4 • / r &'1 V% r&CUMMR* SS4 [ // // Qualifie i 1 Phone (2(1_6 State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUIIING ELECTRIC ' PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION /1. re C'eA Square Ft. Estimated Cost(value) eo WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work state Sign time o Contractor or Owner- ilder Date: II) 43 A /.�I.e as to Contractor or Owner- Builder y Commission Expires: ** * * * * * * * * * * * * * * * ** PEES: PERMIT RADON C.C.F. SO NOTARY D TOTAL DUE, T r , APPROVED: Fire Other Zoning Building (E1/ ectrical Mechanical Plumbing_ Engineering Date )V0/ Job Address Ss-( N 1 O ff/t Tax Folio / Ya24 / 9.�-I1-Jij Legal Description / 41/1/ 00 'tg 1 �`� (Own.Lessee / Tenant Cot ' New Master Permit 4�,J11d`% Owner's Address i 74 � Phone 73 ` 906 Contractin Co. " . c uipz 2 Address lYsZ( AAA) 13 4G it ! Qualifier D • F F Y t Q U H 4 r \ ss# Phone lh 'gr /2 /g State # Municipal # Competency # 409.4 9.4 Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION 20 l3u'r�e fJ Square Ft. Estimated Cost(value) / 200 t WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: ** * * APPROVED: FEES: PERMIT Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE * * * * * * RADON C.C.F. NOTARY Fire Other Building 1.94fJ ` l fw. -h4e, Signature of Contractor or Owner- Builder Date: / 40UF / !'' `'B JOSEPHINE CHURCH /4( y �(t /JOSEPHINE P"bhc. State of it'ids as to Con 'il cairCesonemthwiokbenal y Commission Ek .i Na CC197545 Electrical * * Mechanical Plumbing Engineering Legal Description PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 .5: Job Address /1) E 41„, JT . Tax Folio 1/ -11 7 Hai jgclkk/km, 1 6 ,Le ( Owner / Lessee / Tenant (lOry Master Permit itj/ieer, Owner's Address ✓5 / " Contracting Co. 20 U) A( Ei e c fr t ` Address 0S S2i /U W 13 4 (A_ Qualifier J � � n SS# - — Phone ‘g-r )2 Vh State #EA- / Municipal # Competency # ) 601- t Ins.Co. -r 4e��4., Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRIC: PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1/ ere4 8c41t. Set01c e s ilvl S Square Ft. Estimated Cost(value) ! ,7 OL� WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work state Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: ** * * * * * * * * * FEES: PERMIT 36 RADON C.C.F. Sign t g9fContractor or Own builder Date . /7 Phone NOTARY ! TOTAL DUE 6 APPROVED: Fire Other R. Zoning Building Electricalt) ,) Mechanical Plumbing Engineering * ** PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date /a /9�9z Job Address S5'/ NE' /OZ ST. Legal Description /1 Tax Folio// 3 ��v �/ �� ' ` o 0 9 9 `50 / Lessee / Tenant 1/6'6,gN To SJ1/964) Master Permit # -- X// Owner's Address S-57 /1/6 /O Z ST, Phone Contracting Co. UM/ 7 je j/C. Address /7Z5 ,ivw S/ /IL/ c.E QualifierJ4/1165 /)?. u/H/75 J/L SS# Phone 6 Z /9Z-77 /y33 State #000 SG 86 Municipal # Competency # /'f 335 Ins .Co . Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 'CPC W /gee /V szE evic ev6,4 rhiexA* , Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Signatur Date: Date: / /9t Notary as to Owner and /or Condo President My Commission Expires: 4 or stamp name of Notary Public ; El��`il'�L��n�1 Product Lj) e . n num e� f •gdIMI/ l/a ^r My Commission 'xpires: 0 DID take an oath, or 1D NOT take an oath. ** * * * * * * * * * * * FEES: PERMIT , AO// RADON C.C.F. s NOTARY TOTAL DUE A5= ,0 APPROVED: Fire Other Zoning Buildin Mechanical Plumbing_ It' //0 .6-D Engineering * ** s$J3,54S_ o j MIAMI SHORES VILLAGE, FLA. 9 JOB - G 7>2 ADDRESS $ ( L— . / ° 2 INSPECTION f /i r B / s c TIME READY f &e'�2 INSPECTOR REMARKS. /t Y P " S N9 6649 DATE FLOORS FIXTURE ONLY NUMBER OF Total Outlets SIZE OF Size Service Conduit No. Circuits Lights Ceiling Brackets Mains Subs Branches asement— irst :cons hird ourth Form 246 LO CATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICA- TWIIt WILL BE RETURNED_ / 1 1 Lot Number / �' Block Number Subdivisio Street and Number © s Owner t: 7,1/ ; Occupied as ✓�`' � ' Building —New or Old (underline which). H. P. of each motor Volts Total Amps Phase F S T Lights Kind of Installation Open or Concealed Knob, RX., BX., Mldg. Conduit REMARKS j d Tns ection Want Contractor_...: P e B ddresq Received by Inspector Progress Will Inspect again Rough Wiring FINAL No Corrected Temporary Date Issued Ceiling Electrical Department of the City of Miami Desiring your Certificate of Approval, application is hereby made for an inspection of the electric installation in the premises stated be- low, for which undersigned agrees to correct any infractions of the National Electrical Code and the City Ordinance pointed out by Inspector. Brackets .Days Receptacles APPL,ICATION Switches x 40. SPECIFICATIONS No ATE 1 _ _ 193 ,.. Side Occupant Work— Additional, New, Alteration or Repair. Stoves I Water Heaters S � Signs Other Apparatus SPACE B OW FOR INSPECTOR'S USE ONLY e9 inspected / 1 t �J i_Y marks Fee remitte Inspector Date ' v , 192 r f FOR FIXTURE WORK ONLY ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI Desiring your Certificate of Approval, application is hereby made for an inspection of the electrical installa- tion in the premises stated below, for which the undersigned agrees to correct any infractions of the National Electrical Code and the City Rules pointed out by Inspector. LO CATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED, OR APPLICATION WILL BE RETURNED. Block Number — c��:' �' Lot Number r . e Street and Number t. " E SidP Owner '' • - Occupied as Building —New or Old (underline which). Work— Additional or New (underline which). FLOOR Basement 1st Floor 2d Floor 3d Floor 4th Floor 5th Floor 6th Floor 7th Floor 8th Floor Attic REMARKS- Q , �, E e ; ` L Work will be started h 3 (Applicant sign here) X144.4.4.4_ Received by Inspector NUMBER OF LIGHTS CERTIFICATES Form 155 Progress Will inspect again Rough Wiring FINAL No Corrected Temporary Days Approved Letter Date Issued APPLICATION CEILING OUTLETS SPECIFICATIONS BRACKET OUTLETS i will be finished SPACE BELOW FOR INSPECTOR'S USE ONLY 40' DEFECTIVE Time Allowed: Days Na Occupant NUMBER OF CIRCUITS Address Street f ` Inspected Correct Location Correct Equipment Electric Light Co Fee remitted Remarks • inspector