EL-09-131209/30/2009 14:48 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Q002/002
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 125725
Scheduled Inspection Date: September 30, 2009
Inspector: Devaney, Michael
Owner: SULTZ, BRADLEY
Job Address: 816 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor: ALARM TEAM iNC
Permit Number: EL -8 -09 -1312
Permit Type: Electrical - Residential
inspection Type: Final
Work Classification: Alarm
Phone Number
Parcel Number 1132060142450
Phone: (866)430-2338
Building Department Comments
alarm installation
inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee Is paid.
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For inspections please call: (305)762 -4949
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Building Department
AUG 0 6 2009 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. d09 ° I ) g •
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type: Electrical
Owner's Name (Fee Simple Titleholder) .662.A b LEY 5 U LT 2 Phone # 3 O$ --75? - -78
8 3
Owner's Address \:o T I E. 99 S ---
City (111l41NN1 S No RE S State
Tenant/Lessee Name
Zip 3313
Phone #
E -MAIL:
Job Address (where the work is being done) 16 N E 99 ill' St .
City Miami Shores Village County Miami -Dade Zip 3 (3'8
FOLIO / PARCEL # u- 3 ZO (o - O ( Z+y SO
Is Building Historically Designated YES NO
gam on (-60)-7 9-s41
`t
Contractor's Company Name AL Ws "'-TEA %\ ", N C • Phone # g(o(o - 4 3 0.23 3'8
Contractor's Address (1O to A 2 O C.a,.►
City fp yen6...(i L-LE State GA • Zip 302.1S
Qualifier Name EN) is Lee +2Ac1To& Phone# 8(p(�- -2338
State Certificate or Registration No. E. F OOO 1) 26 Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 2 4.5a Square / Linear Footage Of Work:
Type of Work: Addition ❑Alteration -VNew ❑ Repair/Replace ❑ Demolition
Describe Work: IN-ARW%. ZN5- t'A1.4_,►Tt00
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ ---fn-eo Permit Fee $ 'efd' , CCF $ O' If 20 CO /CC
Notary $ Training/Education Fee $ ' @() Technology Fee $ Q'
Scanning $ 3'00 Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $
Total Fee Now Due $
56.40
See Reverse side -+
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
Owner or Agent
The foregoing instrument was acknowledged before me this `c
d a y of 1 M_ _, 20 Oct , by .6rGdQ j f L
who is personally known to me or who has produced pV
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Signature l4174A �
Cdhtractor
The foregoing instrument was acknowledged before me this 3-9
day of
2(0_9_, by 7¢LA h L Pd
who is perso . o , me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
°N. e( II DD 8A9?2
3 MY OMISSION
EXPIRES: FeDruaiy 25,
air*********** * ** ** * * * **** * ** * * ** * * * * * ** **4,*
**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED B
(Revised 02/08/06)
Sign:
Print:
My Commission Expires:
*
p�<t. KmNAA 01.00M
0I9
* MY COMMISSION $ D0 848226
EXPIRES: February +agl 25 2013
* of ' Winces
Plans Examiner
Engineer
Zoning