EL-11-875Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 169028 Permit Number: EL -5 -11 -875
Scheduled Inspection Date: January 23, 2012
Inspector: Devaney, Michael
Owner: HUTCHINSON, MARK
Job Address: 1041 NE 96 Street
Miami Shores, FL
Project: <NONE>
Contractor: HI -TECH ELECTRIC & FIRE CORP
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060143720
Phone: 305/225 -1447
Building Department Comments
NEW LOW VOLTAGE WIRING /DATA/TV /CAMERA
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 165182. CREATED AS
REINSPECTION FOR INSP- 159794. No access 4:15.
T. V. o. k. need the location of the camera.
January 20, 2012
For Inspections please call: (305)762 -4949
Page 44 of 47
Miami Shores Village mo,«�
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 1 I
Permit No 1
Master Permit No. AC-1-1("-1VV
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: Electrical
OWNER: Name ( Fee Simple Titleholder): ,40K__ / 7/ gf/A j 74/ Phone #: 9cci—INC 90
_
Address: /® i V "6
?6 Sr
City: 74N/ / $rn $ State: Zip: 33/ Se
Tenant/Lessee Name: R Phone #:
Email:
JOB ADDRESS: 5jj I'24 it 5 )4 4d V E
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
31) '029.73 7
Phone #: 02,5 ',/`, 7.,50<
CONTRACTOR: Company Name:
Address/ SW j
City: /41,41........1 �/ State: /.¢
Qualifier Name: e� 0a9 ‘7:119,/,
r'
State Certification or Registration #: Z6 / � Gc _, Certificate of Competency #:
Contact Phone #: 7sey5 37,6 °mil' Email Address:
DESIGNER: Architect/Engineer: Phone #:
tF'e 2
Phone #:
Value of Work for this Permit: $ 2. (90 Square/Linear Footage of Work: et'
Type of Work: Address ❑Alteration Xlew ❑Repair/Rep ce Demoliti n
Description of Work: /V &.� 14.' 1� / (j. j ;ii7 9��i t 7 p2/ G A t,
� v
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ (vv 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 MR CONDITIONERS, ETC
OWNER'S A}'FIDAVIT: 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 e'.. roved and a section fee will be charged.
Signature
Signatur,
er or Agent
The for
day of
who is personal
strument lwas ac
,20 ll,b 1�
The forego
day of
ho is
known to me or who has produced
As identification and ,..: id take an oath.
NOT• 'Y 'UBL C: 66",6\ ti s,
Sign: _.IJ! _4(� fttt, 4 Sign:
Print: V ,..,Y. o'
�+I` Print:
�� u
My Commission Expires: \ . ,'��
@a
Contractor
ment wa ac
,20 I1,by
own to me or who has produced
ged befor
me
13
entification and who did take an oath.
PUBLIC:
* * * * * * * * * * * * * * * * * * *., * **
APPROVED BY
My Commission Expires:
* ****** ** * * ** ** * * *:x**** ** * *** ** *** * * * * * * * ****** ***** *******+ x*****:x********** * ****
21'' //
/7X/keI Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk