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ELC-12-2338Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 182765 Permit Number: ELC -12 -12 -2338 Scheduled Inspection Date: December 20, 2012 Inspector: Devaney, Michael Owner: LLC, DEVINELLA Job Address: 9165 PARK Drive Miami Shores, FL Project: <NONE> Contractor: VOLT -TECH Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Temp for Test Phone Number (305)785 -8990 Parcel Number 1132060141350 Phone: (321)268 -4348 Building Department Comments TEMP FOR TEST Infractio Passed Comments INSPECTOR COMMENTS False Passed • Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments December 19, 2012 For Inspections please call: (305)762 -4949 Page 11 of 22 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 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 9165 Park Drive City: Miami Shores FBC 20 i leLL, No. y��/� Master Permit NoeC 1) + t� �� DO County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): DM N 1st-LA LA-C- Phone #: 3 its-s- "7 fo 1 _ •?q 5� Address: 4,41-tkf' (JUJ City: MI IAU& \ State: , Tenant/Lessee Name: Phone #: Zip: 3(4I Email: CONTRACTOR: Company Name: Volt -Tech Address: 4555 Capron Rd. City: Titusville Qualifier Name: Jonathan B. DeWitt State Certification or Registration #: EC0001808 Contact Phone #: 321 - 268 -4348 Email Address: Jdewitt@volt- tech.net DESIGNER: Architect/Engineer: Phone#: Phone #: 321 - 268 -4348 State: FL zip: 32780 Phone #: 321 - 268 -4348 Certificate of Competency #: Value of Work for this Permit: $ ( (.541 Square/Linear Footage of Work: Type of Work: Address OAlteration CllAw ¢� �Repair/Replace Demolition Description of Work: T6444 (-60.1".„ ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees********** **: x*** ********+x***** **** *****:x **** Submittal Fee $ Permit Fee $ / it 0 a ee Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 FT ECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIT.RRS, 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 %' d. `-e Owner or Agent The f oing instrument was ackn wleiiged bef - me this day of , 20 byt .M w o is - r o ally known to me or who has produced entification and who did tak NOT Sign: Print: My Commission Expires: Contractor The oing instrument was ac owledged before me this day .- ' %- 20 wh is personally kno , o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign. = &∎_ _ Print: • , A-iW-V. My Commission Expires: * * * * * * * * * * * * * * * * * * *., ***************** ix******************************* * *** ***** * ** **************** * ** APPROVED BY Yip Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk o` .rt'''a HILLARY PAGE _ Notary Public - State of Florida I ,� vsl My Comm. Expires Oct 26, 2014 1 Commission # EE 37750 MIAMI•DADE COUNTY Building 11805 SW 26th Street Miami, Florida 33175 -2474 786 - 315 -2100 AFFIDAVIT FOR 30 DAY TEMPORARY ELECTRIC SERVICE ELECTRICAL CATEGORY 26 miamidade.gov ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED OR CERTIFICATE OF OCCUPANCY OBTAINED. It is understood thatthe temporary electrical approval by the Miami -Dade Building Department is given in connection with the building being constructed under the Building Permit # and Electrical Permit # at address 9165 Park Dr. Miami Shores, FL 33138 for owner: and is being given only for construction purposes or for testing the following equipment in said structure: The owner does hereby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and /or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the Building Official and will be disconnected if the building concerned is occupied before final inspections are approved and /or a Certificate of Occupancy or Completion is obtained. I, , being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building contractor has obtained approval of final inspections and /or obtained 'a Certificate of Occupanc or Completion. Note: Failure to comply with the provisions of this affidavit will re future Temporary for Test , t its. Signature of Owner I, Jonathan B. DeWitt the above - described property and temporary service is connected. Ign � sill 14 Sign '" re of No My Commission Expires: , being duly sworn, depose and say that I am the that the electrical installations as n. existin Through State of Florida es Sep 23, 2015 EE 128810 Nation ature of Electrical Contractor d if Slgnat re of Not LARY PAGE blic - State , orida 26, 2014 1 My Commission I, ( G � lt°! Ccx�r�`l � �� , being first duly sworn, depose and say that I Building .. actor of the above described property and that I will not permit occupancy of this building untl final inspections have ' been called for by the contractors and sub - contractors concerned and final approval by the NO ' /dyision obtained and that I have the authority insofar as the owner of said property is co cerned to pap . it gccUp. c$ anti I s c. final inspections are obtained and/or a Certificate of Occupancy ; Corn Ieti. iss O, ,ei,',; v ='T o• :`c,,��s4 f4,. goilimItios Signature of Building Contractor Signature of Electrical Inspector 123_01 -124 6/06 Signature of Notary My Commission Expires: Date: Date released to FPL: THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK'" PATENTED PAPER ct . lelow I^ . CERTI er the provisions irat 2012 - 2013 THE PERSON(S), OR ENTITY BELOW: LOCATION: VOLT TECH 4555 CAPRON RD TITUSVILLE FL 32780 4555 CAPRON RD CITY OF TITUSVILLE, FL 32780 OWNED BY: _ _. JONATHAN B- DEWLTT _ BREVARD COUNTY BUSINESS TAX RECEIPT SUBJECT TO COUNTY ZONING RESTRICTIONS TAX RECEIPT SHOULD BE DISPLAYED ON PREMISES BUSINESS CLASSIFICATIONS, DISCLAIMERS, AND RELATED FEES: BUSINESS PERIOD: OCTOBER 1, 2012 - EXPIRES: ACCOUNT NO. 9710732 SEPTEMBER 30, 2013 SEPTEMBER 30, 2013 ISSUED PURSUANT AND SUBJECT TO FLORIDA STATUTES AND BREVARD COUNTY CODE ISSUANCE DOES NOT CERTIFY COMPLIANCE WITH ZONING OR OTHER LAWS. BUSINESS TAX RECEIPT IS SUBJECT TO REVOCATION FOR ZONING VIOLATIONS, AND / OR FAILURE TO MAINTAIN REGULATORY PRE - REQUISITES AS REQUIRED FOR BUSINESS CLASSIFICATION(S), OR SUBSEQUENT ACTIVITIES. NOTIFY TAX COLLECTOR UPON CLOSING OF BUSINESS. A PERMIT IS REQUIRED TO ADVERTISE (Including with signage) °GOING OUT OF BUSINESS". LISA CULLEN, CFC, Brevard County Tax Collector P 0 Box 2500, Titusville, Florida 32781 -2500 (321) 264 -6910 UPON A CHANGE OF OWNERSHIP OR LOCATION, BUSINESS TAX RECEIPT SHOULD BE TRANSFERRED WITHIN 30 DAYS. EXEMPTIONS: NON EXEMPT PENALTY: $.00 300240 ELECTRICAL CONTRACTOR 820005 2012 - 2013 RECEIPT AMT $37.00 BRANCH OFFICES: Merritt Island Office, 1450 N. Courtenay Pkwy, Merritt Island, FL 32953 Melbourne Office, 1515 Sarno Road, Melbourne, FL 32935 Palm Bay Office, 450 Cogan Dr. SE, Palm Bay, FL 32909 MAIN OFFICE: 400 South St., 6th Floor, Titusville, FL 32780 (321) 264 -6910, (321) 633 -2199, ext. 46910 BTR- TX/RCPT -a CITY OF TITUSVILLE BUSINESS TAX RECEIPT FOR FISCAL YEAR 2012 2013 EXPIRES: September 30, 2013 ACCOUNT NO: 13-00003942 ISSUED: July 19, 2012 THE PER IN THE BU TITUSVILLE ENGAGE E CITY OF BUSINESS CLA ELECTRICAL CON Titus SPECIAL CONTINGENCIES ale — Gateway to Nature and Space AUTHORIZING REPRESENTATIVE: TOTAL: 109.20 THIS RECEIPT BECOMES OFFICIAL ONLY WHEN SIGNED BY AN AUTHORIZING REPRESENTATIVE OF THE CITY OF TITUSVILLE. PLEASE RETURN THIS RECEIPT SIGNED AND . DATED IF YOU GO OUT OF BUSINESS. THE DEVELOPMENT SERVICES DEPARTMENT CANNOT TAKE YOU OUT OF BUSINESS WITHOUT THIS DOCUMENTATION!