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!