EL-13-1498 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197764 Permit Number: EL-7-13-1498
Scheduled Inspection Date: September 30,2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: CATHERINE HABERMANN,GLENN Work Classification: Alarm
tenon
Job Address: 164 NE 105 Street
Miami Shores, FL 33138-2033
Phone Number
Parcel Number 1121360130660
Project: <NONE>
Contractor: SAFE STREETS USA Phone: (813)514-2693
Building Department Comments
Infractio Passed Comments
BURGLAR ALARM INSPECTOR COMMENTS
False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-197692. Need to find the
transformer and grounding conductor.
Failed
Correction ❑ �� r� �� /�
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 27,2013 For Inspections please call: (305)762-4949 Page 8 of 30
Miami Shores Village - - `-
Building Department 4t 0 3 2013
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 --
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No
Permit Type: BUILDING ROOFING
JOB ADDRESS: 164 NE 105 St
City: Miami Shores County: Miami Dade gip; 33138
Folio/Parcelt 11-2136-013-0660
Is the Building Historically Designated: Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder):Glen Ford Phone#;786-558-4765
Address: 164 NE 105 St
City: Miami Shores State: FL gip: 33138
Tenant/Lessee Name: Phone#:
Email; ford.glen @btintemet.com
CONTRACTOR:Company Name: SafeStreets USA Phone#: 919-861-8521
Address: 5660 W Cypress St Suite G
City: Tampa State: FL Zip. 33607
Qualifier Name: William Alan Peacock Phone#: 919-861-8521
State Certification or Registration#. EG13000404 Certificate of Competency#:
Contact Phone#: 919-861-8521 Email Address: Jadams @safestreets.com
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$99.00 Square/Linear Footage of Work:
Type of Work: UAddition &(Alteration UNew URepair/Replace ODemolition
Description of Work: Wireless Burglar Alarm - 1 Cell, 1 Panel, 2 Button Fob, 3 Door/Window, 1 Motion
Color thru tile:
Submittal Fee$ Permit Fee$ AP 0 ®® CCF$ CO/CC$
Scanning Fee$ Radon Fee$ 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 licable if applicable)
PP )
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 Signature N�` J%
caner or Agent Contractor
The foregoing instrument was acknowledged before me this 4th The foregoing instrument was acknowledged before me this 4th
day of April ,2013,by Glen Ford day o f April ,2013,by William Alan Peacock
who is personally known to me or who has produced DL who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
JARROD M.ADAMS JARROD k ADWS
NOTARY PUBLIC NOTARY PUBLIC
Sign: Si
Print: a Adams ��� Print: d Adams . Comm#EEC
_sn r moires 3/18/2016
My Commission Expires: 3/18/2016 My Commission Expires: 3/18/2016
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)