10-1042-018I
Building & Neighborhood Compliance
MIAM Herbert S. Saffir Permitting and Inspection Center
OMME 11805 SW 26th Street
Miami, Florida 33175-2474
786-315-2100
miamidade.gov
REQUESTED REVIEWS
❑ ALL ❑ BLDG *ERM ❑ ELEC ❑ ENRG ARIRE
❑ HCAP ❑ LANDSCAPING ❑ MECH ❑ PLUM ❑ PWKS ❑ PWCC
❑ ROOF ❑ SIGN ❑ STRU ❑ ZNPR ❑ WASD
❑ PERMIT BY AFFIDAVIT CHECK ❑ SHORT TERM EVENT AFFIDAVIT CHECK 1:1 OPTIONAL PLAN REVIEW
❑ BLDG U ELEC ❑MECH ❑ PLUM U STRU
Dear Applicant:
Please complete the following information for notification on the status of your plans.
Applicant's First Name: (PRINT CLEARLY) ' - Last Name: (PRINT CLEARLY) ��Vyy'_
Cellular Number: (a —C)24 ( '0 Office/Home Number: b)
EMAIL Address:
Comments:
NOTE: IF AN EMAIL ADDRESS WAS PROVIDED YOU WILL BE NOTIFIED VIA EMAIL AND/OR AUTOMATIC
TELEPHONE CALL CONCERNING THE STATUS OF YOUR PLANS
_---------------------------------------
-FOR OFFICE USE ONLY-
TO BE COMPLETED BY BUILDING AND OCCUPANCY REPRESENTATIVE OR PLANS PROCESSING SPECIALIST-
Application Date:1Q?A Clerk Name: Arrival Time: t,)-: 44,
ProcessNo(s): MDr(9jj00z-r/7_-2>0/
❑ Walk-Thru 1* Drop-Off
❑ Residential M Commercial
❑ Rework
❑ Plan Revision
❑ Re-issue
❑ Shop Drawing
TO BE COMPLETED BY BUILDING AND OCCUPANCY REPRESENTATIVE OR
PLANS PROCESSING SPECIALIST.
BLDG UA LID UN HCAP ❑A LID UN ROOF UA LID UN
DERM CIA UD UN LAND JA LID UN SIGN ❑A LID UN
ELEC UA UD UN MECH UA LID UN STRU JA LID UN
CL
ENRG UA UD UN PLUM ❑A UD UN ZNPR UA UD UN
FIRE UA LID UN WASD UA UD UN HRS UA LID UN
Customer Notified By: Date: Time:
12301-117 12/09