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COUNT) <br />Regulatory and Economic Resources <br />Herbert S. Saffir Permitting and Inspection Center <br />11805 SW 26th Street <br />Miami, Florida 33175 -2474 <br />786 - 315 -2100 <br />REQUESTED REVIEWS <br />miamidade.gov /development <br />❑ ALL ❑ BLDG ❑ DERM ❑ ELEC � j ENRG ❑ FIRE <br />❑ HCAP ❑ LANDSCAPING ❑ MECH ❑ PLUM ❑ PWKS ❑ PWCC <br />❑ ROOF ❑ SIGN ❑ STRU ❑ ZNPR ❑ WASD <br />❑ PERMIT BY AFFIDAVIT CHECK ❑ SHORT TERM EVENT AFFIDAVIT CHECK ❑ OPTIONAL PLAN REVIEW <br />❑ BLDG ❑ ELEC ❑MECH ❑ PLUM ❑ STRU <br />Dear Applicant: <br />Please complete the following information for notification on the status of your plans. <br />Applicant's First Name: (PRINT CLEARLY) '� V Last Name: (PRINT CLEARLY) <br />Cellular Number: <br />EMAIL Address: <br />Comments: <br />Office /Home Number: <br />j"e-e ka r t Cam-, le <br />NOTE: IF AN EMAIL ADDRESS WAS PROVIDED YOU WILL BE NOTIFIED VIA EMAIL AND /OR AUTOMATIC <br />TELEPHONE CALL CONCERNING THE STATUS OF YOUR PLANS <br />---------------------------------------- <br />-FOR OFFICE USE ONLY- <br />TO BE COMPLETED BY BUILDING AND OCCUPANCY REPRESENTATIVE OR PLANS PROCESSING SPECIALIST: <br />Application Date:A /��/ l Clerk Name: <br />Process No(s): <br />�, 3.- Walk -Thru ❑ Drop -Off <br />❑ Residential Commercial <br />Arrival Time: <br />❑ Rework ❑ Re -Issue <br />❑ Plan Revision ❑ Shop Drawing <br />TO BE COMPLETED BY BUILDING AND OCCUPANCY REPRESENTATIVE OR <br />—PLANS PROCESSING SPECIALIST: <br />BLDG ❑A ❑D ❑N <br />HCAP ❑A ❑D ❑N <br />ROOF ❑A ❑D ❑N <br />DERM ❑A ❑D ❑N <br />LAND ❑A ❑D ❑N <br />SIGN ❑A ❑D ❑N <br />ELEC ❑A ❑D ❑N <br />MECH ❑A ❑D ❑N <br />STRU ❑A ❑D ❑N <br />ENRG ❑A ❑D ❑N <br />PLUM ❑A ❑D ❑N <br />ZNPR ❑A ❑D ❑N <br />FIRE ❑A ❑D ❑N <br />WASD ❑A ❑D ❑N <br />HRS ❑A ❑D ❑N <br />Customer Notified By: <br />123 01 -ii7 6/12 <br />Date: / / Time: <br />