10808Permit No. /vim ro
Employing Electrician's Name
Location and Legal Description L
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR .ELECTRICAL PERMIT
Street and Number where work is to be performed —N
No
(wed)
aela. o• / 9c7/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith mined for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
b during progress of work.`! J
%Cge X.44 -r No. 02 o 7 • - a.-_ -.--/ G �' .
Owner's Name and Address ✓
Registered Architect and /or Engineer
/. ".. S:IUgtreer t?`'
lock SubdiAi�iopT
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Underground. Size Feeders Conduit Main Sw._.__._ Amps Main Fuses Amps
Type of Installation c onduit Tubing , Moulding
Amount of Permit $ /' (Signed)
Electrical Inspector .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under! this permit, as are
licensed by Miami Shores Village.
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appearei
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
II
My Commission Expires Notary Public, State of F1onda
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for'inspection, or faulty
materials and /or workmanship.
SWITCH.
OUTLETS
LIGHT
OUTLETS
PLUG
REOE'P'T'8
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP!
HEATER
TOTAL.
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
7. PERM.
-
MOTORS
0 -1 HP
MOTORS
- 1 -8 HP
NEON
TRANS.
RADIO.
TOTAL
CONTR.
LIST
-� ,
/� / /�
_ _' !
_:.
CHECK
Permit No. /vim ro
Employing Electrician's Name
Location and Legal Description L
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR .ELECTRICAL PERMIT
Street and Number where work is to be performed —N
No
(wed)
aela. o• / 9c7/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith mined for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
b during progress of work.`! J
%Cge X.44 -r No. 02 o 7 • - a.-_ -.--/ G �' .
Owner's Name and Address ✓
Registered Architect and /or Engineer
/. ".. S:IUgtreer t?`'
lock SubdiAi�iopT
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Underground. Size Feeders Conduit Main Sw._.__._ Amps Main Fuses Amps
Type of Installation c onduit Tubing , Moulding
Amount of Permit $ /' (Signed)
Electrical Inspector .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under! this permit, as are
licensed by Miami Shores Village.
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appearei
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
II
My Commission Expires Notary Public, State of F1onda
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for'inspection, or faulty
materials and /or workmanship.