15966CONTR.
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Permit No I.O �....d
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fio:ida,
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 plaits and specifications must be kept at
building during progress of work
Owner's Name and Addre ✓z a 1
Registered Architect and /or En ineer
Employing Electricians s Nam l o✓sy "�fi t:. der No & -47 / `S Str e .1 "°"s 33 f 3
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
SWITCH
OUTLETS
LIGHT
OUTLETS
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date.. 073
PLUG
RECE•P•T'S
•T°
Amount of Permit S. /9 '
Before Vhe undersigned
MIAMI SHORES VILLAGE
FIXTURES
NO. LAMPS
REPRIG.
OUTLET
IRON
OUTLET
No/ Wee ee it' 'Y��
, /''
/� i'
RANGE
OUTLET
igned)
RANGE
CONN.
WATER
H EATER
ENT.
Sw.
DIST.
CAB.
SERVICE
TEMP.
L k
1
fdAz
/
3 so
MOTORS
O.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
SERVICE
PERM.
/g JP
at. -
Overhead Size Feedon y'
ers Cduit Main Sw Amps .Main Fuses Amps
nderground
Installation— Conduit Tu B.X.L.....r .Metal Moulding
W. HEAT.
CONN.
SPACE
HEATER
Electrical Inspector.
The undersigned applicant for this building permit does hereby cer fy that he understands and accepts his pbligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5,,966, 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 inspeijio 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'contractod on work to be. pe under this permit, as are
licensed by Miami Shores Village. t - it ,
BURNS tit JAEGER, INC. d : _ r
501 S. W. 37th AVENUE (Signed)
STATE OF FLORIDA, } MIAMI, FLORIDA 33135
COUNTY OP DADS.
•
to administer oaths and take acknowledgments, personally
authority, a notary public, duly authorized
appeared /
to me well known, and who, being by me first duly sworn, upon oath deposes and 0-le says that he is the.e ' . '. °''
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.
NOTARY PUBLIC, STATE of FLORIDA at LARGE
MY COMMISSION EXPIRES JULY 12, 1974
BONGED THROUGH FRED W.DIESTELHORST
My Commission Expires
NOTE: A re "inspection fee of $1.00 will be made Ahen such re "inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
STRIP
HEATER
otary Public, State of Florida
PAAS
Master Electrician.
TOTAL
3e
IYo
TOTAL
/A. 0