1230 NE 91 Terr (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address / 3 /V l 1 J tgitax Folio
Legal Description �J Historically Designated: Yes No
Owner/Lessee /Tenant v1 2 / G,�i M aster Permit # � 9 V) ¥ 9ss��
Phone
Owner's Address / 0 . L'- • 9 I 7`_ /•
Contracting Co. fi 7 -Z 6-=- C - 7 --,. 1 i C rftc - Address 6 C (D P //, , j 3c' /
Qualifier 'S r0' it/( E - C 2 — SS# Phone 3UJr 6 / 2)1
State # G 0 00 6 6 Municipal # Competency # Ins. Co. P.M& , - D- r e Y
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION kvc I re
Square Ft. ‘F-1C
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that one in compliance with all appl cat e laws regulating
constction and zoning. I� thermore, I authorize the above -named contractor to do th
(..
l ,z-e.-4A-- 7/� / ®/ �
Signature of owner and/or President Date Si aturr � for or Owner- Builder
gna � o Condo Presr en gn � �a
APPROVED:
Zoning
Mechanical
Notary as to Owner and/or Condo President
My Commission Expires:
1/
RITA K. POLLARD
I.: ,a‘ , .� MY COMMISSION # DD 030203
W,. ",-
•.— a/ EXPIRES: May 30, 2005
' Bonded Thru Notary Public Underwriters
FEES: PERMIT i/ �° kf RADON
.&. !/' /
Date
Building Electrical
Estimated Cost (value) .a
9,7,0/
Notary as to Contrac or Owler- tL •AON ,i d
My Commission Expires: S3HIdX3 SbLaL NOIS AP o . > 31 ° a
D
ElasvnN Nassir Woo
83aNVN8 sun U '�g ,0
,VAS ANVlON 1VYJWO ' , d A
C.C.F. I . ,, f NOTARY (. BOND
TOTAL DUE
Date
e
Plumbing Structural Engineer
ITEM
BATH TE
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
Co
FEE
7
ITEM
SPACE HEATERS
UNIT
FEE
B IOET
LIGHT CUTLETS
/7
,2,RE,cCENTRAL
HEATING
DISHWASHER
RECEPTACLES
/ AV
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN A PS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/IETER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
'/
OCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
i
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTCRS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 FP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWI)f,IING POOL
CUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER '
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION CUTLETS
ORAINFIELO, 4' TILE/RES.
PUMP
VIOLATION
3 ABANDON SEPTIC TANK
SOAKAGE
REINSPECTION
PIT CU. FT.
CATCH BASIN
D
I SC`{ARGE WELL
DOMESTIC
WELL
AREA GRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE
STANDPIPE
'COL
PIPING
LAWN SPRINKLER SYSTEM
3AS RANGE
ZTER
SET (GAS)
3AS PIPING
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No N ®� C D ate. .. t �°' G 77
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiucida,
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
building during progress of work
MIAMI SHORES VILLAGE
No
Street./
Owner's Name and Address
Registered Architect and /or Engineeerr 14V
,
Employing ElectriciaA's Name Q' 6 �� "�� / No
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
Street i,
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Ins ation— Conduit Tubing B.X.L Metal Moulding
di4;
mp ,. 4-? 'ity P-°,-54 e'
Amount of Permit $ 1 (Signed)..F!" LUG - *tt
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 3966, 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 ins ection 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- ntracto , on • ork to be performed under this permit, as are
licensed by Miami Shores Village. f - �? 7
Master Electrician.
STATE OP FLORIDA, D
COUNTY OP DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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
RECE'P•T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
H
TOTAL
CONTR.
LIST
y�
/ '
o( F
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No N ®� C D ate. .. t �°' G 77
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiucida,
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
building during progress of work
MIAMI SHORES VILLAGE
No
Street./
Owner's Name and Address
Registered Architect and /or Engineeerr 14V
,
Employing ElectriciaA's Name Q' 6 �� "�� / No
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
Street i,
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Ins ation— Conduit Tubing B.X.L Metal Moulding
di4;
mp ,. 4-? 'ity P-°,-54 e'
Amount of Permit $ 1 (Signed)..F!" LUG - *tt
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 3966, 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 ins ection 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- ntracto , on • ork to be performed under this permit, as are
licensed by Miami Shores Village. f - �? 7
Master Electrician.
STATE OP FLORIDA, D
COUNTY OP DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
c): - --
Owner's Name and Address. j9.� � -, ..../ Ce. .1..Q/ C- No /.c23 Li 0 Street i/• ,• 9 � .
Registered Architect and /or Engineer....d .C../ "Z. ‘12-0..)/.0/e-/
STATE OF FLORIDA, 1
COUNTY OF DADE. I j
Employing Electrician's Name No
Z Jk"- .4r o T �
Location and Legal Description Lot„�ca. /..d, . ✓..at4.,�Gr ..E4...Block
Street and Number where work is to be performed—No...../..a2.,30 .
State work to be performed and purpose of building (By Floors).._.0..oL.o1. .4..
New Building Remodeling Addition V
5$.
Street
Subdivision
...... atreet....0y....F
A .t ..O ern,
2 — .
Cce,
Repairs No. of Stories .1
• Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground \�
Type of Installation — Conduit A. Tubing ... B.X.L Metal Moulding
Amount of Permit S . '� (Signed)
El e cal 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.
(Si
OWNEkr
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
H ATER
STRIP
HEATER
TOTAL
CONTR.
LIST
l 0
pr
; )
.�.
�;� y
CHECK
(
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
I
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
c): - --
Owner's Name and Address. j9.� � -, ..../ Ce. .1..Q/ C- No /.c23 Li 0 Street i/• ,• 9 � .
Registered Architect and /or Engineer....d .C../ "Z. ‘12-0..)/.0/e-/
STATE OF FLORIDA, 1
COUNTY OF DADE. I j
Employing Electrician's Name No
Z Jk"- .4r o T �
Location and Legal Description Lot„�ca. /..d, . ✓..at4.,�Gr ..E4...Block
Street and Number where work is to be performed—No...../..a2.,30 .
State work to be performed and purpose of building (By Floors).._.0..oL.o1. .4..
New Building Remodeling Addition V
5$.
Street
Subdivision
...... atreet....0y....F
A .t ..O ern,
2 — .
Cce,
Repairs No. of Stories .1
• Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground \�
Type of Installation — Conduit A. Tubing ... B.X.L Metal Moulding
Amount of Permit S . '� (Signed)
El e cal 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.
(Si
OWNEkr
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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.
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE 192
PLUMBING ❑ P E R M I T N? 9 9 7 7 Contractor's
License No.
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements oy-specifi tions and that he assumes responsibility for work
done by his agents, servants or employees.
Signed•
Subdi-
vision
Sq. Ft
Value of
Project $
SPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for work done by either, myself, my agent, servant or employee.
1
CONTRACTOR OR BUILDER
Amt. of
BY AUTHORITY
Work to be performed under this Permit
. 01P
Permit $
BY
building during progress of work.
Owner's Name and Address L
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date 15 Iff/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of 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
Registered Architect and /or Engineer 1.7--7../...5' �`
Em loyi g Electrician) ame .. /.. .ZE ." � 7 No Street... ~ f�`. "I.���4 -- -�
# ,� II n/ Gtr . ` � 1;1;24 > f.° 6' � n � ' '
Location and Legal Dcscnph n Lot. Block Subdivision o
Street and Number where work is to be performed —No /�'°3 0 A A ' ?f / 2 -
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition 51`3
Se 0e Und rground Size Feeders .✓ " Conduit Main Sw Amps .,c® Main Fuses Amps
Type of Installation — Conduit.....) Tubing B.X.L Metal Moulding
I/
STATE OF FLORIDA, 1
COUNTY OF DADE
se.
(Signed)
fl
Repairs No. of Stories /
Amount of Permit S. ifi ®O (Signed) 1 7) , %lam
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 inspect' • on the site of the work such public not or notices
as are required by the Act. The undersigned agrees to employ only such sub•contracto work to be performed -.'i4 permit, as are
licensed by Miami Shores Village.
- ^!
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. HEAT.
CONN.
SPACE
H
STRIP
H
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•S HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
'I
p y
1-1-
building during progress of work.
Owner's Name and Address L
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date 15 Iff/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of 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
Registered Architect and /or Engineer 1.7--7../...5' �`
Em loyi g Electrician) ame .. /.. .ZE ." � 7 No Street... ~ f�`. "I.���4 -- -�
# ,� II n/ Gtr . ` � 1;1;24 > f.° 6' � n � ' '
Location and Legal Dcscnph n Lot. Block Subdivision o
Street and Number where work is to be performed —No /�'°3 0 A A ' ?f / 2 -
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition 51`3
Se 0e Und rground Size Feeders .✓ " Conduit Main Sw Amps .,c® Main Fuses Amps
Type of Installation — Conduit.....) Tubing B.X.L Metal Moulding
I/
STATE OF FLORIDA, 1
COUNTY OF DADE
se.
(Signed)
fl
Repairs No. of Stories /
Amount of Permit S. ifi ®O (Signed) 1 7) , %lam
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 inspect' • on the site of the work such public not or notices
as are required by the Act. The undersigned agrees to employ only such sub•contracto work to be performed -.'i4 permit, as are
licensed by Miami Shores Village.
- ^!
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
s� APPLICATION FOR ELECTRICAL PERMIT
Permit No. ..CZ / / f
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure hcrcin described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu: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 plans and specifications must be kept at
building during progress of work.
Owner's Name and Address -/ No / Street Pv' f q
Registered Architect and /or Engineer • Employing, Electricia6's,,.Namcc,. . 5i ,.Q..`? ` •t'�G i ' c-- 4 s'.L�'' .. No q' od -`/ Street
"II' o �/ fe ® oO' o2 q' y� , a ,
uon and tga teenpt n Lot ��� L (2 lock °l Subdivision 1y!?.e. � � ;�
Street and Number where work is to be performed —No I .�.6 ..... Street de s i
State work to be performed and purpose of building (By Floors) LA u :;A' �� 4 P ��'s� % 'i + ” �%
,,,,,,I. - ..
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit.. Main Sw Amps Main Fuses Amps
Underground
Type of Installation-- Conduit....11,` u e Tubing.. ... B.X.L.. .Metal Moulding
Amount of Permit $ .... ".�
STATE OF FLORIDA,
COUNTY OP DADE. I °°'
(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 subcontractors 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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).. . - .:�'
Jw6
4.79
Date ' ; .gyp/
Master Electrician.
Before me, the undersigned authonty, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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.
t,
SWITCH
0
LIGHT
OUTLETS
PLUG
RECE•••T'0
FIXTURES
NO LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
M
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
GIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
;-
�''��;
y�, S
.�,/,A; „
MOTORS
0.1 HP
MOTORS
1.0 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
�,1-
�I
,/
.� 11 . , '
9 c 1
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
s� APPLICATION FOR ELECTRICAL PERMIT
Permit No. ..CZ / / f
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure hcrcin described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu: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 plans and specifications must be kept at
building during progress of work.
Owner's Name and Address -/ No / Street Pv' f q
Registered Architect and /or Engineer • Employing, Electricia6's,,.Namcc,. . 5i ,.Q..`? ` •t'�G i ' c-- 4 s'.L�'' .. No q' od -`/ Street
"II' o �/ fe ® oO' o2 q' y� , a ,
uon and tga teenpt n Lot ��� L (2 lock °l Subdivision 1y!?.e. � � ;�
Street and Number where work is to be performed —No I .�.6 ..... Street de s i
State work to be performed and purpose of building (By Floors) LA u :;A' �� 4 P ��'s� % 'i + ” �%
,,,,,,I. - ..
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit.. Main Sw Amps Main Fuses Amps
Underground
Type of Installation-- Conduit....11,` u e Tubing.. ... B.X.L.. .Metal Moulding
Amount of Permit $ .... ".�
STATE OF FLORIDA,
COUNTY OP DADE. I °°'
(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 subcontractors 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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).. . - .:�'
Jw6
4.79
Date ' ; .gyp/
Master Electrician.
Before me, the undersigned authonty, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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.
My Commission Expires Notary Public, State of Florida
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.
t,
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n l(� -1 6 1 Permit No. ! --
Name
Address J2ao I' A
Company
Phone # I / ,'S. 453
For Inspector: i/ 2:7/0/ J Name : Date
/
Approved
Correction
Re- Insp'n Fee
Date
My Commission Expires:
FEES: PERMIT
PERMIT APPLLIICATION FOR MIAMI SHORES VILLAGE 6
Job Address / ®/ Y E 'q / relf • Tax Folio
Legal Description / / j� Historically Designated: Yes No
Owner/Lessee / Tenant / °!I' r "/ �f t ° l a m r / p� /f a' /;! l % Master Permit # ' 9 ' 41 3
Owner's Address (2X' C it lef/Q e ' Phone 6-4 7 9 l 0g5 <k
::3°) 4L3 5---- /'72YV0W/ Y/ ir
Contracting Co. h QW1 ,PV
Qualifier SS#
State # Municipal # Competency #
Address
Address
Architect/Engineer
Bonding Company Address
Mortgagor
5 " 2 r' �dds's
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION t er ' 'O 1 W V N 6 OF /I77Nfr tri k' fad /1- 4L/PIP p
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that ,all work will be d
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
APPROVED:
_Zoning Building
Mechanical Plumbing
RADON C.C.F. ' NOTARY —®
. ()/r; 72 d k// /b' M. t /2) P(3 ' / r-rir 1l . rd R6 -/yf '�i
Square Ft. Estimated Cost (value) /2
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
a/64.4
Signature of owner and/or Condo President Date ' Signature of Contra or or Owner- Builder
Notary as to Owner and/or Condo President Date No
My Commis ion expires: `1\- b - ?
o�
ctor or Owner- Builder
NANCY JONES
MY COMMISSION # CC.876384
EXPIRES: November 6, 2003
, h Bonded Thru Notary Public UndNMVlt$r6
Structural Engineer
in compliance with all applicable laws regulating
Phone
Ins. Co.
1 ec!
PERMIT NO,
ADDRESS:
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
SECTION
BY
DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
" PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
I. Sub!act to compliance with alt Federal. State.
Co wtyXt1tage rules and regulations. Village assumes
no responsibility for accuracy of /or results from
these plans.
2. This copy of plans must be available ea
buAding site or no tnspection will be conducted.
' JOB ADDRESS
APPLICANT
PHONE #
APPLICATION # (9�
SHEET OF
MISCELLANEOUS
•
DATE
2 3®, e
CRITIQUE SHEET
COMMENTS INITIALS
r
- -
/
/
;i1 1!1
' 1,
/
2
A "‘
,
1- OJ -- 1N70:Z7- 1 ,AT T. ON 7
C017,711n: 12,0632
No. 93
of
.J
Elevation:
H'00 2LVD
Note Underground
:2ncroachments and
1:ti if any,
'fence
ewnersnip by
ownersnio
.71ot determined.
11
I I
4-
This
Tasterly of
the Esterly 20 feet therec
accordinc to the Plat t.lcof_
Plat 9, PaL3e 1/1
1.),7dfl CoLlnti,
Cerified To: tioduff, i;orn - Aa . 11, P.A., Aftorney - ±nn=lnee and, inc.,
mael A. and 2-ilenele A. and 7layh t Associate-:,
steces:r4ors .:11d/or assitIns.
-
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In
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