800 NE 91 Terr (5)APPLICATION FOR ELECTRICAL PERMIT
Permit No 7 Date ll
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su•' itted fo 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 Vill ge shall • - : plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progre of
Owner's Name and Ad
Registered Architect
Employing Electrician's Nam
Location and Legal Description Lot / lock Su i' •ision : f. '1-
Street and Number where work is to be performed— No.1,0.o..� 9 ® Street. . ' . .r.`... 'ere C-... ..,_,...
State work to be perfumed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
0
Service Overhead Size Feeders Conduit Main Sw
Underground
Amount of Permit $
I r ?D' (Signed "fvd
STATE OF FLORIDA, AS S 7,
l
COUNTY OF DADE.
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
60
No Street
Street
Master
Notary Public, State of Florida
Amps Main Fuses Amps
Type of Installation— Conduuit Tubing B.X.L Metal Moulding
(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 =: ch 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 4 rmit, as are
licensed by Miami Shores Village. ,7 j �
ri an.
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.
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.
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APPLICATION FOR ELECTRICAL PERMIT
Permit No 7 Date ll
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su•' itted fo 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 Vill ge shall • - : plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progre of
Owner's Name and Ad
Registered Architect
Employing Electrician's Nam
Location and Legal Description Lot / lock Su i' •ision : f. '1-
Street and Number where work is to be performed— No.1,0.o..� 9 ® Street. . ' . .r.`... 'ere C-... ..,_,...
State work to be perfumed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
0
Service Overhead Size Feeders Conduit Main Sw
Underground
Amount of Permit $
I r ?D' (Signed "fvd
STATE OF FLORIDA, AS S 7,
l
COUNTY OF DADE.
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
60
No Street
Street
Master
Notary Public, State of Florida
Amps Main Fuses Amps
Type of Installation— Conduuit Tubing B.X.L Metal Moulding
(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 =: ch 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 4 rmit, as are
licensed by Miami Shores Village. ,7 j �
ri an.
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.
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.