ELECTRICAL PERMITBUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
❑
PERMIT N? 9744
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Work to be performed under this Permit:
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
heretor 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 or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed•
�* f
r
DATF.
Contractor's
License No.
196
BY
INSPECTOR
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 all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
a 17
r
n
Lot
BI.
Subdi-
vision
If
,
Sq. Ft
Amt. of
Permit
$
Value of
Project
$
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
❑
PERMIT N? 9744
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Work to be performed under this Permit:
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
heretor 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 or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed•
�* f
r
DATF.
Contractor's
License No.
196
BY
INSPECTOR
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 all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
a 17
Permit No
7
New Building Remodeling Addition
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
1/
88.
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made when
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
iJ /7 c)
r 7
/
(Signed).
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.
Owner's Name and Address t.? E < E
Registered Architect and /or Engineer -
Employing Electrician's Name „ �" 'c '
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)
No 1.• t9 Street
P 1
Overhead j
Service Underground Size Feeders Conduit Main Sw. Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub•contractors, on work to
licensed by Miami Shores Village.
No Street '1../ Lej ,/I!w'Zt t. •
Repairs No. of Stories
4
(Signed) ., --•U
ricdl Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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 facto
therein by him stated are true.
Notary Public, State of Florida
such re•inspection is made necessary by improper notice for Inspection, or faulty
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER .
STRIP
HEATER
TOTAL
CONTR.
LIST
•
-• 2
G (�
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/ c-`, OF/
.3_ 1/I
CHECK
Permit No
7
New Building Remodeling Addition
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
1/
88.
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made when
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
iJ /7 c)
r 7
/
(Signed).
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.
Owner's Name and Address t.? E < E
Registered Architect and /or Engineer -
Employing Electrician's Name „ �" 'c '
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)
No 1.• t9 Street
P 1
Overhead j
Service Underground Size Feeders Conduit Main Sw. Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub•contractors, on work to
licensed by Miami Shores Village.
No Street '1../ Lej ,/I!w'Zt t. •
Repairs No. of Stories
4
(Signed) ., --•U
ricdl Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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 facto
therein by him stated are true.
Notary Public, State of Florida
such re•inspection is made necessary by improper notice for Inspection, or faulty
REQUEST FOR INSPECTION
Company 7 1 /'
- -
PHONE
Job C
Address
Time Ready
Inspection
A.M. /' P.M.
. 4
Date Ready
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.
Owner's Name and Address '
Permit No .....
/
No
Street
Registered Architect and/or Engineer
Employing Electrician / 's Name / 41 `" .t 4 No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No L Street
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—Conduit Tubing r B.X.L Metal Moulding
(Signed) .- 1 *if
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he' u‘derstands and accepts his- o ligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flotidk Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-cohtfactors 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.
Amount of Permit $.
STATE OF FLORIDA, }
t
SS.
COUNTY OF DADE.
(Signed) 1
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
R EFR I G.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
/
7----
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1-5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CH ECK
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.
Owner's Name and Address '
Permit No .....
/
No
Street
Registered Architect and/or Engineer
Employing Electrician / 's Name / 41 `" .t 4 No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No L Street
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—Conduit Tubing r B.X.L Metal Moulding
(Signed) .- 1 *if
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he' u‘derstands and accepts his- o ligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flotidk Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-cohtfactors 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.
Amount of Permit $.
STATE OF FLORIDA, }
t
SS.
COUNTY OF DADE.
(Signed) 1
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
1
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 or specifications and
that he assumes responsibility for work done by his agents, servants or employees. ;
d r ,
Signed: Ke .•" By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ppdinances and g a.
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami hd1ek'
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3723
j,..
Bl.
Subdi.
vision
Value of
Project
DATE
Work to be performed under this Permit °�
r
A . N .
Contractor's
License No.
Amt. of
Permit
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Build
Legal
Descripti
Address
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 3723 1
DATE
Work to be performed under this Permit
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 or specifications and
that he assumes responsibility for work done by his agents, servants or employees. i
j.
Signed By J
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions 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 all work done by either myself, my agent, servant or employee.
13Y AUTHORITY
Contractor's
License No.
194 °'
�! �
W. ,
)
You are ;,i, i ,. � r; ;f .. , . , J1'; � r(
Gr. d in ^^:: r 't
Bond office before sat ,,;;� t;.e ;�o,h auti,o-;zd m
this permit.
)1.
r
]
�!
i i
Dn
Lot
BI. 7.
{�..,
vision
vision
)f
'
`L
f!
`�
f
Value of
Project
Amt. of /
Permit
i
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Build
Legal
Descripti
Address
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 3723 1
DATE
Work to be performed under this Permit
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 or specifications and
that he assumes responsibility for work done by his agents, servants or employees. i
j.
Signed By J
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions 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 all work done by either myself, my agent, servant or employee.
13Y AUTHORITY
Contractor's
License No.
194 °'
)UII.DING
14,ECTRICAL PERMIT N° 9899
iLUMBNG
Owner of
Bl
Architect
Contractor �t
or Builder ,/,/
Legal Lot Bl.
Description
Address of
Bi4ilding
MIAMI SHORES VILLAGE, FLORIDA
DATE ` ' --r� -- / 195
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit $
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
het�efor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
dra wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
e 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
g ted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
p aining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
doe by his agents, servants or employees.
Signed • 1 - BY 1
IN ECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorit s of Miami Shores Village.
In ccepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
A J'
CONTRACTOR OR BUILDER
BY AUTHORITY
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith Sub fitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shor Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r gulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plansd specifications must be kept at
building during progress of work.
, /"� �,
Owner's Name and Address ___. ..✓ ± ?.._.,1_ - _..-e.a :___ No.___:__ z____. Street .__.,, ,-
Registered Architect and /or Enginee
Employing Electrician's Name "z. "" No.
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition.. Repairs
Amount of Permit $
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
ELECTRICAL INSPECTION DEPARTMENT
_Block
Service Overhead Size Feeders_____ Conduit.__ Main Sw.______ ___ Amps. Main Fuses__
Underground
Type of Installation— Conduit 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 com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Date
Street
My Commission Expires Notary Public. State of Florida
r.
No. of Stories._
Master Electrican.
Amps.
STATE OF FLORIDA,
COUNTY OF 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, that 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.
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
HEATER
STRIP
HEATER
TOTAL.
CONTR.
LIST
i-
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
N HON
TRANS.
RADIO
TOTAL.
CONTR.
LIST
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith Sub fitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shor Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r gulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plansd specifications must be kept at
building during progress of work.
, /"� �,
Owner's Name and Address ___. ..✓ ± ?.._.,1_ - _..-e.a :___ No.___:__ z____. Street .__.,, ,-
Registered Architect and /or Enginee
Employing Electrician's Name "z. "" No.
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition.. Repairs
Amount of Permit $
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
ELECTRICAL INSPECTION DEPARTMENT
_Block
Service Overhead Size Feeders_____ Conduit.__ Main Sw.______ ___ Amps. Main Fuses__
Underground
Type of Installation— Conduit 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 com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Date
Street
My Commission Expires Notary Public. State of Florida
r.
No. of Stories._
Master Electrican.
Amps.
STATE OF FLORIDA,
COUNTY OF 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, that 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.
FLOORS
FIXTURE ONLY
NUMBER OF
Total
Outlets
SIZE OF
Size Service
Conduit
No.
Circuits
Lights
Ceiling
Brackets
Mains
Subs
Branches
asement_
first
b
/ t ) t
o I
;.«
A�
A
tcond
hird
ourth
Form 246
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICA-
Lot Number
Street and
Owner
Occupied as
Building —New or Old (underline which).
H. P. of each motor Volts
Lights
� LJt/J
Ceiling
APPLICATION No. ��'
DATE 19 _
Electrical Department. of the City of Miami
Desiring your Certificate of Approval, application is hereby made
for an inspection of the electric installation in the premises stated be-
low, for which undersigned agrees to correct any infractions of the
National Electrical Code and the City Ordinance pointed out by Inspector.
Block Number
_ wither / z O " `. d 9 /
Su TC Id /F
Brackets
Kind of Installation Open or Concealed —Knob, RX., BX., Mldg. Conduit
F
S
T
REMARKS
By
Contrac
Received by Inspector
Progress
Will Inspect again
Rough Wiring
FINAL No
Corrected
Temporary
Date Issued
_Days
Remarks
TION WILL BE RETURNED, _ •
Gam/
5
Subdivision
Receptacles
Switches
SPACE BELOW FOR INSPECTOR'S USE ONLY
-
Occupant
Work — Additional, New, Alteration or Repair.
SPECIFICATIONS
nspection Wanted
ddress rr Its _ —
•A
Inspected
Total Amps Phase
Stoves Water Heaters
a---
Side
S
Inspector
Signs I Other Apparatus
Fee remitted J .1