ELECTRICAL PERMITPermit No
Owner's Name and Address
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
ci
SS.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
”Lit
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. /1
y (n
_ _ " -9 No
Registered Architect and /or gine
/Employing Electrician's Name_.'
'-'2--,.P and Legal Description Lot /�
. ZS2,re d
2t "Number where work is to be performed —No � ?
-7� � a
' - to to be performed and purpose of building (By Floors)
r ile /uilding Remodeling Addition
i ( j _
Overhead / O /. e
Service U� 2 / � Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation — Conduit Tubing. B.X.L Metal Moulding
r
62,2_ ,eLa
Block Subdivision
t� 4 7/
I
A l Inspector.
The undersigned applicant for this building permit does hereby ce tify that he understands and accepts his obli 'ions as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida P manent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contra rs 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 emplo only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village
Date
Street.°
P72-31
St eet
o.
1
Street ' Lfr 3 v""
Repairs No. of Stories /
(Signed ). .� L
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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
�� ��� Y ]
TOTAL
CONT
LIST
y
�I
1
I
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•5 HP
N EON
TRANS.
RADIO
TOTAL
CL
LIST
' ' -6
�'C9�
CHECK
Permit No
Owner's Name and Address
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
ci
SS.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
”Lit
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. /1
y (n
_ _ " -9 No
Registered Architect and /or gine
/Employing Electrician's Name_.'
'-'2--,.P and Legal Description Lot /�
. ZS2,re d
2t "Number where work is to be performed —No � ?
-7� � a
' - to to be performed and purpose of building (By Floors)
r ile /uilding Remodeling Addition
i ( j _
Overhead / O /. e
Service U� 2 / � Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation — Conduit Tubing. B.X.L Metal Moulding
r
62,2_ ,eLa
Block Subdivision
t� 4 7/
I
A l Inspector.
The undersigned applicant for this building permit does hereby ce tify that he understands and accepts his obli 'ions as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida P manent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contra rs 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 emplo only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village
Date
Street.°
P72-31
St eet
o.
1
Street ' Lfr 3 v""
Repairs No. of Stories /
(Signed ). .� L
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.
Permit No
1335?
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date July 14, 1970
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 Oliver No 324 N . E. 91 s t re e t
Registered Architect and /or Engineer
Employing Electrician's Name G i l M c D o n a l d E l e c t r i c Co . N 6930 S. W. 5 9 tst' feet l a c e, Miami , Fla
Location and Legal Description Lot Block Subdivision
324 N. E. 91st Street
treet
State work to be performed and purpose of building (By Floors) Instal l 21/2 H P air con d i ti one r
New Building Remodeling Addition X Repairs No. of Stories
Street and Number where work is to be performed —No
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P P
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 3 •0 0
STATE OF FLORIDA, y
COUNTY OF DADE. ss.
appeared
Before me, the undersigned authority, a notary public, duly authorized
Gil McDonald
to me well known, and who, being by me first duly sworn
of the above described construction, and he has carefully
therein by him stated are true.
(Signed) '11.L1.f
(Signed)..i 1 McDonald
lectrical Inspecto
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 sub - contractors, on work toe performed under this permit are
licensed by Miami Shores Village.
Master Electrician.
to administer oaths and take acknowledgments, personally
, upon oath deposes and says that he is the E l e c t r i c a l Contractor
read the foregoing application, and that he did sign the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T's
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS MOTORS
0.1 HP 1.$ HP
NEON
TRANS.
RADIO
TOTAL
C LST R,
2 2HP
Air Conditioner
$3.00
CHECK
Permit No
1335?
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date July 14, 1970
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 Oliver No 324 N . E. 91 s t re e t
Registered Architect and /or Engineer
Employing Electrician's Name G i l M c D o n a l d E l e c t r i c Co . N 6930 S. W. 5 9 tst' feet l a c e, Miami , Fla
Location and Legal Description Lot Block Subdivision
324 N. E. 91st Street
treet
State work to be performed and purpose of building (By Floors) Instal l 21/2 H P air con d i ti one r
New Building Remodeling Addition X Repairs No. of Stories
Street and Number where work is to be performed —No
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P P
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 3 •0 0
STATE OF FLORIDA, y
COUNTY OF DADE. ss.
appeared
Before me, the undersigned authority, a notary public, duly authorized
Gil McDonald
to me well known, and who, being by me first duly sworn
of the above described construction, and he has carefully
therein by him stated are true.
(Signed) '11.L1.f
(Signed)..i 1 McDonald
lectrical Inspecto
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 sub - contractors, on work toe performed under this permit are
licensed by Miami Shores Village.
Master Electrician.
to administer oaths and take acknowledgments, personally
, upon oath deposes and says that he is the E l e c t r i c a l Contractor
read the foregoing application, and that he did sign the same, and that all facts
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
ZONING
LINE & GRADE SURVEY
FIRE PREVENTION
PLUMBING
Owner L. O LI VER
This space represents the lot: make outlin of ground
plan showing distance of building from I 1 lot lines.
Miit4t rHo acs a AGE
CITY OF pF FLORIDA
Orr1CZ Or BUILDING INSPVCTOII
APPLICATION FOR BUILDING PERMIT
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 and
Zoning of the City of North Miami, Florida, and all provisions of the Laws of the State of
Florida, all ordinances of the City of North Miami, and all rules and regulations of the
Building and Zoning Department of the City of North Miami, shall be complied with whether
herein specified or not. A copy of approved plans and specifications must be kept at building
during progress of the work. p
Date... ` ( � L .. ._.._.. 19..7 C
_Address 3� T • `° • '
Signed.
Registered Architect and /or Engineer: J '� _ '��
Contractor D ') R D i E' f f Address )' - 6. �° L el & ER v I
Location of Proposed Work: Lot
Subdivision.
Street and number where work L t be done • T L
Description of proposed work • E � C L /v I ° Q( 1 i 0
n
' and for no other purpose.
New building. Remodeling..._.._.._ Addition....._....__...._... Repairs... No. of stories._ _ _
To be constructed of_.__..._ ..__ ___ . _ _.._ _I Ind of foundation.
Estimated cost of improvements: 8 . v 0 .-- .._........_... Plumbing
Block
Roof
Electric.
I hereby submit all the plans and specifications for said building. I hereby make application for a Certificate of
Occupancy. All notices with references to the building and its construction may be sent to:
o d
dersigned applicant for this building permit
s hereby certify that_... ....._._........,...nnderetande
d accepts...........__......_ .._ ...... _.._.._..obligations as an
employer of labor under the Florida Workmen's Com-
pensation Act, being Section 5966, Compiled General
Laws of Florida, Permanent Supplement, and has corn•
plied with the provisions thereof, and will require
similar conpliance from all contractors or subcon-
tractors employed by_._. __.. .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 u are required by
this aa4
wok L„
Mgr as Oontraa fa
Address:
is Space
0
of rife In T
Board of Adjustments Approval:
Planning and Zoning Board Approval:
Council Approval:
Sq. Footage: -----
Estimated
Bldg. Cost.
Bldg. Permit Fee •
Certificate of Occupancy Fee.
Total Fee: _...�
Approved by
Building Inspector:
Permit No.: A._.
- �.. ......
BUILDING
ZONING
LINE & GRADE SURVEY
FIRE PREVENTION
PLUMBING
Owner L . 0 L VE R
Registered Architect and /or Engineer:
Contractor O V A A i IV E d
Location of Proposed Work: Lot
This space represents the lot; make outline of ground
plan showing distance of building from all lot lines.
I St4o& St4okel )‚LL4ce
CITY OF I, FLORIDA
OFFICE Or BUILDING INSPECTOR
APPLICATION FOR BUILDING PERMIT
Application is hereby mode 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 and
Zoning of the City of North Miami, Florida, and all provisions of the Laws of the State of
Florida, all ordinances of the City of North M1emi, and all rules and regulations of the
Building and Zoning Department of the City of North Miami, shall be complied with whether
herein specified or not. A copy of approved plans and specifications must be kept at building
during progress of the work.
Address " • `� � G cot R J'r
Block
Subdivision.
Street and number where work L be done. 3 ti 7 '" •• 9/ .1
Description of proposed work. Ir M C f r s' ' �� ,, Ce ('( Ti o A
and for no other purpose.
New building.._.._.._ _.._ Remodeling..._...._._ Addition _...__. ._ Repairs.. No. of stories..
To be constructed of... __ __----------Kind of foundation. Roof
Estimated cost of improvements: _._.. ...v ®0 _ Plumbing Electric
I hereby submit all the plans and specifications for said building. I hereby make application for a Certificate of
Occupancy. All notices with references to the building and its construction may be Bent to:
Signed:
Address
The undersigned applicant for this building permit
does hereby certify that_...._.._.._. .understands
and accepts.... ____ _ _.. .. ..obligations as an
employer of labor under the Florida Workmen's Com.
!sensation Act, being Section 5966, Compiled General
Laws of Florida, Permanent Supplement, and has com-
plied with the provisions thereof, and will require
similar conpliance from all contractors or subcon•
tractors employed by..._.._.. .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 u are required by
this act (IC) , - •
(npr )
0
Board of Adjustments Approval:
Planning and Zoning Board Approval:
Council Approval:
of rite In T is Space
Sq . Footage: _..._...— ........_.._.. _ _._ ._._.._._.._.._.._.__
Estimated
Bldg. Cost:
Bldg. Permit Fee: ...._.__ ? �..._ �.._.._.._..�__.._..
Certificate of Occupancy Fee: _
Total Fee •
Fiuilding Inspector: Approved y l�•1 7/ _
b
Permit No.: A._..- - -• _!._` _ !,1
1
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
•
State work to be done and purpose of building (by floors)
C.
Date ? 1/ ) , 19
,_ �
Owner's Name and Address.... . � u?_ ._..� __ � ��' �'-� No.. ._:� �� `�%� � Street -/
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done �' %� �?� f. ef
r 7
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stones
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) `f, /: e
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
( Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member ... Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
r
Owner of
'Building
Architect
Contractor
'or Builder
Legal
Description
Address of
Building
Lot
1f/
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE ? 195_(
❑ PERMIT N? 4124 Contractor's
License No.
El ❑ Work to be performed under this Permit ' r `
'r : �.
Bl.
Subdi-
vision
Value of
Project $ `
Amount of r
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.
Signed ; r `' r 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY s,
Permit No
Application is hereby m{de 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 kcpt at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
,_.: No../
Employing Electrician's Name- .�' � _���f ` � ' '' '� �
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
Service
Type of Installation— Conduit Tubing 1{` B.X.L. Metal Moulding
oft
1 /
Overhead Size Feeders
Underground
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o gations 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 pefformed, under this permit, as are
licensed by Miami Shores Village.
• r c r ;° `
Q f `'
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
T erein by him stated are true.
r
APPLICATION FOR ELECTRICAL PERMIT
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
/i
No.___ Street_ —
Date
Street__v`_�t_1
Notary Public, State of Florida
Subdivision_ 11 ,
Street_ / 2 4 '
��r� - �_� --__
No. of Stories.__ --
Conduit__ Main Sw.___ - - ` J — Amps. Main Fuses_r__r:? ____Amps.
(Signed)
Master Electrican.
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
�N
!
t
_ `
ti
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
,
/�
CHECK
Permit No
Application is hereby m{de 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 kcpt at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
,_.: No../
Employing Electrician's Name- .�' � _���f ` � ' '' '� �
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
Service
Type of Installation— Conduit Tubing 1{` B.X.L. Metal Moulding
oft
1 /
Overhead Size Feeders
Underground
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o gations 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 pefformed, under this permit, as are
licensed by Miami Shores Village.
• r c r ;° `
Q f `'
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
T erein by him stated are true.
r
APPLICATION FOR ELECTRICAL PERMIT
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
/i
No.___ Street_ —
Date
Street__v`_�t_1
Notary Public, State of Florida
Subdivision_ 11 ,
Street_ / 2 4 '
��r� - �_� --__
No. of Stories.__ --
Conduit__ Main Sw.___ - - ` J — Amps. Main Fuses_r__r:? ____Amps.
(Signed)
Master Electrican.
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.