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ELECTRICAL PERMIT
Type Insp'n Permit No. Name iM Address MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date , Time Phone # 3 Q __ y a\ D1 For Inspector: 1 ) 2..i / 0 3 Name& Approved Correction rne `ZO Sa l l ' 0 '3 Re- Insp'n Fee L`J W `Oa/r v' -t ,62i4 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Date 3 Time For Inspector , . 43 Approved Correction Re- Insp'n Fee Type Insp'n Permit No. E ape; "' e?....3 y Name ah,24,.Q.0 Address 7 �3 A/e 0 61 Company t! iaa Phone # Date Q °/3" ®2) Time Type Insp' n / 4 /h. 4 i' / 1 Permit No. £L O2 ° 0 Name Address Company Phone # For Inspector: $ / y/.. 6 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request I v , s Crao`' a 9 '4J6 f, 574 Sty dos° o ff, m6 ce7 L!7 o �. streo`re. Pj e to)/25 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - °02- I �Time Type Insp' n /�� �i (% 2 Permit No. F2_ Z - 2,3v Name Address `T A ' 3 Company Ciu 7S S Phone # ..3 ®c gi ya_ For Inspector: e� ® Name & Date Approved ❑ �J Correction a — :40%'2— Re -Insp' n Fee ❑ -z 00 b s 7 l e ®,Y - fry ,v - reel -4L - A✓4 452 G /Ze;i ;vim/ atotited ��jzs- j7 ,,62i51- �s1t�i Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request J� Date ° C A 6 1 Time C4140 ra-64 Ne 3os 6s- 7 For Inspector: _ v ®), Name & Dat Approved , ❑,, / c� Correction Re- Insp'n Fee PERMIT APPLICATION FOR MIAMI SHORES VILLAGE � - CIOoI • Date 1/ /3/ Oa Job Address Tax Folio Legal Description eS Ae 'C° Owner/Lessee / Tenant Lb UV') Cc) b c qSo Master Permit # �� p�ja -- ` 0 Owner's Address `ken _\ \ST ( 4-c - \\Q(1'1\ �\(\oSC Phone 30 -(VG —0 6 Contracting Co. Levj \ S S e Dee CAA ) Address \- —) Q c cka(A cY 309 Qualifier Le tio I S 54 O en ( (A rk SS# Phone l blo to \ State # E C., )t)t 3 \—I 5 Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING LECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION j 7c/if 7 i t Square Ft. Estimated Cost (value) 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. OWNERS AFFIDAVIT:, I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. a of owner an or Condo President Date pie? 7 /1 / Notary as to Owner and/or Condo President Date N as to Contractor or Owner -Buil Date My Commission Expires: y Commission Expires: FEES: PERMIT 'OP RADON C.0 Historically Designated: Yes No Competency # Address Address 7 // p Signature of Contractor or Owner - Builder D e OTARY BOND Ins. Co. 40;11 Melinda K. Edelsberg ? Ri o Connnission # DD088207 :=E Expires Mara 8, %.7 , o thr 2006 Atlantic # CO., Fit. APPROVED: Zoning Building Electri ),eg ✓ ' " 3 Mechanical Plumbing Structural Engineer TOTAL DUE Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2002 -234 Printed: 7/18/2002 Applicant: LOUIS Owner: CAPORASO JOB ADDRESS: 428 NE 91 Contractor CURTIS LEWIS STEVEN Local Phone: Parcel # 1132060190060 Permit Status: Approved Permit Expiration: Work: �_. a Total Fees: $6:00 Total Receipts: $0.00 SWITCHES LIGHTS RECEPTACLES If thcrn I'� - - - -- PAY TO THE ORDER OF ACH R/r 06310027 JT Bank of America. Legal Description: 6 53 42 EL PORTAL f 11 L.S. CURTIS INC. 17570 ATLANTIC BLVD. UNIT 309 SUNNY ISLE, FL 33160 Electrical Permit 1/14/2003 CAPORASO LOUIS ST Contractor's Address: 17570 ATLANTIC BLVD Construction Value: 1.7 17:16 DATE $1,800.00 Page 1 of 1 PB 9 -101 LOT 9 & W1/2 OF LOT 8 & E2.5FT OF LOT 10 .3031 63- 271631 FL 966 DOLLARS 8 °° Re- inspection iI 'cation herefor in strict compliance with all ifications that may have been submitted to 3 or if the plans are changed without wnsibility for a thorough knowledge of the that he assumes responsibility for work done 's pertaining thereto and in strict conformity :sponisibility for all work done by either FOR o 273600 I 1'00303Ltt' 1:063 LOO 27? 0036 u.�u \' . -r i_ a czr" a.-G_ —u rater u rzamis+ ITEM BATH TUB UNIT - FEE ITEM SWITCH OUTLETS UNIT ‘ FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS / CENTRAL HEATING OISHWASHER RECEPTACLES T . A/C (WINO) D I S?OSAL SERVICE TEW R RY A/C (CENTRAL.) . DRINKING FOUNTAIN SERVICE SIZE IN PPS DUCT KIRK FLOOR DRAIN SERVICE REPAIR/IETER CHANGE REFRIGERATION GREASE TRAP _ APPLIANCE OUTLETS PROCESS AM PRESS PIPING INTERCEPTIR _ RANGE TOP UNDER *C TANKS L.AVATIRY OVEN ABOVE ADD TANKS LAUNDRY TRAY WATER HEATER 1 U.F. PRESSLRE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT/3 COMP. MOTTRS OVER 3- 5 HP MECHANICAL VENTILATION t SINK, RESIDENCE MWTD S OVER 5- 8 HP TRNGPORT I1G ASSEWLIES SINK. SLCP M1J1t S OVER 8- 10 HP ELEVAT0RS/ESCAIATORS • TEMPORARY WATER CLOSET MOTORS OVER 10- 25 If FIRE SPRINKLER SYSTEMS URINAL MQTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WIICOW _ REIINSPECTION WATER SLPPLY TO: AIR CONDITIONERS - , A/C UNIT STRIP HEATER F IRE SPRINKLER GENERATORS TRANSFCRIERS _ HEATER -NEW INST. GENERATORS. TRANSfERWRS HEATER - REPLACE GENERATORS TRAH6FDFt1ERS LAWN SPRINKLER -WELL SPECIAL REPOSE _ , SWIMMING POOL ' OUTLETS MUCCI& WATER SERVICE • SIGN RUES SEWER CONNECTIONS SIGN 1RANSfOR1ER;S - UTILITY-SERER SIGN TIME CLOCK UTILITY -WATER FIXTURES ' 6 _ _ SEPTIC TANK • ANTENNA RELAY TELEVISION CUTLETS , GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABAIOON SEPTIC TANK RE I!6?ECT ION SOAKAGE PIT W. FT. CATCH BASIN OISCNARG( WELL _ DOMESTIC WELL AREA GRAIN ROOF INLET SOLAR MATER NEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM _ 1 GAS RAGE METER SET (GAS) GAS PIPIIG t ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT RUST ACCOMPANT THIS ADDENDUM. IF A MASTER PERHIT HAS B. OBTAINED, THE OWNZ NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL LO t S C A ?o2 FSo Res 4 2'8 NE Q -7' st \\\r\r1 1 iotae , R- T�1 BOOK 2� 1`� O p L I N Cr CRFPLACEMENT ©F 2IN) 1 NlDO S) LEGAL DESCRIPTION WT n <. = NO:. ' ?..5h F (4 .�Z78'DIV S ON: (C. ✓ ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK AT PAGE 16) I ! OF THE PUBLIC RECORDS OF '/P COUNTY, FLORIDA. i LOCATION SKETCH SCALE 1 i d Ij C..D.S. : CO CR_TE ^ OC( STRUCTURE 6 m.c Te :T:fi*F- T ER MACSTENAI7 E EAI.7MT. P.FE 2.t = FIIJ`:D QR1L KIILE (VC cA cc MEtrr 7; D UXR SIP. H. ti0... �✓ -- — CHECKED BY: '.7TE CF: TI F ,Et DSUFiVE'Y ° It?- ) I c 7 P v:S!ON DAL:: ABBREVIATIONS IF ANY APPLID) CL =CLEAR U.E. :.EY.CRII CKICENT t�l PROP. Cal F.H. EASMT. F.R.O. 3.0 .H. CALC. SURVEYOR'S NOTES. - ^l :1: `,C;::= 7:.,i`: t, r:.<N:_Yf D ai' a.!ENT. .A'1;;.^,!1 C.. I:!RRO'JFx.1 T8 HAV"r_ REEK LtICATEJ, EXC':PT AS 7OTiD. ND V '1':': E F :•.:R1ACFCVE iTS OTI -FR THAN THOSE S!:O :N '+ C2 "1 A :'H17CT me: Mid HAVE TO ES MADE TO CATER'4NE RECORDED !Y3 r..,...: x" Y'? SY V...1:171. MEA'...1 ONLY (IF ANY), LEGAL OWNEi x :P NOT DETFR'".'xto. `t'; ;;1. :''- ;T Ti) ANY CED.:CA:IO;J, 11M TATiL`NS, RISTROTIO�;S, REST RVATICNS OR = UT UTY EASEMErTT urs c "�4XLZ EA Er. ='7CXLIM.EJJT UXE E PERRY COWER F n KYDRR'.4T 7IID 'RE-CAR : T D::'li KOLE .CALL ED r ./0`r vjnf ��f� I -11M-i■ �'�1•�?)r �i ` . %gym „� SURVEY CERTiks TO e ✓ °� ;1?1, 7RUM NT, IF ANY EASEMENTS OF RECORDS. BLOCK i T,:'± A: TACHF :D SKF..T( ;H (IF POUNDARY SURVEY OF THE ABOVE OESCRI3ED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE I:Ni;f i ;Y 331ECP!t:N Alin ^ ?EL S THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AM) MAPT:.:RS U c:HAP';I - 61' G17-6 F1.(:ii,'!A ADMIN:STRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. .. J NL': fluR �I ;y ' a /� �� _ DRAWN BY: L E. BELTRAN ASSOCIATES, INC. 12533 S.W. 30th STREET MIAMI, FLORIDA 33175 PHONE: (305) 552-7450 CERTIFICATE OF AUTHORIZATION NUMBER LB 523 ERNESTO BEETI:&A! 1 PROKESSI6UAL St!AVEYF>R Ck FAPP-Ti 3 Ntt:'0 ;3 STATE OF FLOR:D'�3 DATE: _1? -- ti�H 1 -) NOTE: THIS IS NOT A VALID Si FLT ?t WiYF': r `7`1.70 I\Dte•MI .2.n1N, ..., .2 ...r tl 1.1' ''' -. o1,) Va■Q . 0b0 1PS PPrcr MICK TrfA : „ 1 5 / -p 3 ) SKETCH OF BOUNDARY SURVEY SCALE 1 '-' it- ∎rat 4 G,° za_sL1 I :r AMvt AOC OCCCDs`) J' Ytl Dell ACCI Imo 1 I ns: i':63A1- ^ nA 2; • ,tom ,/ I15 C! . rsnsa Baas= NEN Wt .p) (i < . filiom f go rr pca0R.. 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NoLL)V $I\Ir10 V4 o 3 1.1I1 oy ata 1■1 31-11- Ja 3 4r A")\19 d blsM iv i .541 jM 16 „S 1219 a3 iN 04r 11114 �Ilt�,lM10 .113 o MI -21 1,It (NYla c;cri4 339 C13H1 N 1w Id oy -N I I—.o MOdN I NI Qts -$) jNo ) I N3dD M oetN oNy 2102 3 &ler of To7 .�li y (Mi.)(1.j )1, k 61 7 ) (3atc) (j )t,No) �►o J.V1J1�n (it 5 9 G o t� t M M (04 * M o4N 1 M (h j�� /N oti.•tio ( C991 e.V1, J H ,x - NO,, N ou 4 i1Q 0_1141 a3 131106. 941 ad Y -AS33 1>J N SNoC.NIM 1+1012 C 14 ,S a36N0 tJ9 io S1406,11 I ri t•{1D4 J- I 1- 5 N0IvIM1131v z alo 121 nd��o�� ��d�idlJ- 58� CAPOIWO • EX1 -51114 1\11.JoiTZG--EMENT OV E)( r0cDr1 tqcw coNvre.uarra •-• coLoOTE EL a 20 CAL T IAN / o'°3" CA l& i NE TO D sa kio ArU 5e-rn)m 1'o J& ® crrtzr '1 AGt10i NE■J P�fi�4�20pf.'� rcJ TO -Ste: foc1 uooR. t 3 7 " _ _--- -- 29" ... . ' Neo 1 M ?PtiC t c= 1,R)irriooOF o�� IN lVow (5o 6/2. x 57 ") ►J ■ t4Do0" ro 0-.?E. Ctaco-. � GAWOR.k.S0 k 4)0- a • C %-r . • PI9 -Deter1 vi W %Z'.= • WitPOW Leis CAPo 1 SO VC6 i p €NGt. 42S N£ V 1 P Pt ( SHOILE-s ) . k. - 4.5130 O•i E Le, VA1ION • ma 5�. •,. c 1T �j. s _,_ • ;14i • / ; pb�n W 1 wpow L2,G a?l. icert5 I 1CC 4RE5►VENC g28 NE 4 11 41 '5i. 11iAt1I 641oQ,Es , �l,331 r. c. 1 _ _t:►iz. :��. • __.:_1,4in a mss 13 \Csi (‘-,1 E) C Le V R 1► 0 N �►�1t N'Po vJ ReptAcs EleN BUILDING ❑ PLUMBING ❑ PERMIT ROOFING ❑ 0 Owner of Building T+'► CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE / 3g N° 7902 Work to be performed under this Permit 'F._ CJ L . Architect Contractor or Builder C. LC % , - -- 1=-- L ,... c;.._ T 4 i t Legal Lot II Su}�df- Description Bl vision Address of L i Z c' - ! t Value of I Amount of f ------ # ''� L Building �t E ' Project $ I Permit $ vw — 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 applica- tion 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 respon- sibility for work done by his agents, servants or employees. ~ f 4 i � 19 6(.0. Contractor's S- S 0 License No. Signed. ` r ' r .. r c. ,. 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 ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT �"` • SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S -- T FIXTURES NO. LAS REFRIG. OUTLET id' IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEA ;ER STRIP HEATER TOTAL CONTR . LIST CHECK ENT. SW. DIST. CAB. SERVICE TC I:P. SERVICE PERM. MOTORC O.1 HP MOTORS 1.5 HP NEON TRANS. \- RADIO TOTAL Cow'. R. LIST CHECK MIAMI SHORE VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PE Permit No r Da Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su;.'itted 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 plied 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 Addres v No 7 /�17S / —O Street / �" Registered Architect an. eer - Employing Electrician's Name.. , g G . . ,. / Street _/ e5 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 STATE OF FLORIDA, l COUNTY OF DADE. I j 65. l5> (Signed) j Master c 'ri Service Overhead P Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding ‘1,. o U� 1 0 A .net of Permit $ (Signed) 1 `k Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts ' i 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, .✓ . re licensed by Miami Shores Village. 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date •7 --‘,/ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address �/ .. 1... �� [2 No / Street A ` l Registered Architect and/or ,.ifgineer Employing Electrician's Name - a .� - N �,'` .. .,..�. , � � L., �.�.: '. o Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of t$llation— Conduit Tubing. ...fl B.X. ..T Metal Moulding a ti' . (Signed) Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. 55. El ctrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 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 to be performed under this permit, as are licensed by Miami Shores Village. r _ ! �� o- ,^ S' /,'.i ✓ L�� / / - - -` (SignS�d) 7/ � Mastrer Electricia 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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. H EAT. CONN. ACE HATER STRIP HEATER TOTAL LIST 0 CHECK /f / E NT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. I MOT.ORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST . / L CHECK Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date •7 --‘,/ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address �/ .. 1... �� [2 No / Street A ` l Registered Architect and/or ,.ifgineer Employing Electrician's Name - a .� - N �,'` .. .,..�. , � � L., �.�.: '. o Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of t$llation— Conduit Tubing. ...fl B.X. ..T Metal Moulding a ti' . (Signed) Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. 55. El ctrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 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 to be performed under this permit, as are licensed by Miami Shores Village. r _ ! �� o- ,^ S' /,'.i ✓ L�� / / - - -` (SignS�d) 7/ � Mastrer Electricia 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.