1020 NE 93 St (8)BUILDING
ELECTRICAL
PLUMBING
Owner of
Building ..��! j tj
Architect
Contractor
or Builder , G .�L_ t l �!'
Legal Ldt S 4r.. t 1 .1 BI.
Description r e, t •
.; , $
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N? 109;89
CONTRACTOR OR BUILDER
Work to be performed under this Permit_
Signed:
vi lion
Contractor's
License No.
INSPECTOR
BY AUTHORITY
195`
i s
Address of Vclue of Amt. of
Building
-- f !fi \ ,�,, .�'� v'" Prciject $ y Permit $
This permit i I granted to the contractor or builder named above to clnstruct 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 and trstanding 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 ate • esponsibility for a, thorough knowledge of the ordinances and regulations
pertaining to the wol;k covered hereby whether shown on the plans or drawings or -in rthe "statements or specifications and that he assumes responsibility for work
done by his agents, 6ervants or employees. �'�"`
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all dinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authori4iWof Miami Shores Village.
In accepting this per,nit I assume responsibility for all walk done by either, myself, :ny agent, servant or employee.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 10544
Work to be performed under this Permit
DATE
195 1.
Contractor's
License No.
Sc bdi-
Legal Lot Bl. vi; ion
Description
Address of 1 Volue of Amt. of
Buildin Project $ Permit $
This permit it 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 und:rstanding 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 nf`t done in compliance with such ordinances or if the plans are c'ha'iged without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the ; esponsibility 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, lervants or employees.
Signed: t BY .. j
INSPEC R ,at
In consideratitln of the issuance to me of this permit I agree to perform the Nzork covered hereunder in compliance with all ordinances and regulations
pertaining thereto anit 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, iny agent, servant or employee.
c I
COl OR BUILDER" PY AUTHORITY
Owner of
Building
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal Loll
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 10551
Work to be performed under this Permit
Bl.
Su xdi-
vis Lon
Vcz,ue of
Prcject $
DATE 195
Contractor's
License No
Amt. of
Permit $
This permit ia granted to the contractor or builder named above to construct tI,e building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the and trstanding 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 nllt 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 • 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 Vill, ge.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Permit No .Q�.. e
Application is hereby made for the approval of the detailed statement of the pl sns 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 No Street
Registered Architect and /or Engineer '-----..
Employing Electrician's Name 9 No Street
Location and Legal Description Lot Bloc'. Subdivision... J„ > .'
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 Undeground
Site Feeders ' °.. Conduit:... Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
i
Amount of Permit $
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, Coripiled 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.coritractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
s s.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date _-
(Signed)
Electrical Inspector
(Signed . )
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
F;ANGE
(:ONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
/
e
°
)
A
/!
/7
CHECK
( �( tt�
`f eilt%
�f
A kir
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p ��� O .�
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,,,:7 5
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
C•I HP
MOTORS
1.3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
p _
/
, ___
Permit No .Q�.. e
Application is hereby made for the approval of the detailed statement of the pl sns 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 No Street
Registered Architect and /or Engineer '-----..
Employing Electrician's Name 9 No Street
Location and Legal Description Lot Bloc'. Subdivision... J„ > .'
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 Undeground
Site Feeders ' °.. Conduit:... Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
i
Amount of Permit $
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, Coripiled 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.coritractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
s s.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date _-
(Signed)
Electrical Inspector
(Signed . )
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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 1l
Application is hereby made for the approval of the detailed statement of the plates 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 � fi � ',C ' f ' No Street
Registered Architect and /or Engine f ,
Employing Electrician's Name /lo Street
Location and Legal Description Lot Block Subdivision
ll
`` ^�
Street and Numbi:r where work is to be performed —No �...� Street...•�•y/ 4a�J
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
88.
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (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 rhquire 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 Miam:i Shores Village.
' 0
(Signed' J G U i
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 n:-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
R, MOIL
C )NN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
D1ST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MC
0.1 HP
MOTORS
1•5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
-
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�
/ •
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r--,
�1 �
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V
( �`
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* �S—
CHECK
/ , .
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> ,f
//
a- �
Permit No.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 1l
Application is hereby made for the approval of the detailed statement of the plates 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 � fi � ',C ' f ' No Street
Registered Architect and /or Engine f ,
Employing Electrician's Name /lo Street
Location and Legal Description Lot Block Subdivision
ll
`` ^�
Street and Numbi:r where work is to be performed —No �...� Street...•�•y/ 4a�J
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
88.
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (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 rhquire 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 Miam:i Shores Village.
' 0
(Signed' J G U i
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 n:-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.
Amount of Permit $
A1k,11 SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
G y - �jp�
Permit No APPLICATION FOR ELECTRICAL PERMIT
19 .1 f! d Date
Application is ):,ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
otructure herein deocribed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fio:ida,
and all provisiorlo of the Lawo of the State of Florida, all ordinances of Miami Shies Village and all rules and regulationo of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or nct. A copy of approved plans and specifications must be kept at
building during progress of work
Owner'o Name and Address > No. ia lit." Street 9-,3
Registered Architect and /or Engineer
Employing ElecrriciaA's Name`/ � ....alLe S +�d! No a A5 Street......dfi_ r�...
Location and L, :gal Description Lot Bloc c 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 erhea Site Feeders Conduit Main Sw Amps.. S.l�_ 2 Main Fuses Amps
Un ergnund
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 /.ligationo ao an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Ccmpiled General Laws of Flori Permanent Supplement, and
hao complied with the provisions thereof, and will require similar compliance rrom all contractors or sub-con !' .ctors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the sit of the wo ? public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub•ccnttractors, on work o be perfor ) der t permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OP :DADE. SE.
Before me, the undersigned authority, a notary public, duly authhricl to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly oworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing atiplication, and that he did
therein by him stated are true.
sign the same, and that all facto
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re•inapectio.i 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
REPRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
:ONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIFT
CHECK
ENT.
$W.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
AIOTORS
2.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHUCK
Amount of Permit $
A1k,11 SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
G y - �jp�
Permit No APPLICATION FOR ELECTRICAL PERMIT
19 .1 f! d Date
Application is ):,ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
otructure herein deocribed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fio:ida,
and all provisiorlo of the Lawo of the State of Florida, all ordinances of Miami Shies Village and all rules and regulationo of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or nct. A copy of approved plans and specifications must be kept at
building during progress of work
Owner'o Name and Address > No. ia lit." Street 9-,3
Registered Architect and /or Engineer
Employing ElecrriciaA's Name`/ � ....alLe S +�d! No a A5 Street......dfi_ r�...
Location and L, :gal Description Lot Bloc c 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 erhea Site Feeders Conduit Main Sw Amps.. S.l�_ 2 Main Fuses Amps
Un ergnund
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 /.ligationo ao an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Ccmpiled General Laws of Flori Permanent Supplement, and
hao complied with the provisions thereof, and will require similar compliance rrom all contractors or sub-con !' .ctors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the sit of the wo ? public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub•ccnttractors, on work o be perfor ) der t permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OP :DADE. SE.
Before me, the undersigned authority, a notary public, duly authhricl to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly oworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing atiplication, and that he did
therein by him stated are true.
sign the same, and that all facto
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re•inapectio.i is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
PCMMIT APPLICATION FOR MUNIG1PAL1I11S OF DADS COUt4TY
(OWNER TQ„RETA±N COPY)
1 ,
toc2.0 ecc TAX Folio U. 3zos -4 -Ult(a
Oa te - q /
2141 .lob Addreae
d-p-� Li 37, 6 1t4 L-0-ti / � (3c „Jc� -1 EiA e.rmit. r� . 31',3 _'
legal Desoription
Owner / Leeee• / Tenant AN
phone7. -C A 7c 7
Add =ee
3 3 - P khone
Owner's Addross/( ,J /4E 3` S r
contracting Co.
Qualifier
3tdte p
Architect /Engineer
gondirg Company
lortksgoi
P.•rrnie Rao) i EUI)f.DINO St.ECxaICAL Vtw 4B INd
V)ORK b ESCRtrti.p t ��! :Z r
Competency p
Ina. Co
Address
Address
Address
PAvINa FENCE 8I
. 1
HECUUAN ICAL
yq,.ia1rait; _ Estimated Cast •
WAANINd TO O'WNEA i : YOU MUST RECORD : A NOTICE, OF COMMENCEMENT AND YOUR FAILURE TO
UO SO MAY RESULT IN YOUR PAYING TWXCE FOR IMPROVEMENTS TO YOUR PROPERTY (IF you
INTEND TO OBTAIN FxNANCZitU, cons= WMTfi YOUR t LENDER OR AN ATTORNEY BEFORE
RECOADING YOUR NOTICE OF COMMENCEMENT): '' '
�pplic +t�oa is hereby Medi to obtain a permit to do wo:
on the ittiched addendtlio (it applicable) . ; t estt&e I„ t
itenderd$, aii i+ti+e kitbliiing oonatrl►ablon !m t la
Permits lie seidir+ iak ELECTRICAL; WTHai.4O4 130N9 j
OWNER'S krxDAVITi I airtiLy that all tht foregoing
vilt be done in ooinpv llanoe with all Jlppiiob.bib i
Furtheirmoki i t authoriti the above -named oontraotor
C
signet
Datii
!
o President
Notary s2 to Cwna'r and or Condo o acme
es3aa3,1�2
Hy Commieltion
'PERMIT IHEi AppROVRDi • F .re ,.,,,,^._....�
P•G -3 ► s'+ 19cl I
- k and installation as indicated above, and
hat eli murk will be performed to meet the
jurisdiction. I understand that separate
POOLS, hoorINa, and MECHANICAL work.
information is accurate and that ail Work
awe regulating construction and toning.
p do the Work stated.
19i j of C
bdto 1—
r otary as t
y Cormniaei
//� Zoning � + p
�' N: al Ylutnbing �
)Engineering
Nichpnic
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t r aONAN60O1ot5ASui a.de r
r ayY RE8
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DrD MU NOTARY 'MUG momAWmule
'C ; °1(t •f•.ri "..I 1,'j l:If.0 ^7!l l+n - ;. + 1 7 %r;.i.�ii 1Q • /$n71pPl. + :. r ; .. .ry , : " si r f!a:, :aa•.• a.•rin - cr, +•_.+ •.ra• + .. +r ..........��
. Electrical
- • -
REASON; IF Of.'.FECTIVE IN WARRANTY, INUICA'IE MOOEL. EERIAL #, Ar•c lt UAW:
VIA:
'73PECIAL INSTRUCTIONS:
DATE COMPLETED:
I have aeuptad drilivery and inspected the
aNPLETE0 BY: above cquipmonL and/or ap c
pliane(a) and
Foun:1 them tn be Free of any visual &erect.
')ARTIAL BILL THAL):
ACCE:-=TED BY:
'orm 417O Installation Re.,ised 11/87
PLEASE DRAW SKEICI1
OF J013
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REASON; IF r.JEFEc; IvE WANIANI Y .1. E MODEL_ ij , SE: F9 I AL rt , P.r:11) At _1_ kr]. _
11.111N V 1 A :
5PEC I AL INSTFiliCTI ON,:
lATE COMPLETED:
'30MPtETE0 BY:
'ARTIAL BILL
- orm #170 Instailation Fle 11/87
K .A 0ft ru l
1?1,F,A3r, ORA W
G rtj
01' JOB
Jr_
....
1 have:: ;.iocc:wl,ad dr_tlivery and inspected the
abov i prir 1. nd/or w)pliaftc“5) and
co tmem tn Le Free cF any visuaI derect.
ACCEI iTE.(;) f.3 : . ........._ _
to'
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