ELECTRICALDate
Type Insp'n
Permit No.
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Name J C/ I a l ' t(
Address 1(9 2 AE
Company e - , e)(
Phon _Ja �> • lY O
For Inspector: n NIme & Da
Approved 7/J
Page 4
OFFICE USE ONLY
CHECKLIST
O OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
Q'O
t
6o
$
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
( x .f . x/1000
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL 0 (305) 795 -2207 m FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
ELECTRICAL
T,.pE
Minimum Fee
)T
.1.vi'i:
Dryer (c% co-
inv.
(
Tvi,1,:
Outlet, Appliance
cm
11 IT
Service Repair
inv.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
7
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
S
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
(
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
I
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
7
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
I\1EC1- IANICAL
TYPE QTY.
Minimum Fee
TYPE ()TY.
Condensate Drain
TYPE
Generator
QTY. .1.1.',',, Q v.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE
A/C Condensate
QTY
TYPE
Drains, Roof
QTR
TYPE
Miscellaneous Fixture
QTY.
Tv i
Soakage Pit
Q . Q . Y .
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY:
DATE:
Page 2
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1 °' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STAN OF FLO
Signature of Owner
Print Name
SEAL:
cure of No
Personally known
IDA, NTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
!. r
cr-
tate of.El .Qri
9 O..1CIAL t:0.
l� ANGELA Bet
0 .i conz,'uCO:' plIN.'_..A
° CC7&S39 ti
r co:. ;. L;
Vd
OR, Produced Identification
Type of Identification Produced:
Signature o Contractor / Qualifier
1 /ti/E \ sim E
Print Name
Sworn to and subscribed before me this 3 day of Oc J
7
' to of o '' Public .
Signature .
Personally known OR, Produced Identification
Type of Identification Prod d: 0L Dd ti 1 .5 5o -Id- 953-0
PERMIT APPLICATION
JUSTINE J. SMALE
tary Public. State ^!nrida
; comm. expires ,4pr ?004
No. CC930418
pG L
�� ,)Or
CONTRACTOR
/n OrrE- C - C c car; c- 0—G
p
Name
License No. 95
Address
177fo r (, . 77 cr
O. - u i p /. 7777e
Telephon
✓s) (77g - 2 - 2 - x7 Fax 51
Qualifi Name
/WA, c. i2s ck44
PROPERTY OWNER
Name� Q..NP e. S C 3L
i r-1ER N
Address 1 as cD yV , . "`03, .n tJ1 %V.,
C.SJ- vc \-c, r a'S ,C- \ ' • S' \.,.
'V
Y 1 — —
Home Telephone .s S S
Business Telephone
Fax S'. S-' .V0 A
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
1 NS'I'RUCI'IONS - The following steps must be taken to obtain a permit from the Miami Shores N'illage:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
Job Address: / 2.f C /`�L: c 2. ^ ' O ✓'l= , � . , . . >�10 r2 `� v ► �1� -3313
Address Apt. City State // Zip
Folio Number‘t - 0Q- — 0S00 Description of Work 61./le C y el - L, ./
Lot , Block A
Subdivision PB '123PG Zoning Linear Feet
Current Use of Property S ,r4.‘Aitv. Square Feet Units Floors
Proposed Use of Property V 2, ∎ Value of Work 20o • 00 Bldg Value
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
v
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No. 1 OO2 t3 SS
Subsidiary Permit No.
Tax Assessed/Appraised Value
PERMIT APPLICATION
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: EL2002 -332
Printed: 10/11/2002
Applicant: DONATO MASUCCI
Owner: MASUCCI DONATO
JOB ADDRESS: 1256 NE 92 ST
Contractor MARDECK ELECTRIC INC
Local Phone:
Parcel # 1132050270500
Legal Description: BAY LURE
Y�c ri;, 4 b o o D S_ o
1S- c
Total Fees: $0700...
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 4/9/2003
Work: INSTALL RECEPTACLE & LIGHTS
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before callinn fnr ann +tip► ..tion.
1119
DONATO R MASUCCI
RENEE J MASUCCI
1256 NE 92ND ST /0' 23‘0
MIAMI SHORES, FL 33138 Date
Pay to the
Order of
Dollars •
re line, grey border and background with CAP type, First Union logo on back. If not present, do not cash.
Look for. Micro Pr*,
lit Union National Bank
•
R/T 063000021
For
\ 1:06300002L': 99824831 2811'
CODE
LLL9
Electrical Permit
Contractor's Address: DOING BUS IN DADE CO
Construction Value: $300.00
63 -2/630
BRANCH 00789
BY:
BY:
PB 44 -63 LOT 13
Page 1 of 1
BLK 3 LOT SIZE 75.000 X 125 OR
:he equipment or device described in the application herefor in strict compliance with all
with any plans, drawings, statements or specifications that may have been submitted to
s not done in compliance with such ordinances or if the plans are changed without
:tor or builder named above assumes the responsibility for a thorough knowledge of the
igs or in the statements or specifications and that he assumes responsibility for work done
compliance with all ordinances and regulations pertaining thereto and in strict conformity
is Village. In accepting this permit I assume responisibility for all work done by either
Date: September 17, 2002
Submitted to: Donato Masucci
Re: 1256 NE 92 St, Miami Shores, FL
IIMRDECK ELECTRIC, INC.
13750 SW 37" Ct
Davie, FL 33330
Office/Fax: (954) 436 -1269 Mobile: (954) 478 -2257
ELECTRICAL PROPOSAL
Scope of work: We propose to fumish the materials and labor necessary for the specifications listed below:
Install lights, switches and outlets per drawings
Price: $300.00
With payments to be made as follows: In full at job completion
Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders and will become an extra charge
over and above this estimate.
Acceptance of this proposal: When signed by both parties, this instrument constitutes a legal and binding contract.
MARDECK ELECTRIC, INC. :
Signature
Marc Deckelbaum, President
0014.m O , �R & L.GL ,
Print name
Date:
07/ z
Date: 9-/-7-c Z
Proposal #: 120856
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
DATE 195
PERMIT N® 2342 Contractor's
❑ License No.
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
B1
Subdi-
vision
Value of 1 Amount of
Project $ I Permit $
This permit is granted to the contractor or builder named above to construc 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. v 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.
BY AUTHORITY
STATE OF FLORIDA
COUNTY OF DADE.
Permit No.
Disapproved
(Signed)
.2 971/
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 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 the work.
Date ( 19
Owner's Name and Address JL/ 0 �C / No. / S ---70 Stree' 9
Registered Architect and/or Engineer , / p
Name and address of licensed contractor (- "' rie 19 e D'7 fi9le--/ og
Building Inspector
Location and legal description of lot to be built on:
Lot /3 Black - Subdivision iiy // J o 7 l-5W /,9,c Street and Number where work is to be done /,9,c-, Ai ' 9 57
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
C /i c 9O7' Air 's _ 4 ZN w, 7 ,a /'&5 keirr
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of rl Kind of foundation Roof Covering
Estimated Total cost of improvements $ � 7 -C) • (Y7 ) Amount of Permit $ I* 1-
Zone cubage required Plan Cubage
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the buikling and its construction may be sent to
Size of Building Lot
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Section 6966, 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 pos` cau• to be posted for inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned a: ;s to employ only such s ' ontr• on work to be performed Remarks (Signed) lIfir . under this permit, as are licensed by Miami Shores Village. 1 � , � /// / / C
J ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
Date '42 /9e Read, Sworn to and Subscribed before me.
Date
Notary Public. State of Florida
2 - v
to me well known.
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved /)ate Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged 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
_I ? Date ... <1' — �
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 r not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address. . * e. YL`.9 e175/ ` t/ No Street
Registered Architect and /or Engineer....
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be
State work to be performe an urpose
performed —No
No. ... 7i ? Street 64/ 7aP'e •
Block Subd'vi ion
Street L% >
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 Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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 subcontractors, on work to
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
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.
88.
My Commissio .,Expires Notary Public, State of Florida
NOTE: A rein on fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/ • orkmanship.
(Signed)
Master Electrician.
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.
$@ACE
HEATER
STRIP
HEATER
TOTAL.
CONTR.
LIST
CHECK
ENT.
SW.
DIET.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
LIST
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
_I ? Date ... <1' — �
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 r not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address. . * e. YL`.9 e175/ ` t/ No Street
Registered Architect and /or Engineer....
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be
State work to be performe an urpose
performed —No
No. ... 7i ? Street 64/ 7aP'e •
Block Subd'vi ion
Street L% >
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 Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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 subcontractors, on work to
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
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.
88.
My Commissio .,Expires Notary Public, State of Florida
NOTE: A rein on fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/ • orkmanship.
(Signed)
Master Electrician.
(Signed)
Owner's Name and Address..e.A./..C.,
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.
Location and legal description of lot to be built on
STATE OF FLORIDA,
COUNTY OF DADE.
APPLICATION FOR BUILDING PERMIT
SS. .
Disapproved Date
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date 7
4 S ,19
d d_.e?...d No. / -
Street..A, .0- sr '
Registered Architect and/or Engineer
Name and address of licensed contractor 0 Poi __V .a .. 17 4 t..g .: , xi eq. ? 1 .... ii 6 dc »i,, p,,
Lot / - 3 Block 3 Subdivision 8-0 ‘'s X 44-L
Street and Number where work is to be done / )- tl I/ e; P - a d x A.
State work to be done and purpose of building (by floors) 3
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $ ,./P00.0 0
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 planmnd s ecifications for said building. All notices with reference to the building and its construction may
be sent to___&m.I. e-oo .2 co cLid a tn. ---------------- 4 / 10 .
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 5968, Compiled General Laws of Florida, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance froin 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) ,'2
-' P
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.
GS
Permit No Date it- C -..-6------ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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.
Permit No 3
Service Overhead Size Feeders.
Underground
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 30
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 ordinancesref- 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.. 4/g
Employing Electrician's Name ....!
Registered Architect and /or Engineer
r •.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No / -
r r Conduit ..!...> ...Main Sw
Type of Installation— Conduit Tubing B.X.L
State work to be performed and purpose of building (By Floors)
New Building L/ Remodeling Additiun Repairs No. of Stories
Amount of Permit $
No /, 4 S
Street
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 subcontractors, on work to
licensed by Miami Shores Village.
Amps Main Fuses... a Amps
Metal Moulding
(Signed)
Electrical 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
Street..
C5,
Street
(:/
Q`
7 °s
).• (Signed)
C i
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.
STATE OF FLORIDA, l
COUNTY OF DADE. I 68.
My Commission Expires Notary Public, State of Florida
NOTE: A re•• - spection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /o, orkmanship.
Master Electrician.
SWITCH
OUTLETS
LIGHT
OUTL
PLUG
RECE'P'T'8
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER
STRIP
HEATER
TOTAL
`LILT
�
�
/
J 7
/ /
1 ,.."
l
(
7
j
7
5 7
/ 6
CHECK
7 n r
E NT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
MOTORS
1. HP
N EON
TRANS.
RADIO
TOTAL
CLIST
L1
/
-
CHECK
/
D fr-)
Ab
o
p !
7
15b
Permit No 3
Service Overhead Size Feeders.
Underground
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 30
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 ordinancesref- 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.. 4/g
Employing Electrician's Name ....!
Registered Architect and /or Engineer
r •.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No / -
r r Conduit ..!...> ...Main Sw
Type of Installation— Conduit Tubing B.X.L
State work to be performed and purpose of building (By Floors)
New Building L/ Remodeling Additiun Repairs No. of Stories
Amount of Permit $
No /, 4 S
Street
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 subcontractors, on work to
licensed by Miami Shores Village.
Amps Main Fuses... a Amps
Metal Moulding
(Signed)
Electrical 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
Street..
C5,
Street
(:/
Q`
7 °s
).• (Signed)
C i
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.
STATE OF FLORIDA, l
COUNTY OF DADE. I 68.
My Commission Expires Notary Public, State of Florida
NOTE: A re•• - spection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /o, orkmanship.
Master Electrician.