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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.