ELECTRICALLegal Description
Owner/Lessee / Tenant
Owner's Address
YLKMI 1 AYYLlCN 1 IVA 1' UK MIAMI SHVKI;J VILLAIiE
Date 10 ' Job Address 33 N a q Tax Folio / 7 3 O( 0 / 3 0 353'a
Qu 61 )1 uoln V ?
state # Erooy o g`- Municipal #
Historically Designated: Yes
Contracting Co. ADT SECURITY SERVICES TNC, Address
Master Permit #
Phone 751— 4-108.S
No
• .
SS# )I 5 -,5 _6 hone 624 -7770 x 5254
Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
LOW VOLTAGE SECURITY
SYSTEM
I Cvrrh-n
/0 devices
Ins. Co.
1 d
Square Ft. Estimated Cost (value) , 5J ' ,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
40 ' % •
%'
, ignature of o er an�/or4ondo President Date
0 3nO
Notary as to Owner�fnd/or Condo President Date /
My Commission Expires
..�. !f �I � .7: -- - ire rTln ,,II
I" ' 7 OP,TIA qJ
FEES: PERMIT( v RADON C.C.F. t lA'2
NOTARY
APPROVED:
Zoning Building Electrical
Mechanical Plumbing
Signature of Contractor or Owner Builder
Notary as to Contract. or Qwny Builder
My Commission Expires: H '� . N 0
,,'>,v'r Cc^
BOND
TOTAL DUE
Date
Engineering
Owner's Name and Address M R l'7 R-$
Permit No.._- ...-S —
Disapproved
(Signed) ....
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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.
Registered Architect and /or Engineer
Date — BP R' � / 02...
-- NviQ £ / /se.z. _ No. .33. . . Street.__6 /e _ �3R o.
Name and address of licensed contractor... / .e 1 /?U... $�� 1 3.€,5...AR . aft.N o •,r......76 S /V 71 ' h�T / 9 r'gm./
Location and legal description of lot to be built on:
Lot Block Subdivision ....._,.._.._
Street and Number where work is to be done .3,5...__. ..t _Q..i.n.D..... T f . ; _ ,�ie.ami.. sfd.0.�.s, ...._' q•
State work to be done and purpose of building (by floors)....rrls.Z. st _.. Sy,� .f.e.f.?).... el"
�Z.._.._
. ........... . .......... z a...1,1c1.... '..G.e. . ..... /..fie. T - a...c. 40..rz.a....... �.G.e .7 .1.c...
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 $ ....21,..3 ®OD Amount of Permit S. 6 .OD
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to... •••• •
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or 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 wor to be performed under this
pennit, as are licensed by Miami Shores Village. ��))
Remarks ( Signed) lrt�L "
Wrh. G' , s,, z„ r , R e,
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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
Date �((
PLAN • INC BOARD
Chairman
Member
Member ......
Council Approved. Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and /or workmanship.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
DATE
to me well known,
Member
Member
Member
Disapproved Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection oe faulty
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No
Date
Location and Legal Description Lot Block Subdivision.
(Signed)
Street
„
-16 --78
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu;ida,
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 / �...ce./. No R � K.. Street... .
eds
Registered Architect and /or Engineer
Employing / V /
Employing Electriciafi's Name..c3Jf £7eCi /.0 No�di...5 , r / StreeLD/ I /..ft.4
3n J-s
y
Street and Number where work is to be performed—No
work to be performed and purpose of building (B oo .....44 .I( e4te 7
New Building Remodeling Addition Repairs No. of Stories
� —
Service Overhead
Underground Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
K/
Notary Public, State of Florida
/E lect r ical Inspect6r.
The undersigned applicant for this building permit does hereby cc: 61y that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida , Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the ite of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-con �on to be performed under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
STATE OP FLORIDA, l
COUNTY OF DADE.
I SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, 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
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
RECEIP'T'S
FIXTURES
NO. LAMPS
REPRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
- I 1 <
� J�.,r
p , v/"
G.°n
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.9 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No
Date
Location and Legal Description Lot Block Subdivision.
(Signed)
Street
„
-16 --78
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu;ida,
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 / �...ce./. No R � K.. Street... .
eds
Registered Architect and /or Engineer
Employing / V /
Employing Electriciafi's Name..c3Jf £7eCi /.0 No�di...5 , r / StreeLD/ I /..ft.4
3n J-s
y
Street and Number where work is to be performed—No
work to be performed and purpose of building (B oo .....44 .I( e4te 7
New Building Remodeling Addition Repairs No. of Stories
� —
Service Overhead
Underground Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
K/
Notary Public, State of Florida
/E lect r ical Inspect6r.
The undersigned applicant for this building permit does hereby cc: 61y that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida , Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the ite of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-con �on to be performed under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
STATE OP FLORIDA, l
COUNTY OF DADE.
I SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, 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
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
APPLICATION FOR ELECTRICAL 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, Fiu:rda,
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..: 3 1 Z h l3 s
Registered Architect and /or Engineer
44, /A4
Employing Electriciaft's Name
/
Location and Legal Description Lot /6 k./ „ . P
Street and Number where work is to be performed —No.. ..3 1 '1.
State work to be performed and purpose of building (By Floors)
Service vcr
Un erg
STATE OF FLORIDA, t
COUNTY OF DADE. j
es.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No Street.. 7. cis.? 4 '.- d..6.: C. /..< -°
Block
73 S7
g nJ Site Feeders Conduit Main Sw Amps 2.
Type of Installation — Conduit Tubing
Street
DO
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 sub-contractors, on work to
licensed by Miami Shores Village.
Date 3 ' 2 3
Subdivision 4 1/ 4 P 1- ' : 'g4';'(4 (/t",
New Building Remodeling Addition Repairs No. of Stories
Main FusesY 61 4 Amps
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
(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
therein by him stated are true.
the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE' •'T's
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL '
CONTR.
L 157
/
q
c
/
A Z fJ
+
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
t t C
Q(, ��
3 e:
CHECK
Permit No
APPLICATION FOR ELECTRICAL 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, Fiu:rda,
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..: 3 1 Z h l3 s
Registered Architect and /or Engineer
44, /A4
Employing Electriciaft's Name
/
Location and Legal Description Lot /6 k./ „ . P
Street and Number where work is to be performed —No.. ..3 1 '1.
State work to be performed and purpose of building (By Floors)
Service vcr
Un erg
STATE OF FLORIDA, t
COUNTY OF DADE. j
es.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No Street.. 7. cis.? 4 '.- d..6.: C. /..< -°
Block
73 S7
g nJ Site Feeders Conduit Main Sw Amps 2.
Type of Installation — Conduit Tubing
Street
DO
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 sub-contractors, on work to
licensed by Miami Shores Village.
Date 3 ' 2 3
Subdivision 4 1/ 4 P 1- ' : 'g4';'(4 (/t",
New Building Remodeling Addition Repairs No. of Stories
Main FusesY 61 4 Amps
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
(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
therein by him stated are true.
the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
;UILDING
LECTRICAL
'LUMBING
Dwner of
3uilding
'architect
contractor
it Builder
.ega1
Jescrip
'd
Lot
.eCfiNTRAgOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N°' 4504s
Work to be performed
•
In consideration of the issuance to me of this permit 1 agree to perform the work covered hereunder in compliance with all ordinances regulations'
•ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of les Village.
n accepting „, this pe 1 assume responsibility for a work dora y either myself, s y agent, servant or employee.
Bl.
under this Permit
9 , 'l, Value of Amt. of /
1 A zI „ Project Permit
s granted to the contractor or builder named above to construct the building or to install the equipment or device des b the appli-
strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in ., with any
rigs, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This be revoked
t any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition on which this
iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans or drawings o in t statements or specifications and that he assumes respon-
ibility for work done by his agents, servants or employees. q/ ,,te
By -57/ 4-ir r
Signed:
yf
Subdi-
vision
BY
Ac
INSPECTOR
Contractor's
License No
4 74*
AUTHORITY
1
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
DATE N.-..
RMIT N° 4311
Work to be performed under this Permit `"+� aP .J+��..•.,tr„�,
Owner of
Building 1.1k
Architect
Contractor
or Builder j •�''t --
Legal Lot Bl.
Description
Address of 3 3 L E
Building 3 T I Project Permit
This permit is granted to the contractor or builder named abi ?ve to construct the building or to install the equipment or device described in the a
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further c ndiiioo. upon wbi
permit is granted is the understanding that the contractor or builder named above assumes the res onsibility for a thorough knowledge of the ordiiian = and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in t e statements or specifications and tha assumes . on-
sibility for work done by his agents, servants or employees. .. 4
Signed. .. ! .., B . .imai.. -.
INSPECTOR 'ii
ONTRACTOR OR= -BUILDER
Subdi-
vision
Value of Amt. of
Contractor's
License No
1/
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 Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
AUTHORITY
4( 41
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor i
or Builder ,,t' --
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE " / 1940
PERMIT Nn 4311
Work to be performed under this Permit
Bl.
Subdi-
vision
r
Address of % r- �'"` r ia. Value of Amt. of j
Building 3 3 (-11, l' * > " -"� -'{ Project Permit / : ._+
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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 be assumes respon-
sibility for work done by his agents, servants or employees.
Contractor's
License No.
Signed. ".ham - By
INSPECTOR
1/ 49
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with 4g� r!!ddinances and g$ ns
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorifierof Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
i 2... "�'
• . • ONTRACTOR OR BUILDER
AUTHORITY
Permit No
Registered Architect and /or Engineer
Amount of Permit $
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL 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 work.
Owner's Name and Address )//./ S 4 - No —_ __ __— _ —___ —_ Street___— ___— ___ - -_
Employing Electrician's Name OS- " :-.. __ _— 7 _ -° A S........ No
Location and Legal Description Lot_ ' G! / 7L_a , ' 1 4 Block 3 Subdivision_./J. __ Vi 4 - /'_ Sp_IE
Street and Number where work is to be performed —No �'____T !3Jr
Street
State work to be performed and purpose of building (By Floors)
New Building___; Remodeling Addition Repairs
'
verhea
Service n erground Size Feeders 31ft . Conduit._ � Main Sw._1� 044 Amps. Main
Type of Installation—Conduit _____ _________ Tubing_:_________ B.X.L. Metal Moulding
ss.
■ 1 Street_'_
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
,f -- — Master Electritan.
Date
No. of Stories
E 1 es2c a1Inspector.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _____
of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
TS
LIGHT
OUTLETS
PLUG
RE / T'S
i -I
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
/
IRON
OUTLET
/
RANGE
OUTLET
/
RANGE
CONN.
WATER
HEATER
/
W. HEAT.
CONN.
SPACE
HEATER
Z
STRIP
HEATER
TOTAL
CONTR.
ST
/3
/1
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
Registered Architect and /or Engineer
Amount of Permit $
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL 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 work.
Owner's Name and Address )//./ S 4 - No —_ __ __— _ —___ —_ Street___— ___— ___ - -_
Employing Electrician's Name OS- " :-.. __ _— 7 _ -° A S........ No
Location and Legal Description Lot_ ' G! / 7L_a , ' 1 4 Block 3 Subdivision_./J. __ Vi 4 - /'_ Sp_IE
Street and Number where work is to be performed —No �'____T !3Jr
Street
State work to be performed and purpose of building (By Floors)
New Building___; Remodeling Addition Repairs
'
verhea
Service n erground Size Feeders 31ft . Conduit._ � Main Sw._1� 044 Amps. Main
Type of Installation—Conduit _____ _________ Tubing_:_________ B.X.L. Metal Moulding
ss.
■ 1 Street_'_
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
,f -- — Master Electritan.
Date
No. of Stories
E 1 es2c a1Inspector.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _____
of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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.