422 NE 93 St (4)MIAMI Ba- 3®�''RE V]LLAZEZ
BUILDING INSPECTION DEPARTMENT
ENT
APPLICATION! FOR
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.
Owner's Name and Address ' ...,r -C�
Registered Architect and /or Engineer
Name and address of licensed contractor...
Location and legal description of lot to be uilt on:
Lot Block Subdivision
State work to be done and p rpose of building (by floors) tz:
Street and Number where work is to be done
UILDINO PERMIT
Date...— c rI L Ludt c 19.1 /
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation n �f Covering
Estimated Total cost of improvements $ % Amount of Permit $ ' �
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, Pennanent 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 work, to be performed under this
permit, as are licensed by Miami Shores Village. .
Remarks (Signed). _!/LL
Disapprove
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j 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.
/
Permit No._ 1 Z Date / G 5 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known,
Building Inspector ` Commission Expires
•NNING 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.
S
A-s p 1-4 A L-- L
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
22 APPLICATION FOR ELECTRICAL PERMIT
�
Permit No ( 3 ... Date l — Z ( l 0
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
Registered Architect and /or Engineer
Employing Electrician's Name No Street
Location and Legal Description Lot lock Subdivvisipn (�
�V 7 � *s ops and Number where work is to be performed —No Street t r 6
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
thsie 121°
No Street r
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
Amount of Permit $ ..--" (Signed).
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.
(Signed)
rival Ins• '•r.
ccepts his obli : ti s as an employer of
of Florida ' er anent Supplement, and
sub-contra s employed by him in the
of the work such public notice or notices
be performed under this permit, as are
r Electnaan.
STATE OF FLORIDA,
COUNTY OF DADE. f 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 Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
-
LIGHT
OUTLETS
PLUG
RECE•P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
;Q /j
�_�C
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O -t HP
MOTORS
1-5 HP
N EON
TRANS.
RADIO
TOTAL
IST
LIST I
///
t V /
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
22 APPLICATION FOR ELECTRICAL PERMIT
�
Permit No ( 3 ... Date l — Z ( l 0
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
Registered Architect and /or Engineer
Employing Electrician's Name No Street
Location and Legal Description Lot lock Subdivvisipn (�
�V 7 � *s ops and Number where work is to be performed —No Street t r 6
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
thsie 121°
No Street r
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
Amount of Permit $ ..--" (Signed).
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.
(Signed)
rival Ins• '•r.
ccepts his obli : ti s as an employer of
of Florida ' er anent Supplement, and
sub-contra s employed by him in the
of the work such public notice or notices
be performed under this permit, as are
r Electnaan.
STATE OF FLORIDA,
COUNTY OF DADE. f 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 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.