500 NE 93 StCONTRACTOR
New Construction
Name
Enclosure
1-�u/
Q i(� / - , ,th
/ a � D
License No. �� � Y /109 ( '
Address
Vf
77 V7 »6J
Demolish
Telephon 7 (7/ l33 /1 7 Fax 7 1 /_
w /
�9 G
Qualifier Name �/Ja/J 11/-4
Shell Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
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.
APPLICATION
! .3_/3p
City State
Folio Number *//— d h - 4)S ///6 Description of Work � v
5 C
Lot Block \ - `M 5 3 } ten
Subdivisiot�SeC �-_ PB P Zoning Linear Feet
C
o....)
urrent Use of Property O�i -��C �� Square Feet Units Floors
Proposed Use of Property /� Value of Work // ° c.3' ° -� Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
Job Address:
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 submitted
along with this permit application.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
•
O `)' a Q�.:t i�ila/xu �d',�o')f/d-
Address Apt.
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Address
Name
License No.
Telephone
Fax
PROPERTY OWNER
Name
Address
. 93d e
Home Telephone
Business Telephone
Fax
Master Permit No.
Subsidiary Permit No. So (C,
ENGINEER
License No.
Name
Address
Telephone
Fax
PERMIT APPLICATION
Page 2
IMPORTANT NOTICES
1. 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 • ommencement must be recorded at:
22 N.W. 1st Street, P' Floor, (305) 679 -1078. Once recorded, the Notice of Commence st be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at V Hall on Construction Lien Law and
Choosing a Contractor.
S TE OF FLORIDA, � OF MIAMI -DADE
ignature of Owner
I S5a- ' A i, yA t
Print Name Print Name J Q �� D� �
Sworn to and subscribed before me this day of __t` P� Sworn to nd subscribed before me this / day of D`� ° �!
Signature of Nota Public - State of Florida
SEAL:
Personally known
ALBA GAONA
uV4AARY PUBLr r (.) FLORIDA
COMM2SEtON
Signature of Contractor / Qualifier ee �
yrn 65)-2 d jL4
SEAL:
PERMIT APPLICATION
I�'A, I OUNTY OF MIAMI -DADE
LI /l
Signature of (Notary Public - State of Florida t
.
ALBA GAONA
%NARY PUBLIC STATE OF FLORIDA i
}
MAMMON NO. CO358343
Personally know cn Q�
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE.
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
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
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
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar(a)a..uo.�
c it e
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
MECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
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
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
'TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
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:
SECTION
BY
DATE
Zoning
Electrical
' �` i e
/ /1--"
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$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
$
REVIEWED AND PREPARED BY:
(sq.ft. = x/1000
x ¢.60)
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
MIAMI S I ORES VILLAGE, FLORIDA
BUILDING ❑ I DATE 3 / 4 / 195
ELECTRICAL p,,-- PERMIT I N° 15 916 Contractor's
PLUMBING ❑ License No 1
ROOFING 0 Work to be performed under this Permit
Owner of i
Building f �.� """ " 1
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
;l
Signed •
Subdi-
vision
Value of
Project $
Amt. of
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 application
herefor in strict compliance with all ordinances pertaining ther and with the understanding that the work will be performed in compliance\with any plane,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be 'rtvoked 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.
1 1 +
BY '_' 1111 7111i
INSPECTOR
In consideration of the issuance to me of this permit I agree to p f rm the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, state is or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
coterItA BUl t
BY AUTHORITY
Permit No , 9
Owner's Name and Address.
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
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.
rt-
Date
No Street
No Street
Block Subdivision
Street and Number where work is to be performed —No ,.. )1J
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
[ 3— Street
Repairs No. of Stories
Service Undergro Size Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will 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 sub•contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. A A �
®c
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 OP FLORIDA, }
COUNTY OP DADE.
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 woSJcmanship.
55.
(Signed)
Master Electrician.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'7'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
LIST
C 6 f N __
//
CHECK
.d.i /
/a 0
9
'5
. , c ®
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS MOTORS
0.1 HP 1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
£
(�
n
1
11
—,n�`��
0^ C..� V
-
.e iJ
s l / \♦
CHECK
%
/ •),
�� u//
�/ 6-0 ;�
0
/
Permit No , 9
Owner's Name and Address.
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
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.
rt-
Date
No Street
No Street
Block Subdivision
Street and Number where work is to be performed —No ,.. )1J
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
[ 3— Street
Repairs No. of Stories
Service Undergro Size Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will 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 sub•contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. A A �
®c
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 OP FLORIDA, }
COUNTY OP DADE.
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 woSJcmanship.
55.
(Signed)
Master Electrician.
Permit No
Owner's Name and Address
Registered Architect and /or Engi
Employing Electrician's Name ___
Amount of Permit $� •
STATE OF FLORIDA,
COUNTY OF DADE.
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.
} es.
ELECTRICAL INSPECTION DEPARTMENT
No
Location and Legal Description Lot_______________ Subdivision
U
Street and Number where work is to be performed —No
r' Z Y 5 ~ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling____________ __________ Addition.. Repairs
Service Overhead Size Feeders Conduit .___w._ ___ Main Sw.__ –___ — Amps. Main Fuses___ ___ –Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Permanent Supplement, and has 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 yvork to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed)
(Signed)
No. --- tom/ �_ - `
_.L L ____. Street 4 t
Date
Gte
Master Electrican.
Notary Public. State of Florida
No. of Stories___ __________
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 be did sign the same, and that all facts
therein by him stated are true.
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
O UTLET5
PLUG
RECE'P'T'S
FIXTURES
N O.LAMPS
REFRIG.
O U TLET
IRON
O UTLET
RANGE
O UTLET
RANGE
CONN.
WATER
H EATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
H EATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
CHECK
Permit No
Owner's Name and Address
Registered Architect and /or Engi
Employing Electrician's Name ___
Amount of Permit $� •
STATE OF FLORIDA,
COUNTY OF DADE.
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.
} es.
ELECTRICAL INSPECTION DEPARTMENT
No
Location and Legal Description Lot_______________ Subdivision
U
Street and Number where work is to be performed —No
r' Z Y 5 ~ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling____________ __________ Addition.. Repairs
Service Overhead Size Feeders Conduit .___w._ ___ Main Sw.__ –___ — Amps. Main Fuses___ ___ –Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Permanent Supplement, and has 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 yvork to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed)
(Signed)
No. --- tom/ �_ - `
_.L L ____. Street 4 t
Date
Gte
Master Electrican.
Notary Public. State of Florida
No. of Stories___ __________
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 be did sign the same, and that all facts
therein by him stated are true.
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.
B UILDING
ELECTRICAL
PLUMBING
Work to beperfrmed u
ia""✓ .1
Owner of'
Building -
Architect
Contractor
or Builder r / ,.
Legal Lot
Description
ti
✓
Address of d : ®a / } '24(,--
Building c::: f
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
application herefor in strict compliance with all ordinances pe taining 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 t •rough knowl4dge of
the ordinances and regulations pertaining to the work covered hereby whether arhown on the pl oor drilwi s in the , . - or :. cificatiqns and
that he assumes responsibility for work done by his agents, servants or employees. --w •r
Signed •� ' -
rF" r't .� '
4, 4L
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 1 4/
PERMIT 1857 Contractor's f #' 7
7
erase No.
BI.
his Permi
In consideration of the issuance to me of this permit I agree to perform
tions pertaining thereto and in strict conformity with the plan, drawings,
Village. In accepting this permit I assume responsibility for al work don
Subdi-
vision
Value of
Project
Amt. of
Permit
i✓"'
INSPECTOR
rk covered hereunder in compliance with all ordinances nd regula-
ents or specifications submitted_to the proper., uthorides of i Shores
y either myself, my agent, servantfr emp1
, R , F 1
BY At794O ITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
PERMIT ° 15801
0
❑ Work to be performed rider this Permit
MIAMI SHORES VILLAGE, FLORIDA
r..
I LL
Subdi-
vision
Value of
Project $
DATE
Contractor's
License No
u
Amt. of
Permit $
t y
•
.0
195
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 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 plar s or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
)
Signed: w BY x .
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY
AUTHOgITY
Permit No
S k ®/
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 Mimi 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
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date .A t 4
No Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot _ �'.�s � B l lock Subdivision
Street and Number where work is to be performed —No 5 b ® 7 • Q ! Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No Street
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 $
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.
STATE OF FLORIDA, ,)
COUNTY OF DADE. I
53.
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 Exp' s 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.
(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
(Signed)
Master Electrician.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
•W.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
S k ®/
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 Mimi 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
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date .A t 4
No Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot _ �'.�s � B l lock Subdivision
Street and Number where work is to be performed —No 5 b ® 7 • Q ! Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No Street
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 $
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.
STATE OF FLORIDA, ,)
COUNTY OF DADE. I
53.
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 Exp' s 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.
(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
(Signed)
Master Electrician.
Permit No. ...1 /
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE. j
55.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
(Signed).
Date 7/2 -.1 t 9
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. /J
Owner's Name and Address ,/a fl..id .74'AN1 No f-Q a Street .. 4-?r7-
Registered Architect and /or Engineer
Employing Electrician's Name..ct. - -SE.R.- ✓ ` No. .rz Street 2- 4 i.€..
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No �� ® Street ...&" 9
State work to be performed and purpose 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
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) -.�
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'7'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
.40,e- yE
R.._
1 ;a- a''
CHECK
ENT.
SW.
DIST.
CAe.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No. ...1 /
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE. j
55.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
(Signed).
Date 7/2 -.1 t 9
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. /J
Owner's Name and Address ,/a fl..id .74'AN1 No f-Q a Street .. 4-?r7-
Registered Architect and /or Engineer
Employing Electrician's Name..ct. - -SE.R.- ✓ ` No. .rz Street 2- 4 i.€..
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No �� ® Street ...&" 9
State work to be performed and purpose 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
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) -.�
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.