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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.