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501 NE 92 St (3)Owner of Buildin Architect Contractori , or Builder Legal tot Description Address of Building = (' / This permit is herefor in stir drawings, statementi or time if the *ark h act cbmie p itt � done age SUMO accepting t this permit I assume ct r t me of thin i s, I In consideration of the pertaining thereto and in strict et+Gdform�r with the picas, +- In respoasibilitf for all CONTRACTOR OR BUILDER Signtd: Owner of Building Architect Contractor., or Builder Lewd Description Address of Building This permit is herefor apl °ODt drawings, isateneets ar : time if the work knot dorm granted is the pauin to the done by Ws agents, 1 In consideration of the " ce to me of this perm I r pertaining thereto- sad in strict; wit the plsrr acbepting this permit I responsibnlit*' r all CONTRACTOR Q BUILDER ,ny Permit No. Application is hereby made for the approval of the detailed statement o f 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______.____________ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Employing Electrician's Name----=-= L=------ -____- -- - - - - � :A - -= -- -- -No. - - -.. - - - - Street - = : -Z---2 Location and Legal Description Lot Block _Subdivision__ Street and Number where work is to be performed- No.___- __- _:__ ____ _._ .. .. --` ' : Street State work to be performed and purpose of building (By Floors) New Building _________________Remodeling__ _______ _Addition______ Repairs No. of Stories______________ Service Overhead Si Underground ze Feeders Conduit_ _____Main Sw._______ _ Amps.____________ Main Fuses .Amps Type of Installation- Conduit______________ Tubing ___ -____- B.X.L._—_________Meta1 Moulding_ Amount of Permit $____ ` ---------------------------------------- - -___. (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that nderstands and accepts his o ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Co . pi d General Laws of Flori ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance fro all contractors or sub -con tors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. STATE OF FLORIDA, l COUNTY OF DADE. I ss. Date_ ! /2 . 0 _•---------- _ _ _No . Street. (Signed) -1 J Master Electrician. Before me, the undersigned authority, a notary public, duly a uthorized 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 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK ,ny Permit No. Application is hereby made for the approval of the detailed statement o f 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______.____________ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Employing Electrician's Name----=-= L=------ -____- -- - - - - � :A - -= -- -- -No. - - -.. - - - - Street - = : -Z---2 Location and Legal Description Lot Block _Subdivision__ Street and Number where work is to be performed- No.___- __- _:__ ____ _._ .. .. --` ' : Street State work to be performed and purpose of building (By Floors) New Building _________________Remodeling__ _______ _Addition______ Repairs No. of Stories______________ Service Overhead Si Underground ze Feeders Conduit_ _____Main Sw._______ _ Amps.____________ Main Fuses .Amps Type of Installation- Conduit______________ Tubing ___ -____- B.X.L._—_________Meta1 Moulding_ Amount of Permit $____ ` ---------------------------------------- - -___. (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that nderstands and accepts his o ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Co . pi d General Laws of Flori ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance fro all contractors or sub -con tors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. STATE OF FLORIDA, l COUNTY OF DADE. I ss. Date_ ! /2 . 0 _•---------- _ _ _No . Street. (Signed) -1 J Master Electrician. Before me, the undersigned authority, a notary public, duly a uthorized 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. r, 1 Permit � �_L1_ New Building Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. t Iss` My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Owner's Name and Address __ No.___ —. Street___ Registered Architect and /or Engineer Remodeling Addition - Repairs Service Overhead , Size Feeders_______ :__ Conduit Main Sw. r ' Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) (Signed) -1 JDate____ � -- " 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. Employing Electrician's Name � t::_4____: I _L.. . —I No =:.___ Street_ __J., -c Location and Legal Description Lot Block Subdivision_____ —. Street and Number where work is to be performed —No — Street____ .' c -. �__2 J -4 __ " State work to be performed and purpose of building (By Floors) No. of Stories ______ Main Fuses lectrical Inspector. The undersigned applicant for this building permit does hereby certify that be uildirstands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge{lerul 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. 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 _______ _____________ 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. Notary Public. State of Florida Master Electrican. Amps. 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 RECEP'T'S FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CL ST i / ! d }, . 1 l 1 1 r leaf CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK r, 1 Permit � �_L1_ New Building Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. t Iss` My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Owner's Name and Address __ No.___ —. Street___ Registered Architect and /or Engineer Remodeling Addition - Repairs Service Overhead , Size Feeders_______ :__ Conduit Main Sw. r ' Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) (Signed) -1 JDate____ � -- " 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. Employing Electrician's Name � t::_4____: I _L.. . —I No =:.___ Street_ __J., -c Location and Legal Description Lot Block Subdivision_____ —. Street and Number where work is to be performed —No — Street____ .' c -. �__2 J -4 __ " State work to be performed and purpose of building (By Floors) No. of Stories ______ Main Fuses lectrical Inspector. The undersigned applicant for this building permit does hereby certify that be uildirstands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge{lerul 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. 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 _______ _____________ 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. Notary Public. State of Florida Master Electrican. Amps. 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of uilding Lot MIAMI SHORES VILLAGE. FLORIDA p PERMIT N° 2808 ! f f Work to be performed under this 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 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 ime 1f 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 :ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations .ertaining to the work covered hereby whether shown on the plans or drawings or in the statementspr specifications and that he assumes responsibility for work lone by his agents, servants or employees. Signed. 7�`�/ 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 'ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- *piing this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. . CONTRACTOR OR BUILDER BY BY Value of Project $ f DATF Contractor's License No. Subdi- vision Amount of Permit $_.0" - ••+'� 195" AUTHORITY . MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date 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 !/ ' No Street Registered Architect and /or Engineer } < = No Street.. (, Employing Electrician's Name Location and Legal Description Lot Block Subdivision • Street and Number where work is to be performed —No ,.• d , / Street �� • 4 ,. .. 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 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 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. STATE OF FLORIDA, } COUNTY OF DADE. s '' (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'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP M OTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST // / CHECK f MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date 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 !/ ' No Street Registered Architect and /or Engineer } < = No Street.. (, Employing Electrician's Name Location and Legal Description Lot Block Subdivision • Street and Number where work is to be performed —No ,.• d , / Street �� • 4 ,. .. 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 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 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. STATE OF FLORIDA, } COUNTY OF DADE. s '' (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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date CT /Z /�l�dr Job Address 30/ /V '' G Tax Folio ($1 to 4 Warr , ere Car it 316c4e Historically Designated: Yes No ,bec1- A/ y Master Permit # Phone Legal Description Bonding Company Mortgagor / Tenant Owner's Address -Ai (� Contracting Co Qualifier State # Municipal # SS# Phone Competency # Ins. Co. Architect/Engineer Address Permit Type (circle one): BUILDING (ELECTRICAL WORK DESCRIPTION Square Ft. Estimated Cost (value) 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. Notary as Owner and/or .o President Dat My ssion Ex fi "OF ^Y p e FICIAL SEAL" Alfred McKnight My Commission Expires 8/31/97 Commission #CC 312276 FEbS: PERMIT `S APPROVED: Zoning Mechanical RADON C.C.F. Address 3 S3 Address Address PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Notary as to Contractor or My Conlmission Expires: Signature of Contractor or Owner - Builde er- Builder / ' Date O uunv, ' �� ' . 1 "r. ". "OFFICIAL SEAL" *'' ► � ; Alfred McKnight t Commission iuo C Expires 1�6 NOTARY -v-1 TOTAL DUE Building Electrical r '�,�( — / k- i Plumbing Engineering ITEM BATH TL8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE ES WET LIGHfT OUTLETS CENTRAL HEATING 3ISMMASHER RECEPTACLES A/C ()VIM) 3 ISPOSAL SERVICE TEIRCRARY A/C (CENTRAL) 7RINX DG FOUNTAIN SERVICE SIZE IN AMPS OLCT VOX 9.O0R GRAIN SERVICE REPAIRAETER CHANGE REFRIGERATION 4EASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCfPTCR RANGE: TOP UHDERGRQJHO TANKS .AVATORY OVEN ABOVE GROUNO TANKS .AJM Y TRAY WATER HEATER U.F. PRESSLRE VESSELS :LOTHES WAWA IIOTORS 0- 1 If i STEAM BOILERS . •10WER MOTORS OVER 1- 3 If HOT WATER BOILERS 31 MC, POT /3 C06P. MOTORS OVER 3- 5 if • MECHANICAL VENTILATION ;INK, RESIDENCE _ 6DTCRS OVER 5- 8 If TRANSPORTING ASSEb6LIES ; INK, SLOP OTCRS OVER 8- 10 If' ELEVATORS/ESCALATCRS •EM'CPARY WATER CLOSET )OTCRS OVER 10- 25 FP F IRE SPRINKLER SYSTEh6 1RINAL MOTCRS OVER 25-100 HP COOLING TOWERS LATER CLOSET MOTORS OVER 100 If VIOLATION rOIRECT WASTES A/C WIMOW RE INSPECT ION LATER SLPPLY TO: AIR COW ITIONERS • A/C UNIT STRIP HEATER F IRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS ' HEATER - REPLACE GENERATORS TRANSFUIERS ' LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIIAIING POOL OUTLETS COMMERCIAL - WATER SERVICE SIGN TIRES EWER CONNECTIONS S IGN TRANSFORMERS - - rILITY -SEIVER _ SIGN T,IIE CLOCX fILITY -WATER FIXTLRES .PT IC TAN( ANTENNA :LAY TELEVISION OUTLETS IAINFIE10, 4 TILE/RES. - VIOUITION Af & ABANDON SEPT IC TANK RE INSPECT ION . IAKAGE P IT CU. FT. Ref_ Li A , "- " r ,TCH BASIN . � � SCtWtGE WELL MESTIC WELL . EA GRAIN - OF INLET LAR WATER HEATER - .. STANDPIPE ' 1 PIPING , MN SPRINKLER SYSTEM i RANGE fER SET (GAS) ; PIPING ADDENDUM TO BUILDING PERMIT APPLICATION 0//' (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Permit No Registered Architect and /or Engineer SA E46/1 Employing Electrician's Name Amount of Permit S rttO STATE OF FLORIDA, l COUNTY OF DADE. j es. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PER MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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. p / `( le /r (til / r _ No eJ /C C/0 11- D S 7 . Owner's Name and Address � - � / Street Location and Legal Description Lot Street and Number where work is to be performed —No �7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition (Signed) x Street........ 0q. /At' y Block Subdivision Street t" E ( /OS. tee- No /</-: " Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L .Metal Moulding ectrical 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,o on work to. be performed under this permit, as are licensed by Miami Shores Village. V (Signe osip V-3`1 I f f i 1 Muter 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 neceuary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'TS FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET R ANG[ CONN. WATER H W. H EAT. CONN. SPACE H EATER STRIP N EATER TOTAL CONTR. LIST AV) �+ � � L � ff �/ �� � __ 7,'JtY `/�] `` �/ CHECK ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. t MOTORS 0.1 HP MOTORS 1•B HP N EON TRANS. RADIO TOTAL LIST /i CHECK ' _ AX Permit No Registered Architect and /or Engineer SA E46/1 Employing Electrician's Name Amount of Permit S rttO STATE OF FLORIDA, l COUNTY OF DADE. j es. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PER MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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. p / `( le /r (til / r _ No eJ /C C/0 11- D S 7 . Owner's Name and Address � - � / Street Location and Legal Description Lot Street and Number where work is to be performed —No �7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition (Signed) x Street........ 0q. /At' y Block Subdivision Street t" E ( /OS. tee- No /</-: " Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing B.X.L .Metal Moulding ectrical 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,o on work to. be performed under this permit, as are licensed by Miami Shores Village. V (Signe osip V-3`1 I f f i 1 Muter 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 neceuary by improper notice for inspection, or faulty materials and /or workmanship.