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.