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709 NE 93 St'NOV JOB: AD: BUILDING ELECTRICAL : //' PLUMBING Inspector's Report: • WORK • DONE BY: : : REQUESTED : WILL BE READY • • • • • The following is rcody for Inspection: • • • • • Permit No._ Amount of Permit $� STATE OF FLORIDA, COUNTY OF DADE. 1 s s. 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, / Owner's Name and Address - Registered Architect and /or Engineer Employing Electrician's Name _ Location and Legal Description Lot Block Subdivision_ Street and Number where work is to be performed —No No. __. Street No. Street_ State work to be perform----- ed and purpose of building (By Floors) New Building Remodeling Addition Repairs n 4 Service OUnderground Size Feeders.___/_________ Conduit .:___ Main Sw. Amps. Main Fuses. Amps. Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) 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 work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Date r' Street No. of Stories Electrical Inspector. Master Electrican. 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 he has carefully read the foregoing application, and that be 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 H EATER 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 Permit No._ Amount of Permit $� STATE OF FLORIDA, COUNTY OF DADE. 1 s s. 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, / Owner's Name and Address - Registered Architect and /or Engineer Employing Electrician's Name _ Location and Legal Description Lot Block Subdivision_ Street and Number where work is to be performed —No No. __. Street No. Street_ State work to be perform----- ed and purpose of building (By Floors) New Building Remodeling Addition Repairs n 4 Service OUnderground Size Feeders.___/_________ Conduit .:___ Main Sw. Amps. Main Fuses. Amps. Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) 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 work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Date r' Street No. of Stories Electrical Inspector. Master Electrican. 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 he has carefully read the foregoing application, and that be 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. APPLICATION FOR ELECTRICAL PERMIT / /� �f I 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 Permit Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name _________________________ Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Remodeling_____________ Service Overhead Size Feeders Underground STATE OF FLORIDA, COUNTY OF DADE. Amount of Permit Si__ The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. S S. Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT �y Block No. Street No __ Street.. Addition Repairs. Conduit Main Sw. Amps (Signed) Subdivision_____ _ r Street 1 Main Fuses Type of Installation — Conduit Tubing B.X.L. .Metal Moulding Notary Public, State of Florida No. of Stories Electrical Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub- contractors, on work to be performed under this „ permit, as are Master Electrican. Amps. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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 LI GHT OUTLETS PLUG RECE'P FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST i CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1-5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK APPLICATION FOR ELECTRICAL PERMIT / /� �f I 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 Permit Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name _________________________ Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Remodeling_____________ Service Overhead Size Feeders Underground STATE OF FLORIDA, COUNTY OF DADE. Amount of Permit Si__ The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. S S. Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT �y Block No. Street No __ Street.. Addition Repairs. Conduit Main Sw. Amps (Signed) Subdivision_____ _ r Street 1 Main Fuses Type of Installation — Conduit Tubing B.X.L. .Metal Moulding Notary Public, State of Florida No. of Stories Electrical Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub- contractors, on work to be performed under this „ permit, as are Master Electrican. Amps. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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. JOB: , z BUILDING ELECTRICAL PLUMBING Inspector's Report: AD: • WORK • DONE BY: • • • • • • • The following is roody for Inspection: • : REQUESTED • r. : WILL BE READY • • • • • • • • • • • • • • • • • • Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Re stj Date a� Time rO Permit No. CJLJCt.,xo'i'° )"1 Name jOe S Address Na q : Compan -- nOL 5k 10 Phone # i n� -9- 1064 For Inspector: F, 0 �� Name &s Approved Correction Re- Insp'n Fee ❑ BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) , ,ione # Owner's Address t " r - State Zip Tenant/Lessee Name 4 % / Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip r' Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address ,' City :., e Qualifier S Value of Work For this Permit 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 2. 7)3 /ct Permit No. , :6_ ;a 9 Master Permit No. State Zip Architect/Engineer's Name (if applicable) Phone # Architect/Engineer's Address City State Zip Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ❑A dition DAlteration DNew a Repair/Replace ❑ Demolition Describe Work: 7, A: /, 4' et -e,— ( > ,,° e,,, 4`' 1 X ,'t �.'-.'" �"r., -t . , 4c- ""--; _ t * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fee Calculation -Mist Permits * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ ^, b 0 Permit Fee $ i'e' 1 - "! ' Notary $ Educationrl'raining Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ 7 0 ., Fee Totals $ 60.6 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which o s seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approve ands reinspe on fee will be chprged. Signature C Owner or Agent The foregoing instrument was acknowledged before me this day of !` it; , 20 ,1:-,,by , who i(ersonally known to me or who has produced As identification and who did take an oath. tI.IC: NOTARY P Sign: Print: ,/ My Commission Chc6/18/03 i - OF •_ -Ag NOTARY PUB!. ' STATE OF FLORIDA - ''MMISSION NO. DD051229 The foregoin day of who is Contractor instrument was acknowledged before me this f,? ; 20 :2,: by rsonally known to me or who has produced 4 ,;'as i dentification and who did take an oath. OTAR PUBLIC` // Sign: _ / .`,/ '' ✓ �, ' . Print: f C' .t ' L' Xi: OJNi.; W My Commissioi�'Ees?LR - a _ .. (AT r. " I`i fi= I ,A, +1 COM.'iijs ;c) NO.1 •ry:•, ***** * * * * * * * * * * * * * * * * * * * * * * * * * ** * *** it �ir�e *AViii $ * ** *# ** * * * * * * * ** -. „ .t s 1 4,20. State Certificate or Registration No. (.' Certificate of Competency,No..tNC g V ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: �� f� =t'�� ' ' Plans Examiner Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) CRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE /. REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP _ FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION riATER SUPPLY TO: AIR CONDITIONERS ' A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS ' HEATER -NEW INST. GENERATORS TRANSFORMERS i HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE ' SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS JTILITY -SEWER SIGN TIME CLOCK JTILITY -WATER FIXTLRES ;EPTIC TANK ANTENNA IELAY TELEVISION OUTLETS RAINFIELD, 4' TILE/RES. VIOLATION 'UMP & ABANDON SEPTIC TANK REINSPECTION ;OAKAGE PIT CU. FT. ;ATCH BASIN )ISCHARGE WELL :OMESTIC WELL 'REA DRAIN IOOF INLET • OLAR WATER HEATER "IRE STANDPIPE OOL PIPING .AWN SPRINKLER SYSTEM AS RANGE ETER SET (GAS) AS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA DATE 194 PERMIT N9 2301 Work to be performed under this Permit Subdi- vision Contractor's License No. Legal Lot Bl. Description ddress of lding 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 ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may 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 plans or drawings ctr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed- By 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 regula• tions 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. Value of Project Amt. of Permit CONTRACTOR OR BUILDER BY AUTHORITY PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date Job Address 1.70? (�/ ,9 -S � Tax Folio // jXit / / 9 `� / / � n � G Legal Description oC/ // /'/ g vU i j C�� / � 9 2 Master Permit # ✓ 7r Own // Lessee / Tenant ,!51 ' G pl � V o ( Owner's Address - L/ ( p41 , E .9 57L, Phone 3 ? a Contractin o. Ya E) j ( Address l c?.) . c � Q Qualifier fi 0141 R. Pl 5el SS # — (Phone 0�? 4 37 :73 State# / 0 ,S� Competency 1 6 3,5 Ins.0 Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDIN WORK DESCRIPTION e x A) � - - 5 T->ca. v� I (15 0ac Square Ft. 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 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. sTo Signature of Owner and /or Condo President Date: QM �'�1 + /lid ga J Nota a to Owner and /or Co do President N tart' s to Contractor o 0 ner- Builaer My Commission Expires: 4 A Commission Expires: //6p �c �k fit * �Ic �k �c * * * * PERMIT FEE: APPROVED: Zoning Mechanical Fire Plumbing Address Address Address Building UMBING MECHANICAL PAVING FENCE SIGN 1 -) Ct/lqd Estimated Cost Other Electric ignature of Contractor or Owner- Builde_ Date: MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT I Permit No c 1s 77 Date ° t SC 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, Fits :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 heroin specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address C D0 Q -AM c \\. Registered Architect and /or En neer . Em� ing Electrician's fame.. ''i/ Z y / / 1.11 4 d / L al / Defier® tin L ocal - 4 ° 'h40Z Block IC Street and Number where work is to be performed —No 1 09 ..0.c -. ci 3 s÷ Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADS l j sa. New Building Remodeling Addition Ar,.1/l // a" No 6 J State work to be performed and purpose of building (By Floors) 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 (Signed)7j3 .•.. qt/,! Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 to of t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors licensed by Miami Shores Village. (Signed) NO -1 tv9 E "ir Street Street Street ..1,., r t53i Subdivision.. /'?/ to administer oaths and take .mss9 -043 led under this permit, as are Master Electrician. Before me, the undersigned authority, a notary public, duly authorized 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 OU LIGHT OUTLETS PLUG RECE'►'T'S FIXTURES NO LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. MEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 141 MP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT I Permit No c 1s 77 Date ° t SC 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, Fits :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 heroin specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address C D0 Q -AM c \\. Registered Architect and /or En neer . Em� ing Electrician's fame.. ''i/ Z y / / 1.11 4 d / L al / Defier® tin L ocal - 4 ° 'h40Z Block IC Street and Number where work is to be performed —No 1 09 ..0.c -. ci 3 s÷ Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADS l j sa. New Building Remodeling Addition Ar,.1/l // a" No 6 J State work to be performed and purpose of building (By Floors) 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 (Signed)7j3 .•.. qt/,! Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 to of t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors licensed by Miami Shores Village. (Signed) NO -1 tv9 E "ir Street Street Street ..1,., r t53i Subdivision.. /'?/ to administer oaths and take .mss9 -043 led under this permit, as are Master Electrician. Before me, the undersigned authority, a notary public, duly authorized 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.