826 NE 92 St (2)Date
PERMIT APPLICATION FOR MIAMI: SHORES VILLAGE
9 R 9rob Add= t A- I F G/ol Sr. T Tax Folio
Legal Description Historically Designated: Yes No
p.
Owner/Lessee / Tam/ 4 ,4- `%4 /// - � '� aster Permit # q 'g /8
Owner's Address Phone
Contracting Co. 11 cj V e i s E /e c tr t c,.. Address
Qualifier SS# Phone
State # Municipal # Competency # Ians. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (eihCe one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING AVING FENCE SIGN
WORK DESCI LN L-/r jr'c1 e- /e C G Q / Seriii c e Qi-i d! / i:L7h T
/ T�� GI d !i e w J �cjk7 and Jf / 9c Rdcf 7`)O /l
Square Ft. Estimated Cost (value) 4A ---0
4�1
WARNING ll OWNE : YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO S :* , MAY RESULT IN YOU.:;
PAYING TWIICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH Y *UR LENDER
OR AN ATI' I RNEY (,EFORE RECORDING YOUR N TICE 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. Furtheiuiore, I authorize the above -named contractor to do the work stated.
Signature ()Colmar and/or Condo President
r
Signature of Con
Notary as to Owner r'tad/or Condo President Date Notary as to Contfactor or % er Builder Date
My Commission Expires: My Commission Expires{
FEES: PERMIT 77' - RADON C.C.F. NOTARY BOND
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
er -Bui1 . / Date
TOTAL DUE
ITEM
BATH TLS
UNIT
FEE
ITEM
SWITCH CUTLETS
UNIT
di
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
h/
, e,51
HEATING
DISHWASHER
RECEPTACLES
5
A/C (WIND)
DISPOSAL
SERVICE TBPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AM'S
•DC
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
/
_3
' REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND 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
i
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
COOLING TOWERS
URINAL
MOTORS OVER 25-100 HP
WATER CLOSET
MOTORS OVER 100 if
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFCRIGS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMIIING POOL
OUTLETS COMMERCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES T
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP 3 ABANDON SEPTIC TANK
'^
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DIScMARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MIDST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
ITEM
BATH TLB
UNIT
FEE
ITEM
SWITCH CUTLETS
UNIT
FEE
ITEM
HEATERS
UNIT
FEE
BIDET
LIGHT CUTLETS
_
CENTRAL HEATING
DISWASHER
RECEPTACLES_
A/C (WIND)
DISPOSAL
_ SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
___
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/WTER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROAJD TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
-Y �
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
^1
TRANSPORTING ASSEMBLIES
SINK. SLOP
MOTCRS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
IJ)TCRS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 If
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFCRMERS
HEATER - REPLACE
GENERATORS TRANSFCiMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMAING POOL
•
OUTLETS COINERCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTI.RES
SEPTIC TANK
ANNA
RELAY
TELEVISION CUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA CRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
G A S R C E
METER SET (GAS)
GAS PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANT THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
Date //-/t
Legal Desert ;lion Historically Designated: Yes
Owned /Test &1•4 S „0, �� .�i s _.S��r, .o ter ]Permit #
Owner's Adds / 2 (o We 92 s7 I te / £4,a-, 3 31 f( home 3 O 6 7 6 7 6 - 2 3 7
Contracting Co. /!/iEsT/c
Qualifier /cit7r r
State # 4f /2533 Munici
Architect/Ef aagnuteea Address
Bonding Company Address
Mortgagor Address
Permit Type (cirele a e): t U DING EY,ECTRICAJ PLUMBING MECHANICAL R!I OFING PAVING FENCE SIGN
WORK ifES C•, N 44614 F ?oett4 = I - 0Gi L. ADS Aoz--/ r.,A
err i i _ _ a o"). Al #
Square Ft. Estimated Cost (value)7
value /5
APPROVED:
Zoning
Mechanical
PERMIT APPLICATI N FOR MIAMI SHORES VILLAGE
Address 24, .06 S7 Tax Folio
WARNING TO OWNER: : YOTJ MUST RECOl A NOTICE OF C s MMENCEMENT AND Y ='i'UR FAILURE TO 110 SO MAY RESULT IN YOU,
PAYING 'TWICE IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDEE
OR AN ATTORNEY FIRE ^ ; CORDING YOUR NOTICE .F COMMENCEMENT.)
Notary as to Owner :ztdloa Conte Pnagident Date Notary as to
My Commission Expires:
Address 782/0 / v1t/
My Commission E
Signature downer Cdlor C 1Pnsida t ate Signature of Contracto
Building Electrical'
4/4 8
Ss# Phorte 3QS 62 5/ -7533
Competency # CC- /86 7/ leas. Co.
Application is hereby made to obtain a permit to do work and installation as indicated above, and or. 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.
/ / - //- �9
Date
P tut, sr or Own HERNANna,
es ' isIotory Public - State of Florida
My Commission Expires Mcr 1 i', 332
Curnmission :r CC72 ^d
FEES: PERT T/ ;i: RADON C.C.I NOTARY BOND
TOTAL DUE
Plumbing Structural Engineer
■
Permit No
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
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
88.
MIAMI SHORES VILLAGE
ELECTRICAL DNSPECTION DE 'ARTMENT
PPL➢L:ATIDN FDR ELECTRICAL PERMIT
No
N
Date
Registered Architect and /or Engineer
_ f
Employing Electrician's Name Street
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 Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed),
The undersigned applicant for this building permit does hereby certify that he understands and
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 subcontractors, on work to
(Signed)
fif
Street Pk
Electrical Inspector.
accepts his oblig fiogls as an employer of
of Florida Pe maftent Supplement, and
sub•contracto s employed by him in the
of the work /such public notice or notices
be performed under this permit, as are
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
OUTLBTO
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
H ATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIOT.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
_ ,��;;
1 j fj?
^� 2
CHECK
"I t1 r�-�'
■
Permit No
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
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
88.
MIAMI SHORES VILLAGE
ELECTRICAL DNSPECTION DE 'ARTMENT
PPL➢L:ATIDN FDR ELECTRICAL PERMIT
No
N
Date
Registered Architect and /or Engineer
_ f
Employing Electrician's Name Street
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 Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed),
The undersigned applicant for this building permit does hereby certify that he understands and
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 subcontractors, on work to
(Signed)
fif
Street Pk
Electrical Inspector.
accepts his oblig fiogls as an employer of
of Florida Pe maftent Supplement, and
sub•contracto s employed by him in the
of the work /such public notice or notices
be performed under this permit, as are
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Legal Lot
Description
Address of
Building
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
PERMIT ) ? 12376
Work to be performed under this Permit
CONTRACTOR OR BUILDER
31.
Subdi-
vision
Value of
Project $
DATE
Signed: BY
Amt. of
Permit $
BY AUTHORITY
Contractor's
License No
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 roper 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 wit 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 state nents or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
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.
r
BUSING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 19--
° PERMIT ° 3775 Contractor's
❑ License No.
❑ Work to be performed under this Permit
B1
Subdi-
vision
Value of I Amount of
Project $ 1 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 applica-
tion 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 Pcrmit 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 plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed. INSPECTOR
In consideration of the issuance to mo 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 ac•
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT PRINT
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Deal
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 10547
Work to be performed under this Permit
Bl.
, ctor or builder named above to construct the build ng or to install the equipment or device described in the application
nces pertaining thereto and with the understandi Ig that the work will be performed in compliance with any plans,
ay have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
th such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
•or or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
• shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
Signed: BY
INSPECTOR
his permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
all work done by either, myself, my agert, servant or employee.
Subdi-
vision
Value cf
Project $
DATE 195:—L
Contractor's
License No.
Amt. of
Permit $
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 10167
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No.
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 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 plans or drawings or in the sta:ements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: BY
INSPP CTOR
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.
BY AUTHORITY
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 co3y of approved plans and specifications must be kept at
building during progress of work.
MIAMI SHORES VILLAGE
Owner's Name and Address No Street..
Registered Architect and /or Engineer
Employing Electrician's Name...... No Street.....
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 Size Feeders Conduit Main Sw Amps Main Fuses Amp
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 and rstands 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 notice
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. T &$'
(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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
l TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
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 co3y of approved plans and specifications must be kept at
building during progress of work.
MIAMI SHORES VILLAGE
Owner's Name and Address No Street..
Registered Architect and /or Engineer
Employing Electrician's Name...... No Street.....
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 Size Feeders Conduit Main Sw Amps Main Fuses Amp
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 and rstands 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 notice
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. T &$'
(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.
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No / Date
Application is hereby made for the approval of the detai'ed 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 t to 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
Employing Electrician's Name
Location and Legal Description Lot BIock 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
Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 1 (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 tlx
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.
STATE OF FLORIDA, }
COUNTY OF DADE. It
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 fact
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.
SS.
MIAMI SHORES VIL.LAGE
No
Street
(Signed)
Master Electrician.
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.
CAR.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No / Date
Application is hereby made for the approval of the detai'ed 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 t to 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
Employing Electrician's Name
Location and Legal Description Lot BIock 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
Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 1 (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 tlx
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.
STATE OF FLORIDA, }
COUNTY OF DADE. It
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 fact
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.
SS.
MIAMI SHORES VIL.LAGE
No
Street
(Signed)
Master Electrician.
JILDING
FCTRICAL
UMBING
IOFING
rner of
ilding
_hitect
, itractor
Huilder
al
cription
press of
lding
Lot
CONTRACTOR OR. BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 11360
DATE 195
Work to be performed under this Permit
BL
Subdi-
vision
Value of
Project $
Contractor's
License No.
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
for in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
vings, statements or specifications that may have been submitted to and approved by the proper mmicipal authorities. This Permit may be revoked at any
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
ited is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
lining 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
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 regulations
ining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
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
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
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 w'th 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
Employing Electrician's Name No Street
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 Hours)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amp
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
Amount of Permit $ (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he urderstands 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 notice,
as are required by the Act. The undersigned agrees to employ only such sub•contracto -s, on work to be performed under this permit, as arc
Iicensed by Miami Shores Village.
SS.
ELECTRICAL INSPECTION CEPARTMENT
(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.