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ELECTRICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date b B e ` ob Address MD D /JET ?0 h —&/L2e — Tax Folio Legal Description Owner / Lessee / Tenant Lo u i "/".7e47 Master Permit # 3 )4.7 Owner's Address /'70 /I) L 9 �( IJ Phone 73 -C trig e Contracting Co. o L l -e-c 2 ? d>J c S Address 1C0 err s Umv / p Phone (R7 - Qualifier R j0-- SS# //._ - State # F-Foo0o6'/3 Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address - Permit Type(circle one): BUILDING ELECTR I PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION a Notary a o My Commission E ** * * APPROVED: Square Pt. 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. Signature of owner a • /or Condo :resident Date: /;� /? ? L/ air eeS ELIZABETH T LASH NO ARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC326574 MY COMMISSION E P. Oc 26,7997 Zoning Mechanical Plumbing Estimated Cost(value) 2 e( Notary as to OefidractoF�® ‹A‹<.( c My." •Comofi 9, , e e r.::.:l_ { o � o C Not:!. ), i'r ■ .-, ?..r. : '.' ° p *fyCorrni.: *dn - ' r . r _ A •!). *.• o * L *° i Bonded Throu0 F1 Rou Sri t - L ,' c "t,.':r. L . ° !- 8C5- 3- 1.CTAa" ° C.C.F. scssw,g5tkly.ww,:sc.:,m,: ecd.\, iy 4ki I�UE ° Signature of Cont Date: 4 -g Fire Other ° ° °,' ' Building Electrical u Bo er- Builder ,Builder A O _�� ** Engineering BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL j PERMIT Date,`" °- 19 PLUMBING 1 1 N? 8119 Contractor's ❑ ROOFING ❑ License No. O 2 . z ❑ Work to be performed under this Permit Owner of Building Architect Contractor -,./ " p, �- • or Builder ,'�_�r.- ,; � 'i ' - .F' ":�iA.C, Legal Lot i l Description 11 Bl Address of —... - - `�� r rr Building " L � '� -�/ Subdi- vision Sq. Ft. Value of 11 Amount of Project $ 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 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 statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. / ,/ A f Signed :ad ✓ ' Amok? 6[t� (INS BY , ` C- In consideration of the issuance to �e of this permit agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, dr wings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume re onsibilityfor all work done by either, myself, my agent, servant or employee. i� '/ "" CONTRACTOIQ'BUILDER BY AUTHORITY Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL E MIT 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 o • .. ...� No.1..TI 0 Street...✓..1�.. • q Registered Architect and /or Engineer Employing Electrician's Name 13- c, 4._A !L, No. k. B� D� -.. 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 Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. Es. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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. (Signed)... dglectrical r. (Signed) Master Electrician. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST , CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL E MIT 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 o • .. ...� No.1..TI 0 Street...✓..1�.. • q Registered Architect and /or Engineer Employing Electrician's Name 13- c, 4._A !L, No. k. B� D� -.. 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 Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. Es. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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. (Signed)... dglectrical r. (Signed) Master Electrician. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA DATE (-"-' I PERMIT • f... L �.. CONTRACTOR OR BUILDER N° 5346 Work to be performed under this Permit B1 Contractor's 4-' Z License No. Subdi- vision Value of Project $ 11 Amount of 11 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 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 statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. I X- =:f w..... 'I �. ,, INSPECTOR In consideration of the issuance to me of this permit I agree to perform tha work covered hereunder in compliance' 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. f,"? BY AUTHORITY vr / rlt ASSOT 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. Service Overhead Size Feeders Underground Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. APPLICATION FOR ELECTRICAL PERMIT s s. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Owner's Name and Address 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 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 a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to licensed by Miami Shores Village. Date.. No Street ccepts. is obligations as an employer of of Fiorida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Electrical Inspector. (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 TOTAL CONTR. LIST G CHECK \ ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. , N MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST 1 D CHECK 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. Service Overhead Size Feeders Underground Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. APPLICATION FOR ELECTRICAL PERMIT s s. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Owner's Name and Address 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 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 a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to licensed by Miami Shores Village. Date.. No Street ccepts. is obligations as an employer of of Fiorida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Electrical Inspector. (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 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 Registered Architect and /or Engineer Employing Electrician's Name_ 6' —' r .4! -.f� +�'�.VO s No -� Street /r. Location and Legal Description Lot Block Subdivision w Street and Number where work is to be performed —No .� O Street... L State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE: ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT GS. MIAMI SHORES VILLAGE r No / Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding —1(- V I C. ...f :, `�� (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Eleftrician. 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. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST ... / CHECK ENT. SW. •IST. CAS. SZRVICE TEMP. ° RVICE PERM. M OTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST lac& i CHECK 1 e 0 • 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 Registered Architect and /or Engineer Employing Electrician's Name_ 6' —' r .4! -.f� +�'�.VO s No -� Street /r. Location and Legal Description Lot Block Subdivision w Street and Number where work is to be performed —No .� O Street... L State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE: ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT GS. MIAMI SHORES VILLAGE r No / Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding —1(- V I C. ...f :, `�� (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Eleftrician. 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 Architect Contractor or Builder '---' Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 644 Contractor's ❑ License No. Work to be performed under this Permit— Bl. Subdi- vision Value of Project $ Amount of Permit $ 195 - w 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 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 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. CONTRACTOR OR BUILDER BY AUTHORITY , Owner's Name and Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT PPLICATION FOR, ELECTRICAL PERMIT Permit No Date / ® f Application is hereb ,made for the approval of the detailed statement of the plans and specifications herewith submitted for building r o Y PP P p tt d or the other or t 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. No Employing Electrician's Name4.V.Z.. e C-- S.e ' a'' No.... 'S Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No. 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 $ Street f �� StreetaQ r "I�a 0 ,,f ✓, Street.. ..e'°– 9 .2 — (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. r ' (Signed) STATE OF FLORIDA, I 1 COUNTY OF DAIDE s$ Master Electitian. Before me, tl;e 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 PLUO RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST / 3 29 a� L CHECK -' Cd 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 , Owner's Name and Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT PPLICATION FOR, ELECTRICAL PERMIT Permit No Date / ® f Application is hereb ,made for the approval of the detailed statement of the plans and specifications herewith submitted for building r o Y PP P p tt d or the other or t 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. No Employing Electrician's Name4.V.Z.. e C-- S.e ' a'' No.... 'S Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No. 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 $ Street f �� StreetaQ r "I�a 0 ,,f ✓, Street.. ..e'°– 9 .2 — (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. r ' (Signed) STATE OF FLORIDA, I 1 COUNTY OF DAIDE s$ Master Electitian. Before me, tl;e 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 Architect Contractor or Builder Legal Description Address of Building Lot PERMIT N? 12646 I I Owner of Building .- / CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLIIIDA Work to be performed under this Permit Bi. Subdi- vision Value of Project $ DATF i Contractor's License No 1 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 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 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 .. 195