102 NE 94 St (2)Permit No
Disapproved
(Signed)
APPLICATION FOR UILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
tZ
Buildi :inspector
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Da
P'
Chairman
Member
Member
Council Approved Date
�`_ �.. �✓ No / )-
Owner's Name and Address.
Registered Architect and /or Engineer...__ .. /
Name and address of licensed contracto r a1 -tom % • - ..?" d 3—/yrg `,
Location and legal description of lot to be built oi‘ ,)(„, `i
Lot Block Subdivision ....
Street and Number where work is to be done. ./l, - k - V� 7 State work to be done and purpose of building (by floors)
Date �'" mo d / Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
, 19
S etfet
and for no other purpose.
Repairs No. of Stories
New Building Remodeling Addition
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 735.7.1717 Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit 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, Penman T Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e %loved by him
in the work to be performed cinder this permit; and will post or cause to be posted for inspection on the site of the work s public notice
or notices as are required by the Act. The undersigned agrees to employ only such u., ontra.to :, yvork to be t ed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
19
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'7'S
FIXTURES
NO. LAMPS
REPRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. H EAT.
CONN.
SCACE
HCATER
STRIP
HEATER
TOTAL
CONTR.
LIST
y
fr
LI
rr
CHECK
/(
I
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.S HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No t
Owner's Name and Address
STATE OF FLORIDA, }
COUNTY OF DADE. ss'
/ h . 0..:. /..".!(..d / `�
(Signed)
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date F es_
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.
Registered Architect and /or En ineeer 1 / -
Employing Electrician's Name... L ' ) 1( � ' ` f = 71/( No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /a /
Street
Street
Amount of Permit $ .1-4. 0 (Signed)
State work to be performed and purpose of building (By Floors)
' New Building Remodeling Additiun...... 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
Electrical Insp ctor.
The undersigned applicant for this building permit does hereby certify that he understands and ac is his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws f Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors r 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.
I/ 7
/ 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.