1220 NE 94 St (13)Permit No ra
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 . " ��' °') r
Registered Architect and /or Engi ee
Employing Electrician's Name ? � G�
Location and Legal Description Lot Block Subdivisign
Street and Number where work is to be performed —No > Street i ` C .
State work to be performed and purpose of building (By Floors) 'i f �, 00 i--7 C
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE I
ss.
APPLICATION FOR ELECTRICAL PERMIT
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
/ 0
No �7 Street "= 9 C`
/
Date /0. 2/
o
Street
(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.
aster 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
O UTLETS
PLUG
R ECE'P'T'S
FIXTURES
N O. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H EATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
H EATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1.8 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
•
CHECK
Permit No ra
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 . " ��' °') r
Registered Architect and /or Engi ee
Employing Electrician's Name ? � G�
Location and Legal Description Lot Block Subdivisign
Street and Number where work is to be performed —No > Street i ` C .
State work to be performed and purpose of building (By Floors) 'i f �, 00 i--7 C
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE I
ss.
APPLICATION FOR ELECTRICAL PERMIT
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
/ 0
No �7 Street "= 9 C`
/
Date /0. 2/
o
Street
(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.
aster 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
building during progress of w q.
Owner's Name and Address
Registered Architect and /or Engine
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
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.
/7
MIAMI SHORES VI LLAG E
1 ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith suYYmitted 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
No _ /
Employing Electrician's Name -_ -t, r .� 7%/ No
_Block
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amps. Main Fuses.
Date_t±
Street
Notary Public. State of Florida
2.1
Street______ .....
____,��____�_
Street
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 Addition Repairs_ ____________ _ ------ ------ No. of Stories.____ ______
_
(Signed)
Amps.
Electrical Jnspector.
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 auch public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed) o� d' G– U = n
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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO.LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
I q
i
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O -1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
•
Permit
building during progress of w q.
Owner's Name and Address
Registered Architect and /or Engine
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
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.
/7
MIAMI SHORES VI LLAG E
1 ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith suYYmitted 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
No _ /
Employing Electrician's Name -_ -t, r .� 7%/ No
_Block
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amps. Main Fuses.
Date_t±
Street
Notary Public. State of Florida
2.1
Street______ .....
____,��____�_
Street
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 Addition Repairs_ ____________ _ ------ ------ No. of Stories.____ ______
_
(Signed)
Amps.
Electrical Jnspector.
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 auch public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed) o� d' G– U = n
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 he did sign the same, and that all facts
therein by him stated are true.
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.
U BUILDING
ELECTRICAL ,
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is
Work to be performed under this Permi
ci
Lot
Bl.
L . ,
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE g ® 14 191
PERMIT N° 4756
st
Contractor's
License No
Subdi-
vision
Value of
Project
Anit. of
Permit
BY AUTHORITY
ranted to the cont or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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.
• J �}/� Signed. i 7 By d
1 ! INSPECTO
In consideration of the issuance to 1: . th ; permit I agree to perform the work covered hereunder in compliance wit rdinances anc reauliiions
pertaining thereto and in strict conformity with t plans, drawings, statements or specifications submitted to the proper autlibt AIM of Miami Shores Village.
In accepting this periit I assume responsibility for all work done by either myself, my agent, servant or employee.
Owner's Name and Address...
Amount of Permit $✓..�
STATE OF FLORIDA, }
COUNTY OF DADE.
•
88.
@ SHORES VILE.. GE
ELECTRICAL INSPECTION DEPARTMENT
�
j
PLACATION FD ELECTRICAL � `E, ;�.�; 8T
!l
Permit No ‘ Date
(Signed)
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.
No e Street f,4I
Registered Architect and /or Engineer / r ^^� /f
S ,
Employing Electrician's Name. Y � s- ` . C No./ .... .� 'S ,11e..� .. ... .
��� -�
Location and Legal Description Lo( Block Subdivision
Street and Number where work is to be performed— No. .. /.0.."`..ff 9 .e Street
State work to be performed and purpose of building (By Floors)¢���3fe�
New Building Remodeling Addition epairs 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
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 subcontractors, on work to
licensed by Miami Shores Village.
i
•
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
(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
flEFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
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
Owner's Name and Address...
Amount of Permit $✓..�
STATE OF FLORIDA, }
COUNTY OF DADE.
•
88.
@ SHORES VILE.. GE
ELECTRICAL INSPECTION DEPARTMENT
�
j
PLACATION FD ELECTRICAL � `E, ;�.�; 8T
!l
Permit No ‘ Date
(Signed)
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.
No e Street f,4I
Registered Architect and /or Engineer / r ^^� /f
S ,
Employing Electrician's Name. Y � s- ` . C No./ .... .� 'S ,11e..� .. ... .
��� -�
Location and Legal Description Lo( Block Subdivision
Street and Number where work is to be performed— No. .. /.0.."`..ff 9 .e Street
State work to be performed and purpose of building (By Floors)¢���3fe�
New Building Remodeling Addition epairs 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
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 subcontractors, on work to
licensed by Miami Shores Village.
i
•
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
(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. ... 72 7
STATE OF FLORIDA, }
COUNTY OF DADE.
APPLICATION FOR ELECT
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation — Conduit Tubing B.X.L
Amount of Permit $ (Signed)
SS.
MIAMI SHORES VIII_ ,OE
(Signed)
EC
ELECTRICAL INSPECTION DEPARTMENT
L =ERMIT
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. N Owner's Name and Address.. S /� /� `��._.... No 1 Street
Registered Architect and /or EnPine r
No G
Employing Electrician's Name //
Location and Legal Description Lot ,1 Block .Subdivision
Street and Number where work is to be performed —No l .1/ . .......... k ..1..J: .. treet
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Street
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi'
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or sub contra
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the wor
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be
licensed by Miami Shores Village.
1
Amps Main Fuses Amps
Metal Moulding.
lectrical Inspector.
ons as an employer of
manent Supplement, and
is employed by him in the
such public notice or notices
erformed 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
OUTLETS
LIGHT
OUTLETS
PLUG
RECC'P•T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEALER
STRIP
HEATER
TOTAL
CONTR.
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
Permit No. ... 72 7
STATE OF FLORIDA, }
COUNTY OF DADE.
APPLICATION FOR ELECT
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation — Conduit Tubing B.X.L
Amount of Permit $ (Signed)
SS.
MIAMI SHORES VIII_ ,OE
(Signed)
EC
ELECTRICAL INSPECTION DEPARTMENT
L =ERMIT
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. N Owner's Name and Address.. S /� /� `��._.... No 1 Street
Registered Architect and /or EnPine r
No G
Employing Electrician's Name //
Location and Legal Description Lot ,1 Block .Subdivision
Street and Number where work is to be performed —No l .1/ . .......... k ..1..J: .. treet
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Street
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi'
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or sub contra
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the wor
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be
licensed by Miami Shores Village.
1
Amps Main Fuses Amps
Metal Moulding.
lectrical Inspector.
ons as an employer of
manent Supplement, and
is employed by him in the
such public notice or notices
erformed 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.
Permit Noss 3
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PER IgT
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 ' �rC No < l 0 7 4 2 Streetfr 94 S �°
Registered Architect and /or Engineer
Employing Electrician's Name '312- 7/ ems C C
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 5'4 6
No..13.g 7 fir`'' Street S T
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
,� / �C eEi4 I'd f
Service Overhead Site Feeders Conduit t Main Sw Amps Main Fuses Amps 3'"
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE. I j
W vo
S S.
My Commission Expires
(Signed). ...
(Signed)
Date
Street
Subdivision
27 - 67
lectrical 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
aster 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.
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.
(O o (L1L J(rtf 2 43 (JET re- 0 e)
/mot o A/PA j /
M4/ Z7
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1-5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit Noss 3
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PER IgT
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 ' �rC No < l 0 7 4 2 Streetfr 94 S �°
Registered Architect and /or Engineer
Employing Electrician's Name '312- 7/ ems C C
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 5'4 6
No..13.g 7 fir`'' Street S T
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
,� / �C eEi4 I'd f
Service Overhead Site Feeders Conduit t Main Sw Amps Main Fuses Amps 3'"
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE. I j
W vo
S S.
My Commission Expires
(Signed). ...
(Signed)
Date
Street
Subdivision
27 - 67
lectrical 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
aster 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.
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.
(O o (L1L J(rtf 2 43 (JET re- 0 e)
/mot o A/PA j /
M4/ Z7
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA , -A y
Date= - 19f- -r
ELECTRICAL
PLUMBING ❑ PERMIT N? 8727 Contractor's . r <r
License No. z ' �,
ROOFING ❑
ffi ❑ Work to be performed under this Permit
Owner of
Building -
Architect
Contractor
or Builder
Legal
Description
Address of
Building
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 anc
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.
/ (INSPECTOR) • c' // ` 3 ( ) BY
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.
a t,
Lot 11
II BI
CONTRACTOR or BUILDER
//
Subdi-
vision
Sq. Ft.
Value of 11 Amount of
Project $ II Permit $
BY AUTHORITY
IUILDING
LECTRICAL
'LUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N2 4756
`>rchitect
Work to be performed under this Permit
)weer of
luilding
. ontractor
rr Builder
_.egal Lot Bl.
)escription
>ddress of
luilding
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 appli-
,ation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
,lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
i t 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
iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
ibility for work done by his agents, servants or employees.
Signed. a � , 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
)ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
Value of
Project
DATE
Arnt. of
Permit
CONTRACTOR OR BUILDER BY AUTHORITY
194..,•
Contractor's
License No. '"
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
C}- PERMIT N? 13962
n
ll
DATE r 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
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
BUILDING 1=1 MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL Er
PLUMBING ❑ PERMIT N 8553
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder �'` � ' <"'-°
Legal Lot 1
Description � Bl
Address of •
/
Building,',
CONTRACTOR or BUILDER
•
Work to be performed under this Permit
r
-
Date 19_: e%
Contractor's
License No. �� `
y
r �
Subdi-
vision
Sg Ft
Value of I I Amount of
Project $ 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: (INSPECTOR) BY
In consideration of the issuance to me of this permi `'d to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, diawings, 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.
riet
BY AUTHORITY
P G A
tt S r
2 -
Permit No
STATE OF FLORIDA, 1
COUNTY OF DADE. 1?
Z.
4 '' ��►
i a,<< 1 SHORES V RLA E
ELECTRICAL INSPECTION DEPARTMENT
3s
Aftr =L MATRON FOR ELECTRICAL PERMIT
17337
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of 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 .s K, Jackson No 10 Street' %
° E ° 94 Street
Registered Architect and /or Engineer
Employing Electrician's Name....Ma.Ql Fr'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /..d ,: Street At ' 1 Ai ..
State work to be performed and purpose of building (By Floors) Remodeling. (electrical)
New Building Remodeling Addition XXX 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
68.
Amount of Permit $ (Signed)
No /.1....3.5 Street
Date March. 4„,..1975
lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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•contracpr , on work to be performed under this permit, as are
licensed by Miami Shores Village.
G'r'W/ ..7)7 (Signed)_..
Master
ectrician.
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
PLUO
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
/5
/
C
-g_
/
r'
7 J
5'N
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
^O itA
U
CHECK
P G A
tt S r
2 -
Permit No
STATE OF FLORIDA, 1
COUNTY OF DADE. 1?
Z.
4 '' ��►
i a,<< 1 SHORES V RLA E
ELECTRICAL INSPECTION DEPARTMENT
3s
Aftr =L MATRON FOR ELECTRICAL PERMIT
17337
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of 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 .s K, Jackson No 10 Street' %
° E ° 94 Street
Registered Architect and /or Engineer
Employing Electrician's Name....Ma.Ql Fr'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /..d ,: Street At ' 1 Ai ..
State work to be performed and purpose of building (By Floors) Remodeling. (electrical)
New Building Remodeling Addition XXX 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
68.
Amount of Permit $ (Signed)
No /.1....3.5 Street
Date March. 4„,..1975
lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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•contracpr , on work to be performed under this permit, as are
licensed by Miami Shores Village.
G'r'W/ ..7)7 (Signed)_..
Master
ectrician.
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.
OWNER'S AFFIDAVIT:
be done i o.. p1
autho iz
Date.
Notary
My Comm
** *
APPROVED;
PERMIT APP! T{` A'T'TON FOR MIAMI SHORES VILLAGE
2 2 5
4 0 0
4 5 0
6 0 0
3 5 0
2 0 2 5
0 �a
FEES: PERMIT RADON
7
0 TnT
ri7:e cT
Signature of owner an'` r Condo President
7
Competency
Master Permit # 02 4;6
Phone ,742 -4;//
Address 71/9/ O 6/ l �/ .!/0,; _
Phone 8 2 V /—rr.r 9 J
4k Ins.Co.
Address
Address
Address
Square Ft. Estimated Cost(value)
Tax Folio /I 3. e 6r07 090
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �eO'T . 7/ /— i' /1A./// 6 �s Z, e
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.
ify that all the foregoing information is accurate and that all work will
all applicable laws regulating construction and zoning. Furthermore, I
contractor to do the work stated.
Zoning
Mechanical
/ -/ -oo'
dent Nota
330- (- 1o3.0-19-P C
C.C.F. 'CO
ission E Rkgab .
Natan, Puffs - State of Fiadda
My * �m #CamII30 *
Signature o Con aq€or or Owner - Builder
Date
NOTARY -- c'
Builder
**
TOTAL DUE
Fire Other
Electrical
Engineering
■
i
PROPERTY OF Bouto
wr VALID wrlllolrr r,it sit:mart:KC
A rli! IIKI(; tYAi RAL1t:D SEAL or
PION IDA I.K E'sa:D SIIR%'tVoat
..nu AlwrrR
AY
A BOUNDARY
SURVEY
I hereby certify that the survey repre-
sented hereon meets the minimum
technical standards set forth by the Board
of Land Surveyors in chapter 61017 -6
Florida Admi:.istrarive Code pursuant to
Section 472077. Fla. Seatute . There are no
encroachments. overlaps. easements
appearing 't Kat. other rhan as
shown eta.
Z146
71t= v E474 k
NOTE:
r /a L
LO6-4 T79 M /i
L.F. ELEV. = 3, 3 7 denotes lowest
habitable floor elevation.
Elevations shown refer to N.G.V.D.
1929.
Lowest Adjacent Grade =
ELZI. x,74, .
GA8 C
GARAGE ELEVATION = )1 /4 .
E.R.P. = ///,./
, Martin, 1078 N.E. 94th Street, Miami Shores, Florida
FIELpp DATE
07/25/00
GO,0. /HT of 4 UNE
PAR,4 r GL To a,vo So r
NOAr7/ Twe ozir/i Awe
7:&4c 7-- ,& .
LANNES AND (;ARCIA, INC.
LB. # 2098 •
SURVEYORS- h1APPERS -LAND PLANNERS
• E.: E 299
(ffirr allllrrss: 339 :11cacar Asrnue, (*oral Gables. ) urida 33134
(305) 666 -7907 (954) 52.14663
SCALE
7/ '. 20 •
DRAWN BY
Page 1 of 2
33138
3, 70 22.00.. • %
72,
31
•
•
• - ••• •
• • CONG• • p . plli ✓a
2S,y,
•
/1 Ion 1(0)
374 5
0/Ye STOR y
¢5, • - 25 .4o.
Pro,
N
//7,
•
/3/e1c, j 2¢,,0 n
. . i.0 p %54$ %Zo •
.• •
•
col /c..- A/A -4 • r7 _
//700' e' //, OS'
zo
/C 6
� h
,o
�c-
6 5 /0, o
0
r
N
This property described as: All that part of Tract K of Plat of Government
Lot 4, of Section 5, Township 53 South, Range 42 East, as recorded in Plat
Book 5, Page 90, of the Public Records of Dade County, Florida, bounded as
follows: Starting at the intersection of a line parallel to and 80 feet North
of the South line of Tract K, the West , Tineof: East Dixie Highway run
Northeasterly along the West line of the East. Dixie Highway a distance of
76 feet; thence West• parallel to the South line of Tract K, a distance of
133 feet to point of beginning of the Tract hereinFdescrib•ed, thence
continuing West parallel to the South line of Tract K a distance of 117 feet;
thence line of right angles to the last mentioned line a distance of
.74.28 feet; thence East at the right angles to tree last mentioned line, a
distance of 117 feet; thence-North at right angles the last mentioned line
a distancetof 74.28 feet to the Point of beginning.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/23/2004
Applicant: MARY BRIGGS
Owner: BRIGGS MARY
JOB ADDRESS: 785 NE 94 ST
Contractor MOODY ELECTRIC INC
Local Phone: (305)758 -2000
Parcel # 1132060142030
Signed: (INSPECTOR)
Electrical Permit
Permit Number: EL2004 -83
Contractor's Address: 669 NW 90 ST
Permit Status: APPROVED Permit Expiration: 9/15/2004 Construction Value: $1,500.00
Work: ELECTRICAL WORK FOR KIT
Page 1 of 1
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 E1/2 OF LOT 24 & ALL LOTS 25 & 26 LESS E15FT
Fees: Description Amount
FEE2004 -3066 Building Fee $100.00
FEE2004 -3067 CCF $1.20
FEE2004 -3068 Training and Education Fee $0.40
FEE2004 -3069 Technology Fee $2.50
Total Fees: $104.10
Total Fees: $00
Total Receipts $0.00
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miam Shores Village
BUILDING
PERMIT APPLICATION
FBC 2001
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building � / Plumbing Mechanical Roofing
//��( ///
Owner's Name (Fee Simple Titleholder) W &? Phone # 365 757-03y
Owner's Address ?g
Permit No. I x00
Master Permit No. V2_004- 3133 .
City /iMl 6l State FL- Zip 3 / e
Tenant/Lessee Name Phone # (Of 7 56 23O 0
Job Address (where the work is being done) . 185 /U ' 6r
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name J l gL.- eC.7LIC (A)O Phone # 158 -
Contractor's Address 4Q /U) QD
City / // /41/1/ / State PL— Zip 3/50
Qualifier j/ A MOOD,
Zip 3 3) -
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit $ I SQQ COO Square Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition
td)
Describe Work: / e'/1 /e— Ali cX k/
ixj ee.,.,
,e2e-,40 a e'
C iL (0.G 0
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ S U • o d Permit Fee $ /C '' C'6' CCF $ 1 , D c CO /CC
Notary $ Training/Education Fee $ e 4 0 Technology Fee $ a, 0
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due L 1 1 1 0
(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
Application is hereby made to obtain a pennit 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 pennit 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 occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature ,cJ •
NOTARY PUBLIC:
Chc 12/15/03
Owner or Agent
day of , 200 , by
APPLICATION APPROVED BY:
40-
Ay
State Zip
r
The foregoing instrument was acknowledged before me this Cl
who is personally known to me or who has produced
As identification and who did take an oath.
Sign:
•• ` .0 NIi.EABE BEM_ 0
Print: l'� ' y Q 1 V—��-
k * COMMISSION NUMBER
My Comm �. Ir ssic; DD033052
e 4� My COMMISSION EXPIRES
(Certificate of Competency Holder)
************************ * * * * * * * * * * * * * * * * * * * * * * * *. * * * * **
Contractor �i
The foregoing instrument was acknowledged before me this /
day of (1 l /Cif—r--' , 20 0/, by 4
who is personally known to me or who has produced
as identification and who did take an oath.
• NOTARY PUBLIC:
Sign:
Print:
My Co
* COMMISSION NUMBER
8r1es: DDO33o52
**®F'pv, * * * **
a1
* * * * * * * * * **
State Certificate or Registration No. Certificate of Competency No.
7 **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
o e-:;( -Az Plans Examiner
Engineer
Zoning
EM
TH TUB
UNIT
FEE
ITEM
SNITCH CUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
CET
LIGHT CUTLETS
1,
CENTRAL NEATING
S t
RECEPTACLES
Gay
A/C (WIND)
S?GSAL
SERVICE TEbWCRARY
A/C (CENTRAL)
INKING FOUNTAIN
SERVICE SIZE IN AbPS
CLOT IORK
c DRAIN
SERVICE REPAIR/W:1ER CiM E
REFRIGERATION
EASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
TERCEPTCR
RANGE TOP
UNDERGROUND TANKS
:VATCRY
OVER
ABOVE GROUhU TANKS
,UNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
.OTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
:C'tIER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
NK , POT /3 COMP.
MOTORS OVER 3- -5 FP
MECHANICAL VENTILATION
.NK, RESIOENCE
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEhBLIES
INK, SLCP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
1
:W0RARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
HHAL
MOTORS OVER 25-1C0 FP
COOLING TOWERS
;TER CLOSET
MOTCPS OVER 100 FP
VIOLATION
DIRECT WASTES
A/c WINDOW
REIiSPECTION
;TER SUPPLY TO:
AIR COhDITIOHERS
•
A/C UNIT
I
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRAISFCR. "ZRS
HEATER -NEW INST.
GENERATCIS TRANSFCRbERS
HEATER - REPLACE
GENERATCYIS TRANSFORMERS
LAWN SPRINXLER -WELL
SPECIAL PURPOSE
MAIM POOL
OUTLETS CC4ERCIAL
WATER SERVICE
SIGN TUBES
:WER CONNECTIONS
SIGN TRANSMERS
"ILITY - SEWER
SIGN TIME CLOCK
"ILITY -WATER
FIXTURES
:PTIC TAJG(
ANTENNA
:LAY
-
TELEVISION OUTLETS
UINFIELO, 4' TILE/RES.
VIOLATION
;MP & ABANDON SEPTIC TANK
REIFSPECTION
UAXAGE PIT CU. FT.
;TOO BASIN
SCFURGE WELL
'AMC WELL
tEA CRAIH
CF Ih1ET
1LAR RATER HEATER -•
iRE STANDPIPE
bl PIPING
•
\WH SPRINKLER SYSTEM
S RANGE
:TER SET (GAS)
S PIPING
N APPY.ICATION FOR BUILDING PERMIT MUST ACCOCPANT THIS ADDENDUM. IF A MASTER PERMIT HAS
.3TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATI
PLUMBING
ELECTRICAL
MECHANICAL