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1220 NE 94 St (6)PE'' MIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 / 5 - /Job Address j ? O � � �- 611 ( Tax Folio Legal Description r FEES: PERMIT y.� RADON APPROVED: Zoning Building Mechanical C.C.F. / Historically Designated: Yes No Owner/Lessee / Tenant 17 C.' to Master Permit # 4 7. 1 9--, 3 Owner's Address / 2■ - , IV ,r/e.--s— , Phone Contracting Co. Qualifier State # Municipal # Architect/Engineer i��1'1v CZ ( Address /, 0 o we t' lam( J r Bonding Company Address Mortgagor Address Me lress SS# Competency # Square Ft. Estimated Cost (value 8' 6 o 1 ' jfrt lot T •ii -. y c .,ir IF1 S I C W C71 NOTARY PUBLIC, STATE OF FLORIDA My Commission Expires May 24. 1 99q NOTARY Electrical Phone Ins. Co. eeA vo Permit Type (circle one): BUILDING LECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIP'T'ION .4 eG 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 -n ed contractor to do the work stated. Y 0 A' r ' o ?MTE OF FLORIDA My Commission Expires May 24, 1999 Commission # CC 467719 Owner- Builder c- Date BOND ate TOTAL DUE y Plumbing Engineering Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address / Registered Architect and /or Engineer-.‘ Employing Electrician's Name Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date.... A 0 S S. MIAMI SHORES VILLAGE Location and Legal Description Lot Block Street and Number where work is to be performed —No [2.1 (Signed) No Street No Street 9 Str Subdivision 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 -77 e . n 4 r) E1e Inspector. The undersigned applicant for this building permit does hereby certify that h/e'un erstands and accepts his obligations as an/employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Conipilee General Laws of Florida Permanentplement, 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. ( (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 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•8 HP NEON TRANS. RADIO TOTAL CONTR. LIST 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. Owner's Name and Address / Registered Architect and /or Engineer-.‘ Employing Electrician's Name Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date.... A 0 S S. MIAMI SHORES VILLAGE Location and Legal Description Lot Block Street and Number where work is to be performed —No [2.1 (Signed) No Street No Street 9 Str Subdivision 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 -77 e . n 4 r) E1e Inspector. The undersigned applicant for this building permit does hereby certify that h/e'un erstands and accepts his obligations as an/employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Conipilee General Laws of Florida Permanentplement, 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. ( (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. is ‘ ,I,�, Permit No t •■,' 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 A STATE OF FLORIDA, 1 COUNTY OF DADE. I APPLICATION FOR ELECTRICAL PERMIT s s. Street and Number where work is to be performed —No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) r Date Street Owner's Name and Address Registered Architect and /or Engineer vJ 1 ..... 1 Employing Electrician's Name ..................t./.. No / A ' Location and Legal Description Lot " Block Subdivision -/��� / ._ , " , Street....:.. / / Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Ohd Service Size Feeders Conduit ' �` Main Sw 1 � Underground f Amps 9 .Main Fuses Amps Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) `` L ` °- -- 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, Compi ec' 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( <s Electrical Inspector. 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, ^ ' j . �' !it i A-- CHECK /-,', '1 : ( .' . `'N i 4') G ) > C J r,-C) ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1-5 HP NEON TRANS. RADIO TOTAL CONTR. LIST '_ < D /� , 4 a C!. CHECK 1 . ^1 / is ‘ ,I,�, Permit No t •■,' 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 A STATE OF FLORIDA, 1 COUNTY OF DADE. I APPLICATION FOR ELECTRICAL PERMIT s s. Street and Number where work is to be performed —No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) r Date Street Owner's Name and Address Registered Architect and /or Engineer vJ 1 ..... 1 Employing Electrician's Name ..................t./.. No / A ' Location and Legal Description Lot " Block Subdivision -/��� / ._ , " , Street....:.. / / Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Ohd Service Size Feeders Conduit ' �` Main Sw 1 � Underground f Amps 9 .Main Fuses Amps Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) `` L ` °- -- 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, Compi ec' 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( <s Electrical Inspector. 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. �QPFLI110 TOO e=S Permit No Owner's Name and Address STATE OF FLORIDA, } COUNTY OF DADE. 88. M ANO SHORES NOEL ELECTRICAL INSPECTION DEPARTMENT Fl agi UEFA_ T lCAL 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 building during progress of work. No j . D Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot +� ® Block Subdivision / Street and Number where work is to be performed —No ` ,.o� §tfeet /Y E State work to be performed and purpose of building (By Floors) No /A- f( (Signed) GE New Building Remodeling Addition Repairs No. of Stories Service Und eground Size Feeders Conduit Main Sw Amps Main Fuses.. Amps g 5 Type of Installation — Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Street �l Street l E' must be kept at 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 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 d ip 'ERN. MOTORS 0.1 HP MOTORS 1�TRANB. `�di a rrif f N EON RADIO TOTAL CL LIST LIST - t `/ CHECK r �QPFLI110 TOO e=S Permit No Owner's Name and Address STATE OF FLORIDA, } COUNTY OF DADE. 88. M ANO SHORES NOEL ELECTRICAL INSPECTION DEPARTMENT Fl agi UEFA_ T lCAL 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 building during progress of work. No j . D Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot +� ® Block Subdivision / Street and Number where work is to be performed —No ` ,.o� §tfeet /Y E State work to be performed and purpose of building (By Floors) No /A- f( (Signed) GE New Building Remodeling Addition Repairs No. of Stories Service Und eground Size Feeders Conduit Main Sw Amps Main Fuses.. Amps g 5 Type of Installation — Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Street �l Street l E' must be kept at Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot i PERMIT N? 10467 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the 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 ELECTRICAL PLUMBING Legal Description 'address of ' uilding Lot Li PERMIT N? 10394 Owner of Building Architect Contractor or Builder 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 .efor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any e 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 nted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations taining 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 ie 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 - taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect 7,ontractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 10133 CONTRACTOR OR BUILDER Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliancelwith 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 1/ 3 s i o a vzv I P, S � ` V':'`-4) la"'M SHORES VPLLA Permit No C & .? Amount of Permit $ IEL.ECTRICAL. INSPECTION DE ''ARTMENT r ? 066 (Signed) (Signed)... i A PLLOCATI ®RI FOR ELECTRICAL PERMIT Date.. Ff�6 y ../ . ?.3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 01 other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fio:ida, and all provisions of the Lawo of the State of Florida, all ordinances of Miami Shores Village and all ruleo and regulationo of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plane and specifications must be kept at building during progress of work. /� Owner's Name and Address / / l- Registered Architect and/or Engineer StreetFe: / /"s 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 ¶ F & t3Y No of Stories 1 Service Overhead Size Feedera Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he underatando and accepto 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. STATE OF FLORIDA, } COUNTY OF DADE. ao. 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 oworn, upon oath deposes and says that he io the of the above described conotruction, and he has carefully read the foregoing application, and that he did sign the name, and that all facto therein by him stated are true. My Commiaoion Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.10 will be made when [such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or et,orkmanohip. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS RE US. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL C LIST I • 3 3 t i n /Z --2-- g, 3. / V5 3 • CHECGt ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS t•S HP NEON TRANS. RADIO TOTAL CONTR. LIST O Z CHECK l) (�]���] U r "" 1/ 3 s i o a vzv I P, S � ` V':'`-4) la"'M SHORES VPLLA Permit No C & .? Amount of Permit $ IEL.ECTRICAL. INSPECTION DE ''ARTMENT r ? 066 (Signed) (Signed)... i A PLLOCATI ®RI FOR ELECTRICAL PERMIT Date.. Ff�6 y ../ . ?.3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 01 other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fio:ida, and all provisions of the Lawo of the State of Florida, all ordinances of Miami Shores Village and all ruleo and regulationo of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plane and specifications must be kept at building during progress of work. /� Owner's Name and Address / / l- Registered Architect and/or Engineer StreetFe: / /"s 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 ¶ F & t3Y No of Stories 1 Service Overhead Size Feedera Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he underatando and accepto 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. STATE OF FLORIDA, } COUNTY OF DADE. ao. 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 oworn, upon oath deposes and says that he io the of the above described conotruction, and he has carefully read the foregoing application, and that he did sign the name, and that all facto therein by him stated are true. My Commiaoion Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.10 will be made when [such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or et,orkmanohip.