ELECTRICALMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date O
Type Insp'n Lcci
Permit No. � Off-' — 2-5
Name (_Q O t(
Address i 2f5 -) NE c1
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee ❑
❑ /.3/9
41
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 1 O Z
Type Insp'n Lc y n
Permit No. &I 0 25 1
Named Li Q CO
Address l 15 D NF, q J
Company
Phone #
Inspection Date &1 3
Approved L4"
Correction
Re-Insp'n Fee
❑ /3ei 0 '4.e'
G G/ 9 » -L
ft . ' ,
Permit No. ,OZ. i.�
APPLICATION FOR ELECTRICAL PERMIT
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 compli d ith, wheterein specified or not. A copy of approved plans and specifications must be kept
building during progress of work. 41,
i / l e
Owner's Name and Address ___._____ _ —__� __'_ � _� ! ________________ No. -f - g " Street__A.
Registered Architect and /or Engineer __ _ ___ J _
_ __ __''�jj__ _
Employing Electrician's Name `'"�' '� ' No Street i
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)
Amount of Permit $ J r.`� !
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
New Building Remodeling Addition Repairs
Service Overhead Size Feeders Conduit Mtn Sw Amps.
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
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.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
r , '` Electrical Inspector.
rtify t •lie understands and accepts his obligations as an employer of labor
Com ed General Laws of Florida Permanent Supplement, and has corn -
from all contractors or sub - contractors employed by him in the work to be
inspection on • • site • f the work such public notice or notices as are
sub - contract t• se performed under this permit, as are
•j (Signed
Date
Notary Public, State of Florida
f 9tf
6 / y
Master Electrican.
No. of Stories
Main Fuses Amps.
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 be 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
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.
SERV f
J
MOTORS
0-1 HP
OTORS
1 -S HP
NE
TR S.
RADIO
TOTAL
CONTR.
LIST
A
1/(01/1
i
CHECK
ft . ' ,
Permit No. ,OZ. i.�
APPLICATION FOR ELECTRICAL PERMIT
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 compli d ith, wheterein specified or not. A copy of approved plans and specifications must be kept
building during progress of work. 41,
i / l e
Owner's Name and Address ___._____ _ —__� __'_ � _� ! ________________ No. -f - g " Street__A.
Registered Architect and /or Engineer __ _ ___ J _
_ __ __''�jj__ _
Employing Electrician's Name `'"�' '� ' No Street i
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)
Amount of Permit $ J r.`� !
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
New Building Remodeling Addition Repairs
Service Overhead Size Feeders Conduit Mtn Sw Amps.
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
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.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
r , '` Electrical Inspector.
rtify t •lie understands and accepts his obligations as an employer of labor
Com ed General Laws of Florida Permanent Supplement, and has corn -
from all contractors or sub - contractors employed by him in the work to be
inspection on • • site • f the work such public notice or notices as are
sub - contract t• se performed under this permit, as are
•j (Signed
Date
Notary Public, State of Florida
f 9tf
6 / y
Master Electrican.
No. of Stories
Main Fuses Amps.
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 be 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.
Permit No - - - - -- -- — —= — Date — w — — — — =
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 Engine r,,,
Employing Electrician's Name _s— T,E i -r► ._'__
Location and Legal Description Lot__:1____ J _
Street and Number where work is to be performed —No `� t
New Building Remodeling
Service Overhead
Underground
Size Feeders
APPLICATION FOR ELECTRICAL PERMIT
#1
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
I
� /fi
Conduit / Main Sw.l`
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
No. Street------------- ------------ ----- ----- - -- - --
No.__,
Bloc
ss
from
(Signed)
(Signed)
i
Amps.
-
Type of Installation— Conduit Tubing """'"'""' B.X.L. Metal Moulding
77:
- - �
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
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.
- --- - ---- -- - - --
r /
Street__la i , r r
Subdivision_
it Street
Addition Repairs No. of Stories
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 be has carefully read the foregoing application, and that he did sign the same,
therein by him stated are true.
Main Fuses_ ./ '' Amps.
Electrical I spectrf or:
his obligations as an employer of labor
Permanent Supplement, and has com-
all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as
sub - contractors, *tn wcyC o be performed under this permit, as
11�, t:
Master Electrican.
Notary Public, State of Florida
are
are
authorized to administer oaths and take acknowledgments, personally
and that all facts
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
OUTLEY
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
r
CHECK
•
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -S HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No - - - - -- -- — —= — Date — w — — — — =
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 Engine r,,,
Employing Electrician's Name _s— T,E i -r► ._'__
Location and Legal Description Lot__:1____ J _
Street and Number where work is to be performed —No `� t
New Building Remodeling
Service Overhead
Underground
Size Feeders
APPLICATION FOR ELECTRICAL PERMIT
#1
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
I
� /fi
Conduit / Main Sw.l`
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
No. Street------------- ------------ ----- ----- - -- - --
No.__,
Bloc
ss
from
(Signed)
(Signed)
i
Amps.
-
Type of Installation— Conduit Tubing """'"'""' B.X.L. Metal Moulding
77:
- - �
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
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.
- --- - ---- -- - - --
r /
Street__la i , r r
Subdivision_
it Street
Addition Repairs No. of Stories
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 be has carefully read the foregoing application, and that he did sign the same,
therein by him stated are true.
Main Fuses_ ./ '' Amps.
Electrical I spectrf or:
his obligations as an employer of labor
Permanent Supplement, and has com-
all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as
sub - contractors, *tn wcyC o be performed under this permit, as
11�, t:
Master Electrican.
Notary Public, State of Florida
are
are
authorized to administer oaths and take acknowledgments, personally
and that all facts
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
•
WORK
DONE BY:
The following is reedy for Inspection:
Inspector's Report:
*MI
7
•
. .
. .
• • REQUESTED
• •
•
• •
• •
• •
• •
• •
• •
• •
. .
. .
WILL BE READY
‘7.1t
BUILDING
ELECTRICAL
PLUMBING
•
•
•
•
•
•
Inspector's Report:
•
•
•
•
•
WORK
: DONE BY:
•
•
: REQUESTED
The following is ready for Inspection:
•
•
: WILL BE READY
JOB:
BUILDING
ELECTRICAL
PLUMBING
Inspector's Report : -
WO: , C
DC1\1 BY:
:REQUESTED
•
AD:
. . <-7.•., ,
• .
* •
• •
The following is ready for Inspection: -
WILL BE READY
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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 Engine r
Employing Electrician's Name ___ ��jj'- =.�—!—
Location and Legal Description Lot__Z_`- �_ '1 ___Block
Y�
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
STATE OF FLORIDA,
COUNTY OF DADE.
New Building Remodeling Addition
Service Overhead Size Feeders_
Underground
Type of Installation— Conduit
-- - - -- - ---- --
Amount of Permit $ • (Signed)
Electrical Inspector.
SS.
Conduit_ ;L Main Sw
Tubing B.X.L. Metal Moulding
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.
Before me, the undersigned authority, a notary public, duly
appeared — -- - -- to me well known, and who, being by me first duly sworn, upon oath
of the above described construction, that he has carefully read the
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
(Signed)
Date_
No.
Subdivision_�Y .t__
Street
Repairs.__..
Of !/G:
Amps. Main Fuses_____ • Amps.
inspection on the site of
sub - contractors„
Street--___- __- _ _______ ------_____________
—
rtify that he understands and accepts his obligations as an employer of la or
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
the work such public notice or notices as are
to be performed under this permit, as are
2
Notary Public, State of Florida
No. of Stories
1
j r : /,'„zr .z a
Master Electrican.
authorized to administer oaths and take acknowledgments, personally
deposes and says that he is the
foregoing application, and that he did sign the same, and that all facts
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
,(1V
PLUG
RECE'P
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
-
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
HEATER
TOTAL
CONTR.
ST
ij1
?'`
, Jj
2
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No._____________ _______
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 Engine r
Employing Electrician's Name ___ ��jj'- =.�—!—
Location and Legal Description Lot__Z_`- �_ '1 ___Block
Y�
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
STATE OF FLORIDA,
COUNTY OF DADE.
New Building Remodeling Addition
Service Overhead Size Feeders_
Underground
Type of Installation— Conduit
-- - - -- - ---- --
Amount of Permit $ • (Signed)
Electrical Inspector.
SS.
Conduit_ ;L Main Sw
Tubing B.X.L. Metal Moulding
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.
Before me, the undersigned authority, a notary public, duly
appeared — -- - -- to me well known, and who, being by me first duly sworn, upon oath
of the above described construction, that he has carefully read the
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
(Signed)
Date_
No.
Subdivision_�Y .t__
Street
Repairs.__..
Of !/G:
Amps. Main Fuses_____ • Amps.
inspection on the site of
sub - contractors„
Street--___- __- _ _______ ------_____________
—
rtify that he understands and accepts his obligations as an employer of la or
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
the work such public notice or notices as are
to be performed under this permit, as are
2
Notary Public, State of Florida
No. of Stories
1
j r : /,'„zr .z a
Master Electrican.
authorized to administer oaths and take acknowledgments, personally
deposes and says that he is the
foregoing application, and that he did sign the same, and that all facts
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
Amount of Permit $
materials and /or workmanship.
Owner's Name and Address
Registered Architect and /or Engineer ___ ____
____
Employing Electrician's Name
and Legal Description Lot
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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, whet. r herein specified or not. A copy of approved plans and specifications must be kept
building during progress of work. /'
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Block
Service Overhead Size Feeders Conduit n Sw Amps. . Main Fuses Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
The undersigned applicant for this building permit does hereby certify t �fe, understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Corn . ed General Laws of Florida Permanent Supplement, and has com-
plied 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 t. site .f the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contract. , on o ;lr to ,e performed under this permit, as are
licensed by Miami Shores Village.
(Signed
No g b
No.
Date
Stre
Street___KE
Subdivision___ /
Electrica Inspector.
Notary Public, State of Florida
Master Electrican.
STATE OF FLORIDA, 1
ss.
COUNTY OF DADE.
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
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO .LA MPS
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 SERV
TEMP. P
MOTORS
O-1' HP
/� 1 -5 HP
NEON
TRAt S.
RADIO
TOTAL
CONTR.
LIST
Alt
orni
I
fj
�{+
/
CHECK
�s a - '
/
/
Permit No
Amount of Permit $
materials and /or workmanship.
Owner's Name and Address
Registered Architect and /or Engineer ___ ____
____
Employing Electrician's Name
and Legal Description Lot
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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, whet. r herein specified or not. A copy of approved plans and specifications must be kept
building during progress of work. /'
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Block
Service Overhead Size Feeders Conduit n Sw Amps. . Main Fuses Amps.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
The undersigned applicant for this building permit does hereby certify t �fe, understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Corn . ed General Laws of Florida Permanent Supplement, and has com-
plied 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 t. site .f the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contract. , on o ;lr to ,e performed under this permit, as are
licensed by Miami Shores Village.
(Signed
No g b
No.
Date
Stre
Street___KE
Subdivision___ /
Electrica Inspector.
Notary Public, State of Florida
Master Electrican.
STATE OF FLORIDA, 1
ss.
COUNTY OF DADE.
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
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee _
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui) din 'Inspection Request
Dat y- PaDi
Type Insp'n Fined
Permit No. 6I04 - I
Name ( - 6 - C4 W 1W)
Address a8 J 'v_ QS s-i-
Compan
o
0
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request '
Date —�
Type Insp'n r i a ii Poo/
Permit No. (( d_ I
Name F6 r 1 U.1_ \- l _,Q.-Q 0
Address (c ( Mt 9S J I
Compan .7 t "1
Phone #
Inspection Date �f
Approved tom'
Correction ❑ �/" �G
Re- Insp'n Fee, ❑
BUILDING
ELECTRICAL
PLUMBING
Legal Lot Bl.
Description
Address of
Building
MIAMI SHORES VILLAGE, F
PERMIT N? 2268
Work to be performed under this Permit
Owner of 'r,...
Building <.:
Architect
Contractor
or Builder
r` .
CONTRACTOf OR BUILDER BY
Subitf-
viston
Value of
Project
This permit is granted to the contractor or builder named above to construct the building or to
application herefor in strict compliance with all ordinances pertaining thereto and with the understani.
with any plans, drawings, statements or specifications that may have been submitted to and approved b•
be revoked at any time if the work is not done in compliance with such ordinances or if the plans ar
upon which this permit is granted is the understanding that the contractor or builder named above " se_
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans "o
that he assumes responsibility for work done by his agents, servants or employees.
Signed.
IMPEL
In consideration of the issuance to me of this permit I agree to perform the work covered hereunt
tions in g thereto and in strict conformity with the plans, drawings, statements or specifications su.
Villa g ceptt ag this permit I assume responsibility for all work done by either myself, my agent, se
Type Insp'n
Permit No.
Approved
Correction
Re-Insp'n Fee _
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buijdin'Inspection Request
Dat
�l
fro! a)
6(04-
Name )) n���,,�. 'U
Address ��7�.(�ICJ kJ l U 54-
Compan
Phone #
Inspection Date
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request
Dat
Type Insp'n r
Permit No.
Name CM CV. C
Address ir:ash t g s 34
Company
Phone #
I
Inspection Date
Approved
Correction
Re- Insp'n Fee_
BUILDING
ELECTRICAL
PLUMBING
Lot
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Work to be performed under this Permit
CONTRACT Of OR BUILDER
MIAMI SHORES VILLAGE, F
PERMIT N? 2268
Bl. y
ii-
Su
vision
Value of
Project
BY
ORIDA
DATE
above to construct the buildin or t o
This permit is granted to the contractor or builder named g 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 o inances or if the plans ar :,hanged without authorization. A further condition
upon which this permit is granted is the understanding that the contract° or builder named above sutmes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whe her shown on the plans "o s in th s. in knowledge
and
that he assumes responsibility for work done by his agents, servants or e ployees. r " r` .,
igned
1 NSPEQTOR
Contractor's
License No.
Amt. of
Permit
r
In consideration of the issuance to me of this permit I agree to pert rm the work covered hereunder in compliance with all ordinances and ul
tions pp.sa o g thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami S
Vil this permit I assume responsibility for all work clittti by either myself, my agent, servant or employee.
AUTHORITY
Permit No 3 7 cD-
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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, Fiu:ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address... � / No /;-°" Street./Z.‘ 7/
Registered Architect and /or Engineer //
Employing Electrician's Name... &�'"`. /v No., 9# Street ,..e!...6 vGY
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ilr 6 Street......v3.- on � r1 71
State work to be performed and purpose of building (By Floors) e v e, fediz, 'y /e - e,
New Building Remodeling Addition
Service ( - ye Feeders
/ / Conduit
Uri erground
Type of Installation — Conduit
Amount of Permit $ v ®�
Main Sw Amps Main Fuses.. ..,.<2
B.X.L Metal Moulding
(Signed)...r....! c3.?
Date ,�v
0
No. of Stories
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.
(Signed)
aster Electrician.
Amps
STATE OF FLORIDA, t
COUNTY OF DADE. I 6e.
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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P•T•a
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. H EAT.
CONN.
SPACE
HEATER
STRIP
H EATER
TOTAL
CONTR.
LIST
CHECK
/.-
-
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
e°( 4 p' c.
��.,F J
S " ; L.� d
{
> /..f /, 47,444 OTOR$\
p' 0.1 HP `
ee,... c.» /
/We,'
�� °�
MOTORS
1.5 HP
N EON
TRANS.
RADIO
-
..
TOTAL
/9: --- ---- -
CONTR.
LIST
CHECK
Permit No 3 7 cD-
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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, Fiu:ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address... � / No /;-°" Street./Z.‘ 7/
Registered Architect and /or Engineer //
Employing Electrician's Name... &�'"`. /v No., 9# Street ,..e!...6 vGY
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ilr 6 Street......v3.- on � r1 71
State work to be performed and purpose of building (By Floors) e v e, fediz, 'y /e - e,
New Building Remodeling Addition
Service ( - ye Feeders
/ / Conduit
Uri erground
Type of Installation — Conduit
Amount of Permit $ v ®�
Main Sw Amps Main Fuses.. ..,.<2
B.X.L Metal Moulding
(Signed)...r....! c3.?
Date ,�v
0
No. of Stories
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.
(Signed)
aster Electrician.
Amps
STATE OF FLORIDA, t
COUNTY OF DADE. I 6e.
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.
Legal Description
Qualifier 6,1 le A Srn
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 4 286 ,L16 95" Cr Tax Folio /f- 3�6 - ofi( -L7050
N iX 5NoRES Sec 3
Owner / Lessee / Tenant Master Permit # 34-;g y0
Owner's Address (2.476, u E 95 ST Phone - -7 5l- i3(f)
Contracting Co. PIA Sec (Ar1 + Address PC105 A/W 53 S r
ss# ?
Phone 5"9 -0 /2/
NOTARY
Other
Electrical
or or Owner- Builder
or cii
;. NANCY VELASQUEZ
Mj Commission Expires
March 20, 1997
Comm. No. CC 259235 **
TOTAL DUE b"�l ��
eg'9-- rol
Engineering
• 61 0641 ?DO lb (t .
• PERMIT APPLICATIONFOR MIAMI SHORES VILLAGE
Date 2 ' C IS Job Address 1 ,1� , L . Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant i L,l,t5. i Master Permi
Owner's Address / $ ' - i/ ,S" ST Q J Phone n-
Contracting Co. _ ) 1 Y' 7 I CAL L A4---- ex Y4 ddress 1 b) L1 0. Oo P 1� r l) 2 +` / B J
,^� plgri �4i u
in, 3
I. 332 2
Qualifier 1V 11 /kr■ e . 9. t' SS# - 65 - a � 5 Phone q 5L/ • 7,9-6- 3(e 59
`` , i 1 G , r
State # ( Municipal # I c0� ? Competency # l �`t Ins. Co. '
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING N G MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 0 �'h - 14 • -
so, Square Ft. A C0 J ' Estimated Cost (value) J
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do tl ek stated.
Signature of owner and /or Condo President Date
FEES: PERMIT 7.� mo RADON
Signature of Contractor or Owner - Builder Date
Notary as to Owner and/or Condo President Date (Notary as to Contractor or Owner - Builder Date
My Commission Expires: My Commission Expires: _ 3'—qg
C.C.F. NOTARY X1'`7 BOND
TOTAL DUE itg
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
f
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
NO
/,f
CENTRAL HEATING
DISHWASHER
RECEPTACLES
\®
20
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 If
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 If
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTCRS OVER 8- 10 If
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTCRS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SLFPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
.
SWIMdINIG POOL
OUTLETS COM€RCIAL
WATER SERVICE
SIGN TUBES
_
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY - SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA .
RELAY
TELEVISION OUTLETS
ORAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
RE INSPECTION
SOAKAGE PIT CU. FT.
1=C -0 �?"€,„) Bp
1
S '
CATCH BASIN
'
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
lr
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Date e/3/ 1 Job Address
Legal Descriptions
Owner / Lessee / Tenant kJi'
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Contracting Co. (1 E (P t L
WORK DESCRIPTION 4.0, r.,
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
FEES: PERMIT T RADON
APPROVED:
/286 /IC x Folio ce? el I
70./Sab
v ✓ Q_1/` L. ` S Master Permit #
Owner's Address_I 7 8(o N ET 9 f 57 c' -e. f Phone 7
Qualifier V`0 -A C /Ie9 c° d (6SS# Phone 7'S 7 - S 7 S 7
State #2E4-4;(q( Municipal Competency # /3 2-3 r Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
* * *
Address ceer NE 7? S 7 e 7L
1 , 1-411:04 A
Square Ft. Estimated Cost(value) 7
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
C.C.F.
Signature of Contracto
Date:5 95
..,;( JOSEPHINE CHURCH
.Uotar �cb5c. Stat .f
Iy �'. °Gi.k•¢•. in
;� No. CC197545
• 4_ •
N 7 ary as to Co
My Commission E
Or Owner- Builder
NOTARY
t 4'0 TOTAL DUE ,5 °b
Fire Other
Zoning_ Building Electrical
Mechanical Plumbing Engineering
41°,03
a ft /i
* *
q• •
BUILDING
PERMIT APPLICAT
FBC 2001
Permit Type (ciircle): Building
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
AUG 2 7 004
ON
• (305) 756.8972
cieriA
Submittal Fee $nD Permit Fee $ / 5 - 0 / toa CCF $
Master Permit No. 6PO4 ' 1 1 (1.(1
Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) f-Vlt) d 'r -- Phone # c �& ? - 7.;
Owner's Address _ I FS( /v 55 St
Cit l ► - t ° 5 State n Zip . 3 i 3
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 1 � S( I c 4S $r
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Shl hQ. Mat n-le uto 0 Phone #
Contractor's Address • 1 2 )2 3 Ni W g ^
City Muunt.4 State Zip 33 r?--
Qualifier
Architect/Engineer's Name (if applicable) f2 n1 V= -h W-r ( / Phone # J DS - D I 0 b
$ Value of Work For this Permit X \ 0 0 ' ° Square Footage Of Work:
Type of Work: ❑ Addittion ['Alteration Egew ❑ Repair/Replace ❑ Demolition
Describe Work: LQ. L (.41 I CAA +6 LW-Lip -6r p
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit No. a 04_ ,25
Notary $ Training/Education Fee $ Technology Fee $ ' C )''13
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit 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 permit 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. Al m a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspe on which occu
inspection will nj e approved an % a ei ction fee will be charged. / ■
ntractor
The foregoing instrument w c . owledged before me this // The foreg ing instrument as a knowledged before me thi
day of ✓( 20° I , , day of l� , 2t' , by
who is perso who is per,Teitally own : me or who has produced
�� tificati 1 and who did take an oath.
My Commissi
State Certificate or Registration No.
APPLICATION APPROVED BY:
Chc 10/14/03
xpires:
) days after the building permit is issued. In the absence of such posted notice, the
produced
who did take an oath.
r1
NOTARY
NOTARY
Sign: _l. =r "s _ SH
Print: / 14V Comm tat@ Of Florida Print:
r nmr ,, P . M 24 , 200 % M o ssion E fires/ V Comm. exp. May 24, 200?
D 18240 y '� C omm. No. DD 1824 F
******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * **
(Certificate of Competency Holder)
************************************************ ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Certificate of Competency No.
S 4/ Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/23/2004
Applicant: ROBERT BARRIS
Owner: BARRIS ROBERT
JOB ADDRESS: 1286 NE 95 ST
Parcel # 1132060144050
Electrical Permit
Permit Number: EL2004 -251
Contractor SHINE MAINTENANCE ELECTRICAL Contractor's Address: 7323 NW 8 ST
Local Phone: 305 - 269 -1151
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 3 & 4 BLK 85 LOT SIZE IRREGULAR
Fees: Description Amount
FEE2004 -9568 Building Fee $150.00
FEE2004 -9569 CCF $0.60
FEE2004 -9570 Technology Fee $3.75
FEE2004 -9571 Training and Education Fee $0.20
Total Fees: $154.55
Total Fees: $1 5
Total Receipts: $D.00
Permit Status: APPROVED Permit Expiration: 2/23 /2005 Construction Value: $1,000.00
Work: ELECTRICAL FOR POOL
Page 1 of 1
Signed: (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 responisibility for all work
done b* either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: