ELECTRICAL.4►. r
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date r D Job Address 1 1710,2 5 6r Tax Folio
Legal Description S ' p 10
Owner/Lessee / Tenant iSat(l �� J) I /WA
Owner's Address ` � 0 Z t3 e. 45 Sf
Contracting hU l Co. T oo w ._ J G I k) C—
Qualifier JQ tT U ir0)
State # � Municipal # Competency #
Architect/Engineer Address
Bonding Company /61- Address
Mortgagor Address
Permit Type (circle one): BUILDIN a 'AL
WORK DESCRIPTION / ,4(—
Square Ft. Estimated Cost (value)
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 (W 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.
OWNERS 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.
S
er
L' • • • ARY SEAL -
MARY P BRIGGS
v
* COMMISSION NUMBER
CC741860
7 0
�F L �c\ MY COMMISSION EXPIRES
MAY 11,2002
sident
ro
0/
Notary as to
My Comm
ion Ex
FEES: PERMIT 6 ' RADON
APPROVED:
Zoning
Mechanical
� n t
C.C.F.
01
Building
Plumbing
Phone
11- 3.06?-101L-1 -0c-170
Historically Designated: Yes No
s0 03-C
Master Permit #
Address 64)q /Vw q057
SS# Phone g9/-/37V
/(060 2— Ins. Co. 1 779E
PLUMBING MECIIANICAL ROOF PAVING FENCE SIGN
Signature of Contractor or Owner- Builder
oo
&laid Itiligk„/
6 'L NOTARY Sf
Notary as to • lifTI ialitNUMBER
My Commiss r,,s : s� CC741860
F Io MYCOMM1SSIbNEXPIR2S
�F
MAY 11 2002
NOTAR V BOND
Electrical
Structural Engineer
TOTAL DUE
J%/6j
Date
q 10
Date
ITEM
BATH 1.8
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS •
CENTRAL HEATING
DISHWASHER
RECEPTACLES
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 s „
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEM6LIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS /ESCALATORS
,
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
RE INSPECTION
WATER SUPPLY TO:
AIR COtvD I T I ONERS 7
� j/ ,
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TLBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
F IXTL,RES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
PUMA & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
J 2 Q l/- 3 - CD 4 —e y7 0
Date k f/ Job Address I/ /Y e 9■ S' Tax Folio
Legal Description
Lessee / Tenant 1 & V E 1(ROLO P' Master Permit it 31rn
Owner's Address
Contracting Co. ICE ` 2 5E'eVVG
Qualifier.0
- Phone 3 4
stated.
///
Signature
Date:
Notary as EXP.
to Contractor or Owner- Builder
pr-'-.' - -.
My Commiss � e icla�. rsa7wav S AL a
Nvl
* * * e- Jars /0111=1
a A * CO °a ZI NU ?3E{
t * R3S*�S:_-:. -I.,. J
'r F OF � O@ i. f;:::;..; 997
NOTARY TOTAL DUE U 0 1 5
Fire Other
Building Electrical
Phone ‘
of Con ractor or Owner- Builder
r<-° / ^ ''' t om 9
1 /g3
**
Plumbing Engineering
JOB:
Inspector's Report:
6 Na
•
REQUESTED
The following is ready for Inspection:
WILL BE READY
elb
�a
. •
r
Permit _______
Registered Architect and /or Engine
Employing Electrician's Name ___
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed
MIAMI SHORES VILLAGE
Amount of Permit $_
STATE OF FLORIDA, }
COUNTY OF DADE. ss.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date_ 3./
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, whe er herein specified or not. A copy of approved plans and specifications must ,be kept at
building during progress of work. ... r
- - --
l —G` __ L�" i s = 1 N Owner's Name and Address __ iO At _ ____ _____- Street
- --- - -- -- -- - --- - - - - - --
Street
Block
purpose of building (By Floors)
New Building Remodeling Addition Repairs
P - - P.
Overhead j Main Sw 0 Amps. _______ Main Fuses Amps.
Service
Size Feeder Conduit®
Underground —
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
f
(Signed
Street
Subdivision_
Notary Public, State of Florida
No. of Stories
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that hur>derstands and accepts his obligations as an employer Of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled E,efieral 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 the
required by the Act. The under signed agrees to employ only such sub - contractors, ' o�
licensed by Miami Shores Village. t
of the work such public notice or notices
be performed under this permit,
as
as
aster Electrican.
are
are
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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
i [ { - �-�'
_
/
/�
1 s
L
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
r
Permit _______
Registered Architect and /or Engine
Employing Electrician's Name ___
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed
MIAMI SHORES VILLAGE
Amount of Permit $_
STATE OF FLORIDA, }
COUNTY OF DADE. ss.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date_ 3./
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, whe er herein specified or not. A copy of approved plans and specifications must ,be kept at
building during progress of work. ... r
- - --
l —G` __ L�" i s = 1 N Owner's Name and Address __ iO At _ ____ _____- Street
- --- - -- -- -- - --- - - - - - --
Street
Block
purpose of building (By Floors)
New Building Remodeling Addition Repairs
P - - P.
Overhead j Main Sw 0 Amps. _______ Main Fuses Amps.
Service
Size Feeder Conduit®
Underground —
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
f
(Signed
Street
Subdivision_
Notary Public, State of Florida
No. of Stories
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that hur>derstands and accepts his obligations as an employer Of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled E,efieral 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 the
required by the Act. The under signed agrees to employ only such sub - contractors, ' o�
licensed by Miami Shores Village. t
of the work such public notice or notices
be performed under this permit,
as
as
aster Electrican.
are
are
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.
APPLICATION FOR ELECTRICAL PERMIT
s /
Permit
Application 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 grdinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with. whep6er herein specified or not. A copy of approved plans and specifications must jbe kept at
building during progress of work. s /'', /
,f ` r _ a l ` , i i , i f o
/•� sr-
Owner's Name and Address __L 1 No!_" ■ 4 1 Street .-
Registered Architect and /or Engineer 1�'_��'� ,i ft� .�t � ", '° �' �„ __ _
Employing Electrician's Name . _,__ __ No._ t____4____1'!� _________ Street .// _______
Location and Legal Description Lot ,!__`" Block +r - Subdivision ._,-., —`ss
S treet and Number where work is to be performed— No.,____ ,- :'____ -_ _ r_ _______�_4____ ,,,.______ Street __ __ fir + _— ' v___________
State work to be performed and purpose of building (By Floors)
��
New Building 1- Remodeling Addition Repairs
Service Overhead Size Feeders
Underground
" MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Y
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that h rstands and accepts his obligations as an employer labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eral 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 the sit* of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on wor le be performed under this permit, as are
licensed by Miami Shores Village. 7
My Commission Expires
Conduit Main Sw.__i " �,,__ Amps. Main Fuses __ L/ Amps.
t ir
C' (Signed)
(Signed) -- — —
No. of Stories
Master Electrican.
STATE OF FLORIDA,
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.
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
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
-�
C L sT
v
! L"
!
l-
/..
. HEAATER
---/ --
! l
1
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT
s /
Permit
Application 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 grdinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with. whep6er herein specified or not. A copy of approved plans and specifications must jbe kept at
building during progress of work. s /'', /
,f ` r _ a l ` , i i , i f o
/•� sr-
Owner's Name and Address __L 1 No!_" ■ 4 1 Street .-
Registered Architect and /or Engineer 1�'_��'� ,i ft� .�t � ", '° �' �„ __ _
Employing Electrician's Name . _,__ __ No._ t____4____1'!� _________ Street .// _______
Location and Legal Description Lot ,!__`" Block +r - Subdivision ._,-., —`ss
S treet and Number where work is to be performed— No.,____ ,- :'____ -_ _ r_ _______�_4____ ,,,.______ Street __ __ fir + _— ' v___________
State work to be performed and purpose of building (By Floors)
��
New Building 1- Remodeling Addition Repairs
Service Overhead Size Feeders
Underground
" MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Y
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that h rstands and accepts his obligations as an employer labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eral 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 the sit* of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on wor le be performed under this permit, as are
licensed by Miami Shores Village. 7
My Commission Expires
Conduit Main Sw.__i " �,,__ Amps. Main Fuses __ L/ Amps.
t ir
C' (Signed)
(Signed) -- — —
No. of Stories
Master Electrican.
STATE OF FLORIDA,
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.
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.
JOB: •ve 2 € 9�i
BUILDING
Inspector's Report:
YIP
•
.
•
•
•
•
•
•
The following is ready for Inspection:
R.E QUESTED
: WILL BE READY
.."