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ELECTRICAL.3 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY. (OWNER TO RETAIN COPY) Date Address -i0/ A/G 94' s712 Tax Folio f/ 1244 /41 4410 Legal Description LOT / W /4 6a2. Master Permit # ,1/71 . Owner / Lessee / Tenant ,2 i 6 404./O.v Owner's Address -1,0/ tic/ Contracting Co. / G 0 7 4 : - S a.d 3 y s'i,&Address 6S'. /2 " 7 T. Qualifier G124c/ /0/61.50/J Phone State# Competency# &OOOD "Ins. Co. Architect /Engineer / G/AS i �e■u Address !� J.y/�• s ��✓cr Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Patoi>, ?/4 Square Ft. Signature of Property Owner or Condo Pres. Date: 7// ,// Phone Estimated Cost /000 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, PLUMING, 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. Signature of ontractor or Owner - Builder Date: Notary as to Owner and /or Condo President Notary as to Contractor o 'O ner- Builder My Commission Expires: My Commission Expires: Notary Public, State of Florida at Large * * * * * * le * * * * My Corr*iission E*ires Jana124, 1992 Fire Other i Bonded thru Huckleberry & Associates PERMIT FEE: APPROVED: Zoning �r Mechanical Plumbing" '' / 1 N 5 ngineering Building Electrical PgS /237 Flev 11/79 /'1 .s cA) 6/J /Tr Dr Pr /V o r /3, IAJ .9e-K .62 7 0" a_;: evne- AI& ■Z nil rj All VIII!! 11 IN (11 3?-1 Hir1; coqolrio. O1 IU roi tow Ju,t9iliot1i\1 S:e SECTION SCALE A/7 DWG. BY n-70 RP-o P e CP I:014e s s s 9r xvi • 1 /lc. Ce; A/6 47, 41414 DATE — 49— 9/ SHEET / of / J.O. /1 76 /2/ A. E o/o/ 70000/03 P9S /217 Rev 11/79 A.) rr no9P / Pm/ 1 .77.,ne 1/c zecented 10/ A/e. - r er/4 Atee...1( . de- 4 jez r,j N. • 2" Cft 1 LOCATE AN] 2, 11,1T:if:!!-: fi 3, AIL. •!': I' N FROTEr'.1" PIT ARI.:A, Of. 4i..11=1(1.E. fit-P;;1!' 32-1 ;(1 1,F,:f., Fill(1), . 10 NNW JI,I1pc,11ONAI. s1'y,110 A • SECTION ae / SCALE DWG. BY / /V CI-Al "70 ZP-c., P eoples * Inc. " c(e(// e(S"- -4/40/ A/6 9 -1 - 47/4444 • . DATE — 49— 9/ SHEET ' / of / 'J.0: A.F.E.0/0/ 70000 /00_, THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT VARIANCE(S) LISTED IN "REMARKS'° MIAMI SHORES BUILDING AND ZONING UNLESS SPECIFICALLY LISTED BELOW. AND COUNTY LAWS MUST BE COMPLIED Auth'o'red S'gnmture Date • WITH NO VARIANCES • WITH NO OTHER DEVIATIONS FROM THE ORDINANCES WILL BE PERMITTED, ALL OTHER APPI ICABLE STATE WITH BY ALL PARTIES. FIRE DEPARTMENT 1 PUBLIC WORKS 1 POLICE DEPARTMENT BUILDING DIRECTOR ''�` 9) ) PLANNING & ZONING 60..:•:. VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL8 REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTORS ; 'F. ^',•% ' 1:.r K'IOWIEDGE OF ALL BUILD- ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER Job Address L/ °I PE yi S7. Legal Description /S ekkikif 5Z Owner / Lessee / Tenant D rio(✓ TO RETAIN COPY) Owner's Address 40( Pc 94(<7 phone Contracting Co. I--( Al-LA N ( (C (c)w,;7A( C� A ddress 1 S w Qualifier ( P() ( "( PA A.2UUL(S phone State# Architect /Engineer Bonding Company Mortgagor PERMIT FEE: 0(54 1 •'.No ary y' Commission *- Competency# r 4097 U/ ` - Ins. Co Address Address Address WORK DESCRIPTION CL6CTR ( C O N (BOO L 1 S'l () o Con" y C ission Expi Tax Folio// 3,2,4 /f OyeP l • Master Permit # 1" 3i'0 /7lof Permit Type (circle one): BUILDING ELECTRICAL/) PLUMBING MECHANICAL PAVING c( �?RR6 /09 c Il'11/� k. 33 51 S7(�7E FARM FENCE SIGN Square Ft. Estimated Cost 13 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. 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. Signature of Owner and /or Condo President i nat re o Cont ctor or 0 et-Builder Date: APPROVED: Fire Zoning Building Electrical! ✓ ,//t1) Mechanical Plumbing Other Engineering t p ..�tr.✓i:: ilk :ti '/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT -7 Permit No 7 ( o Date `- — Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. �' Owner's Name and Address `� " No 40 / 1/ Street d' r� Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I Registered Architect and /or Engineer Employing Electrician's Name .2--' P4 ti- L7R /L CG No 1 f 6 d 0 1 / ") Street 1 3 v Location and Legal Description Lot ` 6-. iv Block Subdivision Street and Number where work is to be performed —No � / /v , Street 7 ( s. ! State work to be performe and purpose of building (By Floors) 4 L t L7, i L LA) / IQ /N New Building Remodeling Additiun Repairs No. of Stories Overd Underground 2 Service Size Feeders /...Conduit a /.Main Sw Amps Main Fuses Amps hea Type of Installation — Conduit � Tubing B.X.L Metal Moulding ZZ i 65. (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts 'f's obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of fda 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) �� `�• '��� ES pt//c 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. ACE HATER STRIP HEATER TOTAL CONTR. LIST a 5 ..V , j / --e..1 a / J I. I_ I I CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. /� p '�J Pea // //L GV{/ Des# I . K n o y � [ Ai [Y1I/ ! MOTORS 0.1 HP MOTORS NEON 1 -5 HP TRANS. / 1- RADIO TOTAL CONTR. LIST / / /� • CHECK '/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT -7 Permit No 7 ( o Date `- — Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. �' Owner's Name and Address `� " No 40 / 1/ Street d' r� Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I Registered Architect and /or Engineer Employing Electrician's Name .2--' P4 ti- L7R /L CG No 1 f 6 d 0 1 / ") Street 1 3 v Location and Legal Description Lot ` 6-. iv Block Subdivision Street and Number where work is to be performed —No � / /v , Street 7 ( s. ! State work to be performe and purpose of building (By Floors) 4 L t L7, i L LA) / IQ /N New Building Remodeling Additiun Repairs No. of Stories Overd Underground 2 Service Size Feeders /...Conduit a /.Main Sw Amps Main Fuses Amps hea Type of Installation — Conduit � Tubing B.X.L Metal Moulding ZZ i 65. (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts 'f's obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of fda 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) �� `�• '��� ES pt//c 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. ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMI Permit No 76 Owner's Name and Address ES. MIAMI SHORES VILLAGE Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. G44 /1 No 4/ "E. Street /4 Registered Architect and /or Engine rr� �f co- // ?� �� ° Employing Electrician's Name I� � ' No �� � 0 fr° ° � 0 Street 1/ 3 ® Location and Legal Description Lot A' / i f Block s° Subdivision Street and Number where work is to be performed —No 4/ 6 / C✓ ° ° Street q t/ 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 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 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) S. Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. I 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 REPRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMI Permit No 76 Owner's Name and Address ES. MIAMI SHORES VILLAGE Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. G44 /1 No 4/ "E. Street /4 Registered Architect and /or Engine rr� �f co- // ?� �� ° Employing Electrician's Name I� � ' No �� � 0 fr° ° � 0 Street 1/ 3 ® Location and Legal Description Lot A' / i f Block s° Subdivision Street and Number where work is to be performed —No 4/ 6 / C✓ ° ° Street q t/ 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 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 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) S. Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. I 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 ROOFING Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE. FLORIDA PERMIT . N° 7270 Owner of Building Lot •c CONTRACTOR OR BUILDER Work to be performed under this Permit re Subdi- vision Value of Project $ INSPECTOR BY DATE Contractor's 195 License No. - t, AUTHORITY - Amount of C 4. �..- 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 al 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.a9 .�° In consideration of the issuance to me of this permit I agree to perform the work covered h eunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications subm' ted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, .my a servant i b r employe �� .i �� BUILDING ELECTRICAL PLUMBING ROOFING Owner of f� Building > �� MIAMI SHORES VILLAGE. FLORIDA ❑ o PERMIT N? 7062 ❑ Work to be performed under this Perini Architect Contractor or Builder Legal Lot Description Bl Address of 1 Building CONTRACTOR OR BUILDER Subdi- vision Value of Project $ DATE 195 Y — Contractor's License No. Amount 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 th1 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 cr in the statements orrspecifications 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 cpriipliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the F proper authorities of Miami Shores Village. In ac• -epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 6 a: BUILDING ❑ ELECTRICAL ® DATE 195 — PLUMBING ❑ PERMIT N? 8 19 6 Contractor's License No ROOFING ❑ El Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 4., 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. • ' t 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. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Bl. Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ BY AUTHORITY 17 Owner's Name and Address MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT // APPLICATION FOR ELECTRICAL PERMIT Permit No 5 Y Date 4 " - , 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. e c_H e,i2 No 4° Registered Architect and /or Engineer Employing Electrician's Name Ga. { F r r/l t e 7 1 < No 3 7 0 1 Street t ■ ` d " ' / r < t /`s'V"' Location and Legal Description Lot ``'' Block Subdivision Street and Number where work is to be performed —No 4 Street 1 9 ki `S t 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 oQ Amount of Permit $ (Signed) STATE OF FLORIDA, COUNTY OF DADE I j ss. (Sig ... .. .,lL•• Street q.l.o! -.l Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepl 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. 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 LIOHT OUTLETS PLUG RECE•P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. A CQ H TER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS �. HP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL CONTR. LIST , 1l/ CHECK Owner's Name and Address MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT // APPLICATION FOR ELECTRICAL PERMIT Permit No 5 Y Date 4 " - , 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. e c_H e,i2 No 4° Registered Architect and /or Engineer Employing Electrician's Name Ga. { F r r/l t e 7 1 < No 3 7 0 1 Street t ■ ` d " ' / r < t /`s'V"' Location and Legal Description Lot ``'' Block Subdivision Street and Number where work is to be performed —No 4 Street 1 9 ki `S t 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 oQ Amount of Permit $ (Signed) STATE OF FLORIDA, COUNTY OF DADE I j ss. (Sig ... .. .,lL•• Street q.l.o! -.l Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepl 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. 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.