841 NE 95 St (7)BUILDING ❑
MIAMI SHORES VILLAGE. FLORIDA
ELECTRICAL O DATE 195
PLUMBING ❑ PERMIT N? 8868 Contractor s
License No
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
BL
Subdi-
vision
Sq. Ft
Value of Amt. of
Project $ Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, - thyself, my agent, servant or employee.
BY AUTHORITY
"
17
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑
PLUMBING PERMIT N? 9892
❑
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
17
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description II Bl
CONTRACTOR OR BUILDER
Work to be performed under this Permit
Address of y A Value of I Amount of ^ --'°
Building r Project $ 1 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
. fit x "1 ' .: >,�f•. `•. `..` i, �' j: /lf
Signed- " ' r 4S - INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances "a$d,,regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
N° 7020
Subdi-
vision
DATE • • 19 _
Contractor's
License No.
BY ` " AUTHORITY
Location and Legal Description Lot
Amount of Permit $_
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit
— – -- – — – _Block
Overhead
Service Underground Size Feeders____ ___1 Conduit .____1 PP — Main Sw.___-1 100
(Signed)
(Signed)
Date_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for :he 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 George P rtes :1 9406 N E 9 . Y9
� ------------ ____ —_ No.______ -- Street-------- __ -_ mot______ _______
Registered Architect and /or Engineer
Employing Electrician's Name Ze 0Ul s C V`ds ®P N - 9 9 30 • E Street_______ n ye ---
Subdivision____ 13 1.titc 01 _________
Street and Number where work is to be performed—No — _— _________ Street
State work to be performed and purpose of building (By Floors) .L .e.c.t_JIIl.Z111g_ Residence
New Building Remodeling Addition.. Repairs No. of Stories
Main Fuses___ __________Amps.
Type of Installation— Conduit X ._ Tubing X B.X.L. Metal Moulding
d Elect rical Inspector.
The undersigned applicant for this building permit does hereby certify that herftjderstands and accepts his oblig ns as a n employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gederal Laws of Florida Permanent Supplentent, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint 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, of work to be performed under this permit, as are
licensed by Miami Shores Village.
Q (_
ft n � �, _ c /
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.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowlecgments, 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.
(Ma ;ter Electrican.
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
HEATE 2
TOTAL
CONTR.
LIST
27
31
40
31
1
3
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
1
1
1
.L
1
1
CHECK
Location and Legal Description Lot
Amount of Permit $_
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit
— – -- – — – _Block
Overhead
Service Underground Size Feeders____ ___1 Conduit .____1 PP — Main Sw.___-1 100
(Signed)
(Signed)
Date_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for :he 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 George P rtes :1 9406 N E 9 . Y9
� ------------ ____ —_ No.______ -- Street-------- __ -_ mot______ _______
Registered Architect and /or Engineer
Employing Electrician's Name Ze 0Ul s C V`ds ®P N - 9 9 30 • E Street_______ n ye ---
Subdivision____ 13 1.titc 01 _________
Street and Number where work is to be performed—No — _— _________ Street
State work to be performed and purpose of building (By Floors) .L .e.c.t_JIIl.Z111g_ Residence
New Building Remodeling Addition.. Repairs No. of Stories
Main Fuses___ __________Amps.
Type of Installation— Conduit X ._ Tubing X B.X.L. Metal Moulding
d Elect rical Inspector.
The undersigned applicant for this building permit does hereby certify that herftjderstands and accepts his oblig ns as a n employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gederal Laws of Florida Permanent Supplentent, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint 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, of work to be performed under this permit, as are
licensed by Miami Shores Village.
Q (_
ft n � �, _ c /
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.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowlecgments, 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.
(Ma ;ter Electrican.
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No I. D
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PPLICATION FOR ELECTRICAL PE i-' MIT
Amount of Permit $ ‘, 00 (Signed)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for :he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sh )res Village, Florida,
and all provisions of the Laws of the.State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. 'A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name No ............. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. o Stories
0 9g
Date ,
Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elec:zsicl Inape
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Street
Ma stei Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowle dgments, 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 Flori fa
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'7's
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
H� TER
STRI •
HEATI:R
TOTAL
CONTR.
LIST
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADI')
TOTAL
CONTR.
LIST
--.1--
d017
CHECK
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No I. D
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PPLICATION FOR ELECTRICAL PE i-' MIT
Amount of Permit $ ‘, 00 (Signed)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for :he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sh )res Village, Florida,
and all provisions of the Laws of the.State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. 'A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name No ............. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. o Stories
0 9g
Date ,
Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elec:zsicl Inape
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Street
Ma stei Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowle dgments, 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 Flori fa
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.
e9
PLICATION FOR ELECTRICAL PERMIT
Permit No �" Date 1 . 1
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 ti e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and/or Engineer 1 r _
Employing Electrician's Name
1 -1 - Street...v! / ' •
Location and Legal Description Lot Black. Subdivisio
Street and Number where work is to be performed —No 1..i Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed)
No e
Street / 1 Sr 7 � 5 7 -
//
vcrhead
Underground Size Feeders Conduit Z Main Sw....�...� Amps Main Fuses Amps
of Installation— Conduit Tubing B.X.L Metal Moulding
lecti ical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his • i lions as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • Per. anent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- ,. tracto emplo•red 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 t,e wo !such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be /pe -•tined under :his permit, as are
licensed by Miami Shores Village.
as ter Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. f
88.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and " take acknowlecgments, 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 Florid
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
RERRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
STRIP
HEATEII
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.8 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CH�CK
e9
PLICATION FOR ELECTRICAL PERMIT
Permit No �" Date 1 . 1
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 ti e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and/or Engineer 1 r _
Employing Electrician's Name
1 -1 - Street...v! / ' •
Location and Legal Description Lot Black. Subdivisio
Street and Number where work is to be performed —No 1..i Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed)
No e
Street / 1 Sr 7 � 5 7 -
//
vcrhead
Underground Size Feeders Conduit Z Main Sw....�...� Amps Main Fuses Amps
of Installation— Conduit Tubing B.X.L Metal Moulding
lecti ical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his • i lions as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • Per. anent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- ,. tracto emplo•red 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 t,e wo !such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be /pe -•tined under :his permit, as are
licensed by Miami Shores Village.
as ter Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. f
88.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and " take acknowlecgments, 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 Florid
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 $
STATE OF FLORIDA, }
COUNTY OF DADE.
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for 1:he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shares 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 specificati ms must be kept at
building during progress of work..
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name.. .L <- 1 No / Street.... ,
Street and Number where work is to be performed —No
88.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed)
No ...1 � t�
Location and Legal Description Lot �. Block Subdivision
Street k
Date
Street.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Overhead Servi ce Underground Size Feeders Coc
sit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elect ricaf Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his •ligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori ' . Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub.co t ctors 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 t ork such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub °contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florid a
ii
Mai ter Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for i tspection, 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.
ACE
H ATER
STRII.
HEATER
TOTAL.
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIoo
TOTAL
CONTR.
LIST
CHECK
/
n I
/
—
—'
°
Permit No
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for 1:he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shares 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 specificati ms must be kept at
building during progress of work..
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name.. .L <- 1 No / Street.... ,
Street and Number where work is to be performed —No
88.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed)
No ...1 � t�
Location and Legal Description Lot �. Block Subdivision
Street k
Date
Street.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Overhead Servi ce Underground Size Feeders Coc
sit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elect ricaf Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his •ligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori ' . Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub.co t ctors 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 t ork such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub °contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florid a
ii
Mai ter Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for i tspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 8761
Work to be performed under this Permit
Owner of
Building
DATE 194_
Contractor's
License No
Architect
Contractor
or Builder
Legal Lot Bl. Subdi-
Description vision
Address of Value of Amt. of
Building Project 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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Sioniri •
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
By
CONTRACTOR OR BUILDER BY AUTHORITY