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705 NE 94 St (15)? �s PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 765 ALP. . 5'( 9. •Tax Folio /7 3 ®CD / oao g Legal Description) Owner / Lessee / Tenant a e 0 =3C/ ?�' J e) Owner's Address )O J 4' 94 S/ 1 - / ds, Contracting Co. r �,...G �U / � -' ' Address /2 Qualifier �L �� - - SSit Phone ��7-`c State # 6002cf # Competency # V` "� Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one):BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PA ING f WORK DESCRIPTION /`�[..jj // i 6 Square Pt. Estimated Cost(value) e5 vU 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 certi be done in compliance w auth•4- the above -•n Signature Date: Not to c er an• • My Co rls- on Expire : ** * APPROVED: that all the foregoing information is accurate and that all work will 1 applicable laws regulating construction and zoning. Furthermore, I ntractor to do the work stated. ,Condo President as ntractor •r •• er- Builder My C , ission Expires: 0 o President * * * * * * * * * * * C.C.F. , 50 NOTARY Fire Other Zoning Building Electrical FEES: PERMIT 1 0 RADON Mechanical Plumbing Engineering Master Permit # 3 3 :3 ) 9 Phone ature of Contractor Owner - Builder Date: * TOTAL DUE FENCE _SIGN * * ITEM BATH TUN UNIT FEE ITEM SWITCH OUTLETS UNIT 3 FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIIO) 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 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 FP _ ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 If COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP A/C WINDOW VIOLATION REINSPECTION INDIRECT WASTES WATER SUPPLY 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 SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK _ UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & 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 RANG METER SET (GAS) GAS PIPING • n 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 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date 1 (3-) 2 Application is hereby made for the approval of the detailed statement of the plane and specifications herewith submitted for the building ot other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fioada, 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 4 No 7 06 Street it)6 9 sr Registered Architect and/or Engineer Employing Electrician's Narnc...0.4/144/.. 77 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed—No 05 Street 11 - ) E 9 . , State work to be performed and purpose of building (By Floors) e'l'i 4:7'611.771.0.1i.J CONTR. LIST CHECK CONTR. LIST CHECK SWITCH OUTLETS 7 LIGHT OUTLETS 3 ENT. Sw. DIST. CAB. STATE OP FLORIDA, } PLuo RCCEPT5 go SERVICE TEMP. O Service Size Feeders...FA Conduit 1- Main Sw verhead Underground Type of Installation—Conduit C 4-, Tubing. se. COUNTY OF DADE. FIXTURES NO. LAMPS SERVICE PERM. REFRIO. OUTLET IRON OUTLET No....P Street - --? 31 76 CZ) . s? RANGE OUTLET RANGE CONN. (Signed). WATER sr1 c,I eh rnt, .glesee W. HEAT. CONN. SPACE MOTORS MOTORS NEON 0.1 HP 1.5 HP TRANS. FRAG t4/-? et- ,) t /AL. 72,, .e/ 44c 200 Amps 00 New Building Remodeling Addition... Repairs No. of Stories STRIP HEATER /0 RADIO Main Fuses B.X.L Metal Moulding Muter Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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 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, materials and /or workmanship To TOTAL TOTAL Amps Amount of Permit $ ' (Signed) .. / ....,:-.- E ric..1 Insp The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons as an employer o labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of FloridaPermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contr‘ctors employed by h'm 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. personally .... all facts or faulty Vi I lag e of Miami Shores JOB ADDRESS ) C 1 INSPECTION TIME READY REMARKS INSPECTOR 4 - 'Village of Miami Shores N? ATE JOB ADDRESS 7 4- I INSPECTION ea 4 s TIME READY REMARKS INSPECTOR N? DATE 4859 4928 /1/ BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building " Contractor or Builder Legal Lot Description Address of Building • MIAMI SHCIRES VILLAGE. FLORIDA 0 PERMIT N9 4229 0 • Architect f44 :Ars 1 This permit is grinned to the contractor or builder named above to construct the building or to install the equipment or device described in the applicatlon 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 authorizatio A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a th gh knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or s• = •• • . -ns and that he assumes responsibility for work done by his agents, servants or employees. Signet'. INSPECTOR In consideration of the issuance to me of this permit I agree to ironic= the work covered he er 18 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 ac- cepting this permit I assume roaponalbUlty for all work done by either, myself, my agent, servant ar employee. CONTRACTOR OR BUILDER Work to be performed .der this Permit______ BY DATF- Contractor's UMW, No. 7 7/ 195_ Subdi- vision ib Value of Project $ • 1 1 Amount of Permit $ P AUTHORITY °AM° • • • • ' Date PE]RMIT APPLICATION FOR MIAMI SHORES VILLAGE 93 Job Address 76,5 4)' 2• - Tax Folio( v Legal Description] ' IkJ'k/ 6 OS () / - � � 99 5/ - Phone Owner / Lessee / Tenant Owner's Address /0 / ��] Contracting Co._ P lq- _ / /� t Address /2) / " tk • ' / Qualifier 2 6 Q 0 fr a - a - - ss# / Phone 5 State # &)79 1 Competency # eieWee Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PA ING FENCE _SIGN WORK DESCRIPTION /,/ J1l i!/ /1� / � U U Signatur Date: Not My Co ** Condo President w 7� to er an Congo President on Expire : /y , yj Square Ft. Estimated Cost(value) Master Permit # 3 3 3 / / WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO II)0 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 certi that all the foregoing information is accurate and that all work will be done in compliance w ail applicable laws regulating construction and zoning. Furthermore, I auth•M- the above•- n ntractor to do the work stated. ature of Contractor; Owner'Builder Date as ntractor ission Expires: er-Builder ,C3 My * * * * * * * * * * * * *U * I * ** FEES: ALP RADON C.C.F. NOTARY TOTAL DUE 3o5 i APPROVED: Fire Other Zoning_ Building Mechanical Plumbing Engineering ITEM BATH TUd UNIT FEE ITEM SWITCH OUTLETS UNIT 3 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/MIETER 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 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION 1 SINK, RESIDENCE MOTORS OVER 5- 8 HP • TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEhPORARY 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 REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • i HEATER -NEW INST. GENERATORS TRANSFORMERS • HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS. DRAINFIELD, 4" TILE/RES. VIOLATION PUMP & 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 • PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION 4 (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON ELECTRICAL IF A MASTER PERMIT HAS BEEN SUBSEQUENT APPLICATIONS.) MECHANICAL MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT � ` APPLICATION FOR ELECTRICAL PERMIT j Permit No / s" e %��( Date " - 7 2 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, Fiv: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. 4 - 1 4 ./ 7 7,ee Owner's Name and Address..... 4088 /.eh) No .es 4) Street 6 ! G� W 1 Registered Architect and /or Engineer Employing Electrician's Name... n q /� Qi . (/ ! d• 30k 1 % 3 - f�G.i ..7"�' t.��rlL No.... Street" ' 76 %.: ZIP Location and Legal Description Lot Block Subdivision ( � Street and Number where work is to be performed —No Q. Street N E -ti State work to be performed and purpose of building (By Floors) aii�e 4:;14.1.271.0.4.t ° J I '� , 9N�+.e 'xy lee 2b - 200 / , S P P P 7� New Building Remodeling Addition... Repairs No. of Stories ss. My Commission Expires roc,/ F! v S erv i ce Overhead Size Feeders�.FA Conduit /-2 Main Sw 20o Amps c O © Main Fuses Underground Q� Type of Installation — Conduit Tubing 7� B.X.L Metal Moulding Amount of Permit $ ' ..' ` (Signed) ` rical Insp The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons u an employer o 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•contr5ctors 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, r as are licensed by Miami Shores Village. r (Signed). sr' Notary Public, State of Florida Master Electrician. STATE OF FLORIDA, 1 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, 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. Amps NOTE: A re-inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspecti In, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'8 FIXTURES NO LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H W. HEAT. CONN. SPACE H STRIP HEATER TOTAL CONTR. LIST 7 3 �O ! 0 4(4) . ,,f� / e9 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. N A_ / : RADIO Q � �.I A& ' V TOTAL CONTR. LIST I TRA NP eLQs. 1. -- 2 /L Taff 6-o,. CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT � ` APPLICATION FOR ELECTRICAL PERMIT j Permit No / s" e %��( Date " - 7 2 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, Fiv: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. 4 - 1 4 ./ 7 7,ee Owner's Name and Address..... 4088 /.eh) No .es 4) Street 6 ! G� W 1 Registered Architect and /or Engineer Employing Electrician's Name... n q /� Qi . (/ ! d• 30k 1 % 3 - f�G.i ..7"�' t.��rlL No.... Street" ' 76 %.: ZIP Location and Legal Description Lot Block Subdivision ( � Street and Number where work is to be performed —No Q. Street N E -ti State work to be performed and purpose of building (By Floors) aii�e 4:;14.1.271.0.4.t ° J I '� , 9N�+.e 'xy lee 2b - 200 / , S P P P 7� New Building Remodeling Addition... Repairs No. of Stories ss. My Commission Expires roc,/ F! v S erv i ce Overhead Size Feeders�.FA Conduit /-2 Main Sw 20o Amps c O © Main Fuses Underground Q� Type of Installation — Conduit Tubing 7� B.X.L Metal Moulding Amount of Permit $ ' ..' ` (Signed) ` rical Insp The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons u an employer o 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•contr5ctors 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, r as are licensed by Miami Shores Village. r (Signed). sr' Notary Public, State of Florida Master Electrician. STATE OF FLORIDA, 1 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, 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. Amps NOTE: A re-inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspecti In, or faulty materials and /or workmanship. 7 3— Is MIAMI SHORES VILLAGE, FLA. JOB /A).4 ADDRESS 70 �' /0 - 1 ` ` INSPECTION 7r, 4- L ' � - 7/ i N9 5041 TIME READY *�fr` - /=/ -G - p REMARKS: INSPECTOR DATE ,Q z_sc-"4 MIAMI SHORES VILLAGE, FLA. JOB ADDRESS 2 INSPECTION " /- TIME READY REMARKS: INSPECTOR N9 5211 DATE �cc . i` V , k./) ,/,.% • illage of Miami JOB ) crc/ C ADDRESS = INSPECTION 1$ TIME READY (--,/ REMARKS INSPECTOR / Shores N9 4859 ATE '' '--) -) ' , '---)) / SWITCH OUTLETS LIGHT OUTLETS - /� / PLUG RECE'P'T'S v{ / — � ( '1 FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. RP= HEATER STRIP v HEATER TOTAL CONTR. LIST I, / / el CHECK ENT. SW. Dist. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. L LIST UsT 1 CHECK Permit No 4 E' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shore and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications building during progress of work. " �r Owner's Name and Address. r.... ��1,4 -47. . Registered Architect and /or Engineer Employing Electrician's Name. Location and Legal Description Lot /.. r Street and Number where work is to be performed— No. .'8 t�.� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Service Overhead Si ze Feeders... Conduit Underground Type of Installation -- Conduit Tubing STATE OF FLORIDA, COUNTY OF DADS. j s '' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date.. .No Amount of Permit $.......I I • ;.. (Signed) (Signed) 0 (l.' ( No... v Block / Street Main Sw ) Amps Main Fuses Before me, the undersigned authority, a notary public, duly authorized to administer oaths and 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 therein by him stated are true. Street,, Zr Street. Subdivision l r.. ..s R�'.. ...c . Repairs No. of Stories. B.X.L Metal Moulding 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. sign the same, building or other Village, Florida, Building Division must be kept at Master Electrician. Amps take acknowledgments, personally and that all facts 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 Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA PERMIT N9 4229 Contractor's ❑ License No. 12 Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. Subdi- vision — Value of Project $ Signed- BY - DATF 195 er 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 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 regulatio 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 wo:k done by his agents, servants or employees. 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY e