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ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 6" CI Job Address /) 0 S % v e j 7 cl Folio Legal Description / Owner/Lessee / Tenant J 6 G `1 ( /� (� / date G Owner's Address / f s- / 6.? s T Qualifier .A3.7 5 State # ek 8 Municipal # Historically Designated: Yes No Master Permit # (44.3 y J ) 9 Co Phone . i S ) S / S Vf ��A/ /mss�!l/ Address - � Contracting Co. f SS# - act 5 •-44 yy Competency #G�� Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 7 /i„"Ao 4. A Square Ft. "e WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work gate Sit'"` (. 6 / 4 /4 ture of • er and/or Condo President Date S gnature of Contractor or Owner - Date x' L 9!_ 44 -g`/ Q o� Notary , r ' o Owner and/or Cbndo President Date My Commission Expires: Li . Estimated Cost (value) }�' / '/� ,, O 0 RADON APPROVED: Zoning Building Mechanical otary as o Contractor OrOwner- Builder Date My Commission j ®v Wifie§iU ciALKQTARY SEAL p e MARcitalITA MOf EL 0 tr =797277 C«'{ ^C OKEXPIRESS 17 C.C.F.C1-4, NOTARY BOND Electrical TOTAL DUE Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITt'�i.. SPACE HEATERS UNIT FEE BIDET LIGHT CUTLETS CENTRAL H=ATING DISHWASHER RECEPTACLES A/C (WINO) DISPOSAL SERVICE TEWCRARY I A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS EXCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE / 7 REFRIGERATION GREASE TRAP APPLIANCE CUTLETS • PRCCESS AND PRESS PIPING INTERCEPTCR RANGE TCP UrOERGRQ H) TANKS LAVATCRY OVEN ABOVE Ewa TANKS LAUNDRY TRAY WATER HEATER U.F. PRESS.RE 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 I WCHAN1CAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 hP F IRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATICL4 INDIRECT WASTES A/C WINDOW RE I NSPEECT ION WATER SLPPLY TO: AIR CONDITIONERS • A/C UNIT I STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE S TIMING POOL CUTLETS COMMERCIAL WATER SERVICE SIGN TLBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLACK UTILITY -WATER F I XTLRES SEPTIC TANK ANTENNA • RELAY TELEVISION CUTLETS DRAINFIELO, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK RE INSPECTION SOAKAGE PIT CU. FT. re -p j, t- B aS - cio r CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA RAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION PLUMBING ELECTRICAL (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. I= A MASTER PERMIT HAS 3. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) MECHANICAL DRIP LOOP irk BE 30' ArG (MIN) L_ I;Y• CL.UIP • 200A kHE TER i 2' 'WOVE 1200E • e' PAAr11C Kr-1(1116 rn u I IF'D rRA71E 0 ... • e' 10 liar; btro • rwc sucrvL • MAIN C71 PANEL • 11•0" /MI 11EP TI I I J . • I EMI unr JA/11' xn'Xw Mt ° n1111 Q1111) • N.O. 1"11{1 -$ titter • SUB C . PANEL • • coNTRAnDin... i4'.E PER S.F.R.C. A!inii,201) • SIGNATURE of COHTRACToR Noinny ____._...__ _.- ._.___ (-\\, I r----) I3 Y , - 1 r m r • • IU Lk UIs' • Iiuis'I •Hclpll'G /e2 Condul =L•or sue • Conduit stz � Condul -LT pe- "ilu-u ro 1r. Y Ground WI/rc arr. c -•- -_ - - -- M U. IN S YIJNHECT Rahn Hata Sub Breakers • SUB FEEDER ENSEDE PANEL AMPS Amps Zstk.5'i-6 Amps New Ex _ Boni! 3'Lte• ��e f¢� • B Retinp . /S Ai.i g /7/e C'4 Ilona( Suss Yes Vic. _WI Loca L ,A22 \z/ 1- .1? 7>P ti D r Permit No v 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.. s~...; Registered Architect and /or ErigUrer MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date j✓> f r Employing Electrician's Name...... � � � L :� /L • �.No ' �� s Street l' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ...0 ?. (:).(" !.L .V/ c New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation nduit Tubing B.X.L Metal Moulding.. ,„ y4 _ Amount of Permit $ 88. (Signed) (Signed) d l a f'" No / Street Street z 1 -..s- Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of lorida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or au - 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 sub- yerstiactors, "qn work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrician. 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, upd 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 , // / 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 ti D r Permit No v 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.. s~...; Registered Architect and /or ErigUrer MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date j✓> f r Employing Electrician's Name...... � � � L :� /L • �.No ' �� s Street l' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ...0 ?. (:).(" !.L .V/ c New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation nduit Tubing B.X.L Metal Moulding.. ,„ y4 _ Amount of Permit $ 88. (Signed) (Signed) d l a f'" No / Street Street z 1 -..s- Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of lorida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or au - 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 sub- yerstiactors, "qn work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrician. 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, upd 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 PERMIT Permit No / 'J Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engine r 3 Employing Electrician's Name ...s� , MIAMI SHORES VILLAGE No.... /� v Street. ,0 elf t ; Date s2 4..FNo a Streets )/itlr L C • ` r' 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. 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). ctrical 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. .. ' .... sA ; (Signed). Master Electrician. STATE OF FLORIDA, } COUNTY OF DADE. ss. 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 REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE H ATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LISP /. s .�' CHECK J f t ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No / 'J Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engine r 3 Employing Electrician's Name ...s� , MIAMI SHORES VILLAGE No.... /� v Street. ,0 elf t ; Date s2 4..FNo a Streets )/itlr L C • ` r' 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. 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). ctrical 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. .. ' .... sA ; (Signed). Master Electrician. STATE OF FLORIDA, } COUNTY OF DADE. ss. 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. Permit No. New Building . ' SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other stricture herein described. This application is made in compliance and conformity with the Bnildin g Ordinance of M' 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 rust be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer__ .. Employing Electrician's Name Location and Legal Description Lot _ — Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Remodeling Addition Block Se rv i ce Overhead Underground Size Feeders Conduit Main Sw . _____ Amps. Type of Installation — Conduit_" Tubing B.X.L.____.__. ____ Metal Moulding Amount of Permit $ ,e4 L ` (Signed) Electrical Inspector. T :c und.isigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an eolployer of labor under the Florida Workmen's Compensation Act, being Section 5;06, Compiled General Lay.'s of Floricl.r Permanent ieot, and has complied with ti,e provisions thereof, and will require similar compliance from all contractors or ralb- contractors employed by ■tie il: tia work to he performed under this permit; and will post or cause to be posted for inspection on lice si.c of the work such public notice or :(, as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, is are licensed by Miami Shores Village. (Signed) No. Repairs __ Street __ • Date. (. t No _ --_- Street __ Street Subdivision / 1 U ..Main Fuses -_ No. of Stories Master Electrician. Amps STATE OF FLORIDA, ) COUNTY OF DADE. 1 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 auo\e described construction, and he has carefully read the foregoing application, and that 1.e did s'.nl: ir, saole, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOI IL: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary ly improper not ee for inspection, Or faults materials and /or workmanship. SWITCH LIGHT OUTLETS OUTLETS PLUG RECE'P'T'S FIXTURES No. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H:ATER STRIP TOTAL HEATER CONTR. LIST . a 1 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOi AL CONTR. LIST CHECK Permit No. New Building . ' SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other stricture herein described. This application is made in compliance and conformity with the Bnildin g Ordinance of M' 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 rust be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer__ .. Employing Electrician's Name Location and Legal Description Lot _ — Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Remodeling Addition Block Se rv i ce Overhead Underground Size Feeders Conduit Main Sw . _____ Amps. Type of Installation — Conduit_" Tubing B.X.L.____.__. ____ Metal Moulding Amount of Permit $ ,e4 L ` (Signed) Electrical Inspector. T :c und.isigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an eolployer of labor under the Florida Workmen's Compensation Act, being Section 5;06, Compiled General Lay.'s of Floricl.r Permanent ieot, and has complied with ti,e provisions thereof, and will require similar compliance from all contractors or ralb- contractors employed by ■tie il: tia work to he performed under this permit; and will post or cause to be posted for inspection on lice si.c of the work such public notice or :(, as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, is are licensed by Miami Shores Village. (Signed) No. Repairs __ Street __ • Date. (. t No _ --_- Street __ Street Subdivision / 1 U ..Main Fuses -_ No. of Stories Master Electrician. Amps STATE OF FLORIDA, ) COUNTY OF DADE. 1 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 auo\e described construction, and he has carefully read the foregoing application, and that 1.e did s'.nl: ir, saole, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOI IL: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary ly improper not ee for inspection, Or faults materials and /or workmanship. Permit No. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION! FOR ELECTRICAL PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the holding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Snores 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 lh ildin g Divison of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications ma t be k: pt at building during progress of work. Owner's Name and Address No. Street ... Registered Architect and /or Engineer Employing Electrician's Name___ _ Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Block No. Service Overhead _ _ Size Feeders _____ Conduit _Main Sw Underground - -- Amps. ..-------- --_ - -- Type of Installation — Conduit Tubing B.X.L.______ Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that lie rrndt'rstantls and accc;;ts his ololig_,thn:; labor under the rlo ida 'Workmen's Compensation Act, being Section 5;ibfJ, Compiled Gem :.1 1 av s at > lorida 1'cnlzil:. I,t am: has complied with the provisions thereof, and will require similar compliance from all cc tr or gull -eonur ciors :%1111h)) Lci iii I !n ;ilr work to be performed under this permit; and will post or cause to be posted for inspection c:: the site of the work such puO[ic notice or linnet , as are required by the Act. The undersigned agrees to employ only sucit sub - contractors, till work to be performed unc_c'r ti.i, permit, .s are licensed by Miami Shores Village. (Signed)_ _______ Strect Repairs Street S l l': div `ion Main Fuses No. of Stories \luster Electrician. Amps Before me, the undersigned authority, a notary public, duly authorized to administer (Joins and taka acknowlccl!,:nenls, 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 : ;; the SOI I C, and that an att> therein by him stated are true. My Commission Expires Notary Public, State of Flo icia 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 LIGHT OUTLETS OUTLETS PLUG RECE'P'T'S FIXTURES No. LAMPS REFRIG. OUTLET IRON RANGE OUTLET OUTLET RANGE CONN. WA7ER HEATER I W. HEAT. I SPACE CONN. HEATER STRIP HEAT _i: T:✓IaL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1-5 HP NEON TRANS. RADIO ToT, L CONTR. LIST CHECK Permit No. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION! FOR ELECTRICAL PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the holding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Snores 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 lh ildin g Divison of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications ma t be k: pt at building during progress of work. Owner's Name and Address No. Street ... Registered Architect and /or Engineer Employing Electrician's Name___ _ Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Block No. Service Overhead _ _ Size Feeders _____ Conduit _Main Sw Underground - -- Amps. ..-------- --_ - -- Type of Installation — Conduit Tubing B.X.L.______ Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that lie rrndt'rstantls and accc;;ts his ololig_,thn:; labor under the rlo ida 'Workmen's Compensation Act, being Section 5;ibfJ, Compiled Gem :.1 1 av s at > lorida 1'cnlzil:. I,t am: has complied with the provisions thereof, and will require similar compliance from all cc tr or gull -eonur ciors :%1111h)) Lci iii I !n ;ilr work to be performed under this permit; and will post or cause to be posted for inspection c:: the site of the work such puO[ic notice or linnet , as are required by the Act. The undersigned agrees to employ only sucit sub - contractors, till work to be performed unc_c'r ti.i, permit, .s are licensed by Miami Shores Village. (Signed)_ _______ Strect Repairs Street S l l': div `ion Main Fuses No. of Stories \luster Electrician. Amps Before me, the undersigned authority, a notary public, duly authorized to administer (Joins and taka acknowlccl!,:nenls, 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 : ;; the SOI I C, and that an att> therein by him stated are true. My Commission Expires Notary Public, State of Flo icia 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 Owner of Building Architect Contractor or Builder_ Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 9535 Work to be performed under this Permit Bl. Subdi- vision 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,eor 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 BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description Address of Building f , ,• i / Lot PERMIT N? 9271 Owner of Building / ./ CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No. Amt. of Permit $ J 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. _4 I ,.; BY AUTHORITY '" PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date A % U g Job Address /0 g‹ '7S T Tax Folio / /go Owner/Lessee / Tenant -® eAd Owner's Address /0 T>/ / ° 9 - Legal Description Contracting Co. 47,f� Qualifier mature of owner and/or Condo President Date 3 q / 6 -1 1/ X002 x23 -' o President Date P N•.. as to My Commission / kJ 07J/ FEES: PERMIT �� � RADON Historically Designated: Yes No X 5 Master Permit # Phone ° 2,c Address /36 y SS# - State # Municipal # Competency # 4 7 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN LECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION i''e, ) 4.. e,2 44��� o,N �� (may Square Ft Estimated Cost (value) ZA 00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work st d. gnature of Contractor o Poi® ©4 IV' caner- Builder 1. 6 Na ary as to Co aCto .r : r Date My Commission Extii 'io� sCn3 " V lylx c n'M EXP. 1, J2 _ -1 C.C.F. / e 0 NOTARY c BOND TOTAL DUE 9L/, APPROVED: Zoning Building Electrical �f Mechanical Plumbing Engineering 1 1 { i `ter Date ITEM BATH TLB - UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES 44 A/C (WIN)) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR GRAIN 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. PRESSLRE VESSELS CLOTHES WASHER _ MDTORS 0- 1 HP STEAM BOILERS SHOWER 6DTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT/3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK. RESIDENCE MOTCRS OVER 5- 8 HP TRANSPORTING ASSE 8LIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTCRS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER 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 FIXTLRES SEPTIC TANK ANTEpQ1A ' RELAY TELEVISION OUTLETS . ORAINFIELO, 4' TILE/RES. VIOLATION PUMP 5 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 ADDENDUM TO BUILDING PERMIT APPLICATION (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 ELECTRICAL MECHANICAL