1075 NE 96 St (2)BUILDING
ELECTRICAL
PLUMBING •
Owner of
Building
Architect / p� . •
u�f
Contractor
Builder
Legal Lot
Description
Address of
Building_
This permit is gn ed to the contractor or build
cation herefor in strict compliance with all ordinances
/0
ERMIT N? 7023
Work to be performed under this Permit
5 IYZ
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
B
EZ
Signed:
Subdi-
vision
Value of
Project
named above to construct the building or to install the equipment or devi described in the appli-
itaining thereto and with the understanding that the work will he performe in compliance with any
plans, drawings, statements or specifications that may 14ave been submitted to and appr.ved by.tfre pr er 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 re ch. ged without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assu nes t e respopsibility for a thorough knowledg of tl e ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or .r . .+ tfie stn.otciiffcations and at
sibility for work done by his agents, servants or employees.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform �lffL' "work covered hereunder in compli / nce with all ordinan s and regulations
pertamm thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Mi mi Shores Village.
In ace ing this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
BY
DATE
Contractor's
ense No.
... `...
r x
Amt. of
Permit
to_
AUTHORITY
assumes respon-
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building • --
Architec f
Confracto
or Builde
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA.
PERMIT N? 7023
ork to be performed under this Permi
igned-
Subdi-
vision
Value of
Project
This permit is g nted to the contractor or buil . r named above to construct the building or
cation herefor in strict compliance with all ordinances .ertaining thereto and with the understandin
plans, drawings, statements or specifications that may • ave been submitted to and app oved b
at any time if the work is not done in compliance with such ordinances or if the plan are c
permit is granted is the understanding that the contractor or builder named above as es
regulations pertaining to the work covered hereby whether shown on the plans - or
sibility for work done by his agents, servants or employees.
BY
DATE
19
Contractor's
cense No
Amt. of
Permit
to install the equipment or devfe described in the appli-
that the work will be performed in compliance with any
per municipal authorities. This Permit may be revoked
out authorization. A further condition upon which this
sibility for a thorough knowled.e of e ordinances and
to 'cations an
INSPECTOR
e assumes respon-
Inconsideration of the issuance to me of this permit I agree to perform The.Work covered hereunder in com fiance with all ordina ces an regulations
pertain' thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of amf Shires Village.
In ling this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
? ..,t./L/I 4,%., "+"7 f t 1, - t'
CONTRACTOR OR BUILDIiR
AUTHORITY
H LIGHT
OUTLETS
1
PLUG
RECE'P'T'S
FIXTURES
No.LAMPS
REFRI G.
OUTLET
IKON
OUTLET
RANO!:
OUTLET
HAr0E
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
HEATER
TOTAL
LIST.
CAS.
SERVICE
.:
. MP.
SERVICE
PERM.
I8 Orc RS
0 -1 N'
MOTORS
1 -3 HP
NEON
TRANS.
RADIO
TOTAL
it r
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name
No. Street
No Street_ri .
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit
Application (s 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 ell pros signs of the La , of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Mi -i:I; S7,o7r..s shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during pro,.ess of work.
Date
Location and Legal Description Lot_ __,L_ ----- _- :__ —= _- - - - - -- Block________ _____— ______--- ________
___ --
Street and Number where work is to be performed —No.
State work to be performed and nurposc of building (By Floors)
New reCle.i _ - --_-
L 1:.
O U i L L'
CONTR.
LIST
CHECK
E r. .
Service Overhead Size Feeders
Amount of P'rrnit
STATE OF FLORIDA,
COUNTY OF DADE.
Recr
Type of Ir Cc chit
J.d . .ri a:al Tv'_ouldirg
(Signed) - __ -_ -_-
Street
Addition Repairs_
No. of Stories
Con- i* ' ivr in Sw Amps. Main Fuses_ ` Amps.
Electrical Inspector.
The u applicant for this L�;1:Eng permit does hereby certify that he rnderst.nds and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, Laing Section 5966, Comuiled C an:n1 Laws of Florida Permanent Supplement, and has com-
plied with the previsions thereof, and will require similar compliance from all contractors cr rub - contractors employed by him in the work to be
performed under this permit: and will pm:: cr cause to be posted for inspection on `'ne site of the work such public notice oY notices as are
required by the Act. The under signed ag'rus to employ only such sub- contr_.ctorc, on wprk to be performed under this permit, as are
licensed by Miami Shores Village.
My Con:misson Expires Notary Public, State of Florida
Master Electrican.
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 ______________ —___
of the above do ;ribed 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.
7O T l:: -e -lute_ erica:: Le of Si .CC S7i1'. be r-..de when such re- inspection is made necessary by improper notice for inspection, or faulty
materi,f,
.::d /cr w crk :naarhin.