ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date (jJ ` Address / 1 146 ( F g ? 57: Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 9 9 L. .@ (�
Owner's Address
Contracting Co. (:) R F I F^ fa f (2k ('
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost (value)
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 - .m �. g constn1 Lion and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
( f e .M 6 Y
Si e of owner an or Condo President Date Signature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Address
Master Permit #
Phone
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
FEES: PERMIT RADON C.C.F. NOTARY TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
!
opi
/✓ E q7 4.
•
•
iDR:=LCURAf.
C.;
. .
REC21:7-f,IiTS.
ITEM
BATH 112
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEWORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS , 4
/
DUCT WORK
FLOOR DRAIN
SERVICE REPA•IR/IETER 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.
MOTCRS OVER 3- 5 If
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TEWORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS •
URINAL
-
_ MOTORS OVER 25-100 FP
_
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
.
WATER SPPLY 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
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 STAN3PIPE
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. I: A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Date f 42Job Address /19 6 ,4i 9 7S, Tax Folio
Legal DE .ption Historically Designated: Yes No
Owner/Lessee / Tenant
Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
U / / -4v
Contracting Co. _TeA t C Address /� 4, 6' ,,:,.,,r r Wc 7�`° . .
Qualifier /. / ' i)- - ti)-,e S' 2, 'f i/ SS# Phone 017j , • /7
ej State # E; 00 2 el 5 • Municipal # - : __,, - __ Competency # .F ...r 4 7 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAL c LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost (value) %Xv0
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 stated.
Signature of owner and/or Condo President Date
APPROVED:
Zoning
Mechanical
r
Notary as to Owner and/or on of
My Commission Expires:
FEES: PERMITS P eve? RADON
Date
Master Permit #
Phone
Signatur'•f Conga or or Owner' 1 Date
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
C.C.F. fi- NOTARY 51 TOTAL DUE ��d•
Building Electrica,,,f, / _ \ ,- ) i
Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
Owner of
Huilding
Architect
Contractor
Dr Builder
Legal Lot
1)escription
Address of
iuilding
MIAMI HORES VILLAGE, FLORIDA
DATE 194
PERMIT' N? 7184
Work to be performed under this Permit_
Bl.
Subdi-
vision
Contractor's
License No._
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 appli-
,ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
) lans, 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 clone in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which';this
lermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances 8nd
egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respi)n-
ibility for work done by his agents, servants or employees. \
Signed: B
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 re
, ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this pennit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
1
Permit No Date
Application is hereby made f 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__
Architect and /or Engineer__
Employing Electrician's Name -_ -- }---- ___i -- l No _ Street_- - -_� --
_i L '
Location and Legal Description Lot _,G Block ._ Subdivision '
Street
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 _Repairs No. of Stories
Service
Overhead
Underground Size Feeders Conduit ___ —_Main Sw.
Type of Installation— Conduit_ Tubing B.X.L Metal Moulding
Amount of Permit ( Signed)
-- Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
(Signed) _
_No._______ ___Street_
Amps Main Fuses ____Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared_ -
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH 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
HEATER
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.
LIST
?
CHECK
�+
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
1
Permit No Date
Application is hereby made f 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__
Architect and /or Engineer__
Employing Electrician's Name -_ -- }---- ___i -- l No _ Street_- - -_� --
_i L '
Location and Legal Description Lot _,G Block ._ Subdivision '
Street
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 _Repairs No. of Stories
Service
Overhead
Underground Size Feeders Conduit ___ —_Main Sw.
Type of Installation— Conduit_ Tubing B.X.L Metal Moulding
Amount of Permit ( Signed)
-- Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
(Signed) _
_No._______ ___Street_
Amps Main Fuses ____Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared_ -
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N9 7381
Work to be performed under this Permit
Owner of
Building
1 1
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.
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 a work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building e ; _ =
Architect
Contractor
or Builder,
Legal Lot
Description
ft
Address of ' - % Value of Amt. of
Building ' roject Permit
This pe it 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 w th 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 ?` or specifications and that h sumes respon-
sibility for work done by his agents, servants or employees.
INSPECTOR
' Signed. ' B
E
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, statemehta' specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI 4HDRES VILLAGE, FLORIDA'
1
- PERMIT ° N? 7184
Cqntractor's
Licnse No.
Work to be performed under this Permit ' H - ate
Bl.
Subdi-
vision
DATE 194__
0
a
AUTHORITY
74.
Permit No.- 4,
Amount of Permit
STATE OF FLORIDA,
ss
COUNTY OF DADE..
r
MIAMI S�riORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
/0 - 5-
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address " ___ ___ ___ ______ No Street_-
My Commission Expires
Registered Architect and /or Ens y � _
Employing Electrician's Name __ t _
_t___1 ._T ` '! .i1__z__ — No 1.2.. __� 1 1 / "'_ Li '1 '
Street_ -1� -- �
Location and Legal Description Lot__________ ___ _____ Block / Subdivision__ ( _� = ��
Street and Number where work is to be performe d— No. __ �_i ""t +* �0 ii Straet__.`�'___4"_:__q � !__ S
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs
Service Overhead Size Feeders. Conduit.___ _ _ Main Sw.
Underground
Type of Installation— Conduit Tubing - - B.X.L. Metal oul ng N —L
(Signed)
(Signed)
Amps. ____ Main
Electrical Inspector.
The undersig applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida ; orkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on yvork to be perfo ed under this permit, as are
licensed by Miami Shores Village.
1.177 i,I
Notary Public, State of Florida
No. of Stories
1
----------------- - - - - --
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 the
of the above described construction, that be 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 inspection, or faulty
materials and /or workmanship. .
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'8
FIXTURES
NO. LAM PS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H EATER
W. H EAT.
CONN.
SPACE
H EATER
STRIP
H EATER
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.
LIST
CHECK
74.
Permit No.- 4,
Amount of Permit
STATE OF FLORIDA,
ss
COUNTY OF DADE..
r
MIAMI S�riORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
/0 - 5-
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address " ___ ___ ___ ______ No Street_-
My Commission Expires
Registered Architect and /or Ens y � _
Employing Electrician's Name __ t _
_t___1 ._T ` '! .i1__z__ — No 1.2.. __� 1 1 / "'_ Li '1 '
Street_ -1� -- �
Location and Legal Description Lot__________ ___ _____ Block / Subdivision__ ( _� = ��
Street and Number where work is to be performe d— No. __ �_i ""t +* �0 ii Straet__.`�'___4"_:__q � !__ S
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs
Service Overhead Size Feeders. Conduit.___ _ _ Main Sw.
Underground
Type of Installation— Conduit Tubing - - B.X.L. Metal oul ng N —L
(Signed)
(Signed)
Amps. ____ Main
Electrical Inspector.
The undersig applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida ; orkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on yvork to be perfo ed under this permit, as are
licensed by Miami Shores Village.
1.177 i,I
Notary Public, State of Florida
No. of Stories
1
----------------- - - - - --
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 the
of the above described construction, that be 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 inspection, or faulty
materials and /or workmanship. .
) ING
_ ECTRICAL
PLUMBING
Owner of
Buildin
Work to be performed under this Permit ,7 �
Architect
Contractor •
or Builder
Legal Lot
Description
Address of , Value of Amt. of
Building / , � _ Project Permit/
This permit is granted to the contractor or builder nand above to construct the building or to install the equipment or described in the appli-
�ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
:ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
- 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
'rnllt 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.
PERMIT N2 7184
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
Bl.
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
rtaining thereto and in strict conformity with the plans, drawings, staterzfent's or specifications submitted to the proper authorities of Miami Shores Village.
accepting this permit I assume responsibility for all work done by either i4self, my agent, servant or employee.
194
Contractor's
License No.
Subdi-
vision
BY AUTHORITY
*,t
•
— , •
, 1
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4 ats
_ --- rr
cs
. - - -
., --
;"?..
\ '.-
: , . i t e.. ,w, 1';‘..
— t ,.,
Permit No -
Employing Electrician's Name
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
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 9° «i:. .) No // 4 Street d °
Registered Architect and /or Engineer
IK No : , . � Street .4. _......
Location and Legal Description Lot Block Subdivision
r -�
Date
d Street and Number where work is to be performed —No � � :« � ?f -= Street
1 1/' -- State work to be performed and purpose of building (By Floors) O r?
New Building Remodeling Addition Repairs No. of Stories
Service Underground Size Feeders 1? Conduit i 'i Main Sw Amps.... ., ' Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
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 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 sub-contractors, on work :e formed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OP DADS I
ss.
appeared
Before me, the undersigned authty, a notary public, duly authorized to administer oaths and take acknowledgments, personally
My Commission Expires
(Signed)
to me well known, and who, being by ffie 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 did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Flor at Large
G`Jiy eerro;ss :on ;:pares A r. 12, 1965
•
aster Electfician.
otary 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
OUT:.L+TS
PLUG
RaCE'P•T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SCACE
H TER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
I. HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
7 +
1 ° °
CHECK
Permit No -
Employing Electrician's Name
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
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 9° «i:. .) No // 4 Street d °
Registered Architect and /or Engineer
IK No : , . � Street .4. _......
Location and Legal Description Lot Block Subdivision
r -�
Date
d Street and Number where work is to be performed —No � � :« � ?f -= Street
1 1/' -- State work to be performed and purpose of building (By Floors) O r?
New Building Remodeling Addition Repairs No. of Stories
Service Underground Size Feeders 1? Conduit i 'i Main Sw Amps.... ., ' Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
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 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 sub-contractors, on work :e formed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OP DADS I
ss.
appeared
Before me, the undersigned authty, a notary public, duly authorized to administer oaths and take acknowledgments, personally
My Commission Expires
(Signed)
to me well known, and who, being by ffie 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 did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Flor at Large
G`Jiy eerro;ss :on ;:pares A r. 12, 1965
•
aster Electfician.
otary 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.
9AM I SHORES VILLAGE
ELECT {CAL 0NSPECTEON DEPARTMENT
/ Date
APPLIC .TI F `'i,•=' ELECTRICAL PE MIT
Permit No ! /.., / l ' 75
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, Fiu,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.
Owner's Name and Address
.00g/° < No
Registered Architect and /or Engineer
Employing Electriciai's Name... ' 'P...�r ... r, d.. ...A. 7R
Location and Legal Description Lot Block Subdivision..
Street and Number where work is to be performed —No 1 B 4-6 Street M e �.
State work to be performed and purpose of building (By Floors) .. P'8+. — i P'. ¢� .V�E �a tzvic -F
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing..._ .. B.X.L Metal Moulding
Amount of Permit S ... (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed rti er this permit, as are
licensed by Miami Shores Village. e7�
so.
therein by him stated are true.
L..,7 c
m < ' >,_._.,_... ry :via
~ a:::`4:.. ^ .e�i��:5
My Commission Expires
Street..
Notary Public, State of Florida
aster 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, upon oath deposes and says that he is the inae0;&A.
of the above described construction, and he has carefully read the foregoing application, and that he did sign the tame, and that all facto
NOTE: A re-inspection fee of 400 will be made ashen ouch re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
t;iwrrCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'V'S
FIXTURES
O. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONK.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
E NT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O. HP
MOTORS
I.S HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/ - /fR
a
CHECK
.- ____ -____
_
__._._._-__
-__r
9AM I SHORES VILLAGE
ELECT {CAL 0NSPECTEON DEPARTMENT
/ Date
APPLIC .TI F `'i,•=' ELECTRICAL PE MIT
Permit No ! /.., / l ' 75
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, Fiu,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.
Owner's Name and Address
.00g/° < No
Registered Architect and /or Engineer
Employing Electriciai's Name... ' 'P...�r ... r, d.. ...A. 7R
Location and Legal Description Lot Block Subdivision..
Street and Number where work is to be performed —No 1 B 4-6 Street M e �.
State work to be performed and purpose of building (By Floors) .. P'8+. — i P'. ¢� .V�E �a tzvic -F
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing..._ .. B.X.L Metal Moulding
Amount of Permit S ... (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed rti er this permit, as are
licensed by Miami Shores Village. e7�
so.
therein by him stated are true.
L..,7 c
m < ' >,_._.,_... ry :via
~ a:::`4:.. ^ .e�i��:5
My Commission Expires
Street..
Notary Public, State of Florida
aster 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, upon oath deposes and says that he is the inae0;&A.
of the above described construction, and he has carefully read the foregoing application, and that he did sign the tame, and that all facto
NOTE: A re-inspection fee of 400 will be made ashen ouch re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
1 9
, /� y ,� a
Date Job Address // A /y /�Y a Tax Folio //.--320.5c / / �/�
Legal Description �.�
Owner / Lessee / Tenant Ae /lL /�••i Gl L Master Permit #3559
Owner's Address // V /tE f 7 57 .5W 1 Phone
Contracting Co. / 1(17 /K < 4,i v /L- • Address 76:9//3 4 . ,/ c,
Qualifier 4 SS# / Phone 11
State `" .P7- Municipal #
Architect /Engineer
Bonding Company
Mortgagor Address
Permit Type(circle one): B ILDING E
r : r a y !
WORT° DESCR I PT ION -c� 4./Mi..
/11 14,/
Square Ft. Estimated Cost(value)
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 ac 4ate and that all work will
be done in compliance with all applicable laws regulating construction /an¢ zoning. F.'thgrmore, I
authorize the above -na contracto to do the work stated.
gnature of owner and /or Condo President
Date:
,...*..
" ° En0.Y W. r1
Notary ak
My Commig
** *
APPROVED:
•
FEES: PERMIT ' RADON C.C.F. � NOTARY TOTAL DUE n
Fire Other
Building Electrical
Mechanical Plumbing Engineering
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
OF CIA SEAL
J�t , (/ ,f1q � rg a ¢, ; • BLES
e n: � • g8fc" ZStfli�irtrP *sident
Jane 4, 1996
itt Ytn. No. CC 205953
Competency # Ins.Co.
Address
Address
LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
ew R
Signature of Contract or -Builder
Date: Date: Y ,,.• ' OFFICIAL EAL
y a
_ ft * J ,?. I • ,: • BLES
4 . . •` ,* 'k ion Explraa
Notary as VITk9,t4- actoiute0 - Builder
My Commissfmii:: Rpire °sue No. CC 205953