ELECTRICALMIAMI SHORES VLAGE
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 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_ - _- - - - - -- _ Registered Architect 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.
Service Overhead Size Feeders____ Conduit_____ _— Main Sw.
Underground
Amount of Permit $ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Street___
Street
Repairs_
Type of Installation— Conduit Tubing __ B.X.L. Metal Moulding
My Commission Expires Notary Public. State of Florida
No. of Stories ______________
Amps. Main Fuses Amps.
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 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Elcctrican.
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 he has carefully read the foregoing application, and that be 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'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 VLAGE
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 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_ - _- - - - - -- _ Registered Architect 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.
Service Overhead Size Feeders____ Conduit_____ _— Main Sw.
Underground
Amount of Permit $ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Street___
Street
Repairs_
Type of Installation— Conduit Tubing __ B.X.L. Metal Moulding
My Commission Expires Notary Public. State of Florida
No. of Stories ______________
Amps. Main Fuses Amps.
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 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Elcctrican.
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 he has carefully read the foregoing application, and that be 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.
•-•4110 ,
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 6895
Work to be performed under this Permit
Owner of
Building
Legal Lot I Bl.
Description
Address of
Building
i
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
nlans, 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 ordinanccs 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 rcspon-
sibility for work done by his agents, servants or employees.
Subdi-
vision
Value of
Project
. DATE 194
Contractor's
License No
Amt. of
Permit
•
Oman..
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 ntd lealations
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.
CONTRACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Architect
Contractor
or Builder
Legal
Description
Address of
Building
•
Lot
. Value of Amt. of ,-..
' Project Permit .- "
This permit is granted to the ontractor or builder na ed above to construct the building or to install the equipment or device describee in the appli-
cation herefor in strict compliance %'th 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 move as$ume3 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 theetaternents or specifications and that-he asst ti s respon-
sibility for work done by his agents, servants or employees. /' '` • 1
Signed. �, '.-, i° 9 f J � h�- -• .. •
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances anti 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 perms assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 6672
Bl.
Subdi-
vision
Work to be performed under this Permit
DATE • 194
Contractor's
License No.
4
BY AUTHORITY
Permit No.�_y.
Street and Number where work is to be performed —No __/
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Amount of Permit $
MIAMI SHORES VI�LAGE
ELECTRICAL INSPECTION DEPA TMENT
ELECTRICAL INSPECTION DEPA TMENT
APPLICATION FOR ELECTRICAL PERMIT
(Signed)
No. – - -- – - -- – —_ Street
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 Engineer, __�.---
Employing Electrician's Name No.!s__ •', Street_______— _-- _____ —______
Location and Legal Description Lot ___ __/::_–___________________— __ —__— ___Block —_L- Subdivision_______": __________
J Street - °- -- —
Addition. Repairs ___ —____ No. of Stories -----
Service Overhead Size Feeders Conduit___ Main Sw.___ Amps. Main Fuses_
Underground
Type of Installation— Conduit Tubing 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 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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, 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.
My Commission Expires Notary Public. State of Florida
Master Electrican.
Amps.
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.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
.
i `
p
.:..
CHECK
•
ENT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
{ I
CHECK
Permit No.�_y.
Street and Number where work is to be performed —No __/
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Amount of Permit $
MIAMI SHORES VI�LAGE
ELECTRICAL INSPECTION DEPA TMENT
ELECTRICAL INSPECTION DEPA TMENT
APPLICATION FOR ELECTRICAL PERMIT
(Signed)
No. – - -- – - -- – —_ Street
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 Engineer, __�.---
Employing Electrician's Name No.!s__ •', Street_______— _-- _____ —______
Location and Legal Description Lot ___ __/::_–___________________— __ —__— ___Block —_L- Subdivision_______": __________
J Street - °- -- —
Addition. Repairs ___ —____ No. of Stories -----
Service Overhead Size Feeders Conduit___ Main Sw.___ Amps. Main Fuses_
Underground
Type of Installation— Conduit Tubing 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 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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, 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.
My Commission Expires Notary Public. State of Florida
Master Electrican.
Amps.
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.
(
SNITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P•T•S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANG[
CONN.
WATER
M
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
v
CHECK
ENT.
SW.
DIET.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTOR[
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
,. � //-- F ' /i,- .-
ti-- --
CN[CR
•
Permit No
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 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.
Owner's Name and Address No
f
Registered Architect and /or Engineer
10454 Street 17850 State Rd. 9
Employing Electrician's r' :e E D D HELMS, INC.
No
Location and Legal Der Lion Lot Block Subdivision
Street and Number wh• •rk is to be performed —No �1/'J %J Street
State work to be perform and purpose of building (By Floors)
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 $ ` (Signed).... °:. .-C � :�t:k,'
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- contracttors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
a iG��j
(Signed)
` t
aster Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. es.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
'
appeared , . 0 NE4 .... °�eS...... .
to mt well known, and who, being by me first duly sworn, upon oath deposes and says that he is the 19704 64.,4 /e
of the above derenied construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by stated Afe Vie•
�.„ -- -- I -..,O, Inc.
e �iL- &- 1Y(J•Il W(.l H111
My Commission Expires
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. OtijIP
v &
Date C%,.
Street
Notary Public, State of Fiori
1�.
of
t
or
er
Lot Bl. Subdi-
ion vision
of Value of Amt. of
Project $ Permit $ "_r
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner
Building
Architec
Contract
or Build
Legal
Descript
Address
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 12322
Work to be performed under this Permit
DATE 195
Contractor's
License No
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 • M ....• • 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
ROOFING
Owner
Building
Architec
Contract
or Build
Legal
Descript
Address
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 12322
Work to be performed under this Permit
DATE 195
Contractor's
License No
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 • M ....• • 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
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194_
PERMIT N2 6672
Work to be performed under this Permit
Owner of
Building
Contractor's
License No.
Architect —
Contractor
or Builder
Legal Lot Bl. Subdi-
Description vision
Address of , 0 Value of Amt. of
Building /f ,r I Project 1 Permit
This permit is granted to the /ontractor or builder nand above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance ith 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 ordinnces 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 f + - c 1337-' 1337-' x s..,.
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.
-
I
BY AUTHORITY
Permit No L
Owner's Name and Address
STATE OF FLORIDA, }
COUNTY OF DADE.
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.
No
Date
Street
Registered Architect and /or Engineer
Employing Electrician's Nrme No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amp,
Underground
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 a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to
licensed by Miami Shores Village.
ss.
(Signed)
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
4
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
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
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
Permit No L
Owner's Name and Address
STATE OF FLORIDA, }
COUNTY OF DADE.
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.
No
Date
Street
Registered Architect and /or Engineer
Employing Electrician's Nrme No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amp,
Underground
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 a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to
licensed by Miami Shores Village.
ss.
(Signed)
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
4
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.