ELECTRICALAPPLICATION FOR ELECTRICAL PERMIT
Permit No
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 1
Registered Architect and /or Engineer
Employing Electrician's Name
Service Overhead
�d Size Feeders
Type of Installation — Conduit Tubing
Amount of Permit $
66.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
q.'
No
(Signed)
/2 r)
Street
Date
Street. .12.u; , —
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)
New Building t Remodeling Addition Repairs
No. of Stories
Conduit � Main Sw Amps Main Fuses Amps
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 subcontractors, ors work to
licensed by Miami Shores Village.
B.X.L Metal Moulding
(Signed)..'1 �•�'s^
rieal Inspector.
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
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OP DADL. I
Before me, the undersigned aut:.lority, a notary public, duly authorized to administer oaths
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.
and take acknowledgments, personally
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'7'S
F � XTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
=
STRIP
HEATER
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CONTR.
LIST
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CHECK
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ENT.
SW.
DIET.
CAB.
SERVICE
TEMP.
EIERVICE
PERM.
/
l
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1 HP
MOTORS
1.1 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
- ' ■
1 1 V
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.
1
I
APPLICATION FOR ELECTRICAL PERMIT
Permit No
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 1
Registered Architect and /or Engineer
Employing Electrician's Name
Service Overhead
�d Size Feeders
Type of Installation — Conduit Tubing
Amount of Permit $
66.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
q.'
No
(Signed)
/2 r)
Street
Date
Street. .12.u; , —
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)
New Building t Remodeling Addition Repairs
No. of Stories
Conduit � Main Sw Amps Main Fuses Amps
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 subcontractors, ors work to
licensed by Miami Shores Village.
B.X.L Metal Moulding
(Signed)..'1 �•�'s^
rieal Inspector.
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
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OP DADL. I
Before me, the undersigned aut:.lority, a notary public, duly authorized to administer oaths
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.
and take acknowledgments, personally
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.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING 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 the work.
Date/0/ /` 6 / J 19 6 1
Owner's Name and Address M & Ac �i A \ No. 1 t)? Street 7-: q 6 5 -7-,
Registered Architect andior Engineer �M /
Name and address of licensed contractor _L_ POP ( A/c_ ?a-0 itiw c--r
-r / -I (A h (( F/. 'j
Location and legal description of lot to be on:
Lot i Block t Subdivisi g &v$ /1 JC®6 7f 3 ' £
ie L >J / 6 c
Street and Number where work is to be done t 0 ) !`J lo ` E . q ✓ 7 / �
State work to be done and purpose of building (by floors), state exterior colors (submit samples) P E PL ,k CG ii 757 / Nv 3
— tAV AM R../ (() k. Q., (c -c - obc 64- e-
and for no other purpose.
New Building Remodeling Addition
To be constructed of Kind of foundation ( Roof Covering
eriin /p�
1 H�l l) ///��,i mount o Permit A f Pe S 1 r 7 1 f } / 1r75 D6v-r
Estimated Total cost of improvements S _
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Section 5966. Comp, led General Laws of Florida. Permanent Supplement. and h:: 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 his 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 a: y s to employ only such su ntractors on work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
Permit No.
Disapproved
(Signed(
} 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, upor, 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.
Building Imppector
Date
6
<
Date
Read. Sworn to and Subscribed before me.
PLANNING BOARD DATE
Repairs No. of Stories
0/, 'e-
Notary Public- State of Florida
My Commission Expires
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 825.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of 825.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship.
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL Ki PERMIT o
PLUMBING ❑ N. 9688
ROOFING ❑
❑ Work to be performed under this Permit '
Owner of
Building
Architect
Contractor
or Builder r' .
Legal Lot
Description
Address of
Building
lfrt
Bl.
Subdi-
vision
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 1 ave 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 and that he assumes responsibility for work
done by his agents, servants or employees. r. •.> /
Signed • ` (y ."7 • 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, - sny agent, servant or employee.
CONTRACTOR OR BUILDER BY
DATE
Sq. Ft
Value of
Project $
Contractor's
License No
Amt. of 4
Permit $ " �►: t
AUTHORITY
1
BUILDING ❑
ELECTRICAL PERMIT U
PLUMBING ❑ 5
ROOFING ❑
Owner of
Building , ,
Architect
Contractor
or Builder
Legal
Description
Lot
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
Work to be performed under this Permit : '
This permit is granted to the contractor for 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 state ents or specificationg and that he assumes responsibility for work
done by his agents, servants or employees. ,
Signed ff f.: ' ` t k ' BY
II+ISPECTOR
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 age servant or employee.
Subdi-
vision
SQ. Ft
Value of
Project $
BY
DATE } 195 ,!
Contractor's f a
License No
Amt. of
Permit
ki
$
AUTHORITY
PERMTT APPLICATION FOR MIAMI SHORES VILLAGE
Date ,- e- /7 Job Address /8f1 4" 1 Tax Folio
Legal Description
Owner/Lessee / Tenant[
Owner's Address 6f.4
Contracting Co. Ap
Qualifier 40 i
State # Toff/
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING
WORK DESCRIPTION
FEES: PERMIT - 1® 4" RADON
5g7,-
,k
IafreY2
Historically Designated: Yes No
Address
Square Ft Estimated Cost (value)
I certify that. all the foregoing information is accurate and tha
d zoning. Furthermore, I authorize the above -named contra
lik - Signature
Master Permit # 67 80 /
53/37 Phone
ss# ? Phone
Municipal # Competency # Ins. Co.
Address
Address
Address
PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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.
r or 0
COi^
EXP
andcd
s'•v�ID��. ��iifii�lii•
Notary • ' on . ctor or • er -
My Commission Expires:
work will be done in compliance with all applicable
do the w. rk stated.
lder
Date
rl
Date
D
C.C.F. D NOTARY BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical /8 ,tea y d✓�
Mechanical Plumbing Engineering