1170 NE 97 St (7)Df
r
:t
for
er
ion
Lot
Bl,
Subdi-
vision
of
r
Value of
Project
$
Amt. of
Permit
$
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner
Buildin
Archite
Contras
or Build
Legal
Descrip
Addres
Buildin
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.
r�.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IT? 13656
DATE
to be performed under this Permit
Contractor's
License No
BY AUTHORITY
/e-,a
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY) .j
/ /74 Ji / , SP Tax Folio o% /�'� • 4 AM
Date Job Address
Apr: a Xe A44&-ar/ -v li l a ' r � z � Legal Description st er Permit #
Owner / Lessee / Tenant .140e• �7�,y/ eA_____NA140"
Owner's Address //7i0 A)" 7 7 : Phone
Contracting Co. jed jfA4 ,iaJ�� A. Address 7.Z7f /1/4/ cll 07,
Qualifier —)/ d h 4 25'y4 Phone e $•• 4 111. 2 e?P
State# EA O A 0'0 Competency#
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING PLUMBING MECHANICAL PAVING FENCE SIG/
WORK DESCRIPTION
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TC
DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOC
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, anc
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 la regu sting construction and zoning.
Furthermore, I authorize the above -named contractor to the w•rk stated.
ignature
Date:
PERMIT FEE:
ner and /or Co
Notar' as to Owner and /o
My Commission Expi'r'es:
* . * * *! * p:
APPROVED:
Zoning
Mechanical
lu - L. InCo
en
Fire
Plumbing
Address
Address
Address
Estimated Cost
Ins. Co.
Notary as to Contra tor of Owner- Builder
.y My Commission Expi ems: p , fy
*
Other
ao4k664gqk q' /g.' 'Electrical
,Engineering
Registered Architect and /or Engineer
Employing Electrician's Name
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No A � 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 Mi.smi 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
No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ' d /L. Street_...✓.:._.. '
State work to be performed 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
(Signed) ��..
Electrical Inspector.
The undersigned applic 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 GeneritL.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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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
- -
• �/
• +I
; � �
i
/, '
1 1
i/
p
//
!)
CHECK
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!,� ✓�
P�
— t---
< c
- " i/ j \
p.
`
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RAO10
TOTAL
+
CONTR.
LIST
4
CHECK
•ti • (�
"
// ,/j
Registered Architect and /or Engineer
Employing Electrician's Name
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No A � 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 Mi.smi 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
No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ' d /L. Street_...✓.:._.. '
State work to be performed 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
(Signed) ��..
Electrical Inspector.
The undersigned applic 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 GeneritL.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 subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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.