1226 NE 97 St (4)BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
✓PERMIT N? 10835
Work to be performed under this Permit
1:7 -"t
Bl.
Value of Amt. of
+ + , , ' ''„ Project $ Permit $ !
This permit is granted to the contractor or build(r 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 wor. i. 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 authoriza.Con. 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 statements or specif:cations and that he assumes responsibility for work
done by his agents, servants or employees.
A w �,,� ,1�j
Signed: . . '' < DNS "'J. E ' , -.4--1,--g ' BY 0, r , ..,/
xsre o
In consideration of the issuance to me of this permit I agree i:o perform the work covered hereunder in compliance with all ordinances and
pertaining thereto and in strict conformity with the plans, drawings, )statements or specifications submitted to the proper authorities of Miami Shores
in accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
x ..1 i
Subdi-
vision
DATE "` 1951_
Contractor's
License No
4-1 r
CONTRACTOR '®R BUILDER BY AUTHORITY
Permit No
�8
Owner's Name and Address..
MIAMI SHORES VILL I!,GE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date.. se',
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, Fiu:ida,
and all provisions of the Lawo 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.
5/44
Registered Architect and /or Engineer
Em to i Electrician's Name. No Street.
o.5 0 V 06 1
cation and Legal Description Lot. .. /Q.. � 1 9 Block Subdivision s � ��
New Building Remodeling Addition
No
/.2- I ,
%# a/
Street. R..757 .. 5, '
Street and Number where work is to be performed —No r Street
State work to be performed and purpose of building (By Floors)
Repairs No. of Stories
Service " " " °` °" Size Feeders. Conduit Main Sw 6 '�%� Amps Main Fuses Amps
n•erground
9i4 Tubing. y— B.X.L Metal Moulding
%v/ —7 7
Type of Ins allation— Conduit
Ze/ Z 1 dim
Amount of Per S (Signed))0!6,44a4.
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 inspectio . •n the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contracto . on work to be performed u• • r this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. I 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, 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
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.
Notary Public, State of Florida
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P•T•S
FIXTURES
NO. LAMPS
RUNIC.
OUTLET
IRON
OUTLET
RANOt
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
NEATER
STRIP
H
TOTAL
CONTR.
LIST
CHECK
/1
ENT.
SW.
D1ST.
CAB.
SERVIC
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
J / / "
/ �
S
'
CHICK
�`
Permit No
�8
Owner's Name and Address..
MIAMI SHORES VILL I!,GE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date.. se',
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, Fiu:ida,
and all provisions of the Lawo 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.
5/44
Registered Architect and /or Engineer
Em to i Electrician's Name. No Street.
o.5 0 V 06 1
cation and Legal Description Lot. .. /Q.. � 1 9 Block Subdivision s � ��
New Building Remodeling Addition
No
/.2- I ,
%# a/
Street. R..757 .. 5, '
Street and Number where work is to be performed —No r Street
State work to be performed and purpose of building (By Floors)
Repairs No. of Stories
Service " " " °` °" Size Feeders. Conduit Main Sw 6 '�%� Amps Main Fuses Amps
n•erground
9i4 Tubing. y— B.X.L Metal Moulding
%v/ —7 7
Type of Ins allation— Conduit
Ze/ Z 1 dim
Amount of Per S (Signed))0!6,44a4.
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 inspectio . •n the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contracto . on work to be performed u• • r this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. I 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, 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
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.
Notary Public, State of Florida
Registered Architect and /or Engineer �'�
lLal rio s '' am ../ 1 1 ( '� ' t
// �o S d2 ®� 1 .. � d –
Location and Descrip ion Lot... Z t
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, Fiv :ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation 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 wor
Owner's Name and Address E' 5h /q ui
ELECTRICAL INSPECTION DEPARTMENT
, , Block
Street and Number where work is to be performed —No 1 Z ( 9
State work to be performed and purpose of building (By Floors).
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
My Commission Expires
MIAMI SHORES VILLAGE /..-fazi-'5/0r
No 12-26, ,M "
IC No
(Signed)..»1
(Signed)
Date /H ,72,
Street
Street
Subdivision.
7
' Street
New Building Remodeling Addition si Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
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 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 subcontractors, ork to be performed under this permit, as are
licensed by Miami Shores Village.
90
k'f2 ooDO 7 4 1
Notary Public, State of Florida
Muter 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.
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'y's
FIXTURES
NO LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
H
TOTAL
CONTR.
LIST
1
I
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
141 HP
•10I1AN.
TRANS.
RADIO
TOTAL
CONTR.
LIST
L.
CHICK
.
Registered Architect and /or Engineer �'�
lLal rio s '' am ../ 1 1 ( '� ' t
// �o S d2 ®� 1 .. � d –
Location and Descrip ion Lot... Z t
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, Fiv :ida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation 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 wor
Owner's Name and Address E' 5h /q ui
ELECTRICAL INSPECTION DEPARTMENT
, , Block
Street and Number where work is to be performed —No 1 Z ( 9
State work to be performed and purpose of building (By Floors).
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
My Commission Expires
MIAMI SHORES VILLAGE /..-fazi-'5/0r
No 12-26, ,M "
IC No
(Signed)..»1
(Signed)
Date /H ,72,
Street
Street
Subdivision.
7
' Street
New Building Remodeling Addition si Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
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 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 subcontractors, ork to be performed under this permit, as are
licensed by Miami Shores Village.
90
k'f2 ooDO 7 4 1
Notary Public, State of Florida
Muter 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.
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
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
I ; PERMIT N? 10612
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Work to be performed under this Permit
Bl.
Subdi-
vision
Value cf
Project $
DATE r' 195_
Contractor's
License No
Amt. of
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 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
BY AUTHORITY
In consideration of the issuance to me of this permit I agree to perform tha work covered hereunder in compliance with all ordinance`s 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, myse;f, my agent, servant or employee.
APPLICATION FOR ELECTRICAL PERMIT
Permit No.....:: .Date ` M
Application is hereby made for the approval of the detailed statement of the plans and specificatior..s 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 1
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No I
STATE OF FLORIDA, 1
COUNTY OF DADE. I
68.
MIAMI SHORES VILLAIGiE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
New Building e' Remodeling Addition
Block
No
No Street
Street.. s� b:.
Subdivision
Street
Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
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 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.
(Signed) w
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
REFRIO.
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 TRANS.
RADIO
TOTAL
CONTR.
LIST
Z-
CHECK
APPLICATION FOR ELECTRICAL PERMIT
Permit No.....:: .Date ` M
Application is hereby made for the approval of the detailed statement of the plans and specificatior..s 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 1
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No I
STATE OF FLORIDA, 1
COUNTY OF DADE. I
68.
MIAMI SHORES VILLAIGiE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
New Building e' Remodeling Addition
Block
No
No Street
Street.. s� b:.
Subdivision
Street
Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
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 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.
(Signed) w
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.
Amount of Permit $....
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No.
Service Overhead Site Feeders
Underground
ss.
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.
(
/� r r . e
, ..
Owner's Name and Address .._ / M � No...�1..2 ..Z, Street. W./. ;� �E
Registered Architect and /or Engineer
Employing Electrician's Name .114-4„e.:. 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
Conduit ,( ^- ...Main Sw Amps , Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal. Moulding
F�Rff "
(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; an will- oos cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersig edagre to.-Cmploy only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. n (',
(Signed) i - N
Before me, the undersigned authority, a potikr3h public, duly authorized to administer oaths and take acknowledgments, personally
appeared /..r"
to me well known, and who, being by me first duly swo,. on oath deposes and says that he is the
of the above described construction, and he h e` ly d the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
0
Date
Notary Public, State of Florida
Master Electrician.
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.
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. H EAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
�
G c
d!
^ 1 '„
� j LAMPS
iI / ''S
F7
F
I
' Y'
ti-U
CHECK
: 6 ('
/f
� 0
F -,
..,
�, ,
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
„i __-,,---
_
Amount of Permit $....
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No.
Service Overhead Site Feeders
Underground
ss.
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.
(
/� r r . e
, ..
Owner's Name and Address .._ / M � No...�1..2 ..Z, Street. W./. ;� �E
Registered Architect and /or Engineer
Employing Electrician's Name .114-4„e.:. 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
Conduit ,( ^- ...Main Sw Amps , Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal. Moulding
F�Rff "
(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; an will- oos cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersig edagre to.-Cmploy only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. n (',
(Signed) i - N
Before me, the undersigned authority, a potikr3h public, duly authorized to administer oaths and take acknowledgments, personally
appeared /..r"
to me well known, and who, being by me first duly swo,. on oath deposes and says that he is the
of the above described construction, and he h e` ly d the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
0
Date
Notary Public, State of Florida
Master Electrician.
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.