1219 NE 96 StPermit No...
3
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. .1 e
Owner's Name and Address ! ' e = - .. =' °' "`" " No /7 Street .A/ 7 '"
Registered Architect and /or ineer
Employing Electrician's Namy � t' ' / 9' 4( Street /( P /6 ti<-
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
Date
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 $ 1 (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his tgations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid • !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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OP FLORIDA, l
COUNTY OF DADE. I
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.
ss.
My Commission Expires
(Signed. %/ ! fool
Master Electrician.
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'E
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER
STRIP
HEATER
TOTAL
CONTR. ST
U
/
CHECK
/
ENT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No...
3
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. .1 e
Owner's Name and Address ! ' e = - .. =' °' "`" " No /7 Street .A/ 7 '"
Registered Architect and /or ineer
Employing Electrician's Namy � t' ' / 9' 4( Street /( P /6 ti<-
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
Date
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 $ 1 (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his tgations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid • !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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OP FLORIDA, l
COUNTY OF DADE. I
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.
ss.
My Commission Expires
(Signed. %/ ! fool
Master Electrician.
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.
■
NO.
Motors
Receptacles
Generators
STREET
Water Heaters' Signs
1
PART OF LOT
LOT
BL'K
TOWN, ADDITION, OR SUBDIVISION
J'. 'tY - -nt jY" ,. C,- - 4 . -
,/'
, �fJ}
` j� Y '1
J
_."
� �
t j 1 »
, 1 r
t
Outlets
Motors
Receptacles
Generators
Stoves
Water Heaters' Signs
1
Billboards
Other Apparatus
Permit Fee
/ (/ j
( i"
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises
during_the construction.
t
Owner of Building. ...53 e.:..,�
Contractor or Electrician
OE ‘ 4 1 ELE�TRICALDPAtTMENT & '
Miami Shores, Florida,./1 >v }r � � , 1
PROPOSED I OCATION
N° 159
This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with
the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
of the Town of Miami Shores and the rules and regulations of the Electrical Department of the Town of Miami Shores. This Permit may be revoked at
any time upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unau-
thorized by this Department.
L : ' (- c.1_LS�___, Electrical Inspector.
In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construcC;iin strict Conformity with
the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of F all Electrical Laws of the
State of Florida, all the Electrical Ordinances and Codes of the Town of Miami Slags, an all rules and regulations of the Electrical Department of the
-;)
Town of Miami Shores.
Dated___ _21.1_._ 7 /' 4.
TRANCE PRINTING CO.. MIAMI, FLA. J
1901C
DESCRIPTION OF WORK
NUMBER OF
(Seal)
---11/ O.
STREET
PART OF LOT
LOT
BL'K
TOWN, ADDITION, OR SUB IVISION
hig09
4 )
/?ri3
4 VJ
ii.e -1. / 0 ' 7, t / '
O utlets
Motors
Receptacles
Generators
Stoves
Water Heaters'
Signs
Billboards
Other Apparatus
Permit Fee
/
I,
/
er
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises
during„te ctructf .
Owner of Building l... � }'r?�({
Contractor or Electrician.
•
Town of Miami Shores. /
Dated____222 1 , 19.1
STRANGE PRINTING CO.. MIAMI, FLA. - L
44 41iVO I F EI TRICAI EPAItTM
Miami Shores, Florida,.
DESCRIPTION OF WORK
NUMBER OF
f °!
PROPOSED LOCATION
This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with
the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
of the Town of Miami Shores and the rules and regulations of the Electrical Department of the Town of Miami Shores. This Permit may be revoked at
any time upon the violation of any provisions of said laws, ordinances, or rules and f)gulati s, or upon cl in the plans and specifications unau-
thorized by this Department.
In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to di/he proposed constru 'on in strict Conformity with
the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions o all Electrical Laws of the
State of Florida, all the Electrical Ordinances and Codes of the Town of Miami Slimes, and all rules and regulations of the Electrical Department of the
N° 159
''S .e.1.- ,L___, Electrical Inspector.
(Seal)
CEILING
BRACKETS
RECEPTACLES
SWITCHES
STOVES
WATER HEATERS
SIGNS
OTHER APPARATUS
BRACKETS
OUTLETS
MAIN
SUBS
BRANCHES
BASEMENT
FLOORS
FIXTURES ONLY
NUMBER OF
TOTAL
SIZE OF
SIZE SERVICE
CONDUIT
1
No.
CIRCUITS
LIGHTS
CEILING
BRACKETS
OUTLETS
MAIN
SUBS
BRANCHES
BASEMENT
FIRST
SECOND
�g�
`+' '7
THIRD
FOURTH
4/
A -S9
t
BY
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FIL}.ED OR APPLICATION
WILL BE RETURNED. i
LOT NUMBE f ' BLOCK NUMBE
STREET AND NUMBE
p;
OWNER / 1 ri
OCCUPIED As
BUILDING -NEW OR OLD (UNDERLINE WHICH)
KIND OF INSTALLATION
REMARKS
CONTRACTOR
RECEIVED BY INSPECTOR
PROGRESS •
WILL INSPECT AGAIN
ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI
Desiring your certificate of Approval, application is hereby made for an inspection of the electric
installation in the premises stated below, for which undersigned agrees to correct any infractions
of the National Electrical Code and the City Ordinance pointed out by Inspector.
er -f- -�...
ROUGH WIRING
FINAL ‘ `a No
CORRECTED
TEMPORARY DAYS.
DATE ISSUED
� fR
- , /10 6 '
REMARKS
APPLICATION
SUBDIVISION
OCCUPANT
DATF
NO dC4
WORK- ADDITIONAL. NEW, ALTERATION OR REPAIR
SPECIFICATIONS
H. P. OF EACH MOTOR VOLTS TOTAL AMPS
PHASF
OPEN OR CONCEALED KNOB. RX., BX., MLDG., CONDUIT. METALLIC TUBING
INSPECTION WANTED 11
ADDRESS
SPACE BELOW FOR INSPECTOR'S USE ONLY
INSPECTED
rJ b
j s
FEE REMITTED
INSPECTOR
4, / ; !1
: d
7I
•
,
S N 'VV
Pal r,
G 5' 9
K
w •
• J
u P
i t
I
g
I /
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date // A:2-93 Job Address /cR/7 ,42E 96 St Tax Folio i(lA// e
Legal Description o 7"S a /3 /c/ S/o .X $ 3 OF
8 P C � /2 u.rli sho Se c.Ti O.v
/ d,nssae / ve ent Edwa/4 d- an/Jc_ L9i6-10.Cor'I 0 Master Permit #�V� e
Owner's Address /01./9 AS. C. 96. St
Contracting Co. iligySe1u F ecTric. Coo Th9cro
Qualifier 60, /iq¢s 8r/Vey SsIf ? Phone 9/6- 9aa0
State # 6,e000-703/ Municipal # Competency #790166331‹ Ins.Co. U. f: 1 " G
Architect /Engineer A/1/9 Address
Bonding Company /v�.10 Address
Mortgagor /1/ /4 Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ,20o 4 ea
'f cif c/ e/(// e C4.9✓fe
Square Ft. Estimated Cost(value) // aVO. 00
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
aut;orize the above -named contractor to do the work stated.
Signature of owner and
** *
30c 00
FEES: PERMIT
APPROVED:
or Condo President
Date: , Q
,PRY P(iz�IC STATE OF FLORI
Notary ascebl , pC bndo President
r rt�1F• µ ' GEC =.Eh`.
�'.
My Commissi�r� xpires
Zoning
Mechanical
Building
Phone 757-- ys /a
Address 56/ SW 9 717 7 '741c2 ,&m/ 9,
/'e% Ca, rc 4/c Crnde/ice
,3
Signature
Date:
of Contractor or Own
NO
Notary as to Contra E
My Commission Expires.
* * * * * * * * * * * **
RADON C . C . F . !' ®� NOTARY TOTAL DUES/
Fire Other
,Electrical
PUBLIC STATE OO}FFFt
U L LOOR
Z ZN5.4- It h
Plumbing Engineering
HUILDING
E LECTRICAL
PLUMBING
.00FING
Owner of
Building
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 7003
Architect
contractor
Dr Builder i r , l ? ` 4 / / i is
•egal Lot
Description 11 Bl
Address of .-
Building 1 i- `7 t" f
CONTRACTOR OR BUILDER
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Contractor's 7
License No.
Amount 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.
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 ac•
-epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 7c. 3 7 Date 7.-°/
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, Fio:ada,
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. / 7 p /
Owner's Name and Address.... /•-.• . 4.4 Z1 No. /... /1/Z Street y‘.3o'
Amount of Permit $
Registered Architect and /or Engineer.
Z So
Employing Electriciad's Name . ...c2ff..`es � P.-C.. �.� No/.5(,, .1/
Street..../. ...... . 3
MIAMI SHORES VILLAGE
Location and Legal Description Lot Block Subdivision...
. .
Street and Number where work is to be performed —No / 2 . 4 Street ..6.5-/ f / ? A
State work to be performed and purpose of building (Boors) Ii4#.1. / 3 76A/ i d
New Building Remodeling
Addition 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
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his 1 as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. /'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 ins. . on the .ite of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub -con actors, � to be performed under this permit, as are
licensed by Miami Shores Village.
55.
Notary Public, State of Florida
Electrical Inspector.
Master Electrician.
STATE OF FLORIDA, 1
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
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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P•T•8
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
/Ole. e�
CHECK
4 " '
ENT.
SW.
DIRT.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
/f /I,�� /
H / 1� ' 7`/tL➢1�Y
MOTORS
0.1 HP
MOTORS
1 -S HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
3.40
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 7c. 3 7 Date 7.-°/
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, Fio:ada,
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. / 7 p /
Owner's Name and Address.... /•-.• . 4.4 Z1 No. /... /1/Z Street y‘.3o'
Amount of Permit $
Registered Architect and /or Engineer.
Z So
Employing Electriciad's Name . ...c2ff..`es � P.-C.. �.� No/.5(,, .1/
Street..../. ...... . 3
MIAMI SHORES VILLAGE
Location and Legal Description Lot Block Subdivision...
. .
Street and Number where work is to be performed —No / 2 . 4 Street ..6.5-/ f / ? A
State work to be performed and purpose of building (Boors) Ii4#.1. / 3 76A/ i d
New Building Remodeling
Addition 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
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his 1 as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. /'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 ins. . on the .ite of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub -con actors, � to be performed under this permit, as are
licensed by Miami Shores Village.
55.
Notary Public, State of Florida
Electrical Inspector.
Master Electrician.
STATE OF FLORIDA, 1
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
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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
l6-- s-7 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiterida,
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.
Permit No
Owner's Name and Address...
Registered Architect and /or Engineer q
Employing Electrician's Name 7i . . a- No .6; ... /....0-6 Street N Z'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No
Amount of Permit $
No 1 9
Date
Street
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Underground Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps
d
Type of Installation — Conduit Tubing B.X.L Metal Moulding
(Signed)
(Signed).
ecto
The undersigned applicant for this building permit does hereby ce:tify that he understands and accepts his obli'J ons as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida F, manent 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.
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. f 85.
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 rc'inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'B
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•5 HP
N EON
TRANS.
RADIO
TOTAL
CLN TR. /
/geode
��
ee
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
l6-- s-7 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiterida,
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.
Permit No
Owner's Name and Address...
Registered Architect and /or Engineer q
Employing Electrician's Name 7i . . a- No .6; ... /....0-6 Street N Z'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No
Amount of Permit $
No 1 9
Date
Street
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Underground Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps
d
Type of Installation — Conduit Tubing B.X.L Metal Moulding
(Signed)
(Signed).
ecto
The undersigned applicant for this building permit does hereby ce:tify that he understands and accepts his obli'J ons as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida F, manent 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.
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. f 85.
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 rc'inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.