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Electrical permit 1988Permit s ∎sleeves . Y 1LL.".1L7 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 ocher 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 Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's of the Building Division of Miami Shorn Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ac building during progress of work. Owner's Name and Address - - 2/ O — .._._No. y Registered Architect and /or Fagiaeer....._ ............... _ ...� t .... _.. ... _..._. .% — Employing Electrician's Namefe. � GfeG� ` �Qf� le/e C!�7o Dar. We9 /.4 _street..ei erz " Location and Legal Description Lot Block Subdivision. ' Street and Number where work is to be performed —No 5/ 7 ' 6 " / lega,ve S tmt Service Overhead Size Feeders_._..__.__.._ Conduit....___Main Syr Underground Type of Installation — Conduit— _______Tubing..... — ...._ .._.. B X L ._ --Metal Moulding • STATE OP ,FLORIDA. COUNTY OF DADE. s` appeared__ performed and purpose of building (By Floors el Remodeling - Addiaun. (Signed) i Main Fuses- 1 A7 alt' No of Scori" • Amps Am Permit of Persc Si .._._._.._ _. _ . .. ..... . .... .. ......._..�...._ (Signed) if\ . 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 3966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•aonoractoa employed by him in the work to be performed under this permit: and will pose or cause to be posted for inspecti• . on the site of the work such public noczQ or notices as are required by the Act. The undersigned agrees to employ only such sub•contracra • o' work to be perform • elver this permit, u are licensed by Miami Shores Village. Masts Electrician. Before. me, the undersigned authority. a notary public. duly authorized to administer oaths and 'take acknowledgments, personally to ms well known, and who, being by me first duly sworn. upon oath deposes and says that he is th* of the above described construction, and he has carefully read the foregoing application, and that be did alga the same. and that all facts therein by him arced are true. My Commission Expires Notary Public, State of Plecids NOTE: A rrinapeccon fee of SI.00 will be made when such re-inspection is made necessity by improper nodes for inspecton. or faulty materials and /or workmanship. Swore, OUTLLTS LIGHT OUTLAYS ►LUO Pt tet•s•T's Ftxruwts No. LAMPS Pr crime. OU Ti. ST laws OYTL=T OuTLiT RAN.E COMM. WATew M"A1'Ia W. 141Ar. SACS COMM. M4T * STRIP MtATES TOTAL CO MTS. Llrr ' Caster ENT. May. *w. CAS. Senvicz Tile. Sinvtet P K. MOTORS 0.1 MP MOTORS ' t.a M► NtON TRANS. RAa,O TOTK CONTR. IST LIST _ _. `/ ✓ C Nacx I I Permit s ∎sleeves . Y 1LL.".1L7 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 ocher 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 Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's of the Building Division of Miami Shorn Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ac building during progress of work. Owner's Name and Address - - 2/ O — .._._No. y Registered Architect and /or Fagiaeer....._ ............... _ ...� t .... _.. ... _..._. .% — Employing Electrician's Namefe. � GfeG� ` �Qf� le/e C!�7o Dar. We9 /.4 _street..ei erz " Location and Legal Description Lot Block Subdivision. ' Street and Number where work is to be performed —No 5/ 7 ' 6 " / lega,ve S tmt Service Overhead Size Feeders_._..__.__.._ Conduit....___Main Syr Underground Type of Installation — Conduit— _______Tubing..... — ...._ .._.. B X L ._ --Metal Moulding • STATE OP ,FLORIDA. COUNTY OF DADE. s` appeared__ performed and purpose of building (By Floors el Remodeling - Addiaun. (Signed) i Main Fuses- 1 A7 alt' No of Scori" • Amps Am Permit of Persc Si .._._._.._ _. _ . .. ..... . .... .. ......._..�...._ (Signed) if\ . 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 3966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•aonoractoa employed by him in the work to be performed under this permit: and will pose or cause to be posted for inspecti• . on the site of the work such public noczQ or notices as are required by the Act. The undersigned agrees to employ only such sub•contracra • o' work to be perform • elver this permit, u are licensed by Miami Shores Village. Masts Electrician. Before. me, the undersigned authority. a notary public. duly authorized to administer oaths and 'take acknowledgments, personally to ms well known, and who, being by me first duly sworn. upon oath deposes and says that he is th* of the above described construction, and he has carefully read the foregoing application, and that be did alga the same. and that all facts therein by him arced are true. My Commission Expires Notary Public, State of Plecids NOTE: A rrinapeccon fee of SI.00 will be made when such re-inspection is made necessity by improper nodes for inspecton. or faulty materials and /or workmanship. Owner of Building l Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ® PERMIT PLUMBING ❑ N • o 7852 ROOFING ❑ ❑ Work to be performed under this Permit Architect Contractor f or Builder Legal Lot 51. Description r [, { 1 Subdi- vision Sq. Ft Value of Project $ DATF 9 1 ' (''' 195 Contractors License No Amt. of Permit $ fi 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 plane, 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 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. BY AUTHORITY 17 MIAMI SHORES VILLAGE. FLORIDA KUILDING ❑ ELECTRICAL [ -- DATE • 3 LUMBING ❑ PERMIT IV'? 3509 GOOFING ❑ ❑ Work to be performed under this Permit ?wner of 1 • ullding = r ' CONTRACTOR OR BUILDER BY �,. - / 4 /J .rchitect f ontractor )r Builder ( F -r f ' .; c r V , .ega1 Lot I $ubdi- )escription Bl vision ..ddress of ' � „� a Value of Amount of uilding -- •' " r Project $ 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 - erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ertaining 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 one by his agents, servants or employees. -1/ ••.,,, Signed. ' I ' M, INSPECTOR //' In consideration of the issuance to me of this permit I agree to perform the work covered �Iereunder in compliance with all ordinances and regulations ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- -pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. 1 Contractor's License No / {r c t. 19s�a_ AUTHORITY e449#0 8 l C METAL STAMPING CO. BETHEA COMPANY. INC. CENTRAL TRANSFORMER CORP. P.W INDUSTRIES. INC. UNIVERSAL POLE BRACKET CORP. ROCHESTER INSTRUMENT SYSTEMS. INC. KEARNEY COMPANY DENNIS F. FISHER CARTER - WATSEY d ASSOCIATES. INC. P. O. BOX 512 LAKE WALES 33853, PHONE: 3.4801 ounurng ounng progress of work. Owner's Name and Address x/07/ Registered Architect and /or Engineer RESIDENCE 17940 N. W. 43RD AVENUE MIAMI, FLORIDA TELEPHONE: HOME: 824 -3188 O ICE: 833 - 3(q. c HORES VILLAGE INSPECTION DEPARTMENT Employing Electrician's Name No Street 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).. 6 ' 9 New Building Remodeling , X Addition Overhead Service .4404aweiand Size Feeders Type of Installation— Conduit Amount of Permit $ STATE OF FLORIDA, } COUNTY OP DADE. SS. My Commission Expires DR ELECTRICAL PERMIT Date ��� ttement of the plans and specifications herewith submitted for the building or other Ice and conformity with the Building Ordinance of Miami Shores Village, Florida, Ices of Miami Shores Village and all rules and regulations of the Building Division specified or not. A copy of approved plans and specifications must be kept at Repairs No. of Stories qqr ConduitT/ ._ Main Sw Amps c Tubing ✓ B.X.L Metal Moulding (Signed).Z. Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • . ' 'ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-con actors 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 - contracto .n work to be performed under this permit, as are licensed by Miami Shores Village. (Signe No. Street ��� Street.- .S Main Fuses Amps r 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. 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. T DeVW- ! - keea w L✓Us'4✓ M OTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. ,Qa L'G� RADIO TOTAL CONTR. LIST / I 1 /734; I CHECK 8 l C METAL STAMPING CO. BETHEA COMPANY. INC. CENTRAL TRANSFORMER CORP. P.W INDUSTRIES. INC. UNIVERSAL POLE BRACKET CORP. ROCHESTER INSTRUMENT SYSTEMS. INC. KEARNEY COMPANY DENNIS F. FISHER CARTER - WATSEY d ASSOCIATES. INC. P. O. BOX 512 LAKE WALES 33853, PHONE: 3.4801 ounurng ounng progress of work. Owner's Name and Address x/07/ Registered Architect and /or Engineer RESIDENCE 17940 N. W. 43RD AVENUE MIAMI, FLORIDA TELEPHONE: HOME: 824 -3188 O ICE: 833 - 3(q. c HORES VILLAGE INSPECTION DEPARTMENT Employing Electrician's Name No Street 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).. 6 ' 9 New Building Remodeling , X Addition Overhead Service .4404aweiand Size Feeders Type of Installation— Conduit Amount of Permit $ STATE OF FLORIDA, } COUNTY OP DADE. SS. My Commission Expires DR ELECTRICAL PERMIT Date ��� ttement of the plans and specifications herewith submitted for the building or other Ice and conformity with the Building Ordinance of Miami Shores Village, Florida, Ices of Miami Shores Village and all rules and regulations of the Building Division specified or not. A copy of approved plans and specifications must be kept at Repairs No. of Stories qqr ConduitT/ ._ Main Sw Amps c Tubing ✓ B.X.L Metal Moulding (Signed).Z. Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • . ' 'ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-con actors 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 - contracto .n work to be performed under this permit, as are licensed by Miami Shores Village. (Signe No. Street ��� Street.- .S Main Fuses Amps r 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. 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. • - L� F 7� e;, 4 `/ ( L j ,7er- /�crs•� -S' 7 / 4,, - / // /e � y Fad , // 74��✓ 7 �� / ��� e" 4 -� �' ", vv flr/ ,-/ C 6 ei) ',I 64-1.-/C; 0 e -1 / - , /r 4, d e4./ ,27 Cf C,z.., - cr . / /i 7 ``>xy e /,'„ .e 74 j" /14e-ti / bz .5 - a t/ -//e, ,4"t„.5 e, . 776 `e Gi,, ,/•/I/ p Ze_, 5c- e- r '�C- rve-r " f� / f Cr-!Cd 7 77 --/ 74 C� .S' e_ �` t: uo // /�C/ 4; ,..-. - Sao', el ✓v r w 7 ei/' 4 t'C'3cj /s'� )• CdC": t, / iCrs.=do ,726:< f:f ° cl CC/ /f'.- • / 7/ t i.� ``4b� >. . I /6:l r/ �I °L li 6 0 ' 1 1 J *' c r i // 9 r �7 5 �. NO. Motors Receptacles STREET PART OF LOT LOT BL'K SUBDIVISION 2 I ,E / ; , ,a: Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee / ELECTRICAL PERMIT Owner of Building Contractor or Electrician k1iami fhores9llage F L 0 R 1 D A N. B. —This Permit must be on display on the premises during the c• struction. ✓ OFFICE OF ELECTRICAL DEPARTMENT /1' y �; Miami Shores Village, Fla , 1 9_1 LO CATION N° 248 DESCRIPTION OF WORK NUMBER OF 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 Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. 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 unauthorized by this Department. "�+► /;r , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with he Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the *ate of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami iores Village. 2- 0/ Dated ll �' ` e) 19 (Seal) NO. STREET PART OF LOT LOT BL'K SUBDIVISION I gy - y e 9� Other Apparatus Permit Fee —W. Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee —W. / / ELECTRICAL PERMIT N. B. —This Permit must be on display on t . e premises d ring t ..4 -art - lie - IL Owner of Building •ractor or Electrician the c. o. ction. ►'I , 19 aiami cJhoresllage F L o R ID A OFFICE OF ELECTRICAL DEP TMENT Miami Shores Village, Fla , DESCRIPTION OF WORK NUMBER OF .37 LOCATION N° 248 • 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 Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time upon the violation of any provisions of said laws, ordinances, or rules and regulations, orppon any chan in the plans and specifications unauthorized by toDepartment. • , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami Shores Village. � Dated A7 .. ,,,. (Seal) BUILDING ELECTRICAL PLUMBING ROOFING Contractor or Builder Legal Description Owner of Building t. 0%3 F • k► .F. �--� Architect ti 4 tow Lot J Address of Li (' Value of Building Z ' `" 1 f Project $ 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 applica- tion 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 conditio on which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility fora horough know�dge of t■ ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the st tements of specifications and t he sumes respon- sibility for work done by his agents, servants or employees. Signed. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wi thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoriti is permit I assume ponsibility for ell work done by either, myself, my agent, servant or employee. PERMIT Y MIAMI SHORES VILLAGE, FLORIDA a DATE B1 Work to be performed under thLs Permit_ N9 7860 BY 195 Contractor's License No. �. r ss. ll; 4 %) 401, 0 4 f ` a9' ` . ( _ ) , 1 4 Of 4Z Y ..,... Subdt- 4 �- vision AUTHORITY Amount of Permit $ -' INSP R ordinances and regulation i Miami Shores Village. In ac. ABBOT CEILING BRACKETS RECEPTACLES SWITCHES STOVES WATER HEATERS SIGNS OTHER APPARATUS BRACKETS MAIN SUBS BRANCHES BASEMENT FLOORS FIXTURES ONLY NUMBERS OF TOTAL. OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIN SUBS BRANCHES BASEMENT FIRST '1 , t J ' c it et, r - / " f f t - SECOND THIRD FOURTH APPLICATION NO DATE y 1 93. ELECTRICAL DEPARTMENT HE O F 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. LOCATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION WILL BE RETURNED A.63 LOT NUMBER STREET AND NUMBE OWNE OCCUPIED As BUILDING- -NEW OR OLD (UNDERLINE WHICH) H. P. OF EACH MOTOR VOLTS TOTAL AMPS PHASE KIND OF INSTALLATION OPEN OR CONCEALED BLOCK NUMBER SUBDIVISION ? _ ': OCCUPANT WORK -- ADDITIONAL, NEW, ALTERATION OR REPAIR SPECIFICATIONS REMARKS CONTRACTOR r 7 e c ° ( INSPECTION WANTED 2 BY • ADDRESS i RECEIVED BY INSPECTOR_ PROGRESS WILL. INSPECT AGAIN ROUGH WIRING FJPIAL , No ,- CORRECTED TEMPORARY DAYS. DATE ISSUED SPACE BELOW FOR INSPECTOR'S USE ONLY REMARKS •. / c' SIDE sy KNOB, RX., BX., MLDG., CONDUIT, METALLIC TUBING i FEE REMITTED INSPECTOR FLOOR NUMBER OF SIZES OF INSULA'PU)N OPEN OR CONCEALED Number of Circuits Outlets Motor Gen. Main Sub Branch asement— irst , e f i ` r ^ 1 P w P I hird l ourth ther Floors_ worm Zit; APPLICATION No. DATE / r , 192 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 be- low, for which undersigned agrees to correct any infractions of the National Electrical Code and the City Rules, pointed out by Inspector. LOCATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICA- TION WILL BE RETURNED Lot Number Block Number Street and Number Owner - , Occupant Occupied as Building —New or Old (underline which). Work — Additional or New (underline which). SPECIFICATIONS H. P. of each motor Number of Motors H P Volts —Amps Phase F S 1' F 0 Outlets I Motors i Receptacles Generators Stoves (Water neaten Signs I Billboards Otter Apparatus Greatest Number of Lights on One Branch (Nature of Work) Open — Concealed Knob— Mldg.— Conduit REMARKS • Work will be started (Applicant sign here) Received by Inspector CERTIFICATES r 1 Progress Will inspect again Rough Wiring ' j FINAL No Corrected Temporary_ Days Approved Letter Date Issued :S SPACE BELOW FOR INSPECTORS USE ONLY s Correct Location Correct Equip. ' r DEFECTIVE Time Allowed Days Will be finished j Address j l Street Inspected Electric Light Co. Fee remitted 3emarks Inspector Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE • ` Job Address Lg3 9 V ° E 96 37 Tax Folio Legal Description Historically Designated: Yes No Master Permit # L44 C9 Owner's Address c2'' 4L , r , cta S t , Phone Contractin >1 ' ► � , e fl C- . -v r Address ) q3 A E 1 L S • Qualifier ` 1 LA I ( . Ma0/5€ f) S S# � - � - Phone �c'� - 9 ( M - Z` Z` State # erne wo Municipal # Competency # Ins. Co. c7 /l2 i CQ Q Owner/Lessee / Tenant *Th k S Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN ELEC RICAL— L1JMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / -e krod e l 754er / rS ` YvD t'✓) l -61,4) u S f ✓1 3 1 - - 3 kes Square Ft. Estimated Cost (value) / ® Q 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 authorize the above -named contractor t o the wok stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: APPROVED: Zoning Mechanical Signature of Contractor or Owner - Builder Date a6- 2 Notary as to Contrac or or Owner - Builder Date My Commission pO L N �vd OFFICIAL L NOTARY SEAL N.L-1 „p_OAFE FEES: PERMIT Z. 4- 7 -419 ' ) RADON C.C.F. NOTARY 3 BOND TOTAL DUE if 0 Building Electri 6"7 /94 Plumbing Structural Engineer