325 NE 97 St (10)CEILING
BRACKETS
RECPTACLES
SWITCHES
STOVES
WATER HEATERS
-.IRS
OTHER APPARATUS
BRACKETS
MAIN
Sues
BRANCHES
3ASEMENT_
- ;
FLOORS
FIXTURES ONLY
NUMBERS OF
TOTAL
OUTLETS
SIZE OF
•IZE SERVICE
CONDUIT
No.
CIRCUITS
LIGHTS
CEILING
BRACKETS
MAIN
Sues
BRANCHES
3ASEMENT_
- ;
�
FIRST
SECOND
THIRD
,-CI
A • GS
ELECTRICAL DIVISION 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 Electric 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
LOT NUMBE BLOCK N /�
' IMBER SUBDIVISION
STREET AND NUMBER ( SIDE_ i
OWNER OCCUPANT -
OCCUPIED As
BUILDING- - NEW OR OLD (UNDERLINE WHICH)
H. P. OF EACH MOTON VOLTS TOTAL AMPS
KIND OF INSTALLATION
F
APPLI CATION
WORK -- ADDITIONAL. NEW. ALTERATION OR REPAIR
SPECIFICATIONS
OPEN OR CONCEALED KNOB, RX.. BX.. MLDG.. CONDUIT, METALLIC TUBING
REMARKS
CONTRACTOR
BY
PROGRESS
WILL INSPECT AGAIN
ROUGH WIRING
FINAL No
CORRECTED
TEMPORARY DAYS.
DATE ISSUED
INSPECTION WANTED
ADDRESS
SPACE BELOW FOR INSPECTOR'S USE ONLY
RECEIVED BY INSPECTOR
FEE REMITTED / (' '
r•
DATE 19361_
INSPECTED
•
No
T �
PHASE.
REMARKS � •�
._t
f r
I
INSPECTOR
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.
Owner's Name and Address F.D. Irwin No .325 .__,97 -h _ Scree t
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Amount of Permit $_. -_A50_
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Connect Hot Water Heater
My Commission Expires
__Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building __ Remodeling Addition. Repairs
Service Overhead Size Feeders Conduit. —____ Main Sw . Amps.
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
Date_ D ecvmber 20tk. 1949
No. – - -- -- -- — Street — — -- -- - -- – —
Street
No. of Stories
Main Fuses
(Signed) -- - - -{'` - '--- L- - ----- ---- ----- - -` °— - --- - --- ---- -----
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 Perrnanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
A_ r u
Master Electrican.
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, 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.
Notary Public. State of Florida
Amps.
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
REFRIG.
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
O -1 HP
MOTORS
1 -3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
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.
Owner's Name and Address F.D. Irwin No .325 .__,97 -h _ Scree t
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
Amount of Permit $_. -_A50_
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Connect Hot Water Heater
My Commission Expires
__Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building __ Remodeling Addition. Repairs
Service Overhead Size Feeders Conduit. —____ Main Sw . Amps.
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
Date_ D ecvmber 20tk. 1949
No. – - -- -- -- — Street — — -- -- - -- – —
Street
No. of Stories
Main Fuses
(Signed) -- - - -{'` - '--- L- - ----- ---- ----- - -` °— - --- - --- ---- -----
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 Perrnanent Supplement, and has com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
A_ r u
Master Electrican.
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, 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.
Notary Public. State of Florida
Amps.
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.
Date "6/ Z, Job Address 5aU ,V E 97 I ° Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 08' .- t0S7 — O Master Permit # 4 9 IO
Owner's A d d r e s s `32 c A 5 r Phone 3 _ 0lO O 3
Contracting Co.
Qualifier
state # A,hi
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
L < 't/ / . _4420-ai
Municipal # Competency #
Address � %'. , ZJ) /57
SS# Phone -5:6
Address
Ins. Co.
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING E PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION % . - !, fwd.• �i�'d! J
f /Z'7/ _7
Square Ft Estimated Cost (value)
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do
'1
No
My Co , ;. sion Expir. -:
FEES: PERMIT l0 V RADON
APPROVED:
Zoning Building Electrica
Mechanical Plumbing
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.
done in compliance with all applicable
work stated.
Notary as t!°ntrac .r or Own - Builder Date
My Commission Expires:
C.C.F. ° ® NOTARY 4 BOND
649
TOTAL DUE E., 12 ----
Date
Engineering
NO.
STREET
PART OF LOT
LOT
BL'K
SUBDIVISION
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building_
"retractor or Electrician
)utlets
Motors
Receptacles
Generators
Stoves
Dated , 19
OFFICE OF ELECTRICAL DEPARTMENT
Miami Shores Village, Fla , 19
DESCRIPTION OF WORK
Water Heaters
aiami Aores91llage
B L O R ID A
NUMBER OF
LO CATI 0 N
Signs
Billboards
This Permit is. granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with
ns and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
mi Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time
the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by
Department.
, 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
Application and tb.e 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 rues „and regulations of the Electrical Department of Miami
cores Village.
Other Apparatus
N° 474
Permit Fee
NO.
STREET
PART OF LOT
LOT
BL'K
SUBDIVISION
Signs
Billboards
Other Apparatus
Permit Fee
Outlets
Motors. _
4leceptacles
Generators
Stoves
Water Heaters
Signs
Billboards
Other Apparatus
Permit Fee
`
/
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building
Contractor or Electrician
ddliami cJhores9llage
Miami Shores Village, Fla ,
F L 0 S 1 D A
OFFICE OF ELECTRICAL DEPARTMENT
NUMBER OF
LO CATI 0 N
DESCRIPTION OF WORK
/- 19
N° 491
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.
, 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 r gulations of the Electrical Department of Miami
Shores Village. 1
•
Dated ,.; , 19 tr 2 (Seal)
Outlets
Motors
Receptacles
Generators
Stoves
Water Heaters
Signs
Billboards
Other Apparatus
Permit Fee
r
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building
Contractor or Electrician
NO.
STREET
iami Aiores9llage
F L 0 R 1 D A
OFFICE OF ELECTRICAL DEPARTMENT
Miami Shores Village, Fla , 19
LO CATI 0 N
PART OF LOT
NUMBER OF
LOT
BL'K
DESCRIPTION OF WORK
SUBDIVISION
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.
, 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 rulea‘and regulations of the Electrical Department of Miami
, hores Village. .
•
Dated 19 _ , _ r' 1 ...�..47)
/
N° 474
(Seal)
NO.
STREET
PART OF LOT
LOT
BL'K
SUBDIVISION
Signs
- Billboards
Other Apparatus
Outlets
Motors
Receptacles
• Generator/
Stoves
Water Heaters
Signs
- Billboards
Other Apparatus
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building •
COactor or Electrician
cJhores91llage
F L 0 A 1 D A
OFFICE OF ELECTRICAL DEPARTMENT
Miami Shores Village, Fla ,
LO CATI 0 N
19
DESCRIPTION OF WORK
NUMBER OF
491
Permit Fee
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
thillepartment.
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 Elect ^ical Laws of the
State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and - ailr ' 1e and regulations of the Electrical Department of Miami
Shores Village.
Dated , 19 = —
(Seal)
Permit No
lit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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 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
Employing Electrician's Name
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors).
Service Overhead Size Feeders Conduit
Underground
Type of Installation— Conduit Tubing
My Commission Expires
NOTE: A re•inspection fee of $1.00 will be made when
materials and /or workmanship.
y n n No 3 w Street I/ 7
(Signed).:
Location and Legal Description Lot Block Subdivision
Street. .77
Registered Architect and /or Engineer
® Et IV. :sue
No Street
New Building Remodeling Addition Repairs No. of Storigs
Amount of Permit $ (Signed) 6
Main Sw Amps Main Fuses Amps
B.X.L Metal Moulding
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, on rk to
licensed by Miami Shores Village. 9 ,y
of the above described construction, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Electrical Inspector.
ccepts his ligations as an employer of
of Flori Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed tinter this permit, as are
`
Master Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE: 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
did sign the same, and that all facts
Notary Public, State of Florida
such re•inspection is made necessary by improper notice for inspection, or faulty
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATT:'.
NW" :■2
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
m.
GIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.0 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
lit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
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 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
Employing Electrician's Name
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors).
Service Overhead Size Feeders Conduit
Underground
Type of Installation— Conduit Tubing
My Commission Expires
NOTE: A re•inspection fee of $1.00 will be made when
materials and /or workmanship.
y n n No 3 w Street I/ 7
(Signed).:
Location and Legal Description Lot Block Subdivision
Street. .77
Registered Architect and /or Engineer
® Et IV. :sue
No Street
New Building Remodeling Addition Repairs No. of Storigs
Amount of Permit $ (Signed) 6
Main Sw Amps Main Fuses Amps
B.X.L Metal Moulding
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, on rk to
licensed by Miami Shores Village. 9 ,y
of the above described construction, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Electrical Inspector.
ccepts his ligations as an employer of
of Flori Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed tinter this permit, as are
`
Master Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE: 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
did sign the same, and that all facts
Notary Public, State of Florida
such re•inspection is made necessary by improper notice for inspection, or faulty
Owner's Name and Address
S S.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date i i
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. m
No 0- . Street
Registered Architect and /or Engineer g � p
Employing Electrician's Name
s t W. ELECTRIC N o � St reet._..G :�� 6' ,
Location and Legal Description Lot Block Subdivision
Street and Number w re work is to be performed —No 0 -
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Amount of Permit $ (Signed)
Street. ..2,?'
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 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 r.otice 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)...:
7 ( Master Electrician.
STATE OF FLORIDA, }
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 thn
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. H EAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
y' LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
M OTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
_. _.
...
�...
.a..�.
Owner's Name and Address
S S.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date i i
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. m
No 0- . Street
Registered Architect and /or Engineer g � p
Employing Electrician's Name
s t W. ELECTRIC N o � St reet._..G :�� 6' ,
Location and Legal Description Lot Block Subdivision
Street and Number w re work is to be performed —No 0 -
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Amount of Permit $ (Signed)
Street. ..2,?'
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 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 r.otice 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)...:
7 ( Master Electrician.
STATE OF FLORIDA, }
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 thn
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
CONTRACTOR OR BUILDER
PERMIT N? 5721
Work to be performed under this Permit_
B1
DATE 195
Contractor's
License No.
Subdi-
vision
Value of 11 Amount of
Project $ " Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the ecuipment or device described ir 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 cr in the statements or specifications and that he assumes responsilility 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 as
:epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building fr
Architect
Contractor
or Builder
Legal
Description
Address of
Building
4
Lot
z
DATR� 195
❑
PERMIT N° 4994 Contractor's
❑ License No
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
2 y
B1
"O, „ • r
1 �.
}
Subdi-
vision
Value of
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 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. 1 / /f
Signed . f' ,.., :. s _ : / BY)
INSPECTOR
In consideration of the issuance to me of this permit 1 agree to perform the work covered reunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications subtiiitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY
Amount of r : �••�
Permit $--1
AUTHORITY
ITEM
BATH ILO
UNIT
FEE
ITEM
SWITCH OUTLETS
I
T
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
0ISHWASHER
RECEPTACLES
-�
A/C (WIND)
DISPOSAL
SERVICE TEWCRARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS a6¢2
1
OLCT WORK
FLOOR DRAIN
SERVICE REPAIR/VETER MANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
i
STEAM BOILERS
EWER
MOTORS OVER 1- 3 If
HOT WATER 80ILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TE} CRARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
"
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
,
HEATER -NEW INST.
GENERATORS TRANSFORMERS
+
HEATER-REPLACE
-
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIM4ING POOL
OUTLETS COMMERCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCX
UTILITY-WATER
FIXTL ES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
ORAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION "
SOAKAGE PIT CU. FT.
CATCH BASIN
-
DISCHARGE WELL
-
DOMESTIC WELL
"
AREA DRAIN
"
ROOF INLET
SOLAR MATER HEATER
FIRE STANDPIPE
'
POOL PIPING
LAWN SPRINKLER SYSTEM
"
GAS RAE
NG
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
PERMIT l S � APPLICATION FOR MIAMI SHORES VILLAGE
Date C Job Address 325 NE Ci 9 Tax Folio 1 ° 3 2a9 01s- s Y "e e
Legal Description Historically Designated: Yes No X Owner/Lessee / Tenant Poi U ( 5 t t ,�, Ul v n5 1a5 Master Permit #
Owner's Address 525 I V I °, qri °w1 Sfre Phone
Contracting Co. Don {n i t ,1 I a fri co I Cone J Address / V W U '2icci Ave, .
Qualifier -- 17 7
ua o.
lifier / .> . , fl /c l SS# 2692. _01-1 - 2.L1 Phone - 2" (T1
State # praZ) I ` M Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN G( ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
OWNER'S AFFIDA
laws r- lati ons
Signature o
FEES: PERMIT
odd -6%1l tV ?, rp.c.tptacL s ,u( -mss
WORK DESCRIPTION
ANA �e e . S e v- e &• —4-t eace) , Amp
Square Ft. C 250 Estimated Cost (value) 5723 co
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.
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
n and zoning. Furth:, ore, I authorize the above -named contractor do the work ed.
. ary as to Owner and/or Condo President Date
•► Commission Expires:
LAURA M. SHINER
;$ MY COMMISSION * CC 812653
February
Bonded EXPIRES:
Notary Public U re
RADON
qq
C.C.F.
Building
Signature of Contractor or Owner- Builder
Not
My ( ommission Expires:
NOTARY
tor or Owner - Builder
Oi eiy NORMA HERRERA
:.; ., ...; MY COMMISSION # CC 698938
WIRES: November 4, 2000
,Rp
• Bonded lieu Notary PubNo Underwriters
APPROVED:
Zoning
Mechanical Plumbing Engineering
Electrical
BOND
TOTAL DUE.
d9
p
ate
Date
® S PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date I!— i 4 - fi t J o b A d d r e s s 3 N E f l St' Tax Folio 1 eta ° b 1 - 5
Legal Description Historically Designated: Yes No Y
Owner/Lessee / Tenant PAU S� r RV 1 a S Master Permit # 4/59
Owner's Address ,S n1 E c17 G4 re—a" Phone
Contracting Co. bA N t ICI CD kit- / /l ddress ,5 AJ $ a' AJ e_ ,
Qualifier T• A, J)p N 1 e l SS#
Phone Yes- C'`j a V71/
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Ref A5 tv
Estimated Cost (value) 4 ,;S — D - i2 • !9-6)
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 WITHI 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.
OWNERS 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 to do the work stated.
Signature of Contractor or Owner - Builder
FEES: PERMIC >0( RADON C.C.F. 4-9 ' NOTARY BOND
APPROVED:
Zoning Building Electrical ✓C
Mechanical Plumbing Structural Engineer
TOTAL DUE
Date
Date
FLOOR
NUMBER OF
SIZES OF
INSULATION
OPEN OR
CONCEAL'D
DUMBER OF
CIRCUITS
OUTLETS
MOTOR
J
GEN.
MAIN
S�
SUB
BRANCH
Basement
First
Second
Third
Fourth
Other
Floors
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for issuance of permit for electrical installation as described below, and for
inspection of same after installation:
Owner
Building Contractor
Electrical Contractor
Location of proposed work: Lot, '' Bloc - Subdivision
x` 1,
Building: Old or new Number of stories Used as
Description of proposed work
Details of proposed work:
Number of Motors
OUTLETS
MOTORS
RECEPTACLES
H. P.
GENERATORS
cl d
iQ bores illage �,
F L O A 1 D i�
STOVES
Address
if
Volts Amps Phase
WATER H'TERB
SIGNS
Additional Information
Signature of Applicant
Address (if other than owner or contractor)
(SPACE BELOW FOR INSPECTOR'S USE ONLY)
Date i 193
BILLBOARDS
OTHER APPARATUS
Work begun Inspected
Work finished Final inspection
, Inspector
ITEM
BATH TIE
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
i
FEE
ITEM
SPACE HEATERS
CENTRAL HEATING
UNIT
FEE
BIDET
LIGHT OUTLETS
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
/
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 If
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 If
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
'
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
_
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
JTILITY -SEWER
SIGN TIME CLOCK
JTILITY -WATER
FIXTLRES
;EPT IC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
)RAINFIELD, 4" TILE/RES.
VIOLATION
'UMQ 8 ABANDON SEPTIC TANK
REINSPECTION
;OAKAGE PIT CU. FT.
:ATCH BASIN
HSCHARGE WELL
)OMESTIC WELL
,REA DRAIN
,OOF INLET
'OLAR WATER HEATER
IRE STANDPIPE
OCL PIPING
AWN SPRINKLER SYSTEM
AS RANGE
ETER SET (GAS)
AS PIPING
'
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
ti
Date :
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 32S" / ct 7 3 J' Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant COQ SU kJ I. Master Permit # C
)------
Owner's Address 3 25 N C. 4 )/ S Phone
Contracting Co. ' P 4 L 1 EC Rv 4 Address e - „g o K 1, / V9. an v e.. - . 3 S/ 4
Qualifier 6"+v 11 ( SS# Phone 40�• 3 a5 ' 1 o3 Z.
State # C4. 9 V 7 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Cl Cc- Fox. 12.0L --- go s -p
Square Ft. Estimated Cost (value) (p e o - dc-N
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 Al.kIDAVIT: 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 to do the work stated.
Signature of owner and/or Condo President Date
My Commission Exp.
s:
FEES: PERMIT' ®19 RADON
C.C.F.
i�
Signature of Con : ctor or Owner- Builder — Date
Notary as to Owner and/. ' ondo President Date No ontractintRVjli 9 JDnifWE OF FLOM A Date
My,�.mnussion Expires. DIANA M. TAVEL
COMMISSION # CC652682
EXPIRES 6/3/2001
WINDED THRU ASA 1- 868- NOTARYI
NOTARY
BOND
APPROVED: TOTAL DUE
Zoning Building Electrical WI / - Ai! .. 0''
Mechanical Plumbing Structural Engineer
Permit No Y $97
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPAInt "MENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitteld for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Flutida,
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
Registered Architect and /or Engi
Employing Electrician's Name
Location and Legal Description Lot
an ega escription of Block Subdivis'o
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors) b s�✓+..�
New Building Remodeling Addition Repairs No. of Stories
Service
Typ�
Overhead
Underground
Islstallation
9
ma
Size Feeders
duit
P
No i Street me' 5 7
„AC..
No /6 1 /I
Street
��z e.x
Conduit Main Sw Amps .Main Fuses Amps
Tu�ing B.X.L , ' . /. .. .Metal Mouldink`
Amount of Jrmit $
STATE OF FLORIDA,
! j ss.
COUNTY OF DADE.
(Signed) 1 /
(Signed)
The undersigned applicant for this building permit does hreby certify that he understands anc" a
labor under the Florida Workmen's Compensation Act, being ection 5966, Compiled General Laws
has complied with the provisions thereof, and will require sinl compliance from all contractors or
work to be performed under this permit; and will post or cause .° b posted for inspection on the site
as are required by the Act. The undersigned agrees to employ qty such subcontractors, on work ro
licensed by Miami Shores Village.
?! `rt? 1
Electrical Inspector
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed u er this permit, as are
aG'
Master Eh_ctrician.
Before me, the undersigned authority, a notary public,
appeared
to me well known, and who, being by me first duly sworn, upon oatheposes and says that he is the
of the above described construction, and he has carefully read the fcgoing application, and that he did sign the same, and that all facts
therein by him stated are true.
dui authorized to administer oaths 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 pection 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
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
RVICE
/i¢ RM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR. L LIST
LIST
CHECK
Permit No Y $97
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPAInt "MENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitteld for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Flutida,
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
Registered Architect and /or Engi
Employing Electrician's Name
Location and Legal Description Lot
an ega escription of Block Subdivis'o
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors) b s�✓+..�
New Building Remodeling Addition Repairs No. of Stories
Service
Typ�
Overhead
Underground
Islstallation
9
ma
Size Feeders
duit
P
No i Street me' 5 7
„AC..
No /6 1 /I
Street
��z e.x
Conduit Main Sw Amps .Main Fuses Amps
Tu�ing B.X.L , ' . /. .. .Metal Mouldink`
Amount of Jrmit $
STATE OF FLORIDA,
! j ss.
COUNTY OF DADE.
(Signed) 1 /
(Signed)
The undersigned applicant for this building permit does hreby certify that he understands anc" a
labor under the Florida Workmen's Compensation Act, being ection 5966, Compiled General Laws
has complied with the provisions thereof, and will require sinl compliance from all contractors or
work to be performed under this permit; and will post or cause .° b posted for inspection on the site
as are required by the Act. The undersigned agrees to employ qty such subcontractors, on work ro
licensed by Miami Shores Village.
?! `rt? 1
Electrical Inspector
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed u er this permit, as are
aG'
Master Eh_ctrician.
Before me, the undersigned authority, a notary public,
appeared
to me well known, and who, being by me first duly sworn, upon oatheposes and says that he is the
of the above described construction, and he has carefully read the fcgoing application, and that he did sign the same, and that all facts
therein by him stated are true.
dui authorized to administer oaths 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 pection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.