ELECTRICALPermit No. /..�
New Building Remodeling Addition
C777? 133.0
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, Fiu:Ida,
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 P lA/AK) 21a 81 6
Registered Architect and /or Engineer
Empl yin ectr' e a 611 1-ES �LE-c7� /C. No g e" . ='r'0 �2 (9
F' "r a � `y n Block A�
�
Location and Leg Description ........ pmt/ ° Subdivision. 7i1
Street and Number where work is to be performed —No 34'9 Ng 9 d
State work to be performed and purpose of building (By Floors)
Service Overhead Site Feeders Conduit Main Sw
Underground
Type of Installation — Conduit Tubing.. ... B.X.L
Amount of Permit $ ...
(Signed).
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 work to
licensed by Miami Shores Village.
Date /PAZ /7/
No 75 7 832 5 Street Vg 9 NE S T
ider
Street
S4,S9 / /Afro.v c• P,>��
Repairs No. of Stories
Amps Main Fuses Amps
.Metal Moulding
Street Wee) 54' 7s-Ai.e
Electrical Inspector.
ccepta his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
(Signed) C� �, 3E ec..#/ 2S
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I j
Before me, the undersigned authority, a notary public, duly authorised to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly morn, 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 fact,
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
0
LIGHT
OUTLETS
PLUO
RECE•P•T•e
FIXTURES
NO LAMPS
RerR10.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
NEATER
W. HEAT.
CONN.
SPACE
HEATER
STRI
NEATER
a %
/,
TOTAL
CONTR.
/0,./,/
y1ali
406
3TITC,
CHECK
�9dv
ENT.
SW.
DIST.
CAR.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
141 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
List
CHECK
Permit No. /..�
New Building Remodeling Addition
C777? 133.0
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, Fiu:Ida,
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 P lA/AK) 21a 81 6
Registered Architect and /or Engineer
Empl yin ectr' e a 611 1-ES �LE-c7� /C. No g e" . ='r'0 �2 (9
F' "r a � `y n Block A�
�
Location and Leg Description ........ pmt/ ° Subdivision. 7i1
Street and Number where work is to be performed —No 34'9 Ng 9 d
State work to be performed and purpose of building (By Floors)
Service Overhead Site Feeders Conduit Main Sw
Underground
Type of Installation — Conduit Tubing.. ... B.X.L
Amount of Permit $ ...
(Signed).
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 work to
licensed by Miami Shores Village.
Date /PAZ /7/
No 75 7 832 5 Street Vg 9 NE S T
ider
Street
S4,S9 / /Afro.v c• P,>��
Repairs No. of Stories
Amps Main Fuses Amps
.Metal Moulding
Street Wee) 54' 7s-Ai.e
Electrical Inspector.
ccepta his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
(Signed) C� �, 3E ec..#/ 2S
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I j
Before me, the undersigned authority, a notary public, duly authorised to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly morn, 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 fact,
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.
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n l/
n
( 9
Permit No.
t T O Q
Name (-12_ , t►-
Address q (2 54,
i
Company r'' '
Phone # �/ 55g i (p
For Inspector: q9 d ''Name & Da
Approved
` / v
Correction / � Z
Re- Insp'n Fee ❑
r`!
BUILDING
ELECTRICAL PERMIT A N°
PLUMBING
AMOUNT
NAME
NAME
LOT BLOCK
96
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Owner of Building "'" —
Architect and /or Engineer
Contractor or Builder
Proposed Location
ADDRESS
NAME ADDRESS
LICENSE NO.
ADDRESS LICENSE NO.
J /
SUB - DIVISION *10. STREET
, 19
This permit is issued to To
the building above described, as per application. Plans and Specifications heretofore filed in this office. 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 in accordance
and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and
regulations of the building 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 the building inspector.
RECD. PAYMENT ACCT. DEPT. INSPECTOR
In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the
building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village.
Dated , 19 - }
(SEAL )
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
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.
BBILDING
ELECTRICAL PERMIT A N9 96
PLUMBING-
v ner of Building _
Architect and /or Engineer
Contractor or Builder'
AMOUNT
Dated
NAME
NAME
RECD. PAYMENT ACCT. DEPT.
19
ADDRESS
ADDRESS
NAME
Proposed Location y`
LOT BLOCK SUB - DIVISION NO.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
, 19
ADDRESS LICENSE NO.
•
This permit is issued to __ _ To .
the building above described, as per application, Plans and Specifications heretofore filed in this office. 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 in accordance
and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and
regulations of the building 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 the building inspector.
In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
an s and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the
building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Mimi Shor,s'Village.
LICENSE NO.
STREET
INSPECTOR
A (SEAL)
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
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.
w
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 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 No Street
Registered Architect and /or Engineer
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amp,
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
MIAMI SHORES VILLAGE
(Signed)
(Signed)
The undersigned applicant for this building permit does hereby certify that he undetands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notice
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.
Electrical Inspector.
//
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
L s'
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.3 HP
NEON
TRANS.
RADIO
TOTAL.
CONTR.
LIST
CHECK
w
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 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 No Street
Registered Architect and /or Engineer
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Servi Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amp,
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
MIAMI SHORES VILLAGE
(Signed)
(Signed)
The undersigned applicant for this building permit does hereby certify that he undetands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notice
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.
Electrical Inspector.
//
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No._ F
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 ___- ________ No._ Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot Block
NoStreet-------- --------------- ------ --- - -----
Subdivision
Street and Number where work is to be performed— No.__C. t -
State work to be performed and purpose of building (By Floors)
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
se
Amount of Permit $_�___
I – � V
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Street
fa a
/ / i
(Signed) -- — - c s - — — —
�; '. 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 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.
(Signed)
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.
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
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
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No._ F
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 ___- ________ No._ Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot Block
NoStreet-------- --------------- ------ --- - -----
Subdivision
Street and Number where work is to be performed— No.__C. t -
State work to be performed and purpose of building (By Floors)
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
se
Amount of Permit $_�___
I – � V
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Street
fa a
/ / i
(Signed) -- — - c s - — — —
�; '. 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 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.
(Signed)
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.
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.
Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date J ,
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 _ ___ _ No Street __________ ^______________
Registerzd Architect and /or Engineer - -
Employing Electrician's Name No. Street
Location and Legal Description Lot • Block__ Subdivision______
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit ____ Main Sw.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $______
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 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.
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
(Signed)
(Signed)
Amps. Main Fuses__. Amps.
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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
-
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date J ,
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 _ ___ _ No Street __________ ^______________
Registerzd Architect and /or Engineer - -
Employing Electrician's Name No. Street
Location and Legal Description Lot • Block__ Subdivision______
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit ____ Main Sw.
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $______
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 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.
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
(Signed)
(Signed)
Amps. Main Fuses__. Amps.
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 be 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.
• /- 2
- 2
,
Amount of Permit $
Service Overhead Size Feeders Conduit
Underground
Type of Installation — Conduit Tubing
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Vi`_lage.
STATE OF FLORIDA,
COUNTY OF DADE.
83.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No._ 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
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
No. ,
- a-
No._
Block
Street and Number where work is to be performed— No.__,`, _ F -
State work to be performed and purpose of building (By Floors
Street
Street
Subdivision__
Street---- ------ - - - -- – -------- - - - - -- – – – - - - - - --
New Building _ Remodeling Addition Repairs No. of Stories
Main Sw. Amps. Main Fuses Amps.
B.X.L. Metal Moulding
(Signed)
(Signed)
7 7 Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
Master Electrican.
Before me, the undersigned authority, a notary public, duly authorized
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.
to administer oaths and take acknowledgments, personally
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR
LIST
CHECK
Amount of Permit $
Service Overhead Size Feeders Conduit
Underground
Type of Installation — Conduit Tubing
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Vi`_lage.
STATE OF FLORIDA,
COUNTY OF DADE.
83.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No._ 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
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot
No. ,
- a-
No._
Block
Street and Number where work is to be performed— No.__,`, _ F -
State work to be performed and purpose of building (By Floors
Street
Street
Subdivision__
Street---- ------ - - - -- – -------- - - - - -- – – – - - - - - --
New Building _ Remodeling Addition Repairs No. of Stories
Main Sw. Amps. Main Fuses Amps.
B.X.L. Metal Moulding
(Signed)
(Signed)
7 7 Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
Master Electrican.
Before me, the undersigned authority, a notary public, duly authorized
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.
to administer oaths and take acknowledgments, personally
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.
ELECTRICAL 1
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
1hrts p
/
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
e
FPL - Load C tral
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
G.. .tees ete /
4
Receptacles
Switchboards
Clear Violations
Heat R er
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
ow -volt Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee .
I, QTY.
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. '1'1'1'E
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wallin. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUMBING
TYPE IQTY.
A/C Condensate
'TYPE
Drains, Roof
QTY.
'TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
LI FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $ / 6 0
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
REVIEWED AND PREPARED BY
$
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(sq.ft. = x/I000
x11.60)
(¢.005 /sq.ft.)
(11.01 /sq.ft.)
•
tor
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PROPERTY OWNER
New Construction
Name ?
4
Alteration Exterior
Address ..0e A i a .,
,‘,.
r,
9.77. ....
Home Telephone
Demolish
Business Telephone
Relocation of Structure
Fax
Foundation Only
TYPE OF MANAGEMENT ( i )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Addl Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS The following steps must be taken to obtain a permit from the Miami Shiores”VIllage:
Step I.
Step 2.
Job Address:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
'APPLICATION
3(4-9 ez-7 q st S -13( aF
Folio Number ' .s40 Descripti n f Work
Lot Block
Subdivision PB PG
Current Use of Property ‘ ° Square Feet Units Floors
Proposed Use of Property Value of Work tn' (4P Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (/)
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Address Apt.
PERMIT CHANGE ( )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
City
State Zip
PERMIT APPLICATION
Zoninj Linear Feet
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
44C11:".1/
License No. F 9,,p9..
Address .9 - 749 -- ,406
fage Or/r.-->
Telephone - Fax
Qualifier Name
Page 2
IN1I'ORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays:
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT.FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is •required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
1.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, P Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Owner
srf LSE"
•nt Name
S t a d subscribed before me this
• J
Signatur
SEAL:
Personally known
ryPu
c - State of Fl
J', Li0 RO_,t.ES
;0,:Y CC 921072
XPI!RES• June 4 200+
Bc d Yhru Puld,c Und rm.ars
OR, Produced Identification
Type of Identification Produced:
STATE OF FLORIDA, CO I F I - DADE
Signat
nt Name
Sworn to and subscribed befo
/a /
blic - State f Flon
• JllLIO
_ : CO:.: :.;ISSION 4 CC 921072
EXPIRES: June 4, 2004
iedll,r ■tary Undcnirifere J ;
Personally known OR, Produced Identification
Type of Identification Produced:
Signa
SEAL:
PERMIT APPLICATION
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3724
BRINKS HOME SECURITY
5765 N.W. 158TH STREET
MIAMI LAKES, FL 33014
PAY
TO THE
ORDER OF
Bank of America,
Customer Connection
FOR / 2.1 " , , '/
DATE
Is
Crx=r
POO 3 7 2 411 1: L L0000 21: b 59 .56 L 48 L
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. •
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Electrical Permit
Permit Number: EL2002 -179
Printed: 5/24/2002 Page 1 of 1
Applicant ELSIE LIEBIG
Owner: LIEBIG ELSIE
JOB ADDRESS: `:349 NE 96 ST
Contractor Contractor's Address: 5765 NW 158 ST
Local Phone: 305 - 558 -6625
Parcel # 1132060135910
Fees: Description Amount
FEE2002 -3004 Building Permit Application Fee $60.00
FEE2002 -3005 CCF $0.60
Total Fees: $60.60
Permit Status:
Work:
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & 20 BLK 43 LOT
Permit Expiration: 11/20/2002 Construction Value:
Total Fees: $60.60
Total Receipts: $60.60
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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
Signed:
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 responisibility for all work done by either
myself, my agent, servants or employes.
SPECTOR) BY:
(Contractor or Builder) BY: