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576 NE 97 St (6)v Permit No Owner's Name and Address 88. 1 SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT PPLICATION I= ELECTRICAL PERMIT Date ./Q ' // ) 3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other otructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Evade, , 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. • t '' fl k No ) Street Registered Architect and /or Engineer a /�- f/ Employing Electricia6's Name � �,� 7'6� .. �a �... No........... .U...a Street 4r �+ Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street / � ," ,2.. `� �.. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses . Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit S (Signed) (1 )4 Electrical Inspector. The undersigned applicant for this building permit does hereby celtify that he understands and accepts his`bligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florid'. Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) /c/, 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 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 51.00 will be made when ouch 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 RERRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. L167 q � , / 4 / l r L 1 ,I. J CHECK �- ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. ° � MOTORS 04 HP MOTORS 1.8 HP NEON TRANS. RADIO - TOTAL CONTR. LIST p , lwl_TJ(-1- /y / 7 CHECK � roe' 3 - J v Permit No Owner's Name and Address 88. 1 SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT PPLICATION I= ELECTRICAL PERMIT Date ./Q ' // ) 3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other otructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Evade, , 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. • t '' fl k No ) Street Registered Architect and /or Engineer a /�- f/ Employing Electricia6's Name � �,� 7'6� .. �a �... No........... .U...a Street 4r �+ Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street / � ," ,2.. `� �.. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses . Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit S (Signed) (1 )4 Electrical Inspector. The undersigned applicant for this building permit does hereby celtify that he understands and accepts his`bligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florid'. Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) /c/, 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 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 51.00 will be made when ouch re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No er's Name and Address __- _.. ic__. -_ ORegistered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Service Overhead Size Feeders Underground Amount of Permit $_ MIAMI S RES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date_ 7 , Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit4ed for tie 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 iami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at ing during progress of work. Block Subdivision_________,_________- p ; rte) , Street and Number where work is to be erformed— No 2 ___L/ Street__Ly_ ?� ^ _._— ___L__: ! '___________ State work to be performed and purpose of building (By Floors) New Building Remodeling Wddition..�� Repairs__ Conduit. to A /' < - _:__ No._:._:�_____ „‘ C. N o . ,c Street_ ? No. of Stories Main Sw . W_ Amps. Main Fuses_ Type of Installation— Conduit fr'Tubing B.X.L Metal Moulding _ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has 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. 1 (Si __/ 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 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. Master Electrican. Amps. 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 / /7i _ ' CHECK ENT. /SW. DLST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No er's Name and Address __- _.. ic__. -_ ORegistered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Service Overhead Size Feeders Underground Amount of Permit $_ MIAMI S RES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date_ 7 , Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit4ed for tie 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 iami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at ing during progress of work. Block Subdivision_________,_________- p ; rte) , Street and Number where work is to be erformed— No 2 ___L/ Street__Ly_ ?� ^ _._— ___L__: ! '___________ State work to be performed and purpose of building (By Floors) New Building Remodeling Wddition..�� Repairs__ Conduit. to A /' < - _:__ No._:._:�_____ „‘ C. N o . ,c Street_ ? No. of Stories Main Sw . W_ Amps. Main Fuses_ Type of Installation— Conduit fr'Tubing B.X.L Metal Moulding _ (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has 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. 1 (Si __/ 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 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. Master Electrican. Amps. OUTLETS MOTORS RECEPTACLES GENERATORS STOVER WATER H'TERS SIGNS BILLBOARDS OTHER APPARATUS MAIN SUB BRANCH Basement First FLOOR NUMBER OF SIZES OF INSULATION OPEN OR CONCEAL'D NUMBER OF CIRCUITS OUTLETS MOTOR GEN. MAIN SUB BRANCH Basement First Second Third Fourth Other o 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: Date �% ;` / ilic�f , � �� %d adre r 7‘) Own �� Tess Building Contractor Electrical Contractor Description of proposed work Details of proposed work: Number of Motors H P. 4liami cJhoresllage F L 0 R 1 D A fi Volts Amps (SPACE BELOW FOR INSPECTOR'S USE ONLY) • Location of proposed work: Lots °f Block 9 ° Subdivision ��' Building: Old or new Number of stories Used as Additional Information Signature of Applica , 1:4,) %a Address (if other than owner or contractor) Phase Work begun Inspected Work finished Final inspection , Inspector OUTLETS MOTORS RECEPTACLES GENERATORS STOVER WATER H'TERS SIGNS BILLBOARDS OTHER APPARATUS MAIN 75 BRANCH Basement ^ f n A �/. First FLOOR NUMBER OF SIZES OF INSULATION OPEN OR CONCEAL'D NUMBER OF CIRCUITS OUTLETS MOTOR GEN. MAIN SUB BRANCH Basement First Second Third Fourth Other Floors aiami cShores F L O R I D A 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: Date C $ 193_4 % f r Owner 2 ��!' �� Address �� �� �� _' 4 Cr �� %�, +` Building Contractor ' / ! A Electrical Contractor fl Location of proposed work: Lot's ". °� B loc k 7' Subdivision 1 7? % t 7 P2 !? Building: Old or new ill " 4 Number of stories Used as Description of proposed work Details of proposed work: Number of Motors H P Signature of Applicant Volts Amps Additional Information SPACE BELOW FOR INSPECTOR'S USE ONLY) Phase Address (if other than owner or contractor) Work begun Inspected r/ Work finished Final inspection , Inspector THIS CERTIFICATE MUST BE PRESENTED TO THE ELECTRIC COMP:. WHEN APPLYING FOR SERVICE. by for TOWN OF MIAMI SHORES %74/7 Office of Electrical Inspector N° CERTIFICATE OF INSPECTION THIS CER FITS that the wirin and apparatus installed at _._� . e ? �� Z �c � �' ® Address t , . ' owner, and occupied as ,4 Other Apparatus has been inspected and current is authorized to be turned on, until otherwise notified, for: Lights: Number of lamps.- Watts i Heating: Stove.___ eneff,i, .ae-e watts. Water Heater ____X & C.zwatts Power: Connected load H. P. volts phase cycle Electrical Inspector. iING TRICAL ,JMING Owner of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 6483 Work to be pe ormed under this Permit Architect Contractor or Builder Legal of /' Description` v Subdi- vision DATE Contractor's License No. By 194K Address of Value of Building . ,.. �' ,�' Project . This permit is ganted to the contractor or bu er =timed above to construct the building or o ' stall the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding t at 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 ordinances and regulations pertaining to the work covered hereby whether shown on the plans car dra ings or i the staements or specifications and ssumes respon- "ability for work done by his agents, servants or employees. Signed. Y In consideration of the issuance to me of this permit I agree to perks ij the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict confoimity with the plans, drawings, stateerrfifients or specifications submitted to the proper authorities of Miami Slofee J'llage. In acceptjag this permit I assume r foonsibilhir for all work done by either self, my a t, servant or employee. ,L,-/t ( 14 at A u1OR ORB LD AUTHORITY NO. STREET PART OF LOT LOT BL'K SUBDIVISION ...›,,,.. „, /11 V/ dz' 4tif*,,,3 1,011._ ,) iiir hid ,/, / „of; -" -/ e/ _.412-9_zo*-04.0 Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee AP / / 2 ELECTRICAL PERMIT N. B. —This Permit must be on display pp the premises during the conk ugtio Owner of Building CSactor or Electrician °' f=•� d ''''"� >a?s,� l� aiami Aores91llage F L O R ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , � ' 19 LO CATI 0 N N° 291 • DESCRIPTION OF WORK NUMBER OF This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit maybe 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 p unauthorized by /" thi Department. J . z - . %. � ; S ST ' , Elect Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami Shores Village. Dated "° 19 (Seal) 4 ‘7). • NO. Motors STREET PART OF LOT LOT BL'K Signs SUB fVISION 0 7 6 // [� a - / G / � / (/ / // c .. Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus I Permit Fee - . G � ' ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Cci ctor or Electrician aiarni Jhores - llage F L O A I D A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla., / - c? LO CATI 0 N 19 N° 317 DESCRIPTION OF WORK Th is 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 lans and specifications unauthorized by th artmen , 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 odes of Miami Shores Village, and al ,rules an. regulations of the Electrical Department of Miami Shores Village. �� • )( ,19 (Seal) Dated NO. STREET PART OF LOT LOT BL'K SUBDIVISION Signs Billboards Other Apparatus Permit Fee ai Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee ai ELECTRICAL PERMIT N. B. —This Permit—must be on display on the premises during the construction. t ., • lC,. Owner of Building Contractor or Electrician Dated , 19 aiami cShores9' llage F L O R ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , / ' • 4 DESCRIPTION OF WORK N This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with .e plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code f Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time on the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by is Department. 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 the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the e of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami r _ . res Village. LO CATI ON 19 , Electrical Inspector. N° _ 291 (Seal) NO. STREET PART OF LOT LOT BL'K SUBDIVISION Signs Billboards Other Apparatus Permit Fee * Outlets Motors Receptacles 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 aiami cShores9llage F L O R ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , 19 LO CATI 0 N DESCRIPTION OF WORK N° 317 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 his 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 the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the e of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules' and regulations of the Electrical Department of Miami res Village. Dated , 19 (Seal) Amount of Permit $ SS. MIA I SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT AFFLICATIit FOR ELECTRICAL PERMIT Date Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, 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. No Street.. f sr Owner's Name and Address Registered Architect and /or Engineer ra Employing Electrician's Name : �-� No f� fie et treet C_yi 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 Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ,/a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, o / work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Electrical Inspector. Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. f 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 ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.9 HP N EON TRANS. RADIO TOTAL CONTR. LIST I 1 CHECK s Amount of Permit $ SS. MIA I SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT AFFLICATIit FOR ELECTRICAL PERMIT Date Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, 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. No Street.. f sr Owner's Name and Address Registered Architect and /or Engineer ra Employing Electrician's Name : �-� No f� fie et treet C_yi 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 Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ,/a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, o / work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Electrical Inspector. Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. f 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.