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.