650 NE 97 St (4)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N? 7717
Owner of
Building
CONTRACTOR OR BUILDER
Bl.
Work to be performed under this Permi
Subdi-
vision
DATE. 195
Contractor's
License No
Sq. Ft
Value of
Project $
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
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.
n ` r�
Signed BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done 'by either, myself, my agent, servant or employee.
c,
BY AUTHORITY
7
APPLICATION FOR ELECTRICAL PERMIT
p
Permit No 2( V‘5 Date C • /t l � s
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sul tted 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
6 ,e. - r8
building during progress of work.
� Owner's . ! =- . s Name and Address........ No Street
Registered Architect and /or Engineer
Employing Electrician's Name Z ) No...i/%!.1 /..... Street ..l,
/ / �►,�""-�� p
Location and Legal Description Lot 1 1)- ` 2 " . a_' Block / 6-0 Subd ivisioniY�(.C�LC i
Street and Number where work is to be performed —No 4 60 ` 7A Atreet
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ > ° % (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acce ts� 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 notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors on work to be performed }+¢d}t"ths permit, as are
licensed by Miami Shores Village.
(Signed)...
"ti
STATE OF FLORIDA,
COUNTY OF DADE. j �'
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.
0
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T's
FIXTURES
No. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
H ATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.I HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT
p
Permit No 2( V‘5 Date C • /t l � s
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sul tted 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
6 ,e. - r8
building during progress of work.
� Owner's . ! =- . s Name and Address........ No Street
Registered Architect and /or Engineer
Employing Electrician's Name Z ) No...i/%!.1 /..... Street ..l,
/ / �►,�""-�� p
Location and Legal Description Lot 1 1)- ` 2 " . a_' Block / 6-0 Subd ivisioniY�(.C�LC i
Street and Number where work is to be performed —No 4 60 ` 7A Atreet
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ > ° % (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acce ts� 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 notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors on work to be performed }+¢d}t"ths permit, as are
licensed by Miami Shores Village.
(Signed)...
"ti
STATE OF FLORIDA,
COUNTY OF DADE. j �'
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.
0
Permit No 77/7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewid 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 co lied 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
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
if trl
Registered Architect and /or En deer
Employing Electrician's Na
Location
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building .,r Remodeling Addition Repairs No. of Stories
Service Overhead Size 'Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L
Amount of Permit $
0
No
Block
Amps Main Fuses Amps
Metal Moulding
(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 sub-contractors, on work to
licensed by Miami Shores Village.
(Signed) /
Street
No / 4 . 2( ��5 treet.... /1.
Date
Subdivision
Street
El ' ; ctrical Inspector.
ccepts 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 perforfne under this permit, as are
Master Electrician.
STATE OF FLORIDA, t
COUNTY OF DADE. Jt SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE''P 'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER
STRIP
HEATER
/
�/` Z•g(/
O ry,
J TOTAL
CONTR.
LIST
' 6 L/
O2
kV
•� V
�. �
1•lf
�i� _i_____
v y/ O
CHECK
ENT.
SW.
DIET.
CAS.
SERVICE
TEMP.
SERVICE L��
PERM. ,.
�
G"�
Y 6
/
MOTORS
O.$ HP
sg
!'/1rJ
MOTORS
1•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
IST
1 � , � `� /
'�/� (i
CHECK
Permit No 77/7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewid 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 co lied 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
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
if trl
Registered Architect and /or En deer
Employing Electrician's Na
Location
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building .,r Remodeling Addition Repairs No. of Stories
Service Overhead Size 'Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L
Amount of Permit $
0
No
Block
Amps Main Fuses Amps
Metal Moulding
(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 sub-contractors, on work to
licensed by Miami Shores Village.
(Signed) /
Street
No / 4 . 2( ��5 treet.... /1.
Date
Subdivision
Street
El ' ; ctrical Inspector.
ccepts 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 perforfne under this permit, as are
Master Electrician.
STATE OF FLORIDA, t
COUNTY OF DADE. Jt SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING ❑
ELECTRICAL DATE 195
PLUMBING ❑ PERMIT N? 7 6 8 5 Contractor's
License No
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder rl
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
CONTRACTOR OR BUILDER
BI.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
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: BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Permit No.. . 5
Street and Number where work is to be performed —No
MIA SHOES \BIUf_ 3E
State work to be performed and purpose of building (By Floors)
ELECTRICAL INSPECTION DEPARTMENT
A F ICATION FD ELECTRIC L i= "(fir "'MOT
Date l a..l.....
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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 KE L.
HOS f No . 1 ( 3 � ' O 11 l 454 ree G50 NE. S T
Registered Architect and /or Engineer --e ( an ;4- S {�rY15 rr\L_
Employing Electrician's Name No Street
L0-1- L0-1- w a
I ' 00
Location and Legal Description Lot � ' l� S Block
Co ..; a -ne- 9 -1 <r+"
New Building Remodeling Addition 7
Street
1 -+ `-{ Ss-4010o
Subdivision m
-4 ao oo • 0-0
Repairs No. of Stories
Service Overhead Size Feeders Conduit
Underground
Type of Installation— Conduit Tubing
Amount of Permit $.....I..`.: B C.l ( Signed )...1 ► .0620
STATE OF FLORIDA, }
COUNTY OF DADE.
as.
Main Sw Amps Main Fuses Amps
B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to
licensed by Miami Shores Village.
Shy
Electrical Inspector.
ccepts 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)
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 facto
therein by him stated are true.
My Commission Empires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 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'0
FIXTURES
NO. LAMPO
RILFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIOT
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORO
0.1 HP
MOTORS
1.0 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
L1OT
CHECK
Permit No.. . 5
Street and Number where work is to be performed —No
MIA SHOES \BIUf_ 3E
State work to be performed and purpose of building (By Floors)
ELECTRICAL INSPECTION DEPARTMENT
A F ICATION FD ELECTRIC L i= "(fir "'MOT
Date l a..l.....
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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 KE L.
HOS f No . 1 ( 3 � ' O 11 l 454 ree G50 NE. S T
Registered Architect and /or Engineer --e ( an ;4- S {�rY15 rr\L_
Employing Electrician's Name No Street
L0-1- L0-1- w a
I ' 00
Location and Legal Description Lot � ' l� S Block
Co ..; a -ne- 9 -1 <r+"
New Building Remodeling Addition 7
Street
1 -+ `-{ Ss-4010o
Subdivision m
-4 ao oo • 0-0
Repairs No. of Stories
Service Overhead Size Feeders Conduit
Underground
Type of Installation— Conduit Tubing
Amount of Permit $.....I..`.: B C.l ( Signed )...1 ► .0620
STATE OF FLORIDA, }
COUNTY OF DADE.
as.
Main Sw Amps Main Fuses Amps
B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to
licensed by Miami Shores Village.
Shy
Electrical Inspector.
ccepts 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)
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 facto
therein by him stated are true.
My Commission Empires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when ouch re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No
so.
ELECTRICAL INS "ECTION EPARTMENT
MP VILLAGE
0
APIPLII ATI N Fa; -' ELECTRICAL PER 0T
Application is hereby made for the approval of the detailed atatement of the plane 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, Fiu :ida,
and all provisions of the Lawo 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. L /
Owner's Name and Address ‘7 F�� No. ••- -.? A" 4 Street "7c 7
Registered Architect and /or Engineer �y
Employing Electrician's Name.c • ¢ c?`, ewe No.. '// Street./ c
o, lo.>.,9 33i8I
Location and Legal Description Lot / Block Subdivision
Street and Number where work is to be performed— No.- . 0.. "/ '.er-
State work to be performed and purpose of building (By Floors). ,,C.c!
New Building Remodeling Addition
Servfut Overhead Site Feeders Conduit Main Sw Ampo Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Repairs
Date OA
Street ..7.7c
No. of Stories
Amount of Permit S . . (Signed) ` R4=t& Cry
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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.
STATE OF FLORIDA,
COUNTY OF DADE. I j
Before me, the undersigned authority, a no�rypublic, duly authorized to adminioter oatho and take acknowledgments, personally
appeared xi,c�r — � A �? says
to me well known, and who, ligirig by me first duly oworn, 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 otated are true.
NOTARY PUBLIC STATE OF FLORIDA AT L 19x4
MY COMMISSION EXFI::ES OCTOBER
My Commission E mpireo
NOTE: A re-inspection fee of 51.00 will be made when ouch re-inspection is mad
materials and /or workmanship.
Master Electrician.
Notary Public, State of Florida
eceaoary by improper notice for inspection, or faulty
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
No. LAMPS
RERRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANOH
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACH
HEATER
STRIP
HEATER
TOTAL
CONTR.
LICIT
/0
/
7 i
/0
4.70'
g
s, y,
s.g.
pi 8, Cc
CH¢CR
6.i.
ENT.
SW.
DI8T.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
PAOTORO
1.8 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LICIT
CHaCR
Permit No
so.
ELECTRICAL INS "ECTION EPARTMENT
MP VILLAGE
0
APIPLII ATI N Fa; -' ELECTRICAL PER 0T
Application is hereby made for the approval of the detailed atatement of the plane 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, Fiu :ida,
and all provisions of the Lawo 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. L /
Owner's Name and Address ‘7 F�� No. ••- -.? A" 4 Street "7c 7
Registered Architect and /or Engineer �y
Employing Electrician's Name.c • ¢ c?`, ewe No.. '// Street./ c
o, lo.>.,9 33i8I
Location and Legal Description Lot / Block Subdivision
Street and Number where work is to be performed— No.- . 0.. "/ '.er-
State work to be performed and purpose of building (By Floors). ,,C.c!
New Building Remodeling Addition
Servfut Overhead Site Feeders Conduit Main Sw Ampo Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Repairs
Date OA
Street ..7.7c
No. of Stories
Amount of Permit S . . (Signed) ` R4=t& Cry
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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.
STATE OF FLORIDA,
COUNTY OF DADE. I j
Before me, the undersigned authority, a no�rypublic, duly authorized to adminioter oatho and take acknowledgments, personally
appeared xi,c�r — � A �? says
to me well known, and who, ligirig by me first duly oworn, 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 otated are true.
NOTARY PUBLIC STATE OF FLORIDA AT L 19x4
MY COMMISSION EXFI::ES OCTOBER
My Commission E mpireo
NOTE: A re-inspection fee of 51.00 will be made when ouch re-inspection is mad
materials and /or workmanship.
Master Electrician.
Notary Public, State of Florida
eceaoary by improper notice for inspection, or faulty