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595 NE 96 St (2)
Vat Owner's Address PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date t(-(2-- Job Address Legal Description /-.:97 ©gam- 99 ,4/ jZi. Sec- i-,/,900 Lessee / Tenant ki /, -t : cers to Q ot icz Contracting Co. Pn euSty SC%( (.1.1 Address 4 So 1* cf. Qualifier &/A® C- Wt►'1 ' SS# L� State # Fn" ®° M nrcipal # Competency # Ins.Co. KILL - �^� Ibha Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ; ELECTRICAL WORK DESCRIPTION - R, - "Cit4IN Square Ft. 2_00c) Estimated Cost(value) 1 77 ` WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accur: and that a ork will be done in com lianc- with all applicable laws regulating construction re, I authori - he Ibove :med contractor to do the work stated. Sign Date: Notary���n a4id /or Condo President My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA MY COMMISSION EXPSEPT 9,1995 BONDED T RU GENERAL INS. UND. ** * * * * * * FEES: PERMIT 30/00 RADON C.C.F. ' NOTARY 5 '. 6 b TOTAL DUE APPROVED: do President P rint type or starn � NOtai3Go I 'g�y I�nBIic� Personally known Airy, CotuaiS107i. Tyr_ and number of LID. produced: NOT rake an oath. Fire Building Mechanical Plumbing Zoning Tax Folio 11- Z 0 (1 KZ() Phone Si ::sire of Contr Master Permit it ,.3 O � Phone t" (/fo PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN or Owner -Bui •er cierr 2 fvc4 tractor or Owner- Builder xpires: Notary Public State of Florida My Commission Expires 9/18/S2 Bonded Thru Stembler -Adams & Sheet Other Electrical 1 Y ry Engineering 1�� Permit No / �fp+8' Amount of Permit $ 3 STATE OF FLORIDA, t COUNTY OF DADE. j �' MIAMI SHORES GILL (Signed)... GE ELECTRICAL INSPECTION DEPA TMVIENT APPLICATION FOR ELECTRIC L PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su'mitted 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. � A' �+ J Owner's Name and Address. . SC A / � " l/ No 6 7 Street. /v ' 9 6 Registered Architect and /or Engineer 6s9 �/ Employing Electrician's Namera ...d.�. ieC � � A i � A'C No , Street Location and Legal Description Lot 0 2 19 7--- Block.. Street and Number where work is to be performed —No 596 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories / /q5/ Subbdivisioli "/ 9 ; SAOR4 C �'G •4 � Street 14A , ( l6 S Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation — Conduit 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 complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performe under this permit, as are licensed by Miami Shores Village. 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 ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 04 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST / CHECK , �p / Permit No / �fp+8' Amount of Permit $ 3 STATE OF FLORIDA, t COUNTY OF DADE. j �' MIAMI SHORES GILL (Signed)... GE ELECTRICAL INSPECTION DEPA TMVIENT APPLICATION FOR ELECTRIC L PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su'mitted 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. � A' �+ J Owner's Name and Address. . SC A / � " l/ No 6 7 Street. /v ' 9 6 Registered Architect and /or Engineer 6s9 �/ Employing Electrician's Namera ...d.�. ieC � � A i � A'C No , Street Location and Legal Description Lot 0 2 19 7--- Block.. Street and Number where work is to be performed —No 596 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories / /q5/ Subbdivisioli "/ 9 ; SAOR4 C �'G •4 � Street 14A , ( l6 S Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation — Conduit 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 complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performe under this permit, as are licensed by Miami Shores Village. 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.