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602 NE 96 St (16)
Registered Architect and /or Engineer • _______ Employing Electrician's Name _ Location and Legal Description Lot_ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. , t__�_� Date // Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for Elrr; 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 ,,rr Owner's Name and Address _ t!._;'_ sue' No _Block ��__— �____ Subdivision _.�._ Street and Number where work is to be performed—No. 6 , 2:. „..:_____L_- Street____________- _ ______ _�.__._________�- State work to be performed and purpose of building (By Floors) �. New Building Remodeling Addition Service Overhead Size Feeders___________ Conduit.___ - -- Main Sw._ Underground Type of Installation— Conduit Tubing __ B.X.L. Metal Mould --- --- ______ -- ----- ------- – Amount of Permit $ . The undersigned applicant for this building permit does hereby under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. ss. My Commission Expires Street ' Repairs________ ____ No. of Stories._ ________ Amps. \'lain Fuses Inspector. erstands and accepts his obligations as an employer of labor General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) – ��- ..* f •. Master Electrican. 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 be 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. Notary Public. State of Florida Amps. 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'8 FIXTURES NO.LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK J / © 5 ENT. SW. DIST. CAD. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST ,..).'/•'' , • r5 en ` CHECK Registered Architect and /or Engineer • _______ Employing Electrician's Name _ Location and Legal Description Lot_ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. , t__�_� Date // Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for Elrr; 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 ,,rr Owner's Name and Address _ t!._;'_ sue' No _Block ��__— �____ Subdivision _.�._ Street and Number where work is to be performed—No. 6 , 2:. „..:_____L_- Street____________- _ ______ _�.__._________�- State work to be performed and purpose of building (By Floors) �. New Building Remodeling Addition Service Overhead Size Feeders___________ Conduit.___ - -- Main Sw._ Underground Type of Installation— Conduit Tubing __ B.X.L. Metal Mould --- --- ______ -- ----- ------- – Amount of Permit $ . The undersigned applicant for this building permit does hereby under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. ss. My Commission Expires Street ' Repairs________ ____ No. of Stories._ ________ Amps. \'lain Fuses Inspector. erstands and accepts his obligations as an employer of labor General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are (Signed) – ��- ..* f •. Master Electrican. 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 be 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. Notary Public. State of Florida Amps. 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.