ELECTRICALDate (v / D Job Address
Legal Description
Owner's Address '1 & D Ng
Co (22 )000
Signa
owner and/or Condo President Date
Notary as Owner and/or
My Commission E • fires:
"3014,,, TERESA CEJAS
,p MY COMMISSION # CC 835275
' "Q`gf t1,6� EXPIRES: Aug 16, 2003
1ID0.3 Fla Notary SaMoa 8 Bonding Co
FEES: PERMIT 6� ,� RADON
APPROVED:
Zoning
Mechanical
C.C.F.
g; Old 7 /'?
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
) 6, D NE- 9 Si'Tax,oho
Historically Designated: Yes No
Owner/Lessee / Tenant J o N &" c / 1/Q C& S -3f Master Permit #
Phone ` 7.S7 —
Contracting Co T & M ELECTRIC, INC. Address 1464 N. W. 78 Ave. MIAMI FL
Queer ANTONIO MORENO SS#
State# 30- 3407244 Municipal# 327059 -2 Competency #94E000420 Ins. Cca7g4440A21
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ���� � / / /
Square Ft Estimated Cost (value) 7,e&
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 perforated 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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
No
Building Electri
:A
i>rl
Signa Qv. ntractor or Owner - Builder
itt TERESA CEJAS
MY COMMISSION N CC 835' *1
Bi iN,p EXPIRES: Aug 16, 200?
1400,3•NOTARY FIa. Notary S•Mw & Bontling C..
-,: AA.
o Contractor or • r
My Commission Expir
NOTARY
BOND
Phone 305 406 -9692
0 e#
TOTAL DUE
Aeevo#
Date
Plumbing Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
' D3 .13 . 100o ST
la J ab Address 9 b o ( �� 97 Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant Master Permit # im 3 , d
Owner's Address q(00 Ne' 97 S T. Phone 38S 75 7 - 430
Contracting Co. (9 `-<4 -[E t? Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION CkQvl � e avid upy c e oc f s i d 6 e, 1 ec co 1 rn t✓4(-e v Awt
Square Ft. Estimated Cost (value) 4 • 6)2
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 OF 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 accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date Si
Notary as to Owner and/or Condo President Date
My Commission Expires: •
FEES: PERMrL.' far 0 0 RADON C.C.F.. 5° 0
APPROVED:
Zoning
Mechanical
of Con
64- JtQJ2p
Date
Notary as to Contractor Owner- Builder
My Commission Expires:
OfFtc tM NOTARY SEAL
1; 1.14 P08, SMAROAFntAMONPEI �('1 cOMIaSno$ NUMBER if CC797277 s O y pgSION EXPIRES
_ e . MY CSC. 1 7,2 002
BOND
Building Electrical
r or Owner- Builder
TOTAL DUE
Date
—,3 .1c00
Plumbing Structural Engineer
DRIP Lo
ro DE 30'
CAFG (MIN)
' 2 00A
METER
.\.....___
rri .-
utva(Lo„ )
4..b •
2, P vL
cw
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u
1
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FHUSIIED I RAIIE
An IC
Bit." 11116
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MAIN CD
PANEL
2
WO' ti IN ]10' 711
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SUB C 13
PANEL
A I
BY
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'I-Ic)pli•4
Conductor
• Conduit -
Con. -b
roof Y —_ P10
Gii wlr-c en- ----- •- -_ —_ --
HArH. DIS ONIIECT
Ra.11n0 24 ' 1"> AMPS
1.1�.. -�? nn
Sub Urg otters l A1•+N
•
•
PER S.F.II.C, 45(16.2(B)
r--• r . - ,— , . ,
•
r
a _
'
SUB FEEDER
New 1 X 511- Exls•un
•rY(�n Ito VID d '� 1J1 u;�rlt 6
size 71 a k)
Boni! �'LZa 14
Cl•NS [DE PANEL
Ratlnfl 12• A4.1.3s
land Bugs _1' _. _I.10
. Locc.-tkn_ _..
•
SIGNATURE of CO1ITRACTOR
• NOTARY "--- .— .-- •----- -- - - -- . - - - --
1 \/' I- 17)
2 maw
a
A
Date
Legal Description
Owner / Less»e /
Owner's Address
Contracting
Qualifier
Signature
Date:
Notary as
My Commiss
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Master Permit # 6/605 0
Phone — 1S — i
co. Address � 9 S - g /k214
S'9 X. .9? t
ss# [.( Phone
State # 006 / Municipal # Competency 46 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type one): BUILD 'CTRICA LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION .
/—
Square Ft. Estimated Cost(value) `fa.)
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 accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
owner and /or Condo President
ident
q %xE i esSARINA M HIRSCH •
2
\
'r n COMMUNION NUMNeR
CC714091
** * * MV*COMMISSION EXPIRE*
1 .2002 - .
FEES: PERMIT, e» '' RADON
Job Address 1 (DO (\ � � ` Tax Folio3zo6 V��"� /lcn
Tenant SlUk(0
* * *
C.C.P. 6i) NO
Signature of Contractor or Owner- Builder
Da
Notary as to Contractor or Owner- Builder
My Conrmi
O SP" 4/ L NOTARY SEAL
.B SAMNA M HIRSCH
n COMMIs/p0 NUVER
l'; 0714091
MY colu171Cro�NyEXPi;
**
Fire Other
Zoning - - Building Electrical
Mechanical Plumbing
Engineering
KUILDING ❑
:LECTRICAL
PERMIT N° 8164
PLUMBING ❑
GOOFING ❑
Jwner of
luilding
n rchitect
contractor
,r Builder
.egal
)escription
4ddress of
= uilding
Lot
te
0
MIAMI SHORES VILLAGE. FLORIDA
CONTRACTOR OR BUILDER
Work to be performed under this Permit r
Bl.
k �
4. Q14 }
Subdi-
vision
4 • � .,
Sq. Ft
Value of
Project $
DATF /G. 195 y"
Contractor's
License No
(
2
t . y
Amt. of ♦ --
Permit $ iu
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
ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
irawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime 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
7ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
,ertaining 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
lone by his agents, servants or employees. ./'
Signed• fc. 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
Owner of "7" r•, f�" `
Building t;,l _ .� - i _ ' i (. y <' f , t
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIA 11 SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL V PERMIT iN? 11627
PLUMBING ❑
ROOFING ❑ Work to be performed under this Permit
,% —h.- Value of
i i ' , ' ,, i i "i. ede Project $
This permit is granted to the contractor or builder n amed above to construct the building or to install the equipment or device sloongied in the application
herefor in strict compliance with all ordinances pertaining \thereto and with the understanding that the work will be performed iti ann.anee with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Petit Oy be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorisation. A further condition which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the and regulations
pertaining to the work covered hereby whether shown, on the plans or drawing,' or in the statements or specifications and that he `bility for work
done by his agents, servants or employees.
Signed; '' BY : ',
DATE
t'
Subdi-
vision'? I i Nor/rc A � �r r .!`i► "
11 Amt. of
Permit
INSPECTOR
In consideration of the issuance to me of this permit agree to perform the work covered hereunder in compliance with
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autho
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY
O
-
195
Contractor's
License No.
and regulations
Shores Village.
APPLICATION FOR ELECTRICAL PERMIT
Permit No It(°
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.
Registered Architect and /or ngineer
Employing Electrician's Nam
Owner's Name and Address
Location and Legal Description Lot Block Subdivision
9 �
72 . 92
State work to be performed and purpose of building Floors)..
f: ( Y ) lR,�° Jeep „G- (:........q.,.,F,a.- ..carat' �•'.4y�.u..,;.�'z. . – �x.,at..: ° -
•
New Building Remodeling Addition Repaifs No. of Stories
Street and Number where work is to be performed —No
Amount of Permit $ eCo (f
STATE OF FLORIDA, }
COUNTY OF DADE.
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No 6) T
(Signed)
Date.. –
.Street
(Signed) fl. !?4?*ir..
Street
Street
-x'
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Notary Public, State of Florida
1
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 L s 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 performed under this permit, as are
licensed by Miami Shores Village.
aster 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.
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.
SCACE
H ATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
M OTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
' `
J
/-.7,4
CHECK
APPLICATION FOR ELECTRICAL PERMIT
Permit No It(°
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.
Registered Architect and /or ngineer
Employing Electrician's Nam
Owner's Name and Address
Location and Legal Description Lot Block Subdivision
9 �
72 . 92
State work to be performed and purpose of building Floors)..
f: ( Y ) lR,�° Jeep „G- (:........q.,.,F,a.- ..carat' �•'.4y�.u..,;.�'z. . – �x.,at..: ° -
•
New Building Remodeling Addition Repaifs No. of Stories
Street and Number where work is to be performed —No
Amount of Permit $ eCo (f
STATE OF FLORIDA, }
COUNTY OF DADE.
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No 6) T
(Signed)
Date.. –
.Street
(Signed) fl. !?4?*ir..
Street
Street
-x'
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Notary Public, State of Florida
1
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 L s 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 performed under this permit, as are
licensed by Miami Shores Village.
aster 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.
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.
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No .. _l___GP Date — — /
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 riles and regulations of the Building Division
of Miami Shores Village shall be plied v ith, w,ether 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
Registered Architect and /or En er
Employing Electrician's Nam
1 , 4 *
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performe and purpose of building (By Floors)
New Building_ Remodeling .Addition Repairs
------
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. 1
ss.
MIAMI SHORES VILLAGE
No ■ftry Str s /C;
Conduit ,____Main Sw
Service Overhead Underground Size Feeders
Type of Installation— Conduit v Tubing
Block ,7
Street
(Signed)
/Ge
Metal Moulding
(Signed) < '
_Stree
Subdivision_
No of Stories__________________
Amps Main Fuses Amps
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 5066, 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 p osted for inspection on the site of the wo such public notice or notices
as are required by the Act. The undersigned agrees' to employ only such sub - contractors, on wo to be per timed under this permit, as are
licensed by Miami Shores Village.
fe_,,ALLe_
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 I when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
/
/ /�.
77
PLUG
RECEE''P'T'5
." ��
FIXTURES
NO. LAMPS
/
REFRIG.
OUTLET
/
IRON
OUTLET
RANGE
OUTLET
/
RANGE
CONN.
WATER
HEATER
*id
W. HEAT.
CONN.
• SO
SPACE
HEATER
'
STRIP
HEATER
/
v
/�
.
TOTAL
CONTR.
LIST
/ 7
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
'
CHECK
/ ;,,�.�
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No .. _l___GP Date — — /
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 riles and regulations of the Building Division
of Miami Shores Village shall be plied v ith, w,ether 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
Registered Architect and /or En er
Employing Electrician's Nam
1 , 4 *
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performe and purpose of building (By Floors)
New Building_ Remodeling .Addition Repairs
------
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. 1
ss.
MIAMI SHORES VILLAGE
No ■ftry Str s /C;
Conduit ,____Main Sw
Service Overhead Underground Size Feeders
Type of Installation— Conduit v Tubing
Block ,7
Street
(Signed)
/Ge
Metal Moulding
(Signed) < '
_Stree
Subdivision_
No of Stories__________________
Amps Main Fuses Amps
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 5066, 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 p osted for inspection on the site of the wo such public notice or notices
as are required by the Act. The undersigned agrees' to employ only such sub - contractors, on wo to be per timed under this permit, as are
licensed by Miami Shores Village.
fe_,,ALLe_
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 I when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
qq �•
Permit No.__ __!_'_____________ Date__- _- __._.._
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.
Owner's Name and Address
Registered Architect and /or Engipe¢r
J g,N - it_c•K
Employing Electrician's Name
APPLICATION FOR ELECTRICAL PERMIT
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
• emode�j g,.
Addition
Service Overhead Size Feeders_ Conduit._________ Main Sw.________^__ Amps. ___ Main Fuses____________________Amps.
Underground
Type of Inst tion— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit
The undersigned applicant for this building permit does hereby ce
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.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made when such
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No
6 Street .. �!� __ c�5?
No 47_S Street._A Q v b
Block
ADp _IONA L
pairs
d
(Signed)
Street N
Electrical Inspector.
•
rtify that he P nderstands and accepts his obi ' ions as an employer of labor
Compiled General Laws of Florida Perman nt 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
i� // • (Signed) — `_ = -- — /77"
Master Electrican.
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 be 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
No. of Stories.___________
re- inspection is made necessary by improper notice for inspection, or faulty
SNITCH
C}YTL•i1
LIGHT
FIXTURES
O.LIrMRS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
IST
IST
j
J
3
4
3
/
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
qq �•
Permit No.__ __!_'_____________ Date__- _- __._.._
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.
Owner's Name and Address
Registered Architect and /or Engipe¢r
J g,N - it_c•K
Employing Electrician's Name
APPLICATION FOR ELECTRICAL PERMIT
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
• emode�j g,.
Addition
Service Overhead Size Feeders_ Conduit._________ Main Sw.________^__ Amps. ___ Main Fuses____________________Amps.
Underground
Type of Inst tion— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit
The undersigned applicant for this building permit does hereby ce
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.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made when such
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No
6 Street .. �!� __ c�5?
No 47_S Street._A Q v b
Block
ADp _IONA L
pairs
d
(Signed)
Street N
Electrical Inspector.
•
rtify that he P nderstands and accepts his obi ' ions as an employer of labor
Compiled General Laws of Florida Perman nt 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
i� // • (Signed) — `_ = -- — /77"
Master Electrican.
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 be 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
No. of Stories.___________
re- inspection is made necessary by improper notice for inspection, or faulty