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790 NE 96 St (8)Date Job Address 7 9e7 . A/2: ' 6 S % Tax Folio i,7 l ' C,/ . ab d Legal Description )41/7,,,,, Historically Designated: Yes No /� Owner/Lessee / Tenant , 1v v ! C �SSOJ, ' b ; 9 l6 c 1---c - Master Permit # le.nq Owner's Address 7 0 /V r' /c- 6 7 Contracting Co. 4 t i i ." • j� "A I Addressc> - K . ,"� ,/ .d /__<: Qualifier W - a l , 6C / 0 . SS #4,24 - % 2 7 - ' Phone -Cr, State # - Atfl> 9W Municipal # PERMIT APPLICATION FOR MIAMI S Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING LE�Y L LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTI Square Ft. Estimated Cost (value) RES VILLAGE Phone 3 .) 9 S/ `f„2 5, 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 • ,' zoning. Furthermore, I authorize the above -named con' . ctor to do the work stated. 0 Signature of owner and/or JU ,•T ORES SION # CC 550034 . une 4, 2000 il °"- Signature Notary My Commission Expires FEES: PERMIT S RADON C.C.F. ' 6v NOTARY APPROVED: Zoning Building Electrical Mechanical Plumbing BOND Date Date n 6 TOTAL DUE t✓ Engineering C t 1 . . / / • fr / - , 7., .("' 2 .'`; • • , • Function Public Serj'ice lage maintenance departments, asanagement the cost of rounding public buildings. clude: -street tree trimming, i s' planting new areas and in tamed and clean. Equipment ation wagon, two pick4up, truck an pith water tk_'arid two other of Public Services is shown in go of the streets and waste vers ton holpers and twe artment. When other maintenance nest'or vacations personnel from .-k of the more important sans— ;:: r N •• 8• MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J G Permit No .. _ s 1 Application is hereby made for the approval of the detailed statement of the plans and specifications f'ewith s pitted for the building o: other structure herein described. This application is made in compliance and conformity with the Building •rdinance of Miami Shores Village, Fioada, 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 -9. ..., .. Registered Architect and /or Engineer {/ / � ' y Employing Electriciafi's Name..... e..s.. i. .. e e No. //70 • Street... . 4.2 ... Location and Legal Description f o f Block Subdivision. • (Signed) (Signed)..' Date. No 9 O Street. 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.. 9� Y/ � �,.....tio. of Stories / Service Overhead Site Feeders Condit?.. Main Sw Amps Main Fuses . Amps Underground Type of Installation Conduit .Tubing.... ... B.X.L Metal Moulding Amount of ermu l; T ..... .._.... The undersigned applicant for this budding permit does hereby certify that he understands and accepts his o gations 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•cont mctors 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 perfornteder this permit, as arr licensed by Miami Shores Village. Electrical Inspector. Master Electrician. STATE OF A LORIDA, COUNTY OF DADE. 85. 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 the 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 oign 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 w + :en such re•inspection is made necessaty by improper notice for inspection, or faulty materials and/or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE P r'S FIXTURES NO LAMPS REPRI3. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHICK ENT. SW. I .24 V iL SERVICE TEMP. SERVICE PERM. f MOTORS 0.1 HP MOTORS 1•5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J G Permit No .. _ s 1 Application is hereby made for the approval of the detailed statement of the plans and specifications f'ewith s pitted for the building o: other structure herein described. This application is made in compliance and conformity with the Building •rdinance of Miami Shores Village, Fioada, 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 -9. ..., .. Registered Architect and /or Engineer {/ / � ' y Employing Electriciafi's Name..... e..s.. i. .. e e No. //70 • Street... . 4.2 ... Location and Legal Description f o f Block Subdivision. • (Signed) (Signed)..' Date. No 9 O Street. 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.. 9� Y/ � �,.....tio. of Stories / Service Overhead Site Feeders Condit?.. Main Sw Amps Main Fuses . Amps Underground Type of Installation Conduit .Tubing.... ... B.X.L Metal Moulding Amount of ermu l; T ..... .._.... The undersigned applicant for this budding permit does hereby certify that he understands and accepts his o gations 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•cont mctors 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 perfornteder this permit, as arr licensed by Miami Shores Village. Electrical Inspector. Master Electrician. STATE OF A LORIDA, COUNTY OF DADE. 85. 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 the 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 oign 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 w + :en such re•inspection is made necessaty by improper notice for inspection, or faulty materials and/or workmanship. BUILDING ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA DAT PERMIT N° 2137 Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building 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 ass pek the responsibility for a thorough knowledge of the ordinances and regulations pertaining o the work covered hereby whether shown on the plans or drawly/or t -let -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 la. tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami S ores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. . CONTRACTOR OR BUILDER BY Gv — Subdi- vision Value of Project Contractor's License No. Amt. of " '" „ cs Permit f. 9 ►VTHORM e 1944 (i -DING ECTRICAL -)PLUMBING 1" Owner of Building MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N° 2067 Work to be performed under this Permit CONTRACTOR OR BUILDER BY Subdi- vision Contractor's License No. Architect Contractor or Builder Legal Lot BI. Description Address of Building 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 tray., 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 - upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough kpowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans q,:dsawfflgs or in the atatements.or specifications and that he assumes responsibility for work done by his agents, servants or employees. t f INSPECTOR By Signed. NSPE TO Signed: By Value of Project In consideration of the issuance to me of this permit I agree to perform the - work covered hereunder in compliance with all ordinances and regula- tions 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. Amt. of Permit AUTHORITY 194 / APPLICATION FOR ELECTRICAL PERMIT Permit No. / - - -- ------ - - - - -- Date / _ i 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. Amount of Permit $_ STATE OF FLORIDA, COUNTY OF DADE. Bs. 1._ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Owner's Name and Address ___._`- No Street Registered Architect and /or Engineer Employing Electrician's Name No Street 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___ - Service Overhead Size Feeders Conduit Main Sw. Amps. Main Fuses Amps. Underground 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 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. (Signed) 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 No. of Stories Master Electrican. 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 H EATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST t` '( CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK APPLICATION FOR ELECTRICAL PERMIT Permit No. / - - -- ------ - - - - -- Date / _ i 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. Amount of Permit $_ STATE OF FLORIDA, COUNTY OF DADE. Bs. 1._ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Owner's Name and Address ___._`- No Street Registered Architect and /or Engineer Employing Electrician's Name No Street 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___ - Service Overhead Size Feeders Conduit Main Sw. Amps. Main Fuses Amps. Underground 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 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. (Signed) 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 No. of Stories Master Electrican. 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. Permit No. Application is hereby mafde for the approval of the detailed statement of the plans and specifications herewith sub itted 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 specifie 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 Engineer Employing Electrician's Name 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 Remodeling____. Addition___. Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. APPLICATION FOR ELECTRICAL PERMIT 8s. 1 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT No No Street Block �._ Street Repairs Date Subdivision Street My Commission Expires Notary Public, State of Florida No. of Stories / �• - 7 7 T (Signed) f � , , ,;(/ s Electrical Inspector. Master Electrican. • Service Overhead Size Feeders. Conduit Main Sw. Amps. Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding The undersigned applicant for this building permit does hereby certify that hwunderstands 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 ynder this permit, as are licensed by Miami Shores Village. u ; (Signed) - 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. 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 H EATER STRIP HEATER TOTAL CONTR. LIST CHECK E NT. SW. DIST. CAB. SERVICE TEMP. SERVICE PER MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST 1 L ' CHECK Permit No. Application is hereby mafde for the approval of the detailed statement of the plans and specifications herewith sub itted 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 specifie 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 Engineer Employing Electrician's Name 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 Remodeling____. Addition___. Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. APPLICATION FOR ELECTRICAL PERMIT 8s. 1 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT No No Street Block �._ Street Repairs Date Subdivision Street My Commission Expires Notary Public, State of Florida No. of Stories / �• - 7 7 T (Signed) f � , , ,;(/ s Electrical Inspector. Master Electrican. • Service Overhead Size Feeders. Conduit Main Sw. Amps. Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding The undersigned applicant for this building permit does hereby certify that hwunderstands 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 ynder this permit, as are licensed by Miami Shores Village. u ; (Signed) - 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. 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. Permit No._ 7/ ____ Service Overhead Size Feeders / Underground MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Amount of Permit $ (Signed) ss. My Commission Expires No Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) 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 y5ith, whither herein s. led 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 Engineer Employing Electrician's Name ` ! L � No Location and Legal Description Lot 1 _ '# Block \ j ____ 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 Street Notary Public, State of Florida Street.. Conduit .—Main Sw. 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 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. 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 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. 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 J1 PLUG RECE'P'T'S FIXTURES NO.LAMPS 2 REFRIG. OUTLET IRON OUTLET � RANGE OUTLET -�- RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. sT LIST / /� J CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No._ 7/ ____ Service Overhead Size Feeders / Underground MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Amount of Permit $ (Signed) ss. My Commission Expires No Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) 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 y5ith, whither herein s. led 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 Engineer Employing Electrician's Name ` ! L � No Location and Legal Description Lot 1 _ '# Block \ j ____ 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 Street Notary Public, State of Florida Street.. Conduit .—Main Sw. 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 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. 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 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. 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. JOB: BUILDING • • • • • • Inspector's Report: ELECTRICAL : 1 /' : WORK PLUMBING • : DONE BY: : REQUESTED ! f 1 • • • • if7.1- -it • • • • • • The following is ready for Inspection: , 77a /de fG • • • . • • • WILL BE READY JOB: BUILDING PLUMBING • . ELECTRICAL : • • • • The following is ready for Inspection: - Inspectors Report: : WORK : DONE BY: • REQUESTED : WILL BE READY • • • • • • • • • • • • • • • • • • • • . • • • • • J ) JOB : L.- 't .. ;a*.► BUILDING ELECTRICAL PLUMBING Inspector's Report: • • • • • • • • • • • • AD: WORK DONE BY: : REQUEST? The following is ready for Inspection: : WILL BE READY •. • • • • • • • • • • • '-r Registered Architect and /or Engineer Employing Electrician's Name APPLICATION FOR ELECTRICAL PERMIT Permit No. �'��__`�_,l Date Application is hereby de for the approval of the detailed statement of the plans and specifications herewith sub itted 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 t h, whether herein speeifi or not. A copy of approved plans and specifications must be kept at building during progress of work. ) Owner's Name and Address No Street No Street Location and Legal Description Lot / f Block ,o. Subdivision and Number where work is to be performed —No { Street _ ti.— 4_:_: 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 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that h nderstands 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, op- work to be performed yhder this permit, as are licensed by Miami Shores Village. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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. 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. CAS. SERVICE TEMP. SERVICE PER MOTORS 0-1 HP MOTORS 1 -a HP NEON TRANS. RADIO TOTAL CONTR. LIST J CHECK Registered Architect and /or Engineer Employing Electrician's Name APPLICATION FOR ELECTRICAL PERMIT Permit No. �'��__`�_,l Date Application is hereby de for the approval of the detailed statement of the plans and specifications herewith sub itted 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 t h, whether herein speeifi or not. A copy of approved plans and specifications must be kept at building during progress of work. ) Owner's Name and Address No Street No Street Location and Legal Description Lot / f Block ,o. Subdivision and Number where work is to be performed —No { Street _ ti.— 4_:_: 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 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that h nderstands 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, op- work to be performed yhder this permit, as are licensed by Miami Shores Village. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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.