ELECTRICALPERM-IT APPLICATION FOR MIAMI SHORES VILLAGE
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Date; . r 7Job Address / £ a /, > x ` Tax Folio
Legal Description Historically Designated: Yes No \
/ Tenant /OA u E A .,L.JC 2 V M + Master Permit # 'Y /p b/
Owner's Address /0,) CE. C(9 )-L! ` �6Res3'3):3'Phone I-- j--- 7Sg- - lie I n
Contractin Co. e_ 6 �-eru �- ,(4,4 AJ Address / / `7 P. 1 s l P. /-& .1J .
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Qualifier RU6.0 i SS# , / - Phone 5. / 41 a4 ( , 33l
5u °-r
Z # illy °; 2 �Ins. Co.
State #
OWNER'S AFF D VIT
laws regulating
. •Jor Condo President Date
At OLeLi f7
Not as to Owner and/or C • do President
My Commission Expires: I1 /i f/ 2.000
o' •••.•-•
"OFFICIAL SEAL"
: = Rev. Jose Alberto Borbon
iiio , .e`, My Commission Expires 11111 /2000
U
Commission #CC 600350
FEES: PERMIT ,51 RADON
Z5Municipal #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICATPLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTIOl e . n� C R�x�l'l ra I� J C ' _ S C aTnw �-- p7��- i,w6) J7, 1 faR sal
( kw - Kw.j ZZ` cc��
Square Ft. Estimated Cost (value) (9
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.
s tion an
/ that all the foregoing information is accurate and that all work will be done in compliance with all applicable
onmg. Furthermore, I authorize the above -named contractor to do the work stated.
C.C.F.
Building
Signature of Contractor or per- Builder
N ary as to Contractor or 0 er- Builder D to
y Commissi ` " -y e,.. // "OF FICIAL SEAL
. k ' a ,,
',; *= R ev. Jose Alberto Borbon
41 My Commission Expires 1111112000
- , �f •FO f� °p� Commission #CC 600350
NOTARY
Electrical
oD
BOND
Date
TOTAL DUE
APPROVED:
Zoning
Mechanical Plumbing Engineering
Permit No
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
STATE OP FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
14:5-/ 7 Date /1 - - 13'"
55.
No
Amount of Permit $ / °t ° 1 (Signed)..
/fl
. Registered Architect and /or Engineer
. ' mploying Electrician's Named No / 9
l cation and Legal Description Lot Block Subdivision
t reet and Number where work is to be performed —No Street
The undersigned applicant for this building permit does hereby certify that he understands and
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General La
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 subcontractors, on work to
licensed by Miami Shores Village.
Street..
Street 1 Y k/ f ../
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 —Cop uit Tubing B.X.L Metal Moulding
Electrical Inspector.
pts his obligations as an employer of
of Plorida Permanent Supplement, and
sub-contractors 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 facts
therein by him stated are true.
My Commission Expires Notary Public, State of Plorida
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'7'S
FIXTURES
NO. LAMPS
REPRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
M
H TER
STRIP
HEATER
TOTAL
CONTR.
CHECK
ENT.
SW.
T
DIST.
GAB.
SERVICE
TEMP.
SERVICE
PERM.
/.
� �If ��
�y��1 TO
�/ 01 e HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
-' /
'
/_
3
CHECK
_
Permit No
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
STATE OP FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
14:5-/ 7 Date /1 - - 13'"
55.
No
Amount of Permit $ / °t ° 1 (Signed)..
/fl
. Registered Architect and /or Engineer
. ' mploying Electrician's Named No / 9
l cation and Legal Description Lot Block Subdivision
t reet and Number where work is to be performed —No Street
The undersigned applicant for this building permit does hereby certify that he understands and
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General La
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 subcontractors, on work to
licensed by Miami Shores Village.
Street..
Street 1 Y k/ f ../
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 —Cop uit Tubing B.X.L Metal Moulding
Electrical Inspector.
pts his obligations as an employer of
of Plorida Permanent Supplement, and
sub-contractors 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 facts
therein by him stated are true.
My Commission Expires Notary Public, State of Plorida
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.
BUILD
ELECTRICAL
PLUMBING
Owner of
Building ij 4.t-._ a1 �` -/ •
Architect
Contractor
or Builder
Legal Lot
Description
Address of AA �
Building GN' F.
time if the work is not done in compliance with such ordinances or if t
granted is the understanding that the contractor or builder named abov
pertaining to the work covered hereby whether shown on the plans or d
done by his agents, servants or employees.
Signed:
In consideration of the issuance to me of this permit I agree t
pertaining thereto and in strict conformity with the plans, drawings, stat
In ac e ting this pemit - \su responsibility for all work done by eit
11
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORID
PERMIT N° 9972
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATE
on
state
Contractor's
License No
12: L‘1,k BY <1
Amt. of
Permit
195a
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
plans are changed without authorization. A further condition upon which this permit is
assumes the rep flit for a thorough knowledge of the ordinances and regulations
wings, or in t ,' il4ts or specificatio and that he assumes responsibility for work
INSPECTOR
rm the work covered hereunder in compliance with all ordinances and regulations
is or specifications submitted to the proper authorities of Miami Shores Village.
myself, my agent, servant or employee.
AUTHORITY
i
/7 w Building
Service Underground Size Feeders 1 Conduit
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT /
APPLICATION FOR .ELECTRICAL PERMIT
Permit No Date 3 - 3-6
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 / '.r ,
Registered Architect and /or fi r �Q
Employing Electrician's Name.. i ./.. -? No ? / Street.
Location mid Legal Description Lot Block
No ® Street
Type of �tallation— Conduit Tubin� B.X.L A Metal Moulding
d �� �j c n(.. / i l-, n �, % ^ c
6
Amount of Permit $ 1
The undersigned applicant for this building permit does hereby certify that he
labor under the Florida Workmen's Compensation Act, being Section 5966, Comp'
has complied with the provisions thereof, and will require similar compliance fro
work to be performed under this permit; and will post or cause to be posted for i
as are required by the Act. The undersigned agrees to employ only such sub-cont
licensed by Miami Shores Village.
(Sign
/ Subdivision
2, Street and Number where work is to be performed —No Street
i S.tate work to be performed and purpose of building (By Floors)
Remodeling Addition
Repairs No. of Stories
Main Sw hit Amps Main Fuses Amps
Electrical Inspep(or.
u stands and accepts his obligations as an a ployer of
ed General Laws of Florida Permanent Supplement, and
all contractors or subcontractors employed by him in the
spection on the site of the work such public notice or vices
actors, on work to 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 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
REC S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
--- ���F� -- -
IC'J
CHECK
2,
'
•
ENT.
SW.
DIBT:SERVICE
CAB. TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
•
TOTAL
CONTR.
LIST
/
/
i.
CHECK
Ir
1 C
/O
i
/7 w Building
Service Underground Size Feeders 1 Conduit
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT /
APPLICATION FOR .ELECTRICAL PERMIT
Permit No Date 3 - 3-6
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 / '.r ,
Registered Architect and /or fi r �Q
Employing Electrician's Name.. i ./.. -? No ? / Street.
Location mid Legal Description Lot Block
No ® Street
Type of �tallation— Conduit Tubin� B.X.L A Metal Moulding
d �� �j c n(.. / i l-, n �, % ^ c
6
Amount of Permit $ 1
The undersigned applicant for this building permit does hereby certify that he
labor under the Florida Workmen's Compensation Act, being Section 5966, Comp'
has complied with the provisions thereof, and will require similar compliance fro
work to be performed under this permit; and will post or cause to be posted for i
as are required by the Act. The undersigned agrees to employ only such sub-cont
licensed by Miami Shores Village.
(Sign
/ Subdivision
2, Street and Number where work is to be performed —No Street
i S.tate work to be performed and purpose of building (By Floors)
Remodeling Addition
Repairs No. of Stories
Main Sw hit Amps Main Fuses Amps
Electrical Inspep(or.
u stands and accepts his obligations as an a ployer of
ed General Laws of Florida Permanent Supplement, and
all contractors or subcontractors employed by him in the
spection on the site of the work such public notice or vices
actors, on work to 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 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
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
,Building
Lot
MIAMI SHORES VILLAGE, FLORIDA,
DATE Y -, f '' ' 195 )
ki PERMIT N° 9972
Contractor's
License No
CONTRACTOR OR BUILDER
Work to be performed under this Permit
Bl.
Subdi-
vision
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 re ponsibility 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
FLOORS
F XTURES ONLY
NUMBER OF
TOTAL
OUTLETS
SIZE OF
SIZE SERVICE
CONDUIT
NO.
CIRCUITS
LIGHTS
CEILING
BRACKETS
MAINS
BUBO
BRANCHES
BASEMENT
FIRST
SECOND
THIRD
.
FOURTH
•
'
Form 246
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION ALL SPACES MUST BE FILLED OR APPLICATION
WILL BE RETURNED.
/0-14/1
LOT NUMBER
STREET AND N BER
OWNER
OCCUPIED As
LIGHTS
CEILING
KIND OF INSTALLATION
REMARKS OW' '�( T
CONTRACTOR
BY
RECEIVED BY INSPECTOR
PROGRESS
WILL INSPECT AGAIN
DATE ..V 193....
ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI
Desiring your Certificate of Approval, application is hereby made for an inspection of
the electric installation in the premises stated below, for which undersigned agrees to correct
any infractions of the National Electrical Code and the City Ordinance pointed out by Inspector.
BLOCK NUMBER
ll 7
BUILDING — NEW OR OLD (UNDERLINE WHICH) WORK — ADDITIONAL, NEW, ALTERATION OR REPAIR.
H. P. OF EACH MOTOR VOLTS TOTAL AMPS PHASF
BRACKETS
f //
f
ROUGH WIRING
FINAL/P /0
No (� `y
CORRECTED
TEMPORARY
DATE ISSUED
DAYS.
RECEPTACLES
OPEN OR CONCEALED KNOB, RX., BX., MLDG. CONDUIT
/
SPACE BELOW FOR INSPECTOR'S USE ONLY
REMARKS
FEE REMITTED
APPLICATION
I !
s
SWITCHES
t I
SIVISION
Sr
OCCUPANT
SPECIFICATIONS
STOVES
INSPECTION WANTED
ADDRESS
INSPECTED_
SIDF
WATER HEATERS
No. 3D5 7
SIGNS
OTHER APPARATUS
INSPECTOR