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ELECTRICAL
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE D a t e S 3 -00 J o b Address In) ev /It St Tax Folio 1) 320 r o (5' O.Z.q o Legal Description PIS 1 i , ! Historically Designated: Yes No /` Owner/I essee / Tenant C) C - 1 -- Master Permit # 4 7 1 ' 74 r Owner's Address l 07 N Z R S i' Contracting Co. M Y ? ' St-_ c ug t - 7y S v+ ctg Qualifier CA-i/t'Ld1V; 14 i L1 State # OOP c (69 Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION L if &LI 1!/rL7 Z B c/ R-4 C4/v'72c7 L Square Ft Estimated Cost (value) 1' ZOo- O c 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 MEC • NICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and tha ork will be done in compliance with all applicable laws regulatin: f onstru tion and zoning. Furthermore, I authorize the above -named co ctor to do the work stated. Signature •f o er and/or Condo President b ate R. A. CHIN My Comm Exp. 5/25/2003 NOTAA PUBLIC •' • 'l e[t or,. I.D. Notary as to 0 My Commission xp Cyjo 02 slr /9 f FEES: PERMIT _3" O RADON ss# Phone 63 300) &3 67 Competency # Ins. Co. Address Address Signature o Contractor or Owner - Builder Notary as to C My Commissi C.C.F. ' 0 NOTARY APPROVED: Zoning Building Electrical Mechanical Phone a p t 7 5 1 - b If-O Address 7 Al t../ Lf-8S7 °X / o Date TOTAL DUE j v Plumbing Engineering BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building PERMIT x9 0 Architect or Buililder r r I\ M A J 1� or Bude Legal Lot Description CONTRACTOR 011 BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE " 3 --6) 1' 4 #RI y� Bl. Signed. 5672 Work to be performed under this Permit E L 1 = ie 1b `540 1� . t .1 • £ , Gontifacto>i s t� License o. Subdi- vision Address of Value of of Building : • Project 11 Am Permit ount 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 tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed ie • compliance with plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be rental at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further eondidon upon'Whit6 s permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the oed'ro*it e mid regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he asaumet Pdaqta- sibility for work done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in complianc' tth all ordinances and pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. BY AUTHORITY „■,,, Permit No STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 Mrs. Calloway No 1077 N.E.984treet Street Registered Architect and /or Engineer._ - Employing Electrician's Name Frank Schafer Inc. N 1036 N. W. 54 &h Streeti Location and Legal Description Lot....1.0771... N. ..E...98.0.. .S.fi.rae..11lock Subdivision Street and Number where work is to be performed —No sam Street State work to be performed and purpose of building (By Floors) New Building Remodeling XX Additiun 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 � n Amount of Permit $ © (Signed) tl` S '--~— 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 subcontractors 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 w rk to, performed under this p c if, as are licensed by Miami Shores Village. (Signed) Date Sept. 1, 1964 ast.' E ctrician. 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. $WITCH 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 4 3 2 c 3 1 , CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 Mrs. Calloway No 1077 N.E.984treet Street Registered Architect and /or Engineer._ - Employing Electrician's Name Frank Schafer Inc. N 1036 N. W. 54 &h Streeti Location and Legal Description Lot....1.0771... N. ..E...98.0.. .S.fi.rae..11lock Subdivision Street and Number where work is to be performed —No sam Street State work to be performed and purpose of building (By Floors) New Building Remodeling XX Additiun 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 � n Amount of Permit $ © (Signed) tl` S '--~— 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 subcontractors 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 w rk to, performed under this p c if, as are licensed by Miami Shores Village. (Signed) Date Sept. 1, 1964 ast.' E ctrician. 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. Permit No '2.1 3 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PER T 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 En i Employing Electrician's Name. :I � II L9 L"ele/c,., No. 7i2.— C 7 / Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No /0 7 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Service Overhead Size Feeders Conduit Underground Type of Installation— Conduit Tubing Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. frf SS. Date No 0 7 7 Street Street /5Z/ Repairs No. of Stories Main Sw Amps Main Fuses Amps B.X.L Metal Moulding (Signed) (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accept labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or sub work to be performed under this permit; and will post or cause to be posted for inspection on the site of l .Electrical )ns ector. s his o 7igations as an employer of Florid / Permanent Supplement, and actors employed by him in the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to byperformed under this permit, as are licensed by Miami Shores Village. Muter Electrician. r- 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 rein pection 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. ACE H ATER STRIP HEATER TOTAL / 1 / > _ CONTR. L187 / CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No '2.1 3 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PER T 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 En i Employing Electrician's Name. :I � II L9 L"ele/c,., No. 7i2.— C 7 / Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No /0 7 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Service Overhead Size Feeders Conduit Underground Type of Installation— Conduit Tubing Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. frf SS. Date No 0 7 7 Street Street /5Z/ Repairs No. of Stories Main Sw Amps Main Fuses Amps B.X.L Metal Moulding (Signed) (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accept labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of has complied with the provisions thereof, and will require similar compliance from all contractors or sub work to be performed under this permit; and will post or cause to be posted for inspection on the site of l .Electrical )ns ector. s his o 7igations as an employer of Florid / Permanent Supplement, and actors employed by him in the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to byperformed under this permit, as are licensed by Miami Shores Village. Muter Electrician. r- 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 rein pection 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 // MIAMI SHORES VILLAGE ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date /-- A .5 — 5— 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 Mi.smi 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 — t'e- �..�G.�.S../ No / � 7 7 Street Std ' � Registered Architect and /or Engineer Employing Electrician's Name-- ..!' �_ }. � 1- je etx- ftee...... • -- .No r �1... ... Street- - e5 L Location and Legal Description Lot Block Street and Number where work is to be performed—No.../e, 7 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street. Subdivis 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 S C''" 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. (Signed) (Signed) 20. "2. gs.,k) 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 facto 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. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST / CHECK Permit No // MIAMI SHORES VILLAGE ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date /-- A .5 — 5— 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 Mi.smi 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 — t'e- �..�G.�.S../ No / � 7 7 Street Std ' � Registered Architect and /or Engineer Employing Electrician's Name-- ..!' �_ }. � 1- je etx- ftee...... • -- .No r �1... ... Street- - e5 L Location and Legal Description Lot Block Street and Number where work is to be performed—No.../e, 7 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street. Subdivis 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 S C''" 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. (Signed) (Signed) 20. "2. gs.,k) 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 facto 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. . , Ott lit A $. OF ' : ! K Z § \\ .. o • �� ©:...� » s a E NOffi and A d eon en ag eotiic7�s wat O : Pew The undersigned later under the Florida emend with the to, b4 PinfOOR winked by ed y Miami ' TE OF FLORIDA, TY OFD D: Uwe ERS, 0 [ ? APPLICATION FOR ELECTRICAL PERMIT Permit No 4 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....p� ?�!lr'� Registered Architect and /or Engineer e.„6,41- Employing Electrician's Name �� j�!� Service Overhead Size Feeders Underground STATE OF FLORIDA, } COUNTY OF DADE. Amount of Permit $ SE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Type of I t lation Conduit Tubing B.X.L • , re 01,47i (Signed) No /0 7,7 Street.? ".e rfG'!!. No 97a/ Street '14 i • Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No. Q/ 1401...b4/P Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Conduit Main Sw Amps Main Fuses Amps (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 subcontractors 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 sub - contractors, on work to be , performed 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 REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK APPLICATION FOR ELECTRICAL PERMIT Permit No 4 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....p� ?�!lr'� Registered Architect and /or Engineer e.„6,41- Employing Electrician's Name �� j�!� Service Overhead Size Feeders Underground STATE OF FLORIDA, } COUNTY OF DADE. Amount of Permit $ SE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Type of I t lation Conduit Tubing B.X.L • , re 01,47i (Signed) No /0 7,7 Street.? ".e rfG'!!. No 97a/ Street '14 i • Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No. Q/ 1401...b4/P Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Conduit Main Sw Amps Main Fuses Amps (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 subcontractors 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 sub - contractors, on work to be , performed 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.