ELECTRICALr
BEING
ELECTRICAL
PLUMBING
ROOFING ❑
Architect
Conlr
or Builder
Legal
Descriptio
Addres
Building
This
herder in
rhea if the
granted is
Per
done by
MIAMI SHORES VILLAGE, "FLORIDA
fil PERMIT N? 9588
D
Contractor's
ine
Sane
5
Permit No �
building during progress of work.
Owner's Name and Address C .. " : L.' I 4/ i
Registered Architect and /or En inee
Employing Electrician's Name....
Location and Legal Description Lot
Street and Number where work is to be performed —No
SS.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date ..1
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
y�C
L €' jll 7
4-• . s!&' No
loglr �. Subdivis
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $ ° (Signed)
Conduit Main Sw..... �.. Amps Main Fuses Amps
Overhead
p' Service Underground Size Feeders./
' �'l ype of Installation— Conduit Tubing B.X.L Metal Moulding
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and ccepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General La 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 b performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Street
4s f
Street.y/
Street. ... k1. ..�c
./6/ /-
U Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
',l L�
d '/ ` /
e
CHECK
•
Permit No �
building during progress of work.
Owner's Name and Address C .. " : L.' I 4/ i
Registered Architect and /or En inee
Employing Electrician's Name....
Location and Legal Description Lot
Street and Number where work is to be performed —No
SS.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date ..1
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
y�C
L €' jll 7
4-• . s!&' No
loglr �. Subdivis
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $ ° (Signed)
Conduit Main Sw..... �.. Amps Main Fuses Amps
Overhead
p' Service Underground Size Feeders./
' �'l ype of Installation— Conduit Tubing B.X.L Metal Moulding
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and ccepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General La 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 b performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Street
4s f
Street.y/
Street. ... k1. ..�c
./6/ /-
U Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
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.