ELECTRICAL7
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL RMIT
Permit No. —
Date. ��
Application is hereby made for the approval of the detailed statement of the plans and s pa ,cations herewith submitted ®e rihe building or other
structure herein described. This application is made in compliance and conformity with Building Ordinance of Mia Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores V .ge and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. copy of a .td plane 'and specifications must be kept at
Ap lik .
____.._ Strect-A—g—f----
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name ... + 1.e.
Location and Legal Description Lot 1
Street and Number where work is to be performed —No
No.
Block..
State work to be performed and purpose of building (By Floors) __- _____ —___
New Building !''
Remodeling Addition
Service Overh ead i Size Feeders — / Conduit... y ft' Main Sw...- .2.g.— /Amps
Type of Installation — Conduit_ Tubing. 4 iB.X.L. Metal Moulding
Amount of Permit $ 0• 10
STATE OF FLORIDA,
COUNTY OF DADE. ss•
My Commission Expires
(Signed)
(Signed)
y ......_.... Street e
�_.. Subdivisio .o�+...ao.
S tre e t:...Yl. .....�,�.1
Repairs
No. of Stories —.- —
Main Fuses I O -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 cau.e to be posted for inspection on the site of the work such public notice or notices as act
required by the Act. The under signed agrees to employ only such sub- contractors, on o be rf• -.Fed ender permit, as we
licensed by Miami Shores Village.
e Blectrican.
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 be did sign the same, and that all faces
therein by him stated are true.
.- ......1.1.4.4.,. ... ................,_..
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa
materials and /or workmanship.
{
SWITCH
OUTLETS
LIGHT
OUTLETS ETS
/�
PLUG
RECE'P T's
=�;.
F IXTURES
NO, / LAMPS
,+°.
REPRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
/
RANGE
CONN.
WATER
HEATER
/
W. HEAT,
C
Vii
SPACE
H
STRE•
HEATER
•
TOTAL
//o4
CONTR.
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTOR$
1.3 HP
NEON
TRANS.
t;A41&O
TOTAL.
CONTR.
LIST
•}
CHECK
•
7
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL RMIT
Permit No. —
Date. ��
Application is hereby made for the approval of the detailed statement of the plans and s pa ,cations herewith submitted ®e rihe building or other
structure herein described. This application is made in compliance and conformity with Building Ordinance of Mia Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores V .ge and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. copy of a .td plane 'and specifications must be kept at
Ap lik .
____.._ Strect-A—g—f----
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name ... + 1.e.
Location and Legal Description Lot 1
Street and Number where work is to be performed —No
No.
Block..
State work to be performed and purpose of building (By Floors) __- _____ —___
New Building !''
Remodeling Addition
Service Overh ead i Size Feeders — / Conduit... y ft' Main Sw...- .2.g.— /Amps
Type of Installation — Conduit_ Tubing. 4 iB.X.L. Metal Moulding
Amount of Permit $ 0• 10
STATE OF FLORIDA,
COUNTY OF DADE. ss•
My Commission Expires
(Signed)
(Signed)
y ......_.... Street e
�_.. Subdivisio .o�+...ao.
S tre e t:...Yl. .....�,�.1
Repairs
No. of Stories —.- —
Main Fuses I O -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 cau.e to be posted for inspection on the site of the work such public notice or notices as act
required by the Act. The under signed agrees to employ only such sub- contractors, on o be rf• -.Fed ender permit, as we
licensed by Miami Shores Village.
e Blectrican.
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 be did sign the same, and that all faces
therein by him stated are true.
.- ......1.1.4.4.,. ... ................,_..
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 fa
materials and /or workmanship.
{
IJ
i/ %.{' %
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Archite
Contractor A � E4G,
or Builder
Legal Lot
Description
•
.ONTRACTOTOR'Bt YLD R
PERMIT 'N? 58i8
Work to be performed under this Permit
Varisti7
�o
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
_ y r
DATE 7 ' / 19
4 . 1 7)
Contractor's
License No
Address of • Value of I I Amt. o
Building I�/ _./ Project Perm
This permit is granted to the con ct or builder named above to construct the building or to install the equipment or deviee described in: the ap _.
cation 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 maybe 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 o y for through l otfi�l gC ci f the Ordinances and
whether own eh. the plans or drawings or in � :•:;: .X sr spe ' ications . he assumes respon-
sibility
Sighed • r ^ r
INSFE1
In consideration of the issuance to me of this permit 1 agree to perform the work covered hereon er in-compliance wi
pertaining thereto and in strict conformity with the plans, drawings, statements er specifications submitted to the proper auth!
In acceptin his permit I assume responsibility for all work done by ei er myself, agent, or employee.
B