ELECTRICALDate Job Address I ( W. ` Tax Folio t ( 31- 01 • P) SO
Legal Description
/:Lessee / Tenant 1; SE V frIA N Master Permit I
Owner's Address I) (_p) ratio
Phone 761 - 1)r)9D
Address 1 Dna PC)l! L h O f/ e /1Ci
Qualifier,�CY�p� Q ) R / ) ( . ss # Phone (o L/— 77 70
State 01' // Municipal 0 Competency 11 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one):. BUILDING(ECTRIC PLUMBING MECHANICAL ROOPING PAVING PENCE SIGN
WORK DESCRIPTIOP /L) /)L Q J
l - C. ') a
Square Ft. Estimated Cost(value)
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 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.._
Contracting Co. M
OWN " 'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be ••.e in compliance with all applicable laws regulating construction a zoning. Furthermore, I
aut • 'ze the above -named contractor to do the work stated.
Signature of owner and /or Condo Preside
Date:
Notary as to Owner
My Commission Expi
APPROVED:
:PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Y03/99
onded By Service In
No. CC431261
inter +uw. fi'Mh' 1 2.
Signature
Date:
a-
of Cpn'tractor `o '�IC`ta`'t�.e 4 11de
,,
• ,; • y EXPIRES: C� 9�11SSICN # CC 383081
4 - a , Ju 14, 1998
Aj . Bo e4 Ng btic Unden. ders
iris lia 4
Notary as to Con ra for or
My Commission Expires:
* * *
Builder
**
FEES: PERMIT 5 /C' RADON C.C.F. NOTARY TOTAL DUE
Fire Other
Zoning Building Electrical
Mechanical Plumbing Engineering
I UILDING
LECTRICAL
LUMBING
Work to be performed under this Permit
iwner of f o
wilding' r ti ./G.-
� _-
rchitect
ontractbr 1 / , Ct. (
r Builder
.egal Lot
description
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 8513
Bl.
Subdi-
vision
DATE �,- :, � / a'
Contractor's
License No.
_ ddreSS of / j } r w. "� Value of Arnt of"
uilding 1 / (. � f _i Project Permit `'
This permit is granted to the contractor or udder named above to construct the building or to install the equipment or device described in the appli-
=tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
laps, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
any tilne 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
ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
�ru1ations pertaining to the work covered hereby whether shown on the plans or drawintCS or in the stici ents or specifications and that he assumes respon-
bility for work done by his agents, servants or employees.
Signed: 1 f , ' . �t r'''' . Li i By
INSPECTOR t�
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all o ces and regulations
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of iami Shores Village.
1 accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. . - ..
CONTRACTOR OR BUILDER BY AUTHORITY
194
CY 3 S
SWITCH L
LIGHT P
PLUG F
FIXTURES R
REFRIG. I
IRON R
RANGE R
RANGE W
WATER W
W. HEAT. S
SPACE S
STRIP T
TOTAL
C OLIST NTR. -
-Tv /
/ �
�
cut. t
t- -- 6
6 °S `
` _ - -
ENT. D
DIST. S
SERVICE S
SERVICE M
MOTORS M
MOTORS N
NEON R
RADIO T
TOTAL
J CONTR.
LIST /
/ •
•■
CHECK ) -- /
/ -_," 0 /
/ 7
75t
36/s1 ew Building b Remodeling_
2 --
V
7
/F .
Permit
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
/ 74
j am_ C �
MIAMI SHORES VILLAGE
Addition
•
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMI
CDC
Date ---_---- ......
.L
Application is hereby made for the approval of the detailed statement o f 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.
/t C
3 Li t.71 Street__
Owner's Name and Address ,�_
Registered Architect and /or Engineer ___________ ___ _____ ________
a _� .. ,
Employing Electrician's Name - --4 C__ S1 1L__- - 1: t-'._------ _--- ------ -- •--------- ____No r Street _f
I I _ti
Location and Legal Description Lot __ _ __ _______ Block_____:_____ Subdivision
Street and Number where work is to be performed—No-1 ' , x Street __
S R State work to be performed and purpose of building (By Floors)
Repairs No. of Stories —
Service Overhead ✓ Underground A __ Size Feeders_ T Conduit__,— :.;___Main Sw. mps Main Fuses
Type of Installation—Conduit .......... _______Tubing B.X.L. .___.______ Moulding__
f
< _ 0
Amount of Permit $ t - - — - -- -- (Signed)- - - — �-f — ---
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.
e -/ ) f
(Signed)._ < r i' 1 i 1
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
rnaterials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBItIG
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA r ,
DATE ; ,31. K
J
Contractor's
License No
PERMIT N° 8237
Work to
erformed under this Permit
.�
C:9)
' 9 Bl. ��
1 �' � Col
Subdi-
vision
crt
ermit is granted to the contractor or builder named above to c�truct the building Address
Building
This p g g t o
cation herefor in strict compliance with all ordinances pertaining thereto and with the understandin
plans, drawings, statements or specifications that may have been submitted to and ap
at any time if the work is not done in compliance with such ordinances or if the plan
permit is granted is the understanding that the contractor or builder named above as
regulations pertaining to the work covered hereby whether shown on the plans or
sibility for work done by his agents, servants or employees.
Sign
In consideration of the issuance to me of this permit I agree to
pertaining thereto and in strict conformity with the plans, drawings,
In accepting this permit I assume responsibility for all work done b
;
/
CONTRACTOR OR BUILDER
Value of
Project
BY
�b.
Amt. of
Permit
AUTHORITY
- 1941_
-4 $
install the equipment or device describe the appli-
at the work will be performed in compliance with any
municipal authorities. This Permit may be revoked
t authorization. A further condition upon which this
ty for a thorough knowledge of the or. na . ces and
ents pecifications and that he ass !. s respon-
INSPECTOR
perform the work covered hereunder in compliance with a13,.grdinances and g tigns" )
statements or specifications submitted to the proper authoriEt1ddss of Miami Shy �fll e.
ither myself, my ag t, serva or employee.
Permit No 57.2o 7
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.
I(� • f f l
Owner's Name and Address__ �� 4f._ _fr_s' _ ' t ' 1 No.- f
. . t ._� _ - — — Street --- -
Registered Architect and /or Engineer__
Employing Electrician's Name____a___t__i__!
Location and Legal Description Lot j?
No f .Z `-f- f: `-
Subdivision,i ti v / ! ,__J , ...t:. j '
1 Street and Number where work is to be performed— No.__L 1 _.__ -i ____/_,_ _, Street _'
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 p
Underground ' - s
Type of Installation— Conduit_ Tubing B.X.L.__ —___ Metal Moulding
Amount of Permit $__ __ L! __ o __d
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that . e understands and acce � is obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co .iled 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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date - •
_Block
ff
(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
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
1
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 57.2o 7
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.
I(� • f f l
Owner's Name and Address__ �� 4f._ _fr_s' _ ' t ' 1 No.- f
. . t ._� _ - — — Street --- -
Registered Architect and /or Engineer__
Employing Electrician's Name____a___t__i__!
Location and Legal Description Lot j?
No f .Z `-f- f: `-
Subdivision,i ti v / ! ,__J , ...t:. j '
1 Street and Number where work is to be performed— No.__L 1 _.__ -i ____/_,_ _, Street _'
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 p
Underground ' - s
Type of Installation— Conduit_ Tubing B.X.L.__ —___ Metal Moulding
Amount of Permit $__ __ L! __ o __d
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that . e understands and acce � is obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co .iled 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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date - •
_Block
ff
(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 - I
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8937
Legal Lot Bl. Subdi-
Description vision
Work to be performed under this Permit
DATE f, i 1940 JJ
Contractor's
License No.
Address of Value of Arnt. of
Building / ! 1 / 1 ; Project Permit
This permit is granted to the contractor or builder named above to construct the building or tb install the equipment or device described in the appli-
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 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 responsibility 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 staterotnts or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed: % By
/ INSPECTOR lJ
In consideration of the issuance to me of this permit I agree to perform the viork covered hereunder in compliance with all ordi¢ances 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.
- 1 r
,./ / . 1 c • �. , f t.�.►.,, - '" �..,r. Cam`
I CONTRACTOR OR BUILDER BY AUTHORITY
1
Permit No._ f_Z __
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 specifie d or not. A copy of approved plans and specifications must be kept at
building during progress of work.
r .
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date__ - it cJ
_kr
ss.
Owner's Name and Address_ .*Z4'
_
Registered Architect and /or Engineer •
Employing Electrician's
Location and Legal Description Lot
Street and Number where work is to be performed —No
Block Subdivision
/it
No 1_i_ (p ___! Street__ __ 4 '
No.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhe Siz Feeders Conduit ___Main Sw.__ Amps ___Main Fuses Amps
U nder gr ound
Type of Installation— Conduit_ Tubing — ___ _B.X.L.___.___ Metal Moulding
(Signed)
/ lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that derstands and accepts his ob igations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co . ed 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 p osted 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.
(Signed)_ L''S�/ v _ / Y :7,4 1e'
M er Electrician.
0,4640
Vd ___Street- J,_ - _!C
Street___
9,
Before me, the undersigned authority, a notary public, duly a uthorized 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.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTOR EI.2ANS.
0.1 H
MOTORS
N ON
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No._ f_Z __
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 specifie d or not. A copy of approved plans and specifications must be kept at
building during progress of work.
r .
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date__ - it cJ
_kr
ss.
Owner's Name and Address_ .*Z4'
_
Registered Architect and /or Engineer •
Employing Electrician's
Location and Legal Description Lot
Street and Number where work is to be performed —No
Block Subdivision
/it
No 1_i_ (p ___! Street__ __ 4 '
No.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhe Siz Feeders Conduit ___Main Sw.__ Amps ___Main Fuses Amps
U nder gr ound
Type of Installation— Conduit_ Tubing — ___ _B.X.L.___.___ Metal Moulding
(Signed)
/ lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that derstands and accepts his ob igations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co . ed 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 p osted 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.
(Signed)_ L''S�/ v _ / Y :7,4 1e'
M er Electrician.
0,4640
Vd ___Street- J,_ - _!C
Street___
9,
Before me, the undersigned authority, a notary public, duly a uthorized 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
ROOFING
Owner of
Building
Architect
Contractor
or Builder
0
gr. 1.,
PERMIT
. Ciec`■)t)s)'l L
'�..
/./ /IF 7--
sibility for work done by his agents, servants or employees.
MIAMI SHORES VILLAGE, FLORIDA
-
DATE 4- 9 19_
Contractor's
License o No. 7 I ? f
nse No L—_
N° 6445
Work to be performed under this Permit
Legal Lot
Description Bl
Building
Address of . - , �r , Value of Amount of 2 ...-
Project $— I Permit $
This permit is granted to the contractor or buil named above to construct the building or to install the equipment or device described in the applica-
tion 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 responsibility 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 respon-
!
Signed. l°1 — .r INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance th all ordinances art -regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper au . •rities of Miami Shores Village. In as
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
• /I, i " I
CONTRACTOR OR BUILDER BY All ROT `° °'
Subdi-
vision
AUTHORITY
/
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
HEALER
STRIP
HEATER
TOTAL
CL
LIST
;
1
7
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEI'P.
SERVICE
PERM.
MOTORO
0.1 HP
MOTORS
1•5 HP
N EON
TRANS.
RADIO
TOTAL
CON , R.
LIST
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
AF ALICATION FOR ELECTRICAL PERMIT
Permit No Date..' 1 ' r
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. / { 6 ,� /
Owner's Name and Address 91/.6 ;X/ / ✓� . '.. o No / ) ,(1� 1 Street 8 t
Registered Architect and /or Enginee
Employing Electrician's Name -L'-L No Street
Location and Legal Description Lot / / y Block Subdivision
Street and Number where work is to be performed —No 11 ") A/ k / ' t Street
State work to be performed and purpose of building (By Floors)
/
D^ New / Building Remodeling Addition X Repairs No. of Stories
SS.
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing.. B.X.L .....................Metal Moulding
2
Amount of Permit $ (Signed)
ctrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati ns as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pnent 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 work to be performed under this permit, as are
licensed by Miami Shores Village. t
w
(Signed)
"J
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. I j
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, a,id 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.