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ELECTRICALczs PERMIT APPLICATION FOR MItMI SHORES VILLAGE Q � C Date 3 / 2 31D i Job Address /? (00 /Ug- q9 S ( T Folio Legal Description Historically Designated: Yes No !/< Owner/Lessee / Tenant )-<d /2i 4y Master Permit # I W Owner's Address W R 9 9 s i / Phone Contractin Co. rn °0 Ol £(.. -c '[2l C / �' Address 669 ,UW q ST Qualifier J0 Mv J M00 SS# Phone 0 q/ ' State # &r i X / / 9 / Municipal # Competency # 6620 2 Ins. Co. klAe -r ie. Architect/Engineer 1 Bonding Company /� / f" Mortgagor JJJ �� Address Address Address Permit Type (circle one): BUILDIN E LECTRICAL,PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / 1 _/ /J ,Wig ; ii /1/ r/f #0 Square Ft. eV ' ' ` &I stimated Cost WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT ANDYOUR 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. , OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contr. •r to do the work stated. Signature of owner and/or Condol'rest nt Date My Commission Expires: FEES: PERMIT RADON p, AY PGa OF • ■ . i Y Lm • .1;17±;'t �� nQ coMMISSI ; AMER CC741860 OF FLn p`O MY COMMISSCNEXPIRES MAY 11,2002 Signature of Contractor or Owner- Builder MAY 11,2002 otary as to ' ontractor My Commission Expir C.C.F. t tO O NOTARY — " BOND Electrical TOTAL DUE 2/ Date 0O o/ Date APPROVED: Zoning Building Mechanical Plumbing Structural Engineer ITEM BATH TLB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS • CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS J I DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY ,,, OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET MJTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Permit No ”(73 Owner's Name and Address Registered Architect and /or Engineer Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. ss' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date /C 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. Employing Electrician's Name, Location and Legal Description Lot / Block �y Street and Number where work is to be performed —No . .v 0 4(4;... State work to be performed and purpose of building (By Floors). C- No.A t 9 Street No 1.° 36 /Ka,/ Street.( ' (Signed) (Sign Street Subdivision New Building Remodeling Addition ' Repairs No. of Stories...../ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Underground Type of Installation— Conduit Tubing B.X.L .Metal Moulding Amps Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of " 'rida 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 work to be performed under this permit, as are licensed by Miami Shores Village. 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. >ACE H ATER STRIP HEATER TOTAL CONTR. LIST CHECK 1 0 ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS MOTORS 0.1 HP 1.8 HP NEON TRANS. RADIO TOTAL LIST CONTR. / '/ / � C � ` . CHECK Permit No ”(73 Owner's Name and Address Registered Architect and /or Engineer Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. ss' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date /C 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. Employing Electrician's Name, Location and Legal Description Lot / Block �y Street and Number where work is to be performed —No . .v 0 4(4;... State work to be performed and purpose of building (By Floors). C- No.A t 9 Street No 1.° 36 /Ka,/ Street.( ' (Signed) (Sign Street Subdivision New Building Remodeling Addition ' Repairs No. of Stories...../ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Underground Type of Installation— Conduit Tubing B.X.L .Metal Moulding Amps Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of " 'rida 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 work to be performed under this permit, as are licensed by Miami Shores Village. 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 ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building BL T MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 195 PERMIT 'N? 12585 Contractor's n License No ❑ Work to be performed under this Permit Subdi- vision 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 underst 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 responsibility for yiq, done by his agents, servants or employees. Signed: IN& CrOR � BY 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. CONTRACTOR OR BUILDER Value of Project $ BY Amt. of Permit $ �' Permit No" Owner's Name and Address ___._ Registered Architect and /or Eng Employing Electrician's Name Location and Legal Description Lo 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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wor State work to be performed and purpose of building (By Floors) Date 1 7 / 2 / / No. / 2 6 No Street__ Street and Number where work is to be perfo med— No.__ /2 .40 Street Subdivision__ – —__ New Building Remodeling Addition.. Repairs No. of Stories _________ _______ Service Overhead Size Feeders Conduit._______ —___ Main Sw. Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amount of Permit $_ 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 \Vorkmen'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 cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires _ (Signed) Main Master Electrican. 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 facts therein by him stated are true. 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 LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS O -I HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No" Owner's Name and Address ___._ Registered Architect and /or Eng Employing Electrician's Name Location and Legal Description Lo 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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wor State work to be performed and purpose of building (By Floors) Date 1 7 / 2 / / No. / 2 6 No Street__ Street and Number where work is to be perfo med— No.__ /2 .40 Street Subdivision__ – —__ New Building Remodeling Addition.. Repairs No. of Stories _________ _______ Service Overhead Size Feeders Conduit._______ —___ Main Sw. Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amount of Permit $_ 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 \Vorkmen'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 cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires _ (Signed) Main Master Electrican. 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 facts therein by him stated are true. 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 Owner's Name and Address Amount of Permit $.....(' STATE OF FLORIDA, 1 COUNTY OF DADE. I v 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 here ith subMitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Or nance 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. No Street Registered Architect and/or Q gi eer Q s, F p Employing Electrician's Name /ljeir - Tr aL . � Islo ..... F... d.Gl.(. -. c.J[<...J Street. -.2Z. I(� � Location and Legal Description ot. 3't' P 1Y..' . + Block . _ Subdivision.-.1., Street and Number where work is to be performed— No...- j 1 ✓�� 71 ; 2: State work to be performed and purpose of building (By Floors) New Building Y. Remodeling Addition II 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 ( Signed) .. Date.. The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws 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 sub - contractors, on work to licensed by Miami Shores Village. Before me, the undersigned authority, . a notary public, duly authorized to administer oaths K Street (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida 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 Master Electrician. 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 FLANGE C:ONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAS. SERVICE Temp SERVICE PERM. M OTORS 0.1 HP M OTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK ,, ..0" � 1 Permit No Owner's Name and Address Amount of Permit $.....(' STATE OF FLORIDA, 1 COUNTY OF DADE. I v 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 here ith subMitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Or nance 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. No Street Registered Architect and/or Q gi eer Q s, F p Employing Electrician's Name /ljeir - Tr aL . � Islo ..... F... d.Gl.(. -. c.J[<...J Street. -.2Z. I(� � Location and Legal Description ot. 3't' P 1Y..' . + Block . _ Subdivision.-.1., Street and Number where work is to be performed— No...- j 1 ✓�� 71 ; 2: State work to be performed and purpose of building (By Floors) New Building Y. Remodeling Addition II 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 ( Signed) .. Date.. The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws 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 sub - contractors, on work to licensed by Miami Shores Village. Before me, the undersigned authority, . a notary public, duly authorized to administer oaths K Street (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida 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 Master Electrician. 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 ' �f�► a y MIAMI SHORES VILLAGE, FLORIDA ' PERMIT N? 11782 (1 Work to be performed under this Permit de-f-air(4. Bl. Legal Lot Description. Address of /� Building �+�C Subdi- vision DATF " f ~* " ' 195 Contractor's License No Value of Amt. of >- Project $ 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 responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawingq or i the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. , + Signed • l/ �5.�' t BY / >�l LNSPECTOR 1 In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a 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. t)�. ` tII °1 • t CON CR CS� BUILDER BY y? AUTHATY II Lot BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description. MIAMI SHORES VILLAGE, FLORIDA (1 h DATE - 195 PERMIT 'N° 11904 n ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER BL /V '�' ,• Subdi- vision Contractor's License No Address Oft ,f r Value of Amt. of Building ) Project $ 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 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 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 W Permit No ,,. 5 ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT a 41 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 y� =�l t MIAMI SHORES VILLAGE Registered Architect and /or Engineer Employing Electrician's Name '= ' y ' Location and Legal Description Lot Block Street and Number where work is to be performed—No ..44 .. State work to be performed and purpose of building (By Floors) New Building !/ Remodeling Addition Repairs No. of Stories Overhead f Service Underground Site Feeders > STATE OF FLORIDA, COUNTY OF DADE. ss. Conduit I Main Sw ' No Street , No / Street Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding s u Amount of Permit $ (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 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 em ploy only such sub' contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (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 andl 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. �' f✓! Street / oU f 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 ' terials an or workmanship. Date Subdivision. i3 - .5i SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE . CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST / G % / 2 ^ .• ' CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST �- /' n I, ../ CHECK W Permit No ,,. 5 ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT a 41 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 y� =�l t MIAMI SHORES VILLAGE Registered Architect and /or Engineer Employing Electrician's Name '= ' y ' Location and Legal Description Lot Block Street and Number where work is to be performed—No ..44 .. State work to be performed and purpose of building (By Floors) New Building !/ Remodeling Addition Repairs No. of Stories Overhead f Service Underground Site Feeders > STATE OF FLORIDA, COUNTY OF DADE. ss. Conduit I Main Sw ' No Street , No / Street Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding s u Amount of Permit $ (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 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 em ploy only such sub' contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (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 andl 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. �' f✓! Street / oU f 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 ' terials an or workmanship. Date Subdivision. i3 - .5i / , )