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
/
,
)