Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
ELECTRICAL
Type Insp'n Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / e / �J"l>> a Time Permit No. Nam r � Address t 0 nf, l 9 ` Company Phone # For Inspector //0)\ Name & Date ❑ �� ✓Gl�. —�'�s p • aooa • a 7ee Printed: 2/1/2002 Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Applicant: PASTOR Owner: GONZALEZ Contractor MEGA ELECTRIC INC Local Phone: (305) 828 -5205 Parcel # 1132060134330 Job Address: 240 NE 99 ST l Permit Status: Approved Permit Expiration: 7/31/2002 Construction Value: $1,200.00 Work: REMODELING ELECTRICITY FOR A FAMILY ROOM ,vla5 {�t2 77eA 3S If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. _ This Permit is granted to the contractor or builder named above to construct the ordinances pertaining thereto and with the understanding that the work will be perfc PASTOR C. GONZALEZ 09 -97 and approved by the proper municipal authorities. This Permit may be revoked at authorization. A further condition upon which this permit is granted is the understa ordinances and regulations pertaining to the work covered hereby whether shown by agents, servants or employees. Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work with the plans, drawings, statements or specifications submitted to the proper with myself, my agent, servants or employes. Signed: (Contractor of Electrical Permit Permit Number: EL2002 -43 GONZALEZ PASTOR Address: 8560 NW 169 TERR Cellular: Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & W1/2 OF LOT 6 BLK 32 LOT SIZE Pay to the order of r 1 $ a0•vo )c4-1 ` O° ' ,QV Collars , • BankofA erica. ACH R/r 063100277 For Page 1 of 1 1:063 100 27 ?I: 0034 354 3 LS9711' 7 -LA rni ic-12. 4.0 oo Total Fees: $0.00 Total Receipts: $0.00 Atom, 1-10(1_€,5 O II Ae Date 2-`2-0 2__ 8L7 817 63- 27/631 FL 937 ftv { Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES O / (e\ . ( sq.ft. = x/1000 SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CJ . ( .6 CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. TYPF. Dryer QTY. d TYPE Outlet, Appliance QTV. 'INIT. Service Repair QTV. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall ' Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch I. Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light (p Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights 2. Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL Tl'1'F Minimum Fee QTY. 'I'YPF Condensate Drain QTY. 'TYPE Generator Q'I'1'. 'I'1'I'E Q'I'V. Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C WalWVin. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE A/C Condensate QTY. TYI'I Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. 'I'1'I'F. Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well lice Maker Pump, Sump Utility - Water Dishwasher 'Indirect Wastes Relay Repair Vacuum (Pump Disposal 'Interceptor Roof 'Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainiseld, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: .Z f��9�, Page 2 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature � � /of Owner i Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Type of Identification Produced: PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Vill .: - all ' n Construction Lien Law and Choosing a Contractor. STAT Signature of Contra Print Name Sworn to and subscribed befo Signature of Notary SEAL: day of< lie - State O f ri I . CRUZ NOTARY PU3L!c STATE OF FLORIDA CO I;aSION NO. CC 379559 MY CO MISSION EX?. OCr. 3203 Personally known !/ OR, Produced Identification Type of Identification Produced: CONTRACTOR Name 1 el., '__;-- e t e. —=N ;e. • License No. e - Go/' / -9 2 y Address .65'6, D k i L e /6 9 7 r rcc e /`i,ifiat; Pre-e S fl .330 /(p Telephone Z &5 — Fax 3as._ .szif_ 9774/ Qualifier Name fl ,..„STi 0 is T7v'ycS _ l- ,► ✓ PROPERTY OWNER Name P2717g 4 y/ LP/4 att=al / Address 210 A/ • Lr . .99S Home Telephone 3©.5 751 .- 5 7 830 Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior epair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step I. Subdivision Proposed Use of Property Tenant Information INS'T'RUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION N- Job Address: 240 N L ' G / °'f i 5 d e ES l L`#4 C& Address Folio Number' I 3r) L D /3 f 336 x Lot / Block Zoning Current Use of Property %/ * -- � Square Feet Units Floors yy Value of Work Hi - Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Description of Work Master Permit No. 5 e j 4 3 Subsidiary Permit No. 7 `� c:Q DO • & City State R » - toi7Lft\t 0 PERMIT APPLICATION Zip pQ- ) r 7/20/-ii Linear Feet ENGINEER Name License No. Address Telephone Fax PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date D Job Address 24 0 Alt � T / 6 ( Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenn Master Permit # 41.9 7) t q 6 I Owners Address Z 4 0 A) 6 "M kt(if4 f SAWS FC331 phone Contracting Co. .» & `ec 72 s, 'W(eg C Address (( ? . 8O 'a) 441,1 17331 it Qualifier J eyVw 1 ( 2 ss# . 30r-22B- (Z,s4 State # E,G 0 0 /saw Municipal # Competency # 006.00046q Ins. Co. Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING(E ECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION gCCC(Z C4 C w6 i2 ,)2W AQG(?z ex tAci ,t>ew Ser(/t« Sed Square Ft. 3 60 Estimated Cost (value) l /D • 00 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 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 contractor to do th, % k stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT cy /s RADON C.0 ontractor or Owner - Builder otary as C o I is . ' � ARY SEAL OF My Commissio O� de, ANGELA • M BECKER r OOMMISSION NUMBER • .• Q CC786697 . `.•, C MY COMPASSI EXPIRES • ` F\.O NOV. 15,2002 NOTARY Date Dat BOND e TOTAL DUE g soy APPROVED: Zoning Building Electri Mechanical Plumbing Structural Engineer !TEM 3ATH TU3 UNIT FEE ITEM. SWITCH OUTLETS UNIT 3 FEE ITEM SPACE HEATERS UNIT FEE 3IOET LIGiT CUTLETS 2.77/, CENTRAL HEATING ISiWASHER RECEPTACLES 6J . Arc (WIND) )ISrOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN APPS 200 DUCT WORK FLOOR DRAIN SERVICE REPAIR/PETER GUNGE 2soA REFRIGERATION 2REASE TRAP APPLIANCE CUTLETS Yom' PROCESS AND PRESS PIPING • INTERCEPTOR RANGE TOP UNDERGROUND TANKS ;AVATCRY OVEN ABOVE GROUND TANKS _AU?DRY TRAY WATER HEATER U.F. PRESSURE VESSELS 2LOTHES WASHER MOTORS 0- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COW. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION 3INX, RESIDENCE MOTORS OVER 5- 8 FP TRANSPORTING ASSEM$LIES SINK, SLOP MOTORS OVER 8- 10 FP ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS .AINAL MOTORS OVER 25-100 FP COOLING TOWERS riATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES [ A/C WINDOW REINSrECTION .i'ATER SLFPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRAPSFCRMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN S -WELL SPECIAL PURPOSE SWIMMING POOL CUTLETS COWERCIAL WATER SERVICE SIGN TUBES • ;EWER CONNECTIONS SIGN TRANSFORMERS KT I L I TY- SE'WER SIGN TIME CLOCK TILITY -WATER FIXTLRES EPTIC TANK ANTENNA • FLAY TELEVISION CUTLETS RAINFIELO, 4' TILE/RES. VIOLATION Ulf & ABANDON SEPTIC TANK REINSPECTION OAKAGE PIT CU. FT. ATCH BASIN r --- ISCHARGE WELL CMESTIC WELL • AEA DRAIN • . OOF INLET OLAR WATER HEATER IRE STANDPIPE CL PIPING • \WN SPRINKLER SYSTEM LS RANGE :TER SET (GAS) LS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT RUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE, FLORIDA DATE, PERMIT 0 ❑ Work to be performed under this Permit -�a Lot B1 CONTRACTOR OR BUILDER r • N° 7725 • ? Subdi- vision '� Value of I Amount of y 1 ' I/ Project $ I 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 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- sibility for work done by his agents, servants or employees. Contractor's ;�✓ .* ,a License No. Signed' !�� ' / , � ! +' [ 6 / to: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder fin 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 as ceptinq this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. • BY AUTHORITY 19 1UILDING LECTRICAL 'LUMBING Owner - =wilding Architect ■ MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N° 5214 Contractor's License No Work to be s erfprmed under this Permit �1 Contractor )r Builder i ■ Legal Lot / i Bl • Subdi- 24.1 ` 1.- / vision 3escription 1 Address of Value of 3uilding r Project This permit is granted to the contractor or builde nam: , above to construct the building or to install the equipment or device : escribed in the appli- ,ation herefor in strict compliance with all ordinances p taini thereto and w th the understanding that the work will be performed in compliance with any glans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t 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 iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and - egnlations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- Ability for work done by his agents, servants or employees. CONtRACTO$ OR BUILDER BY Amt. OT Permit Signed • B y INSPECTOR AUTHORITY r In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulatiods lertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I responsibility for all work done by either myself, my agent, servant or employee. BUILDING ELECTRICAL PLUMBING . Owner Building MIAMI SHORES VILLAGE, FLORIDA DATE 194 Contractor's / P 7 License No. 'T r PERMIT N? 5214 Work to be performed under this Permit -- 4�t.r°`-t.t.t...�%.4e..1, l Ai V - 4 -: 1 1 1t#1-- )4 . thice_..."... ' Architect (-) Contractor �y, _..•■ or Builder FLL,C, , Legal Lot j / Bl. Subd 0.,r - Description �w I vi sion Address '� Address of i� � Value of Amt. o � S - Building 7 / 7.. , * Project I Permit This permit is granted to the contractor or build nam above to construct the building or to install the equipment or device/ described in the a li- g PP cation herefor in strict compliance with all ordinances p rtaini g thereto and w th the understanding that the work will be performed in compliance with any plans, drawings, statements or specitications 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 don,; 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- sibility for work done by his agents, servants or employees. CON OR BUILDER 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 regulati pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authpjip of Miami es'il1ge. In accepting this permit 1 assume responsibility for all work done by either myself, my agent, servant or employee. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Z / L Permit No Date__ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte for the b ding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi i Shores illage, 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 • a c- Owner's Name and Address 0\ °--7 _ • _� _ _ No. _ ,14 a Si _____ . Street_ Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Block Subdivision__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition.. Repairs No Service Overhead Size Feeders____ Conduit.___ ;' Main Sw. i` � Amps. t� r ' Main Fuses_ 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 Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or 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) (Signed) r `(� )" — Street No. of Stories. ______ _______ f My Commission Expires Notary Public. State of Florida Master Electrican. • Amps. STATE OF FLORIDA, COUNTY OF DADE. ss. 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 / R - b ,,,e,/ ^I ) 4 ( .(' S � . .s CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Z / L Permit No Date__ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte for the b ding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi i Shores illage, 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 • a c- Owner's Name and Address 0\ °--7 _ • _� _ _ No. _ ,14 a Si _____ . Street_ Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Block Subdivision__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition.. Repairs No Service Overhead Size Feeders____ Conduit.___ ;' Main Sw. i` � Amps. t� r ' Main Fuses_ 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 Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or 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) (Signed) r `(� )" — Street No. of Stories. ______ _______ f My Commission Expires Notary Public. State of Florida Master Electrican. • Amps. STATE OF FLORIDA, COUNTY OF DADE. ss. 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. • • • ^ �a