130 NE 98 St (4)NO.
STREET
PART OF LOT
LOT
BL'K
SUBDIVISION
Signs
obi
Other Apparatus
Permit Fee
r
/
Outlets
Motors
Receptacles
Generators
Stoves
Water Heaters
Signs
Billboards
Other Apparatus
Permit Fee
r
/
1'F
,j
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building / i
Contractor or Electrician %
ddliami cJhores9Illage
F L O A ID A
OFFICE OF ELECTRICAL DEPARTMENT
Miami Shores Village, Fla , / l ` 3 ! ` 3 f" 19
LO CATI 0 N
N° 464
DESCRIPTION OF WORK
NUMBER OF
This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with
the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time
tpon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by
this Department.
A s t , Electrical Inspector.
In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree t do the proposed construction in strict conformity with
the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the
State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rum and regulations of the Electrical Department of Miami
Shores Village.
Dated �''' ~ .,,.' ;� , 19 (Seal)
-41
OUTLETS
MOTORS
RECEPTACLES
GENERATOR•
STOVES
WATER H'TERS
SIGNS
BILLBOARDS
OTHER
MAIN
SUB
BRANCH
Basement
First
FLOOR
NUMBER OF
SIZES OF
INSULATION
OPEN OR
CONCEAL'D
NUMBER OF
CIRCUITS
OUTLETS
MOTOR
GEN.
MAIN
SUB
BRANCH
Basement
First
Second
Third
/
Fourth
Other
_
Floors
iami cfhores
F 1. 0 R 1 D A
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for issuance of permit for electrical installation as described , and for
inspection of same after installation:
Date — 3 / 193
Owner �'' , Address / 3 o /%
Building Contractor
Electrical Contractor
Location of proposed work: Lot Block Subdivision
Details of proposed work:
Number of Motors
Additional Information
H P
Volts
(SPACE BELOW FOR INSPECTOR'• USE ONLY)
Work begun Inspected `
P •
Work finished Final inspection
c
Building: Old or new Number of stories / Used as
Description of proposed work ( -A 7 1 "
L �Q✓l_Q
Amps Phase
Signature of Applicant L..._ �'
Address (if other than owner or contractor)
6 a c", '- C
l
I M�
, Inspector
Amount of Permit $-
i
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
7 / /'I
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. aLi4id M S_- ,L��' / . -_ Owner s Name and Address __ __ _ __ No.
Registered Architect and /or Engineer — _w_ ,J+
Employing Electrician's Name No. /L3.5� 14/1 _
Location and Legal Description Lot Block
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. of Stories____________
Service Overhead Size Feeders Conduit. ____ Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding _________________________ _
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 w9r flto be performed under this permit, u are
licensed by Miami Shores Village. C-
c
(Signed) 5.:��.,12_ C —1
(Signed)
Amps
Street
Subdivision ___r__________- _- ________
M ain Fuses__--_-_ ...... __ ..... Amps.
Eleetircal Inspector.
STATE OF FLORIDA,
COUNTY OF DADE.
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 he 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
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0 -1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Amount of Permit $-
i
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
7 / /'I
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. aLi4id M S_- ,L��' / . -_ Owner s Name and Address __ __ _ __ No.
Registered Architect and /or Engineer — _w_ ,J+
Employing Electrician's Name No. /L3.5� 14/1 _
Location and Legal Description Lot Block
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. of Stories____________
Service Overhead Size Feeders Conduit. ____ Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L. Metal Moulding _________________________ _
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 w9r flto be performed under this permit, u are
licensed by Miami Shores Village. C-
c
(Signed) 5.:��.,12_ C —1
(Signed)
Amps
Street
Subdivision ___r__________- _- ________
M ain Fuses__--_-_ ...... __ ..... Amps.
Eleetircal Inspector.
STATE OF FLORIDA,
COUNTY OF DADE.
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 he 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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
MIAMI SHORES VILLAC1E, FLORIDA
DATE
4EtRma N?' 4640
Work to be perform1d under this Pe
-;fri".• a 44.4420(
Legal Lot BL
Description
Address of ,,o
Building
This permit is granted to the contractor or builder named to .struct the building or to install the emnpment or device
cation herefor in strict compliance with all ordinances pertainnitg and with the mdst.udlng that the work will be performed
plans, drawings, statements or specifications that may have been submitted to and apwoved by the proper municipal authorities. This
at any time if the work is not done in pliance with such ordinances or if the plans are changed without mthorization. A further
permit is granted is the understanding t the contractor or builder named above ammo the y for a thorough knovelwais
ty for work *A by his agents, servants or employees. -
lions p to the work covered hereby whether shown on the plans or drawisor in te rtements or
• • MS and
re
• Signed: By
INSPECTOR
In *deration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance With all
ertaining eto and in 'et . ,, °runty with the plans, drawings, statements or specifications submitted to the proper authorities of
this permit I ty for all work done by either myself, my agent; servant or employrio.„
' • y ... .
Subdi-
vision
DT
Contractor's
License
7`11Flimr
Value of Amt of
holed Permit
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of � - t; I 1 j /' - . Value of Amt. of ' 4
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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawl or in e or specifications and that ssumes respon-
sibility for work dtytild by his agents, servants or employees. � ' ,fL l rr �.�E
reto and in s Signed: By "��
INSPECTOR \ y
In cg ideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a rdinances antrg ions
pertaining k€t�rrict c rjformity with the plans, drawings, statements or specifications submitted to the proper authoti es of Miami Shores Vivage
In ,pl ig this permit I is / responsibility for all work done by either myself, my agent, servant or employee. "- . 4.
CONTRACTOR OR BUILDER 6 I BY AUTHORITY�t,
,
MIAMI SHORES VILLAGE, FLORIDA 1 /
DATE 194 4
PERMIT N? 4640
Work to be performed under this Permit j.��.I{ J ''�/`�•t.�,,i
/I/ 4..
Bl.
Subdi-
vision
Contractor's
License No.
rs j
BUILDING
ELECTRICAL
PLUMBING
ROOFING
❑ MIAMI SHORES VILLAGE, FLORIDA Z
DATE 2-11 19 04
PERMIT
0
Owner of
Building ti• V �-
Architect
Contractor
or Builder j 2.1 iJ lr
N° 7225
Legal Lot Subdi-
CONTRACTOR OR BUILDER BY
Contractor's
License No.
Work to be performed under this Permit
Description B1 vision
).. Q C Value of I Amount of
Project $ rib
Address of
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 apt. that he assumes respon-
sibility for work done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in comp ce with all ordinances mad regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the prope uthorities of Miami Shores Village. In ao
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
•
AUTHORITY
dal
INSPECTOR
A SOT b'
Permit No
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 eules 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 �TC 1 No a
Registered Architect and /or Engineer _ �7-
Employing Electrician's Name -a --- 7 1r-7/C-8- 1 . 7 - No
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps
Underground
Type ,f Installation — Conduit Tubing B.X.L ... . .....Metal Moulding. ....
u
Amount of Permit $ (Signed)
STATE OF FLORIDA, l
COUNTY OF DADE. !t
SS.
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.
Dste 6v ` � I tT
Street
Street
Main Fuses Amps
j Electrical Inspector.
ccepts his objtions as an employer of
of F °orida #'ermanent Supplement, and
sub•contr ors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, a, id he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re'inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
tti
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLY
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. H'AT.
CONN.
SPACE
HE:.. ER
STRIP
HEATEFI
TOTAL
CLIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
Tc: P.
SERVICF
PERM.
MOYO■.;
0.1 HP
. "..JTORS
1.3 HP
N3` N
TRANC.
RADIO
TOTAL
CON : R.
LIST
CHECK
Permit No
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 eules 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 �TC 1 No a
Registered Architect and /or Engineer _ �7-
Employing Electrician's Name -a --- 7 1r-7/C-8- 1 . 7 - No
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps
Underground
Type ,f Installation — Conduit Tubing B.X.L ... . .....Metal Moulding. ....
u
Amount of Permit $ (Signed)
STATE OF FLORIDA, l
COUNTY OF DADE. !t
SS.
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.
Dste 6v ` � I tT
Street
Street
Main Fuses Amps
j Electrical Inspector.
ccepts his objtions as an employer of
of F °orida #'ermanent Supplement, and
sub•contr ors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, a, id he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re'inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
tti
w
NO.
Motors
Receptacles
STREET
Stoves
PART OF LOT
LOT
BL'K
SUBDIVISION
iC
( /
f�
f
r y
.e
Outlets
Motors
Receptacles
Generators
Stoves
Water Heaters
Signs
Billboards
Other Apparatus
Permit Fee
7i
•
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building / 4
ractor or Electrician
! C'/
ciami Aores 9' llage
F L O A ID A
OFFICE OF ELECTRICAL DEPARTMENT
Miami Shores Village, Fla, / ` L� 19
LO CATI 0 N
DESCRIPTION OF WORK
NUMBER OF
This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with
the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time
upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by
this Department.
In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with
the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the
State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami
Shores Village. r r,
Dated //e%
19 (Seal)
N° 464
, Electrical Inspector.
APPLICATION FOR ELECTRICAL PERMIT
...(
Permit No { f . Ie
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu.ida,
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 No VO °� � � " ' Street
STATE OF FLORIDA, 1
COUNTY OP DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
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
(Signed)
to administer oaths and
7,C6 . /c/J;!;,
Date
Registered Architect and/or Engineer
10
Employing Electriciats's Name y e.. d "f\' �� No diI S Street ,
Location and Legal Description Lot J � t " ' i
' 'a A
�'� s''' 1ock Subdivision s t
Street
Repairs No. of Stories
Service OveleEr d Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
\\ f
Amount of Permit V
e (Signed) f if3 w y) � Vt
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u an employer of
labor under the Florida Workmen's Compensation Act, being Section 3966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all cont ctors or sub- rl ractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspect on the site of th 4rork such public notice or notices
are required by the Act. The undersigned agrees to employ only such sub•contr ors, on ar9rk to be r armed under this permit, as are
•d by Miami Shores Village.
Master Electrician.
take acknowledgments, personally
Before me, the undersigned authority, a notary public, duly authorized
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 81.00 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
H
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
I. 2
L
f
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT
...(
Permit No { f . Ie
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu.ida,
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 No VO °� � � " ' Street
STATE OF FLORIDA, 1
COUNTY OP DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
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
(Signed)
to administer oaths and
7,C6 . /c/J;!;,
Date
Registered Architect and/or Engineer
10
Employing Electriciats's Name y e.. d "f\' �� No diI S Street ,
Location and Legal Description Lot J � t " ' i
' 'a A
�'� s''' 1ock Subdivision s t
Street
Repairs No. of Stories
Service OveleEr d Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
\\ f
Amount of Permit V
e (Signed) f if3 w y) � Vt
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u an employer of
labor under the Florida Workmen's Compensation Act, being Section 3966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all cont ctors or sub- rl ractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspect on the site of th 4rork such public notice or notices
are required by the Act. The undersigned agrees to employ only such sub•contr ors, on ar9rk to be r armed under this permit, as are
•d by Miami Shores Village.
Master Electrician.
take acknowledgments, personally
Before me, the undersigned authority, a notary public, duly authorized
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 81.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.