MECHANICALMIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date Zl ed , 3o /
s-
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 K � T9 D PG2. £ No Street
Registered Architect and /or Engineer C
Employing Electrician's Name Le W /S C W al 74 et- NoV 930 NW .Street..
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No gS N E•. -. Street ... .340"' u5
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 1
(Signed) GJ' 1•
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl rids 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 sub-con ..ctor work to be performed under this permit, as are
licensed by Miami Shores Village.
(Si
e 14/
Muter Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I °°'
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.
$[
HEA TER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIET.
CAR.
SERVICE SERVICE
TEMP. PERM.
MOTORS
0.1 HP
MOTORS
1.6 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
{r'
1 F3 /Q. /
�/ /�
� A
I r .'' �
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d—
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No Date Zl ed , 3o /
s-
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 K � T9 D PG2. £ No Street
Registered Architect and /or Engineer C
Employing Electrician's Name Le W /S C W al 74 et- NoV 930 NW .Street..
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No gS N E•. -. Street ... .340"' u5
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ 1
(Signed) GJ' 1•
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl rids 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 sub-con ..ctor work to be performed under this permit, as are
licensed by Miami Shores Village.
(Si
e 14/
Muter Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I °°'
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
ROOOIEG
Owner of
Building P+ E
PERMIT. - N? . 6533
MIAMI SHORES VILLAGE, FLORIDA
DATA: a- /l
Contractor's 2
License No.
to be performed undeer ibis Permit
$7o44 • rs'►t` dt 4 4,4 (41,,40 +'Pb•.►
Architect
Contractor --'' A
or Builder 1.c.4t Cl 4474 1:
Legal Lot it
Description I 81.
Address of 2 H c c A
Building 7
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device desesfla8d OIL
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed In compliance • .. Icmo
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be sevakkd of any
time if the work is not done in compliance with such ordinances or If the plans are changed without authorization. A further co a vyfaa whink lidEpennit le
granted is the understanding that the contractor or builder named rtbov$ assumes the responsibility for a t . gid knowledge o .e s w?- sanaea efilli so4ulatione
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or spec s "and that he rarity ter wort
done by his agents, servants or employees.
Signed
INSPECT
In consideration of the Issuance to me of this permit 1 agree to perform the work covered in compliance with all o MO
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications sub= tt' d to the proper authorities of Miami Shores V111
cee g this permitI assume responsibility for 11 work done by either, myself, m agent, servva o employee.
CONTRACTOR OR BUILDER BY AUTH I
1- I4.1w%._ telF
Ott* f a. ; £ c c—
Bubdi- /
vision / Is e 3
Value of
Project $ � a► 16
dt
,unt o
t$
6�
Owner's Name and Address. r cY/
STATE OF FLORIDA,
COUNTY OF DADE. s ' 4
Registered Architect and /or neer
Name and address of licensed contractor._
Location and legal description of lot to be built on:
Lot 1 S" Block
Disapproved Date
( Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Date
Subdivision ..._ e.
Street and Number where work is to be done •S _ ��'�' �_ l�_l _ j�
State work to be done and purpose of building (by floors) 0- �"'
Notary Public, State of Florida
1'
and for no other purpose.
i ✓�
New Building Remodeling Addition Repairs No. of Stones
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ o 3 6e Amount of Permit $ _ r �l
Zone cubage required plan Cubage
Distance to next nearest building.___ Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on wor�t , be r rnnder this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) _. x OP. •
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.