301 NE 98 St (12)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
2)0/ A),F. 78 i
I ,,// t� /� Tax Folio // 50W 7� -
Legal Description X/ / / �✓ 1 � j Q f Master Permit ik_S 70 7
/ Lessee / Tenant DAAJ! EL. A • 72ogS et/4S
Owner's Address 6Th#64/TQ a A tie
Job Address
Contracting Co. , N' Fie C7 /C ';ic
Qualifier c' !�! ' / / , e , BII R
State #
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle
WORK DESCRIPTION
Square Ft.
- 1 4 7 E 0 SS# phone 514 - 5q6
Competency# /74/6 Ins. Co.W&- 7724 Uekg
Address
Address
Address
one): BUILDING( ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
ReItz /
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. 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 the work stated.
Signature of Owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
Ng Commission Expires:
PERMIT FEE: APPROVED:
Zoning
Mechanical
Fire
Notary as to Contractor or Owner - Builder
My Commission Expires:
* * * * * *
Building
Plumbing
Address
phone
.. .5.6)/ Am) 82 ' 40e.
Estimated Cost
fr
Other
Electrical
Engineering
- Builder
It
707- a� 2 5 '7 7- // 3 /g
Date / ✓ Job Address ,�O/ � �' � � Tax Folio /� 3�0 r
Legal Description Z7 141° /� e5(/4r O S 5 / ' � ` ` /i
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
�anei.)/ Lessee / Tenantfi"Z t5 5 Master Permit # 353/
Owner's Address "00/ /4" ,J - -"": 77- Phone
Contracting Co�4 90 . Address 773 c ,/i'�/� J�°
Qualifier % /,3' 1/d j -/ SS# ,/ Phone er,,Y ?0
State 4 da0 /73
Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
. Permit Type(circle one): BUILDING PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Pt. Estimated Cost(valu
gna
ate:
re of owner
OFFICIAL SEAL
y,9OBLES
✓
res
Preefiti9 §6
7.4 OFf:: 0 ,:* Comm. No. CC 205953
+*r+veya
Notary as( Owner ana
My Commission Expires:
and /or Condo President
r*
ANN
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 AFFIDAV:[T: I certify that all the foregoing information is acc rate and that all work will
be done in compliance with all applicable laws regulating constructio an. zoning. F rthermore, I
aut , �' e e above -game contractor to do the work stated.
/
Signature of Q$c
Date: 441*"" Pe77 : '%J
r- Builder
L SEAL
ROBLES
Notary to jigabt6Ommr Ouneray40er
My Commission Expires:
** * * * * * * * * * * * * * * * **
FEES: PERMIT 1 RADON C.C.F. NOTARY TOTAL DUE _ 5i,
APPROVED: Fire Other
Zoning Building Electrical �
Mechanical Plumbing Engineering
Permit No
/
Application is hereby made for the approval of the detailed statement of the plans and specifications her+ith su itted 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. y
Owner's Name and Address J4 0
Registered Architect and /or Engine 'r
Employing Electrician's Name..._ L� -. -•fie �� ..g.. No. 3.." �Q..9.._... • Street.. .r% i
Location and Legal Description Lot Block Subdivision ��L
Street and Number where work is to be performed —No c�.Q..1 � :. Street . Y-4 =— 4
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 $
0
STATE OF FLORIDA, }
COUNTY OF DADE.
Q
A
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PLICATI®N F CIR ELECTRICAL PERMIT
Date
No ,, e)/ .l./ 4Q Street .9.6
(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 of Florida 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.
i - i3O
(Signed) .,g�;i.:..r L...
og
r�
Notary Public, State of Florida
' 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hire 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
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/ ii.
..
`. .,.
h ✓-A/
1
/ es ))
CHECK
Permit No
/
Application is hereby made for the approval of the detailed statement of the plans and specifications her+ith su itted 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. y
Owner's Name and Address J4 0
Registered Architect and /or Engine 'r
Employing Electrician's Name..._ L� -. -•fie �� ..g.. No. 3.." �Q..9.._... • Street.. .r% i
Location and Legal Description Lot Block Subdivision ��L
Street and Number where work is to be performed —No c�.Q..1 � :. Street . Y-4 =— 4
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 $
0
STATE OF FLORIDA, }
COUNTY OF DADE.
Q
A
SS.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PLICATI®N F CIR ELECTRICAL PERMIT
Date
No ,, e)/ .l./ 4Q Street .9.6
(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 of Florida 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.
i - i3O
(Signed) .,g�;i.:..r L...
og
r�
Notary Public, State of Florida
' 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hire 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.
APPLICATION FOR ELECTRICAL PERMIT
Permit No ° .. – – = – -- Date r
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 �____, ____ ______w�� No._ Street-
Registered Architect and /or Engineer
Employing Electrician's Name c ^' * �'s f No . Street__
Location and Legal Description Lot _ _Block _____________ Subdivision _________________________.
Street and Number where work is to be performed— No. ___.___s'.. _ _ ` Street
State work to be performed and purpose of building (By Floors)
New Building____.. Remodeling Addition. - Repairs
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 $
STATE OF FLORIDA,
COUNTY OF D14DE. ss'
MIAMI SHORES VI LLAG E
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.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed) -
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
No. of Stories
Master Electrican.
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
FIXTURES
NO.LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
e
999
f • -
".
I
..
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT
Permit No ° .. – – = – -- Date r
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 �____, ____ ______w�� No._ Street-
Registered Architect and /or Engineer
Employing Electrician's Name c ^' * �'s f No . Street__
Location and Legal Description Lot _ _Block _____________ Subdivision _________________________.
Street and Number where work is to be performed— No. ___.___s'.. _ _ ` Street
State work to be performed and purpose of building (By Floors)
New Building____.. Remodeling Addition. - Repairs
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 $
STATE OF FLORIDA,
COUNTY OF D14DE. ss'
MIAMI SHORES VI LLAG E
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.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
(Signed) -
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
No. of Stories
Master Electrican.
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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No._�' Date__ — 6 4,_
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.
1
Owner's Name and Address \"----'' °' <!_ __ i. _ " _ _L.-' .4. :_-,‹.-'+, No. Street_______
Registered Architect and /or _,
Engineer ____________ —_�
+
Employing Electrician's Name — __________� __ __— \\ No Street___---_____ - -_ _ - -_ —_
8 P - -• -- — 1L' Block L •-- ---------/„;- Location and Legal Description Lot t - -- divlslon- _____�__ -� -_.
Street and Number where work is to be performed —No
\ , . • ; ---_-- - - ---- Street 4,- - - -' 4, '- - -� - -_
State work to be performed and purpose of building (By Floors)
New Building__.. Remodeling Addition Repairs
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 $ r!
(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 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)
My Commission Expires Notary Public. State of Florida
No. of Stories
Master Electrican.
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 be 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.
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
H EATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT. DIST. SERVICE
SW. CAB. TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST /L
-
Nei'
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No._�' Date__ — 6 4,_
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.
1
Owner's Name and Address \"----'' °' <!_ __ i. _ " _ _L.-' .4. :_-,‹.-'+, No. Street_______
Registered Architect and /or _,
Engineer ____________ —_�
+
Employing Electrician's Name — __________� __ __— \\ No Street___---_____ - -_ _ - -_ —_
8 P - -• -- — 1L' Block L •-- ---------/„;- Location and Legal Description Lot t - -- divlslon- _____�__ -� -_.
Street and Number where work is to be performed —No
\ , . • ; ---_-- - - ---- Street 4,- - - -' 4, '- - -� - -_
State work to be performed and purpose of building (By Floors)
New Building__.. Remodeling Addition Repairs
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 $ r!
(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 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)
My Commission Expires Notary Public. State of Florida
No. of Stories
Master Electrican.
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 be 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.
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
Legal Lot BI.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194, _
Contractor's
License No.
PERMIT N9 2945
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Subdi-
vision
Value of
Project
Amt. 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
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 regula-
tions 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 BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
Legal Lot
Description —
Address of,.
Building) '
'
Owner of !�
Building
i
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N? 7387
W, -• .a to perta..Ail '-ceder this Per–°:iitt
Subdi-
vision
Value of
Project $
DATE 195 –
Contractor's
License No, f
�,J
Amount of
Permit $
This permit is granted b 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 w:ith 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
f` '
BY
AUTHORITY
;UILDING
LECTRICAL
'LUMBING
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
PERMIT Nn 6511
Work to be performed under this Permit
)wner of
uilding
architect
Contractor's
License No.
. ontractor
>r Builder
.ega1 Lot Bl. Subdi-
)escription vision
\ddress of Value of Amt. of
iuilding Project Permit ,.L _ ,, ,,.... r
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device dl scribed in the appli-
:ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil be performed in compliance with any
,lans, 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
>ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
ibility 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
,ertaining 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 assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
Contractor's
License No.
PERMIT N9 2835
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project
Amt. 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
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•it tine- etntemetits 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 regula-
tions 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 BY AUTHORITY
Permit No Z C
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PER
Date.
Application is hereby made for the approval of the detailed statement of the plans and specifi ins herew' h submitted for the buil•.' g or other
structure herein described. This application is made in compliance and conformity with the Bui ding Or•' ance of Miami Shores V' age, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and s and regulations of the B Ilding 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
k y — �
Owner's Name and Address
Amount of Permit $
MIAMI SHORES VILLAGE
No 3 c7
Registered Architect and /o a r.
Employing Electrician's Nam • 2�."� 4 " . 11
"0 / J•*-. Street .... /}� siC
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 Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Inst
ndui .. B.X.L. M l Moulding....
(Signed)
lectrical nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o- ations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. ermanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•con. , ors 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 su tors, on work to be performed under this permit, as
licensed by Miami Shores Village.
Street
Master Elect
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, 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
HATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
M OTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No Z C
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PER
Date.
Application is hereby made for the approval of the detailed statement of the plans and specifi ins herew' h submitted for the buil•.' g or other
structure herein described. This application is made in compliance and conformity with the Bui ding Or•' ance of Miami Shores V' age, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and s and regulations of the B Ilding 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
k y — �
Owner's Name and Address
Amount of Permit $
MIAMI SHORES VILLAGE
No 3 c7
Registered Architect and /o a r.
Employing Electrician's Nam • 2�."� 4 " . 11
"0 / J•*-. Street .... /}� siC
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 Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Inst
ndui .. B.X.L. M l Moulding....
(Signed)
lectrical nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o- ations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid. ermanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•con. , ors 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 su tors, on work to be performed under this permit, as
licensed by Miami Shores Village.
Street
Master Elect
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, 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.
APPLICATION FOR ELECTRICAL PERMIT
Permit No ° 3 a Date s 2 F
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..
Registered Architect and /or Engineer
Employing Electrician's Name ...J. m . y....P 1 !i' ett..re, No / !/ I M( Street...)
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No.. I
A - 0 „, , , tate work to be performed and purpose of building (By Floors) / Sr;
/ /New Building Remodeling Addition
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Inst ation— Conduit Tubing B.X.L Metal Moulding
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit $ (Signed)
STATE OF FLORIDA, 1
COUNTY OF DADE. I
58.
No. . 3o, NE Street Cif c-S
Repairs No. of Stories
/
(Signed) a,.
Street
lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his mations 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 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.
0
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, 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
HATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•S HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
q
CHECK
-C --
APPLICATION FOR ELECTRICAL PERMIT
Permit No ° 3 a Date s 2 F
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..
Registered Architect and /or Engineer
Employing Electrician's Name ...J. m . y....P 1 !i' ett..re, No / !/ I M( Street...)
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No.. I
A - 0 „, , , tate work to be performed and purpose of building (By Floors) / Sr;
/ /New Building Remodeling Addition
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Inst ation— Conduit Tubing B.X.L Metal Moulding
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit $ (Signed)
STATE OF FLORIDA, 1
COUNTY OF DADE. I
58.
No. . 3o, NE Street Cif c-S
Repairs No. of Stories
/
(Signed) a,.
Street
lectrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his mations 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 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.
0
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, 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.
MIAMI SHORES VILLAGE
Office of Electrical Inspector
. CERTIFICATE OF INSPECTION
PERMIT
No.
THIS CERTIFIES THAT the wiring and apparatus installed at
by Address
for owner, and occupied as
has been inspected and current is authorized to be turned on, until otherwise notified, for :
Siize of Service Number of Lighting Circuits
Range watts. Water Heater ; watts
Power: Connected load H P Space Heaters watts
Other Apparatus
ELECTRICAL INSPECTOR.
JOB:
BUILDING
•
•
ELECTRICAL : •
.
. -,--
. : WOFK -1
BY:
PLUMBING : : bul\,3
: :RLQUESTED : WILL BE READY
: •
. t f
A/VI 7 v____
, •
.
))
:
The following is ready for Inspection: -
Inspector's Report : -
AID:
0
&
ef/'
(.,
APPLICATION FOR ELECTRICAL PERMIT
Permit No._ "1 Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subnTitted 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 _ __.:,
Service Overhead Size Feeders
Underground
Amount of Permit $ 4
STATE OF FLORIDA, I
COUNTY OF DADE. es.
My Commission Expires
Conduit
Main Sw
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No -- -_ Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot 42.-_ ___T .„ Block
Street and Number where work is to be performed —No. y 0 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No
(Signed)
Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Street
Main
No. of Stories
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he unders s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General L ws 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) --- --- - -- --
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
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.
Master Elcctrican.
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.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT
Permit No._ "1 Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subnTitted 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 _ __.:,
Service Overhead Size Feeders
Underground
Amount of Permit $ 4
STATE OF FLORIDA, I
COUNTY OF DADE. es.
My Commission Expires
Conduit
Main Sw
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No -- -_ Street
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot 42.-_ ___T .„ Block
Street and Number where work is to be performed —No. y 0 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No
(Signed)
Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Street
Main
No. of Stories
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he unders s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General L ws 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) --- --- - -- --
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
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.
Master Elcctrican.
JOB:, ADD:
BUILDING •
ELECTRICAL
PLUMBING
•
W OR K
DONE BY:
REQUESTED : WILL BE READY
The Following is ready for ins poct on:
Inspector's Reports �.
/0
BUILDING
ELECTRICAL
PLUMBIND
•
WORK
DOYE BY: 1
•
REC,%T.T.i•STED
7-
The following is ready for inspection:-
Inspector's Report:-
N/
?
WILL BE AEADY
MIAMI SHORES VILLAGE PERMIT
No.
Office of Electrical Inspector
CERTIFICATE OF INSPECTION
1 n9d C.
THIS CERTIFIES THAT the wiring and apparatus installed at
by Address
for owner, and occupied as
has been inspected and current is authorized to be turned on, until otherwise notified, for :
Size of Service Number of Lighting Circuits
Range watts. Water Heater watts
Power: Connected load H P. Space Heaters watts
Other Apparatus
ELECTRICAL INSPECTOR.
MIAMI SHORES I
ELECTRICAL INSPECTION DEPARTMENT'
APPLICATION FOR ELECTRICAL PERMIT
J 1
Permit No.__' __ ( Date___ � rR
_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub itted 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, whetter herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Addres =
Amount of Permit $
sneer
Registered Architect and /or
Employing Electrician's Name
Location and Legal Description Lot_______
Street and Number where work is to be performed —No
No . – ------
K 4. -.1,5 �
No._________ . Street
Street__
Subdivision_
a
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 —_—_____ ______—___— _______-- ___________
�7_ ----------- _�_� —_ -- __ _ - -__ __
(Signed)
My Commission Expires
Notary Public. State of Florida
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) _______ r y i
Master Electrican.
STATE OF FLORIDA, )
COUNTY OF DADE. j 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 he 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
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVJ
P %EM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
r
MIAMI SHORES I
ELECTRICAL INSPECTION DEPARTMENT'
APPLICATION FOR ELECTRICAL PERMIT
J 1
Permit No.__' __ ( Date___ � rR
_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub itted 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, whetter herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Addres =
Amount of Permit $
sneer
Registered Architect and /or
Employing Electrician's Name
Location and Legal Description Lot_______
Street and Number where work is to be performed —No
No . – ------
K 4. -.1,5 �
No._________ . Street
Street__
Subdivision_
a
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 —_—_____ ______—___— _______-- ___________
�7_ ----------- _�_� —_ -- __ _ - -__ __
(Signed)
My Commission Expires
Notary Public. State of Florida
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) _______ r y i
Master Electrican.
STATE OF FLORIDA, )
COUNTY OF DADE. j 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 he 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.