52 NE 98 St (2)1/
Permit No
;?4?)04
Amount of Permit $ X
STATE OF FLORIDA,
COUNTY OF DADE. I U.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date.. /..
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, Fio: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 ^-/CE EZ/4 f2-
Registered Architect and /or Engineer .. /1)//4) lij /..'.f.
Employing Electricia _Name... 0.0 �! ... . LEG - 7 R _
Block
Street and Number where work is to be performed—No
sZ
(Signed)
(Si
No 5 Street Ai'
No 4' 6 9 Street
Subdivision
Street
60.
State work to be performed and purpose of building (By Floors) 7- �
New Building Remodeling 4 / 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
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 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 public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work cad under this permit, as are
licensed by Miami Shores Village.
Muter rician.
Notary Public, State of Florida
Before me, the undersigned authonty, 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 depose 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.
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
0
LIGHT
OUTLETS
PLUG
RECE'P'T•E
FIXTURES
NO LAMPS
RE /RIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
H
TOTAL
CL
LIST
/
CHICK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
2 /5}
�rSI-'
41.1/43
MOTORS
O.1 HP
MOTORS
14E HP
NEON
TRANS.
RADIO
TOTAL
-
CONTR.
LIST
CHICK
.
1/
Permit No
;?4?)04
Amount of Permit $ X
STATE OF FLORIDA,
COUNTY OF DADE. I U.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date.. /..
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, Fio: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 ^-/CE EZ/4 f2-
Registered Architect and /or Engineer .. /1)//4) lij /..'.f.
Employing Electricia _Name... 0.0 �! ... . LEG - 7 R _
Block
Street and Number where work is to be performed—No
sZ
(Signed)
(Si
No 5 Street Ai'
No 4' 6 9 Street
Subdivision
Street
60.
State work to be performed and purpose of building (By Floors) 7- �
New Building Remodeling 4 / 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
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 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 public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work cad under this permit, as are
licensed by Miami Shores Village.
Muter rician.
Notary Public, State of Florida
Before me, the undersigned authonty, 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 depose 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.
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, FLORIDA
BUILDING ❑
ELECTRICAL El DATE !' 2 -I 1 95/
PLUMBING ❑ PERMIT N° 7547 Contractor's -
License No.
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
1 1/4 J r
Lot
S t rI
c
Signed:
1
C._ Htt ■) -.
Subdi-
vision
f 1 c
Sq. Ft
Value of
Project $
/ o c
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 responsib ity for a thorough knowledge f the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the stat ents or specificatiorys' and that e assumes responsibility for work
done by his agents, servants or employees.
(A-'V L • it A
S c._
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered her - der in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications sub 1•. tted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibili for all work done by either, myself, my agent, s • ant or employee.
,( j ` r
r
CONTRACTOR OR BUILDER BY
AUTHORITY
17
'LOOK
NUMBER OF
SIZES OF
INSULATION
OPEN
OPEN OR
Number of
Circuits
Outlets
Motor
Gen.
Main
Sub
Branch
;ment—
f
c L
•th
-
—
r Floors
— —
—
r orm 21t
Electrical Department of the City of Miami
Desiring your Certificate of Approval, application is hereby made
for an inspection of the electric installation in the premises stated be-
low, for which undersigned agrees to correct any infractions of the
National Electrical Code and the City Rules pointed out by Inspector.
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICA-
TION WILL BE RETURNED
Lot Number 4, Block Number i ' ' v' —t.. � . ! e ,' y
Street and Number S' - e 44‘) ‘1 Side Al 4-777 4 7
Owner \-:,?, " �, .�./ �{ � Occupant ^.�_
Occupied as ,,f i'( i`.,- . 1 -
Building —New or Old (underline which). Work — Additional or New (underline which).
SPECIFICATIONS
H. P. of each motor
Number of Motors H P Volts Amps
Outlets Motors Receptacles Generators
Greatest Number of Lights on One Branch (Nature of Work) Open — Concealed Knob— Mldg.— Conduit
1
Bas
Firs
Seco
Thir
Fou
Oth
REMARKS•
Work will be started
(Applicant sign herer-X
Received by Inspector
CERTIFICATES
Progress
Will inspect again
Rough Wiring
FINAL No
Corrected
Temporary Days
Approved Letter
Date Issued
SPACE B
Correct Location
Correct Equip
DEFECTIVE
Time
Allowed
Days
APPLICATION
DATE ) / ~ S . 1922:4_
Phase
Stoves Xater Heater Signs Billboards Other Apparatus
Will be finishe
W FOR INSPECTORS USE ONLY
22
N
Address /
.t
Street
Inspected
Electric Light Co.
Fee remitted
{emarks
Inspector
Permit No
i
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date o2 �.d....�1
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, Fiv :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. /� ,,/ ,� / / O
Owner's Name and Address Sl o y..IT��f9 No �l �V' C. Street . 7P ST
Registered Architect and /or Engineer
Employing Electrician's Name QW 7a 'Pin'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No qq Street
State work to be performed and purpose of building (By Floora).a4.. �.,
New Building Remodeling Addition
Amount of Permit $
service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L .Metal Moulding
((t (Signed). P DR.
No Street
Repairs No. of Stories
(Signed)
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 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.
dze.e
Master Electrician.
STATE OF FLORIDA, t
COUNTY OF DADE. f ~'
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
0
PLUG
RECE'P'T S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
N EATER
W. MEAT.
CONN.
SPACE
NEATER
STRIP
N EATER
TOTAL
CONTR.
LIST
CHECK
E NT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.11 MP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
i
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date o2 �.d....�1
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, Fiv :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. /� ,,/ ,� / / O
Owner's Name and Address Sl o y..IT��f9 No �l �V' C. Street . 7P ST
Registered Architect and /or Engineer
Employing Electrician's Name QW 7a 'Pin'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No qq Street
State work to be performed and purpose of building (By Floora).a4.. �.,
New Building Remodeling Addition
Amount of Permit $
service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L .Metal Moulding
((t (Signed). P DR.
No Street
Repairs No. of Stories
(Signed)
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 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.
dze.e
Master Electrician.
STATE OF FLORIDA, t
COUNTY OF DADE. f ~'
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.
Permit No
APPLICATION FOR ELECTRICAL PERMIT
V7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi h submitted.fr 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.
6
Owner's Name and Address
Registered Architect and /or gineer
Employing Electrician's Name.. ✓t�L�La.���- zs�n...
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No � Street.M
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition ` Repairs No. of Stories
/' /
Service
Underground Size Feeders VD Conduit y Main Sw 1 5 t Amps Main Fuses ..... /S Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and acce
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of
has complied with the provisions thereof, and will require similar compliance from all contractors or su
work to be performed under this permit; and will post or cause to be posted for inspection on the site o
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be
licensed by Miami Shores Village.
65.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
' No 2d
(Signed)
(Signed)
Date
/ Y` �' L � ® f.! 4
Street ,
Street
•
Notary Public, State of Florida
"F ,
Electrical Inspector.
pta obligations as an employer of
rida Permanent Supplement, and
contractors employed by him in the
the work such public notice or notices
performed under this ermit, as are
Master Electrician.
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, 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.
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.
ccv
�'o
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
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CLNTR.
LIST
l° 1 �zA,.,,,,�
} '
�Z 4
/1
1 -
CHECK
1 O-J
xi
Permit No
APPLICATION FOR ELECTRICAL PERMIT
V7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi h submitted.fr 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.
6
Owner's Name and Address
Registered Architect and /or gineer
Employing Electrician's Name.. ✓t�L�La.���- zs�n...
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No � Street.M
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition ` Repairs No. of Stories
/' /
Service
Underground Size Feeders VD Conduit y Main Sw 1 5 t Amps Main Fuses ..... /S Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and acce
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of
has complied with the provisions thereof, and will require similar compliance from all contractors or su
work to be performed under this permit; and will post or cause to be posted for inspection on the site o
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be
licensed by Miami Shores Village.
65.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
' No 2d
(Signed)
(Signed)
Date
/ Y` �' L � ® f.! 4
Street ,
Street
•
Notary Public, State of Florida
"F ,
Electrical Inspector.
pta obligations as an employer of
rida Permanent Supplement, and
contractors employed by him in the
the work such public notice or notices
performed under this ermit, as are
Master Electrician.
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, 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.
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.
ccv
�'o
`.• - • 4 ' • • rr:4
•••
Permit No... D �/
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be 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
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Qr- xU,Q u No ,S 2,
Registered Architect and /or Engineer
Employing Electrician's Name
No../ .�
Block Subdivision
Date /
Street..4. 7R4-
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 Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub - contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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.
(Signed)
Master 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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CO NN.
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
Permit No... D �/
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be 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
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Qr- xU,Q u No ,S 2,
Registered Architect and /or Engineer
Employing Electrician's Name
No../ .�
Block Subdivision
Date /
Street..4. 7R4-
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 Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub - contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
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.
(Signed)
Master 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.
FOR FIXTURE WORK ONLY
ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI
Desiring your Certificate of Approval, application is hereby made for an inspection of the electrical instal-
lation in the premises stated below, for which the undersigned agrees to correct any infractions of the Nat-
ional Electrical Code and the City Rules pointed out by Inspector.
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION
ALL SPACES MUST BE FILLED, OR APPLICATION WILL BE RETURNED
7
Lot Number Block Number , �! ! ! >, '
- -
Street and N�imber ' - I 4/ /r ,!.., , t Side
Owner 1,'' 4'
r
_. Occupant
Occupied as „t i
Building —New or Old (underline which). Work — Additional or New (underline which).
Floor
Basement
1st Floor
2d Floor
3d Floor
4th Floor
5th Floor
6th Floor
7th Floor
8th Floor
Attic
Received by Inspector
Progress
Vill Inspect Aga'
igh Wiring
T
Number of
Lights
CERTIFICATES
No.
REMARKS:
�C --/...
, will be finished
- A r ' . 7 . Address .'� . ' . ._..s.- ..
.._; ' '' f .
(Applicant sign here) .�
r ,r0-- ...... Street r ' /
Days
'.er
Ceiling Outlets
/SPACE ') BE OW FOR INSPECTOR'S USF ONLY / 1
° / 3 '7 Inspected . l.j �f " � .�
DEFECTIVE
Time
Allowed:
Days
APPLICATION / No.
Date ! , 192 1
SPECIFICATIONS
Correct Location
Correct Equipment
Bracket Outlets
aTtt\A-ks �y4�
Electric Light Co.
Fee remitted
Remarks:
Number of Circuits
A L