453 NE 99 St (7)J
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 " No 3 Street. .. l: l
Registered Architect and /or Engineer ,� /� , J 'I
Employing Electrician's Name IS ^^^�^'� ` G No e Street ..... 7 t` '
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
Permit No
rvice Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
ype of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
J
Date
My Commission Expires
MIAMI SHORES VILLAGE
(Signed)
(Signed)
•
Notary Public, State of Florida
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accept . h' obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of ' - 'da Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or a = •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 to be performed under this permit, as are
licensed by Miami Shores Village.
/ 6(
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I 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.
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 NEON
1.5 HP TRANS.
RADIO
TOTAL
CONTR.
LIST
/� 3°
_ (,/
41/61119
CHECK
_
P -
- -- -
-- --
-- - --
R /n-
J
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 " No 3 Street. .. l: l
Registered Architect and /or Engineer ,� /� , J 'I
Employing Electrician's Name IS ^^^�^'� ` G No e Street ..... 7 t` '
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
Permit No
rvice Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
ype of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
J
Date
My Commission Expires
MIAMI SHORES VILLAGE
(Signed)
(Signed)
•
Notary Public, State of Florida
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accept . h' obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of ' - 'da Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or a = •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 to be performed under this permit, as are
licensed by Miami Shores Village.
/ 6(
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. I 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.
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.
UILDING
ECTRICAL
UMBING
ontractor "a
Builder
MIAMI SHORES VILLAGE, FLORIDA
DATE "9 194
Contractor's
License No.
PERMIT N° 8451
Work to be performed under this Permit
wner of / t
ulding f x ,,
chitect
_gal Lot Bl.
escription
dress of i
r` M ( Value of Amt. of
iilding / ' _ Project Permit -
This permit is granted to the contractor or huilder named above to construct the building or to install the equipment or device described in the appli-
tion herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work wil be performed in compliance with any
ms, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
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
rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
'illations pertaining to the work covered hereby whether shown on the plans or drawing or in the state rents or specifications and tl}at he assumes respon-
,ility for work done by his agents, servants or employees. ., �
Signed: 1 , e , d {
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
rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Mitmi Shores Village.
accepting this permit I assume responsibility for a work done by either myself, my agent, servant or employee.
Subdi-
vision
CONTRACTOR OR BUILDER BY
AUTHORITY
Permit No._
STATE OF FLORIDA,
COUNTY OF DADE.
}
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date I S 7 d
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_ _ —el' Street_ -
Registered Architect and /or Engineer
.Y � ' ; 1` ,-._ _ - l .
Employing Electrician's Name 4 4I%`= . ' _i_s �Fi___ -------- ----- •------------- No._ -___f . _ `- .�
" / ° Street___;—
_:
Location and Legal Description Lot _____ 1_ ___�______________— ____________ Block 4,____1 Subdivision e
Street and Number where work is to be performed—No .____.... � ' =__ Street_ ../.. - • ``''
State work to be performed and purpose of building (By Floors)__ b __- ___ ;�_-
New Building Remodeling_ Addition__ _Repairs No. of Stories
ss.
Service 1 Overhead Size Feeders Conduit, l __Main Sw. —__ Amps. Main Fuses Amps
Underground —
Type of Installation — Conduit Tubing ___B.X.L.______ Metal Moulding
Amount of Permit $ _— `Y '4e -- —_ __ ( Signed)— �'= Y ' �° --1 'I
\ — — — — . 2, .7, 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, Corp iled 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 p osted 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed)
1 •.
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 *lade 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
E..
'•
/-' 1
_ ,.
/'
/
N, 't
' ' ..
1
CHECK
/ //NJ
/
A.
'
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No._
STATE OF FLORIDA,
COUNTY OF DADE.
}
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date I S 7 d
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_ _ —el' Street_ -
Registered Architect and /or Engineer
.Y � ' ; 1` ,-._ _ - l .
Employing Electrician's Name 4 4I%`= . ' _i_s �Fi___ -------- ----- •------------- No._ -___f . _ `- .�
" / ° Street___;—
_:
Location and Legal Description Lot _____ 1_ ___�______________— ____________ Block 4,____1 Subdivision e
Street and Number where work is to be performed—No .____.... � ' =__ Street_ ../.. - • ``''
State work to be performed and purpose of building (By Floors)__ b __- ___ ;�_-
New Building Remodeling_ Addition__ _Repairs No. of Stories
ss.
Service 1 Overhead Size Feeders Conduit, l __Main Sw. —__ Amps. Main Fuses Amps
Underground —
Type of Installation — Conduit Tubing ___B.X.L.______ Metal Moulding
Amount of Permit $ _— `Y '4e -- —_ __ ( Signed)— �'= Y ' �° --1 'I
\ — — — — . 2, .7, 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, Corp iled 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 p osted 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed)
1 •.
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 *lade when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Lot
�-.
NTRA OR 0 BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 7513
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or . evice described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at anytime 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 drawings or in the statements or specifications and that he ass u es respon-
sibility for work by his agents, servants or employees.
Bl.
SPECTOR
In consideration of the issuance to me of this permit I agree to perform alh,
work covered hereunder in compliance with .ordinances :� g�ations
pertaining thereto and in strict conformity with the plans, drawings, statem nt or specifications submitted to the proper authoritfes of Mia ((��'' ores i11Mge.
In accepting this permit I assume responsibility focal work done by either my agent, servant or employee. _
Subdi-
vision
Value of
Project
BY
Signed.
DATE
C�ir
License No
C%� /lit -a✓Z...E� �i� ���
i
Amt. of
Permit
By
0.2 . 7c
AUTHORITY
194g9 —
Company
Job . - \c" ^
,
Address
Inspection
REQUEST FOR iNSPECTION
PHONE
Time Ready
Date Ready
,
' 2
A.M.
P.M.
Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all 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______ • En No L Street______
Registered Architect and /or Engineer __ ________________________
Employing Electrician's Name__- ; - + - -_- _ _ No.--- 9 - -� --- Street - - - - --
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 Y
_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 $ f t_ -— --- ----- -- -- ----- --- ----, (Signed) —
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that 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 Florida ''ermanent 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 p osted 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Villa
( Signed)_
STATE OF FLORIDA, ' 7
COUNTY OF DADE. } ss.
Before me, the undersigned authority, a notary public, duly authorized to
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.
Master Electrician.
administer oaths and take acknowledgments, personally
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
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
Permit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all 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______ • En No L Street______
Registered Architect and /or Engineer __ ________________________
Employing Electrician's Name__- ; - + - -_- _ _ No.--- 9 - -� --- Street - - - - --
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 Y
_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 $ f t_ -— --- ----- -- -- ----- --- ----, (Signed) —
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that 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 Florida ''ermanent 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 p osted 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Villa
( Signed)_
STATE OF FLORIDA, ' 7
COUNTY OF DADE. } ss.
Before me, the undersigned authority, a notary public, duly authorized to
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.
Master Electrician.
administer oaths and take acknowledgments, personally
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.
1: Ifer 5i
Application f hereby made for the approval of the detailed statement of the plans and specifications herewi1 submitted for the b ding or of er
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether • - ein speci or not. A copy of approved plans and specifications must be kept at
b k.
2 . 5
� / 1 ` F
11 3.:Ei C "'
Street_
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PLICATION FOR ELECTRICAL PER
Registered Architect and /or Engineer
Employing Electrician's Name 4 a024SLI S tre _________ Street
Location and Legal Description Lot ,lock
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
(Sign
Street__
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Underground Size Feeders Conduit_ Main Sw. Amps
Type of Installation — Conduit Tubing B.X.L.______ Metal Moulding_
(Signed)...
Elect Inspe .r.
The undersigned applicant for this building permit does hereby certify tha tands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compi ed 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 p osted 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 - contractors, on work to be .erformed under this permit, as are
licensed by Miami Shores Village.
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
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. s r
LIST
L
•
CHECK
oe
1: Ifer 5i
Application f hereby made for the approval of the detailed statement of the plans and specifications herewi1 submitted for the b ding or of er
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether • - ein speci or not. A copy of approved plans and specifications must be kept at
b k.
2 . 5
� / 1 ` F
11 3.:Ei C "'
Street_
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
PLICATION FOR ELECTRICAL PER
Registered Architect and /or Engineer
Employing Electrician's Name 4 a024SLI S tre _________ Street
Location and Legal Description Lot ,lock
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
(Sign
Street__
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Underground Size Feeders Conduit_ Main Sw. Amps
Type of Installation — Conduit Tubing B.X.L.______ Metal Moulding_
(Signed)...
Elect Inspe .r.
The undersigned applicant for this building permit does hereby certify tha tands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compi ed 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 p osted 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 - contractors, on work to be .erformed under this permit, as are
licensed by Miami Shores Village.
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
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is grtnte to the contractor or build ed above t construct the building
cation herefor in strict compliance with all ordinances rt ning thereto d w th the un erstan
plans, drawings, statements or specifications that may have been submit ed to and appro •d by
at any time if the work is not done in compliance with such ordinances or if the plans . - ch
permit is granted is the understanding that the contractor or builder named above assu s th
regulations pertaining to the work covered hereby whether shown on the plans or drawl
sibility for work done by his agents, servants or employees.
Lot
Work to be
jiA145
0041,tcr?,
ERMIT N? 7384
MIAMI SHORES VILLAGE, FLORIDA
.3 Id
CONTRACTOR OR BUILDER
erformed under this Permit
eirS(Ihp
Bl.
n
permit I r e eT'f ht Na v
Subdi-
vision
Value of
Project
� t
e
BY
DATE
194
Contractor's
License No
Amt. of
Permit
the equipment or device desc
work will be performed in complia
unicipal authorities. This Permit
authorization. A further condition
ty for a thorough knowledge o the
statemen s . specification .
In consideration of the issuance to me of this g p eyed hereunder in compliance wi all ordinances .' d regulations
pertaining thereto and in stn conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami shores Village.
In accepting this permit I a responsibil 'ty for all work done by either myself, my agent, servant or employee.
AUTHORITY
in the appli-
with any
ay be - oked
on which 's
rdinances and
sumes respon-