ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address f s / 7 `/ Viax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant JA1 gJ I/r Master Permit # Crc( / :
Owners Address
OWNER'S
laws re
Signature if
Notary as to OWII,
My Commission Expires:
FEES: PERMIT d.3 w0 RADON
Phone
Contracting Co. ES `� U t1 / r /7 / Addred& 5 9 (5 22 , Ad
Qualifier /0 / 1,.4-/ gin r, (C Y 1 O) SS# Phone 65 - (o .o
State # oOQ 9 3 PV Municipal ghbot a fd V anpetency # Ins. Co. '7(/// l45
Architect/Engineer Address
Bonding n
gam!' Y Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /�( C�Q is g /c -(( .� �/1
r. J �
Square Ft. Estimated Cost (value) 4 —
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 met the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLU 1 ING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
• • �' O
IDAVIT: I certify that all •regoing nformation is accurate and thioit 110,641 be done in compliance with all applicable
co��ion and zoning. � ermore uthoriz above -named c
,
I0 . e
ei
At .
to ndo President Date
a ad 4gork stated.
•
R
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
C.C.F. NOTARY TOTAL DUE
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
Electrical6's/
Date
Permit No._
Amount of Permit $__
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
_Block
(Signed)
Street
Application is hereby made for the approval of the detailed statement o f 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 i
Owner's Name and No Street
Registered Architect and /or Engineer
Employing Electrician's Name ✓- 'I_L'�_Z_ No . Street L
Location and Legal Description Lot
Street and Number where work is to be performed —No
Subdivision
t2'
Master Electrician.
State work to be performed and purpose of building (By Floors)
New Building Remodeling _Addition. .Repairs .. No. of Stories
Service Overhead Underground Size Feeders Conduit Main Sw. Amps Main Fuses Amps
Type of Installation — Conduit_ Tubing B.X.L Metal Moulding
(Signed) _ _____<• • _ 1
y Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands ,and accepts his ob igations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the
work to be performed under this permit; and will post or cause to be poseed 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.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly a uthorized 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
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_
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CHECK
•
B'
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
6
/CI (9
&••••
CHECK
Permit No._
Amount of Permit $__
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
_Block
(Signed)
Street
Application is hereby made for the approval of the detailed statement o f 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 i
Owner's Name and No Street
Registered Architect and /or Engineer
Employing Electrician's Name ✓- 'I_L'�_Z_ No . Street L
Location and Legal Description Lot
Street and Number where work is to be performed —No
Subdivision
t2'
Master Electrician.
State work to be performed and purpose of building (By Floors)
New Building Remodeling _Addition. .Repairs .. No. of Stories
Service Overhead Underground Size Feeders Conduit Main Sw. Amps Main Fuses Amps
Type of Installation — Conduit_ Tubing B.X.L Metal Moulding
(Signed) _ _____<• • _ 1
y Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands ,and accepts his ob igations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the
work to be performed under this permit; and will post or cause to be poseed 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.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly a uthorized 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
Owner's Name and Address ..__� __L1�
Registered Architect and /or Engineer
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.
Date - -
LI
_c ) T' ' ! No Street
r % > Ir `= °� �° G c
Employing Electrician's Name_1�__.___ _._ 1.1_�I__n _ ' _; _., No f y__1 t L Street___.__ 2.___a
o '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No _::_. :___. Az , t �1 Street______..:_ �`G! r°
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
STATE OF FLORIDA, )
COUNTY OF DADE. I ss.
y ,
r
Amount of Permit $.
- - -�c I ( Signed) `� �• . 1 � t
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that a nderstands and accepts his o a gations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Comp ed 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 posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
o
r
M ter Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized 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.
LIST
.
7
ti , v L-
-
7,
CHECK
/
Permit No
Owner's Name and Address ..__� __L1�
Registered Architect and /or Engineer
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.
Date - -
LI
_c ) T' ' ! No Street
r % > Ir `= °� �° G c
Employing Electrician's Name_1�__.___ _._ 1.1_�I__n _ ' _; _., No f y__1 t L Street___.__ 2.___a
o '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No _::_. :___. Az , t �1 Street______..:_ �`G! r°
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
STATE OF FLORIDA, )
COUNTY OF DADE. I ss.
y ,
r
Amount of Permit $.
- - -�c I ( Signed) `� �• . 1 � t
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that a nderstands and accepts his o a gations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Comp ed 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 posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
o
r
M ter Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized 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
Architect
Contractor
or Builder
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Li PERMIT N° 9154
Work to be performed under this Permit
Owner of
Building
Subdi-
vision
DATE 1954.,—
Legal Lot Bl.
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 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.
Value of
Project $
Contractor's
License No
Amt. of
Permit $
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
4
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
Ell PERMIT N° 9017
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATR 195
Contractor's
License No
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
1NSPFCTOR
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
•
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'VT'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
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 No
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SI -101 ES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION F ®R ELECTRICAL PE -MIT �7
Date Ye 1, �..+��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
otructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fig :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.
CO y _ i
Owner's Name and Addtess.TH CO. LLE. l T No.. Street... A' RE• 98 .J. 6.
Registered Architect and/or Engineer
Employing Electrician's Name No Street
M I Ai'/11 Si- icxc,!'5
Location and Legal Description Lot.i .0N.ATH
.G. AS�.y.� �j �.
LOT IlBlock J..2 Subdivision.Seei,- (0. ,7
..
Street and Number where: work is to be performed —No... .2 T.�.eb�., Street. 8.Tl�{.
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
(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 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 to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
119) BY
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.
l9GU/LG��Z