ELECTRICALPermit No
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. �+ Q
Owner's Name and Address.. /Ib '4 ` to 4 v S, � No f3 0
Registered Architect and /or Engineer
Employing Electrician's Name v 2 .A' ,'Z477' L
Amount of Permit $
STATE OF FLORIDA, Ij
t
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
(4(1'
(Signed)
(Signed
No / 3,�.to
Date
— �7
Street 4/ " E ? <
Street
Location and Legal Description Lot p Block Subdivision (�
Street and Number where work is to be performed —No 1 d . ..... ...... . �'r�� Street .! F IJ .•• /
State work to be performed and purposc of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories l
� fir►
Serv Overhead S Feeders..�1,1 �..Condui / `. .2 Main Sw.y� - O� Amps.C2!✓0A.Main Fuses. 0 14 Amps
Underground r '
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and accepts his
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-con
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, work to be performed under this permit, as are
licensed by Miami Shores Village.
/9 '`-`' 445c
yti�a
Master Electridan.
Electrical Inspector.
o• ' gations as an employer of
crmanent Supplement, and
ctors employed by him in the
es.
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''S
FIXTURES
NO. LAMPS
REFRIG..
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CO / NN '' N.
WATER
H
W. HEAT.
CONN.
SPACE
H EATER
STRIP
H
TOTAL
LIST
/ P''T T
CHECK
�\
'J-
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
.
TOTAL
CONTR.
LIST
LIST
Q 4
-Z.
CHECK
Permit No
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. �+ Q
Owner's Name and Address.. /Ib '4 ` to 4 v S, � No f3 0
Registered Architect and /or Engineer
Employing Electrician's Name v 2 .A' ,'Z477' L
Amount of Permit $
STATE OF FLORIDA, Ij
t
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
(4(1'
(Signed)
(Signed
No / 3,�.to
Date
— �7
Street 4/ " E ? <
Street
Location and Legal Description Lot p Block Subdivision (�
Street and Number where work is to be performed —No 1 d . ..... ...... . �'r�� Street .! F IJ .•• /
State work to be performed and purposc of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories l
� fir►
Serv Overhead S Feeders..�1,1 �..Condui / `. .2 Main Sw.y� - O� Amps.C2!✓0A.Main Fuses. 0 14 Amps
Underground r '
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and accepts his
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-con
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, work to be performed under this permit, as are
licensed by Miami Shores Village.
/9 '`-`' 445c
yti�a
Master Electridan.
Electrical Inspector.
o• ' gations as an employer of
crmanent Supplement, and
ctors employed by him in the
es.
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.