ELECTRICALAmount of Permit t__Z
es.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
Employing Electrician's Name __
Location and Legal Description Lot_ _._4
Street and Number where work is to be performed —No ,e
4 mot/. E
(Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address _:u272. No. Street__
Registered Architect and /or Engineer
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs
Permit No.___1 _______.___ Date
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.
Street_ O tI
_Block .2 Snbdivision.__e!�f' y
Street e®
No. of Stories_
Service Overhead Size Feeders Conduit.___ _____ Main Sw. Amps. Main Fuses_ .MAmpe.
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 ' nderstands and accepts his obl : done u 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.
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, that he has carefully read the foregoing application, and that he did sign the ame, 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RLCE'r'T'S
FIXTURES
NO.LAMPS
REMR1G.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
NEATER
W. HEAT.
CONN.
SPACE
NEATER
STRIP
NEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
M.
MOTORS
0-1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Amount of Permit t__Z
es.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
Employing Electrician's Name __
Location and Legal Description Lot_ _._4
Street and Number where work is to be performed —No ,e
4 mot/. E
(Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address _:u272. No. Street__
Registered Architect and /or Engineer
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs
Permit No.___1 _______.___ Date
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.
Street_ O tI
_Block .2 Snbdivision.__e!�f' y
Street e®
No. of Stories_
Service Overhead Size Feeders Conduit.___ _____ Main Sw. Amps. Main Fuses_ .MAmpe.
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 ' nderstands and accepts his obl : done u 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.
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, that he has carefully read the foregoing application, and that he did sign the ame, 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.
2
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
0 APPLICATION FOR ELECTRICAL PERMIT
Applicat n is exeby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
structu herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Smp
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all roles and regularities of
of Miami Shores Village *hall be complied with, whether herein specified or not. A copy of approved piefte end spetifictelt4'
building during progreu of work.
Owner's Name and Address ........._A.ZA- S7&B...e....4 No Strut 4.-.0
Registered Architect and/or Engineer
'--=--
Employing Electrician's Name No ,„7 ._ Strut , —
Location and Legal Description Lot _4(12.—±:........7 Block-_7_.Z__ '''''17.:L
Street and Number where work is to be pufonned--No 14c ‘ ALA..- Suser_72 34 0- .
State work to be performed and purpose of building (By Floors)
New Building_ 4. Remodeling Addition_
Overhead
Service Underground Size Feed
en_ Conduit_ Main Sw._/4 Amps Main Fuses
Type of Installation—Conduit Tubing. .B.X.L Metal Moulding
AVM
(sign
or -
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
elm 00 ••■•• •
The undersigned applicant for this building permit does hereby certify that he understands and accepts his
under the Florida Niforkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permautut
plied with the provisions thereof, and will requite similar compliance from all contractors or sub -contractors employed
performed under this permit; and will post or cause to be posted for inspection on the site of the work sub pub&
required by the Act The under signed agrees to employ only such sub-contractors, on work to be performed Ur
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take sekmyerbidellifik
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is tba
of the above described construction, that be has carefully read the foregoing appllcadon. and that be did alga ebe aim
therein by him stated are true.
My Commission Expires Notary Public. State of Model
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inept:do& or hay
materials and/or workmanship.
Date
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address 9 a� ,4/& , ' f f/gee
Legal Description Ak
Owner / Lessee / Tenant ko ,b,Q!`1 l` u,'v Z,e,G.-
Owner's Address A/6 . c 7`i e f
Contracting Co. ( /f � &v, �L1,/SJer7S Address ). 'C ,P(d 1 / W L
Qualifier L 2A) eL,(, /(4 SS# / Phone 067-69
Stated e )4 N/ Competency aG►e1 ///5 :3' Ins. Co. Sec,
7S ot/a
Architect /Engineer
Bonding Company
Mortgagor
7"
Permit Type (circle one): BUILDING C PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION JU f -7 (, } fl ( p 2 r,, y SIf ,.
Square Ft . Estimated Cost 0
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, ROOF) G, and MECHANICAL work.
OWNER'S AFFIDAVIT: I certify that all the foregoing informati
will be done in compliance with all applicable laws reg
Furthermore, I authorize the above -named contractor to do t
Signature of OwT•' an or Co
Date:
Not
MY
v
PERMIT FEE: APPROVED:
y as (/to Owner and /or Condo
mmission Expires: i� / /b rnL
* *
President
President
*
*
Fire
Address
Address
Address
Tax Folio // ?„2 G /y ,, ;.3D
Master Permit # d
Phone
Signature of Contra
Date:
ary as
My Commi
* *
is accurate and that all work
ting construction and zoning.
ork -tate
Ofher
or or
Zoning Building
ti/
Mechanical Plumbing Engineering
Electrical'
er,- Bu}ilder
• '143%.
��ff+5�►�lu
*