MECHANICALPermit No
Service Overhead
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR PERMIT
l'
vi N � -+ ' 1 �' Date .3 "/5 +
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, Fiu: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 �a eJi k 42% (9 J 9 C� $ No _/ 6 0 Street / 9 T
Registered Architect and /or Engineer
Employing Electrician's Name No Street rr
a S ,eS
Location and Legal Description Lot `�7 Block 6 0 Subdivision
4,7) -s sl
Street and Number where work is to be performed —No
STATE OF FLORIDA,
O DADE.
State work to be performed and purpose of building (By Floors)..
New Building Remodeling Addition
(Signed)
Street
C 4 ...Q/Y......lQ. -s�r��
o. o Stories
Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
r l � tress isal- 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.
,c
(Signed).. 9 Y r
C A - 00,9864
A c
COUNTY OF 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 face
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
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. HEAT.
CONN.
SPACE
14
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
Service Overhead
Amount of Permit $
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR PERMIT
l'
vi N � -+ ' 1 �' Date .3 "/5 +
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, Fiu: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 �a eJi k 42% (9 J 9 C� $ No _/ 6 0 Street / 9 T
Registered Architect and /or Engineer
Employing Electrician's Name No Street rr
a S ,eS
Location and Legal Description Lot `�7 Block 6 0 Subdivision
4,7) -s sl
Street and Number where work is to be performed —No
STATE OF FLORIDA,
O DADE.
State work to be performed and purpose of building (By Floors)..
New Building Remodeling Addition
(Signed)
Street
C 4 ...Q/Y......lQ. -s�r��
o. o Stories
Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
r l � tress isal- 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.
,c
(Signed).. 9 Y r
C A - 00,9864
A c
COUNTY OF 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 face
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.