ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address ) N t 11 Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant &/ - ye actok h2 e----b. Master Permit # 3 v7-. . V
Owner's Address f z /" 99 Phone • Contracting Co. ' �j g--/ ;� hiAa Address „17‘.r i✓W /.3-0- Qualifier -,�J� to i P ia..Qi7 SS# phone f "7--
f �� �6 z
State # 4 0 cv 91; Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Notary as to Owner and/or Condo President Date
My Commission Expires:
Competency #
Address
Address
Ins. Co.
Permit Type (circle one): BUILDING T
EC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION L�rl� -lets ° //3 023
Square Ft. Estimated Cost (value)
a- 'fl t 1 i 9v -
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, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate an tha work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named co tractor t. do the work stated.
Signature of owner and/or Condo President Date Signa "!� l�r� ',�' �! Date
Notary as to tractor • r Own -Bui der Date
My Commission Expires:
FEES: PERMIT - RADON C.C.F. NOTARY BOND
TOTAL DUE 3 ®.
APPROVED: /oPi tf_ 7
Zoning Building Electrical
Mechanical Plumbing Engineering
Permit No
vit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT / 1
Date 4119.�(4
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, Fio;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, whe her herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. RCS /. f> r
Owner's Name and Address p 4.49
Registered Architect and /or Engine r
Employing ElectriciaA's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No ® v' 9 " Street
State work to be perfor ed purpose of building (By Floors)
New Building (/ Remodeling Addition Repairs No. of Stories /
.No Street
Block
Street...
'33
Subdivision pttk1'
4
Amount of Permit $ 1
7
(Signed) `r'19/
c 0 Amps Main Fuses Amps
Service uverne y�� Size Feeders qiPConduit Main Sw
s n . erground
Type of Installation — Conduit.... Tubing B.X.L .Metal Moulding
(Signed) '� i E —
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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.
cater Electrician.
STATE OF FLORIDA, l
COUNTY OF DADE. 1 68.
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•1
FIXTURES
NO. L
REPRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. HEAT.
CONN.
SPACE
H
STRIP
H
TOTAL
TR.
COU NS7
®
/1-11
44 e
'
y �'
t i r 00
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^k 1
%.4
1.05
/
r
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
4
t f
Permit No
vit
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT / 1
Date 4119.�(4
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, Fio;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, whe her herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. RCS /. f> r
Owner's Name and Address p 4.49
Registered Architect and /or Engine r
Employing ElectriciaA's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No ® v' 9 " Street
State work to be perfor ed purpose of building (By Floors)
New Building (/ Remodeling Addition Repairs No. of Stories /
.No Street
Block
Street...
'33
Subdivision pttk1'
4
Amount of Permit $ 1
7
(Signed) `r'19/
c 0 Amps Main Fuses Amps
Service uverne y�� Size Feeders qiPConduit Main Sw
s n . erground
Type of Installation — Conduit.... Tubing B.X.L .Metal Moulding
(Signed) '� i E —
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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.
cater Electrician.
STATE OF FLORIDA, l
COUNTY OF DADE. 1 68.
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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
.x,04� APPLICATION FOR ELECTRICAL PERMIT
Permit No 61-$ Date o7 / 79
Application is hereby made for the approval of the detailed statement of the plans and specifications herew th submitte for the building oI 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.
No
Owner's Name and Address
Registered Architect and /or Enginter 1)
Employing Electrician's Name '`v� L' ` "a No
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building
ock
(Signed)
` / / 4; Street
/
� _ Subdivision
v ° WE Street 9
Street
Remodeling Addition Repairs No. of Stories
service
Underground
Site Feeders Conduit Main S w Amps to D Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ 00 (Signed) ) c 1 LU )•19 rN
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 subcontractors 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.
STATE OF FLORIDA,
COUNTY OF DADE. I j
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 81.00 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
14
W. HEAT.
CONN.
SPACE
H
STRIP
H
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIET.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
141 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
1
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
.x,04� APPLICATION FOR ELECTRICAL PERMIT
Permit No 61-$ Date o7 / 79
Application is hereby made for the approval of the detailed statement of the plans and specifications herew th submitte for the building oI 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.
No
Owner's Name and Address
Registered Architect and /or Enginter 1)
Employing Electrician's Name '`v� L' ` "a No
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building
ock
(Signed)
` / / 4; Street
/
� _ Subdivision
v ° WE Street 9
Street
Remodeling Addition Repairs No. of Stories
service
Underground
Site Feeders Conduit Main S w Amps to D Main Fuses Amps
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ 00 (Signed) ) c 1 LU )•19 rN
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations u 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 subcontractors 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.
STATE OF FLORIDA,
COUNTY OF DADE. I j
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 81.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.