ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Datc (- ' -`1 y Job Address SC L 9 Tax Folio / ( - 3 r) 0 L• — () i U - 3 3 Co O
m m, S r e.s
Legal Description o +,-3/ i / f i /< S / -S �' c 3 I listorically Designated: Yes No / /
Owncr/I cssoe / Tenant l c. c ,t;
LA_ Z Master Permit # �1 92 `'� q
Owner's Address
FEES: PERMI
gss N E cl S _st
P I S ,� Address �, t N �� 7 <f �–� - '4 r—
Contracting Co. � c� 5 - a_ - E' c � r ,
8y 4
Qualifier M , p`, f n ct t r j c: r� S SI!
Phone S 3
State # Eh oC , C , (1. '. Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN 'LECTRiCA 1'1 WMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION A r�L - C�
Square Ft. 1:stimated Cost (value)
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 WITII 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).
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits arc required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
t ci6U-■
Signature of owncrand/ Cendf President
( \
N ifi to O648R•1nl44011 * R President
Kit n:i. CC631227
"' EXPIR AMY 5, 2001
a'" BONDED THRU
OF A ATLANTIC QfNt)ING CO., INC.
Date
(n �
Date
eV RADON C.C.F.
Notary as to Contractor or Owner - Builder
"Inis*SCRAPOUCKER
COMMISSION # CC 631227
ff EXPIRES MAY 5, 2001
BONDED THRU
OF F∎ ATLANTIC BONDING CO., INC.
NOTARY
Phone s y - 7 0 0
4c)
--7 C)
y
ij
S ignatursof Contractor or Owner - Buildcr
TOTAL DUE 2 5 '
APPROVED: l' }
Zoning Building Electrical �% L�i"� a S Le 7e9
Mechanical Plumbing Engineering
a h
D a
I
2123—l) tc
PERMIT APPLICATION
�{ FOR MIAMI SHORES VILLAGE
n
Date J ` Job Address `7 SS (� Q �5 �1-") Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant nr Master Permit #
Owner's Address 5a9 l (p (n O • fl 6 . Phone(f - C[ (YD '4"
Contracting Co. 1 1 /,�ir�J Address
Qualifier 7) U l 1 3 Q 0. v
State # E C caU 0 2 K J Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILD ELEC AL)LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost (value) c* 46
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 and that all work will be done in compliance with all applicable
laws regulating construction and zoning. FurthermoreI authorize the above -named contractor to d• the work stated.
A..42-- /it
Suture' downer and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT RS ' mD RADON C.C.F.
SS# Phon�
• ' / J
54
Signature of Contrac
Notary as to Contractor or Owner- Builder
My Comnrissie
O ar . (/d pi OFFICIAL NOTARY SEAL
r Z , ABRAHAM NARKES
• 0+. _ * COMMISSION NUMBER
▪ 4.q; CC383888
7, e MY COMMISSION EXP.
OF F\ JULY 4,1998
NOTARY
wner -Bui
TOTAL DUE
Date
Date
APPROVED:
Zoning Building Electrical
g y
Mechanical Plumbing Engineering
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No r
88.
My Commission Expires
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.
Owner's Name and Address John C No 955 Street N. E. 98th Street
Registered Architect and /or Engineer
Employing Electrician's Name. ..Lew.iB...0y. �I' a,ciQtric No 9930 Street N. 4Y . 7th Avenue
Location and Legal Description Lot Block Subdivision p
Street and Number where work is to be performed —No 955 Street • E` • 9ath
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
Amount of Permit $ 26.90 (Signed)
\,.((
(Signed)
Date....DOC emb Or 11, 1962
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contr
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the w
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfor d
licensed by Miami Shores Village.
til
Notary Public, State of Florida
lectrical I nspector.
ations as an employer of
anent Supplement, and
employed by him in the
ch public notice or notices
under this permit, as are
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.
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
t-
f+x
RANGE
LXT
RANGE
CONN.
WATER ` '
HEATER
yyPrETT.
^:
H 1A.
�9 R
1 OQC
Rn
CONTR.
LIST
16
13
2)4.
dyer
.u
Top
Oyen
1
C.I:!i .
Disp
1
Dsa
1
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
150 AFL
__1,__
CHECK
STATE OF FLORIDA, }
COUNTY OF DADE.
Permit No r
88.
My Commission Expires
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.
Owner's Name and Address John C No 955 Street N. E. 98th Street
Registered Architect and /or Engineer
Employing Electrician's Name. ..Lew.iB...0y. �I' a,ciQtric No 9930 Street N. 4Y . 7th Avenue
Location and Legal Description Lot Block Subdivision p
Street and Number where work is to be performed —No 955 Street • E` • 9ath
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
Amount of Permit $ 26.90 (Signed)
\,.((
(Signed)
Date....DOC emb Or 11, 1962
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contr
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the w
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfor d
licensed by Miami Shores Village.
til
Notary Public, State of Florida
lectrical I nspector.
ations as an employer of
anent Supplement, and
employed by him in the
ch public notice or notices
under this permit, as are
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.
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
APPLICATION FOR ELECTRICAL PERMIT
Permit No
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 colied, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. L% •
Owner's Name and Address John Carroll
Registered Architect and /or Engineer
Employing Electrician's Name Lewis C. Wagner Electric No 9930 Street N • W • 7th Avenue
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 955 Street N. E. 98th S4 ai'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $ 2 .50
No 955 Street N. E. 98th Street
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
Temporary Service 2.50
(Signed) �j.�/�„�
lectrical 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 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.
Date November 26, 1962
St ne G.c:,::L. ....... {...
r Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE. 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•T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
NEATER
W. HEAT.
CONN.
AGE
HrATan
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERU.
MOTORS
0.1 HP
MOTORS
14 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No
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 colied, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. L% •
Owner's Name and Address John Carroll
Registered Architect and /or Engineer
Employing Electrician's Name Lewis C. Wagner Electric No 9930 Street N • W • 7th Avenue
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 955 Street N. E. 98th S4 ai'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $ 2 .50
No 955 Street N. E. 98th Street
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
Temporary Service 2.50
(Signed) �j.�/�„�
lectrical 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 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.
Date November 26, 1962
St ne G.c:,::L. ....... {...
r Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE. 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.