ELECTRICAL PERMITPermit No l b (7
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date March 26, 1969
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 Hobext...Bolen No 1144 Street N.E. 1 01 tt Street
Registered Architect and /or Engineer
Employing Electrician's Name Brothers Electric N 13339 Street N N.W. 7t ,Avenue
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 1 14
Street N.E. 101st Street
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
Underground P Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $..1... 5.Q (Signed).
SS.
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts s 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 sub - contractors, on work to be perforated under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
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, 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
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
1
J
41 • 5c
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL.
CONTR.
LIST
CHECK
Permit No l b (7
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date March 26, 1969
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 Hobext...Bolen No 1144 Street N.E. 1 01 tt Street
Registered Architect and /or Engineer
Employing Electrician's Name Brothers Electric N 13339 Street N N.W. 7t ,Avenue
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 1 14
Street N.E. 101st Street
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
Underground P Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $..1... 5.Q (Signed).
SS.
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts s 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 sub - contractors, on work to be perforated under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
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, 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.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑
PLUMBING ❑ PERMIT N° 9592 Contractor's ..
ROOFING ❑ License No.
❑
Owner of
Building 411116.4 C. 1..
Architect
Contractor
or Builder Y= .` t ,; - e . . r~
Legal Lot ii
Description ii B1.
Address of , p *
Building t t i 1- +..`. tCA ` t
Work to be performed under this Permit
CONTRACTOR or BUILDER BY
Date — PP ital.
fi 4
•
1
Subdi-
vision
Sq. Ft.
Value of Amount of
Project $ II Permit $
AUTHORITY
19
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device des L ibed in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed ••' r ` (INSPECTOR) BY
In consideration of the issuance to me of this permit I agre . o perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawing's," statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BUILDING
ELECTRICAL
PLUM*NG
Owner of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT ■2 6371
Contr tor's
Vcennse No
Work to be performed under this Permit 2l // '�V
O
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is granted to the contractor or builder named above t• construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition u on which this
permit is granted is the understanding that the contractor or builder named above assumes the res onsiliil' .y for a thorough knowledge of the rdinances and
regulations pertaining to the work covered hereby whether shown on the plans.or a 'ngs or ' the ments or specifications and that `as emeel respon -.
sibility for work done by his agents, servants or employees.
Signed - ./. --- , . /" ..r. � r=..
yy SPECTOR
*consideration of the issuance to me of this permit I agree to pe the work covered hereunder in compliance with ordinances ndregu Lions
p■aaining thereto and in strict conformity with the plans, drawings, stat ents or spe ications submitted to the proper authorities of MiamiLShoresdVifiage.
In accepting this ermit I ae2sponsibil3ty for all work done by "er ys , m, agent; servant or employee.
i i g /--/V., a.-- -e_ r --'-'
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Value of
Project
DATE
Amt. of
Permit
AUTHORITY
194_
Permit No.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot___
Amount of Permit $
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 submihed 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.
c
QVg
No //
No.
_Block
Street and Number where work is to be performed—No. I/
State work to be performed and purpose of building (By Floors)
New Building_ Remodeling ____________w Addition.. Repairs
Overhea //'
Service Underground Size Feeders; 1 Conduit._ Main Sw.P Amps. Main Fuses.. 0 __Amps.
Type of Installation ondui _= B.X.L. Metal Moulding
(Signed)
Date
Street /0./
Street__ L2_U
No. of Stories ......
_______
Electrical 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 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 per med under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
My Commission Expires
(Signed)
Notary Public. State of Florida
Master Electrican.
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 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
N0.LA MPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR. LIST
/�
(l /
//
O'V
/
/
/
/
/
/
CJ .
x
CHECK
ENT. DIST. SERVICE
SW. CAB. TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
l-- • `fr'R"Gel....,
/ -____ 'i _ _
/n0 M
(/ g
CHECK
Permit No.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot___
Amount of Permit $
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 submihed 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.
c
QVg
No //
No.
_Block
Street and Number where work is to be performed—No. I/
State work to be performed and purpose of building (By Floors)
New Building_ Remodeling ____________w Addition.. Repairs
Overhea //'
Service Underground Size Feeders; 1 Conduit._ Main Sw.P Amps. Main Fuses.. 0 __Amps.
Type of Installation ondui _= B.X.L. Metal Moulding
(Signed)
Date
Street /0./
Street__ L2_U
No. of Stories ......
_______
Electrical 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 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 per med under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
My Commission Expires
(Signed)
Notary Public. State of Florida
Master Electrican.
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 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.
BUILDING ❑
ELECT
PL MBRNG L ° o PERMIT N °. 9584
ROOFING ❑
Owner of
Building
D
1
Architect
Contractor
or Builder
St."—rs S `
Legal Lot
Description 11 Bl
Address of 11 ,,r l 4) r
Building
Signed
CONTRACTOR or BUILDER
MIAMI SHORES VILLAGE, FLORIDA 19
Date—
Work to be performed under this Permit
t C! V
Contractor's
License No. /-2
Subdi-
vision
Sq Ft.
�
Value of ( Amount of
Project $ 11 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. w.
In consideration of the issuance to me of this permit I ag do perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, draw' ggs, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
(INSPECTOR) BY
it
BY AUTHORITY
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Owner's Name and Address /Vie. _/d efe 30 a>eA/
RegI tered Architect and /or Engineer _
Name and address of licensed contractor_. 517445 atfJe_x } (2).
Location and legal description of lot to be built on:
Lot._ Block.__!.) 7
Street and Number where work is to be done
i x.44 Ai. Ft-- • lc r ,7:'
State work to be done and purpose of building (by floors)__ 7-14 i.. .N.8 e 4 rg fad.- ,
At., • rie
/ and for no other purpose.
New Building Remodeling Y Addition Repairs__ No. of Stories
To be constructed of Kind of foundation__ -. oof Covering_
Estimated Total cost of improvements $ S j 700 7 i v Amount of Permit $
-- ------ -- - - -- -- Zone cubage required _Plan Cubage___
Distance to next nearest building__.._._ . _ . Size of Building Lot
Maximum live load to be borne by each floor__. . . .
I hereby submit all th plans and specifications for said building. All notices with reference to the building and its construction may
be sent to_Sf,4/�t5.._L! ?. f'8.. _C`_K. _._} co, 24'/ -- Ato.
.rofrJD' QNto 3ty 37FM 1 4550014'7!'r?`b
7 ..t,4N -- (10
The undersigned applicant for this building permit doc 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, Pennanent 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.
Remarks _. _ __ .. ( Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 same, and that all facts
therein by him stated are trur.
Permit No ........
_�`�S
Disapproved - �/f
( Signed) • G L! -.
Chairman
Member
Member
Council Approved
D
Building Inspegor
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
Date____..1 ' 0....
ANNING BOARD__
_Date
Date — Y ,
No /,44 - -- Street 'la • /0
Subdivision_._ M. 5 Ma!e F5 r e
GO 57;
My Commission Expires_
DATE
Member
Member
Member
Disapproved
4o 1 AAA). 4 _ 5 T
8
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
Permit No 40-1-
Date .... January ..i5... 9
Application is Eereby 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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address...110.1m N 1144 Street N.E. 101st Street
Registered Architect and /or Engineer Brothers...Electric...._.Corp,
Employing Electrician's Name Brothers E1eotr1.o , N 13339 Street N •W• 7th Ave.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 11 Street N.E. 101st Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Overhead Increase service to 150 =$3.0C
Service Underground Size Feeders Conduit • Main Sw Amps Main Fuses Amps
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
Amount of Permit $7 -*00
(Signed)
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 sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Request to work with
Wednesday, January 17th, 9:00 a.m.
STATE OF FLORIDA, , 1
COUNTY OF DADE. I
SS.
My Commission Expires
(Signed)
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.
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.
Master Electrician.
0
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE - P - T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
dryer
$1.0
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
1 3hp a/
,.
$3.00
CHECK
Permit No 40-1-
Date .... January ..i5... 9
Application is Eereby 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.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address...110.1m N 1144 Street N.E. 101st Street
Registered Architect and /or Engineer Brothers...Electric...._.Corp,
Employing Electrician's Name Brothers E1eotr1.o , N 13339 Street N •W• 7th Ave.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 11 Street N.E. 101st Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Overhead Increase service to 150 =$3.0C
Service Underground Size Feeders Conduit • Main Sw Amps Main Fuses Amps
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
Amount of Permit $7 -*00
(Signed)
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 sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Request to work with
Wednesday, January 17th, 9:00 a.m.
STATE OF FLORIDA, , 1
COUNTY OF DADE. I
SS.
My Commission Expires
(Signed)
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.
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.
Master Electrician.
0