ELECTRICALPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
70), Tax Folio/410105-157 60 #0 ?
Date Job Address
Legal Description /r 44/1 /L/ 5 i Master Permit #
Owner / 1561;s4 1J7�44l1
Owner's Address / /(3 2 /O /. Phone
Contracting Co. A. C ._'pA /s A(C - Address 3/9 W. 30
1K
epo./k1:90(c..> SSia ? Phone Ea 5_LI ?Ks
State# iR g'S ' O Competency# a/ / Y Ins. Co.
Qualifier
Architect /Engineer
Bonding Company
Mortgagor
Sign.'ure .Owner acid /or Condo President
Date:
Nota as / o Owner and /or Condo President
My Commission Expires: °ij // f
PERMIT FEE: APPROVED:
, 124-40 1 Zoning
�Jb
3 SOV Mechanical
*
*
Fire
Building
Plumbing
Address
Address
Address
Permit Type (circle one): BUILDING PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION /! � L/ 2.i/
Square Ft. Estimated Cost ? O C)
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.
Furthermore, I authorize the above -named contractor to he work stated.
/1/
g �
ure of Contractor or Owner- Bu'ildary't'
ot. as to Contractor or Owner- Bui1dar
My Commission Expires:
* * * • *
Engineering
*
*
*
1` ��
�� , - ,fie
JILDING
ECTRICAL
UMBING
wner of
iilding
•chitect
ontractor
Builder
,gal
escription
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8559
Work to be performed under this Permit
(
Bl.
Subdi-
vision
DATE
Contractor's
License No.
194
ddress of / / ` / Value of Amt. of
iilding ,./ / / Project Permit j LL M .
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 appli-
tion herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
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
-rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
Jility for work done by his agents, servants or employees. /
Signed ✓ By . 41"`
INSPECTOR -
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
:rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
Permit No.__ ._
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement o f 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.
ss.
Owner's Name and Address__
Registered Architect and /or Engineer
Employing Electrician's Name_______
Amount of Permit $_____ !
MIAMI SHORES VILLAGE
Service Overhead Underground Size Feeders Conduit__ __ —_Main Sw._
Type of Installation — Conduit_____ —_— _____Tubing_ B.X.L._____— Metal Mo lding
N o . t° ��.
.. — No. Street ------_ ...... — — -- — - - - - - -- --
Location and Legal Description Lot
F � ,
Street and Number where work is to be performed— No.____ ��_ �__.________ _______ �.___ ___Street___ —_
State work to be performed and purpose of building (By Floors) y � '__ `, . '
New Building _Remodeling Addition_____— Repairs No. of Stories___—____—_____
Block'
( gned)
(Signed) r
__Amps Main Fuses____— ______ ___Amps
Electrical pector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an emplo er of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppleme , and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hi in the
work to be performed under this permit; and will post or cause to be p osted 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.
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. 1?
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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
/ ..�
ENT.
SW.
CAB.
GAB.
SERVICE
TEMP.
SERVICE
PERM.
6-'
,
�.
- TORS
c MO
0.1 HP
MOTO
1 -5 H
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
•
-
CHECK
Permit No.__ ._
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement o f 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.
ss.
Owner's Name and Address__
Registered Architect and /or Engineer
Employing Electrician's Name_______
Amount of Permit $_____ !
MIAMI SHORES VILLAGE
Service Overhead Underground Size Feeders Conduit__ __ —_Main Sw._
Type of Installation — Conduit_____ —_— _____Tubing_ B.X.L._____— Metal Mo lding
N o . t° ��.
.. — No. Street ------_ ...... — — -- — - - - - - -- --
Location and Legal Description Lot
F � ,
Street and Number where work is to be performed— No.____ ��_ �__.________ _______ �.___ ___Street___ —_
State work to be performed and purpose of building (By Floors) y � '__ `, . '
New Building _Remodeling Addition_____— Repairs No. of Stories___—____—_____
Block'
( gned)
(Signed) r
__Amps Main Fuses____— ______ ___Amps
Electrical pector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an emplo er of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppleme , and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hi in the
work to be performed under this permit; and will post or cause to be p osted 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.
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE. 1?
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.
APPLICATION FOR ELECTRICAL PERMIT / /
Permit No.___ .6_- ___ � • Date. - _ —__ -1 ! — — e_ — ^ - -
Application is hereby made or th app va1 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
Registered Architect and /or Engineer
Employing Electrician's Name__— _ No.__L__2Zl _Street__
Location and Legal Description Lot_______` Block ,/ 7 Subdivision_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building 11 Remodeling — Addition Repairs
Service
Overhea
Underground Size Feeders
Under
Type of X L —__ Metal Moulding
Amount of Permit $
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 Compens 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.
STATE OF FLORIDA,
COUNTY OF DADE.
}
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Conduit] _Main Sw._ /J 6 Amps.
(Signed)_.
(Signed
No. — — — — — Street
_No. of Stories
Main Fuses -------- _______ —_Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized to administer oaths and take ' owledgments, 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
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL.
CONTR.
LIST
(,
q
1 i
r " {
3
'
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
APPLICATION FOR ELECTRICAL PERMIT / /
Permit No.___ .6_- ___ � • Date. - _ —__ -1 ! — — e_ — ^ - -
Application is hereby made or th app va1 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
Registered Architect and /or Engineer
Employing Electrician's Name__— _ No.__L__2Zl _Street__
Location and Legal Description Lot_______` Block ,/ 7 Subdivision_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building 11 Remodeling — Addition Repairs
Service
Overhea
Underground Size Feeders
Under
Type of X L —__ Metal Moulding
Amount of Permit $
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 Compens 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.
STATE OF FLORIDA,
COUNTY OF DADE.
}
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Conduit] _Main Sw._ /J 6 Amps.
(Signed)_.
(Signed
No. — — — — — Street
_No. of Stories
Main Fuses -------- _______ —_Amps
Master Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized to administer oaths and take ' owledgments, 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.