ELECTRICAL PERMITDate
PERMIT APPLICATION FOR MIAMI SHORES VILLAG;;r;
Job Address
Tax Folio
Legal Description Historically Designated: Yes M No
Owner/Lessee / Tenant / 5cafrJi Master Permit # - -. �
Owner's Address /,Z /117,4,,q. / 21 S7 Phone Ye)) — — 772 — (0 a 1
Contracting Co. /• CM Z Address
Qualifier (ei f S %/e4 (1/ //J SS# - Phone 26r d //f
Stag ■OO , ? ( 7S Municipal # Competency # Ins. Co. ‘411
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING CT CT LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Z/�C 7 # (C / lo,�l-/�i�C
Square Ft. Estimated Cost (value) , / c2 / G 0 v
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 do the work stated.
Signature of owner and/or •
Notary as to Owner an ? Condo President Date
My Commission Expires:
FEES: PERMIT . ,4 RADON C.0
4PPROVED:
tning
sident Date
Signature of Contractor or Owner- Builder Date
/i 05
Not as to Contractor or Owner- Builder Date
M Commission Expires:
�� �����v p�. Melinda K. Edelsberg
?o f tit Commission # DD088207
�� = Expires March 8, 2006
Bosd.d Thru
' Marais BandhtsCa $c4
thanical Plumbing Engineering
r- ku $ 30 'do .0 n
TARY TOTAL DUE
Building Electrical
Permit No
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
/lt77�
Date
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 A.W. PIIILPOZT No 1218 Street N.E. 101st
Registered Architect and /or Engineer
L & M ELECTRIC CO.INC. 99 N.W. 166th
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Same as above
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs XX 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
6.50'
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. I "'
(Signed).
(Signed)
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 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.
Master Electrician.
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 the 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'7'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
'r
,
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
Increase Svc to 1E0 amps
2 2
A/C
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
/lt77�
Date
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 A.W. PIIILPOZT No 1218 Street N.E. 101st
Registered Architect and /or Engineer
L & M ELECTRIC CO.INC. 99 N.W. 166th
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Same as above
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs XX 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
6.50'
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. I "'
(Signed).
(Signed)
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 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.
Master Electrician.
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 the 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.
Permit No
MIAMI SHORES VILLAGE
ELECTR ICAL 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.
Norman Hawkins • 1218 lol
Owner's Name and Address No Street
Registered Architect and /or Engineer
L & M 1 LFCTRIC CO.INC: 99 N.W. 166th St.
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Same as above 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 Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
STATE OF FLORIDA,
COUNTY OF DADE. I �°'
(Signed)
Date December 11, 1972
5.75 (Signed).
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obJ 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 performed under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
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___
1
__5__
CHECK
ENT.
SW.
DIST.
CAB,
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.8 HP
NEON
TRANS.
RADIO
TOTAL.
CONTR.
LIST
Relocate 15) amp Svc.
3.50
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTR ICAL 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.
Norman Hawkins • 1218 lol
Owner's Name and Address No Street
Registered Architect and /or Engineer
L & M 1 LFCTRIC CO.INC: 99 N.W. 166th St.
Employing Electrician's Name No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Same as above 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 Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
STATE OF FLORIDA,
COUNTY OF DADE. I �°'
(Signed)
Date December 11, 1972
5.75 (Signed).
Amount of Permit $
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obJ 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 performed under this permit, as are
licensed by Miami Shores Village.
Master Electrician.
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.
er of
Building
Imo'' PERMIT N° 9921
. tea
or
or B der )4--
Lot
Des iption '
Ad
MIAMI SHORES VILLAGE, FLORIDA .r.
DATE ** ---""
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
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 application
here `, r in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
dry statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
tune 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
is the understanding that the contractor or builder named above assumes the responsibility for thorough knowledge of the ordinances and regulations
g to the work covered hereby whether shown on the plans or. ' • gs or in the statements or - pecifications and that he assumes responsibility for work
by We agents, servants or employees.
Signed: �c C , ,, BY ,./
INSPECTOR
In consideration of the issuance to me of this permit I agree to o rm the work covered hereunder in compliance with all dinances and regulations
'.g thereto and in strict conformity with the plans, drawings, eta ge nts or specifications submitted to the proper authorities of Miami Shores Village.
g this permit I assume es onsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
Contractor's
License No
Amt. of
Permit $
195.(22_
Permit No
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
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 '1,L, ......J
Registered Architect and /or Engineer
Employing Electrician's Name t . ' L.:..< Q = No
? Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /42. .,P / 1
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 $...1.• -•+s.c (Signed)
,...q No � Street. Y .�... �r' / •
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that 11 u erstands and accepts his 1' ations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compile General Laws of Florid ermanent 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 C+
Street.
•
(Signed) ,
f Master Electrician.
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.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
r
CHECK
Permit No
STATE OF FLORIDA, l
COUNTY OF DADE. I
SS.
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 '1,L, ......J
Registered Architect and /or Engineer
Employing Electrician's Name t . ' L.:..< Q = No
? Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /42. .,P / 1
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 $...1.• -•+s.c (Signed)
,...q No � Street. Y .�... �r' / •
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that 11 u erstands and accepts his 1' ations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compile General Laws of Florid ermanent 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 C+
Street.
•
(Signed) ,
f Master Electrician.
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.
•
1 ' BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE / 194
Coh ractor's / ? r
License No.
PERMIT N° 4986
Work to be performed under this Permit ,.A,
Architect
a
or Builder d er r `�" L 9 � l C f
or Builder /"� {f"�" ✓`�-
Legal Lot Bl. / /4/ 4 Subdi �
Description ! ��' /// v ision
Building / '100'i C/ Address of Value of Amt. of
. ♦ Project Permit
This permit is granted to the contractor or builder na above to construct the building or to install the equipment or vice described in the appli-
cation herefor in strict compliance with all ordinances pert ing thereto and w th the understanding that The work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approve by the proper4nunicipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans changes;}''withod au rization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named abrtm ,thy. pp,R thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or o the, a s or si ifications and that he assumes respon-
sibility for work done by his agents, servants or employees. j4. n
Signed • $ / J "" --- 1 By
' SPECTOR
In consideration of the issuance to me of this permit I agree to perform the work cover(d hereunder in compliance with all ordinances a regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami S 1i Village
In aping is permit I assume respoisibility fo; all work done by either myself, my agent, servant or employee. �� , �3 ores S .
;
AUTHORITY
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT 'j ,! �1 ^ 44 -
i
APPLICATION FOR ELECTRICAL PERMIT 6 s-�
Date 4 - 7
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 com•lied 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 ___ _____ ___b _t
Location and Legal Description ot '-- _____
Street and Number where work is to be performed— No. __l,.2...__J_
r No 1L 4 J Street
State work to be performed and purpose of building (By Floors)
New Building ___ Remodeling Addition
Street
_Block
1 street_
Service Overhead IJAd Size Feeders__
g ► _ Z' _1 __ Conduit 4i:____ Main Sw.__ �.t�_� Amps. Main Fuses Amps.
1 ,� p
Type of Installation— Conduit Tubing — B.X.L. 1 el M QQ{{'�I��.ng
,tvW
Amount of Permit $_1�! ____________ _,.Lt"
STATE OF FLORIDA, I
COUNTY OF DADE. es.
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 performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
•
J% __
Repairs ____ No. of Stories
Notary Public. State of Florida
Electrical Inspector.
es__&
/ 1vi
� Electrican.
ssCP�1 -
Before me, the undersigned authority, a notary public, duly
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.
authorized to administer oaths and take acknowledgments, personally
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
FIXTURES
NO.LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
�'
b
/�
//
I
/.-
/
CHECK
ENT.
SW.
DIST. SERVICE
CAB. TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
Q
/ 2 -6.1.
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT 'j ,! �1 ^ 44 -
i
APPLICATION FOR ELECTRICAL PERMIT 6 s-�
Date 4 - 7
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 com•lied 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 ___ _____ ___b _t
Location and Legal Description ot '-- _____
Street and Number where work is to be performed— No. __l,.2...__J_
r No 1L 4 J Street
State work to be performed and purpose of building (By Floors)
New Building ___ Remodeling Addition
Street
_Block
1 street_
Service Overhead IJAd Size Feeders__
g ► _ Z' _1 __ Conduit 4i:____ Main Sw.__ �.t�_� Amps. Main Fuses Amps.
1 ,� p
Type of Installation— Conduit Tubing — B.X.L. 1 el M QQ{{'�I��.ng
,tvW
Amount of Permit $_1�! ____________ _,.Lt"
STATE OF FLORIDA, I
COUNTY OF DADE. es.
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 performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
•
J% __
Repairs ____ No. of Stories
Notary Public. State of Florida
Electrical Inspector.
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� Electrican.
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Before me, the undersigned authority, a notary public, duly
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.
authorized to administer oaths and take acknowledgments, personally
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.