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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. 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.