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MECHANICAL PERMITDate 210• Job Address 1Zw7 Ale, /9) Tax Folio /1- 3h 66 - e A5:40 Legal,Description Z74f ,Brrez.e SU, M -;a 1/ Ots Owner/Lessee / Tenant coo hF' (4. t.L 44 ) Master Permit # 04.' c15 Owner's Address 12. N� lot Si / % ,Fi 53/38 Contracting Co. abp g ®;a4 Sri y Qualifier Wrigi g.„, S-1-61)4 State # claw 3Z7 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICALL f��4 PLUMBING ia AL I ROOFING PAVING FENCE SIGN WORK DESCRIPTION EC/he— atJ>2e/' ✓1 (�Q/v-C, A/;9 C.Ys+.vf At,t/40-7 *z/,n i&ee,1 .-OrX Square Ft. Estimated Cost (value) 4/ ®ee) , Pil 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate an ' at all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contract . o do e work stated. Nothry as to Owifer and/or Condo President My Commission Expires: O,r aY i ^1f w wIIIL • FEES: PERMIT OFFt ` 7l APPROVED: G_ ,,— PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE OFFICIAL NOTARY SEAL RUDOLPH G FARRELL JR COMMISSION NUMBER CC838720 MY COMMISSION EXPIRES R 1I2 Mechanical 26; 6 7. 4,1 Plumbing Date Historically Designated: Yes No 17 S C.C.F. it 4 J NOTARY Zoning Building Electrical Phone 3D-5 759- 9367 Address /7lS A/l✓ S" 4v' 2.. A(in ; 1" "*" SS# . 319. = 6S ZS3O 5.; F oF ' !MtON NUMBER "C838720 ZS/ON EXPIRES Y 19 2003 BOND Notary as 1'o Contractor or Owner- Builder Date My Commission Ex . fires: 0 4 ,(2Y P� OFFICIAL NOTARY SEAL ^OI PH G FARRELLJR 1i l 2 TOTAL DUE ` l/ v� I 1: 70 Structural Engineer ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CEW RAL HEATING / 1 DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) '3 •5 / DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK 84 uei es $ FLOOR DRAIN SERVICE REPAIR/IETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUIJ TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER IOTDRS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE ' MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT _ STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • 'HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS . LAWN SPRINKLER -WELL SPECIAL PURPOSE OUTLETS COWERCIAL SWIMMING POOL - WATER SERVICE • SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA ' RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE _ POOL PIPING .AWN SPRINKLER SYSTEM 3AS RANGE ETER SET (GAS) 3AS PIPING - PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION .4 • (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Permit No. AJ e 0 -(fi' g5 Type Insp' Name Address /a Company Phone # C S For Inspector: Approve) 3k Correction ❑ Re- Insp'n Fee r ❑ • b Name & DatP /���� l0(l7,0g EDD HELMS AIR CONDITIONING, INC. PERMIT ACCOUNT 17850 NE 5TH AVE. MIAMI, FL 33162 �II EIROBANK Dadeland Office .v,\A Miami, Florida 33156 -f� " 00030 L L11! 1:C1670 L.L.7601: LO L66013 L11°07 _NOT NEGOTIABLE 3011 " 63 -11761 670 r EDD HELMS AIR CONDITIONING, INC. PERMIT ACCOUNT 17850 NE 5TH AVE. MIAMI, FL 33162 '7. I 5 /L. METROBANK Dadeland Office Miami, Florida 3,7156 A,E, 1 610.-TIABLE s :2 11'0030 L30 ':0670 L 17601: LO L6608 L"O? 3013 63.11761 \ 676', NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. /J- 320-C O 1$ (940..5 STATE OF FLORIDA: 02R4 2002 JUL 01 11 :55 COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: P4 6' ° A�/r /�/j r cS/ or s Jol 1 /7 ,k// /B/ ftZ 4n,' crrhOr. ,P2.. 2. Description of improvement: 4iek- )4',u ,4/X . 1lte- 3.Owner(s) name and address: Z i /Pt/ 7 X1iS /D/ /V/41 eto/es, , . / 38 Interest in property: Name and address of fee simple titleholder: 6. Lender's name and address: 4. Contractor's name and address: d /1 -/5 I c-f�" '` � f � ^ �� / 7��`) ,(/j CS . /?�, , 3Yl f z OF FLORIDA, COuNTY OF DADE 5. Surety:(Payment E :(Payment bond required by owner from contractor, ! H Y C RTIFY that this rs a true of t'e Name and address: Amount of bond $ 7. Persons within the State of Florida designated by Owner upon whom n•. ces or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to- himself, Owner designates the following person(s) to receive a copy of the Lienor's. Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) Si. a ur: of Owner Pri t O ner's N Sworn to and su Notary Public Print Notary's Name Prepared by\ i\oywQso(' Address: --1 iS -C1) / 5.44A F(- 331k,,1- Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: ME2002 -95 Printed: 7/1/2002 Page 1 of 1 Applicant: JOHN WAYNE Owner: WAYNE JOHN JOB ADDRESS: 1247 NE 101 ST Parcel # 1132050250050 Legal Description: Permit Status: Approved Permit Expiration: 12/28/2002 Construction Value: Work: REPLACEMENT CENTRAL AIR CONDITIONING AND DUCTWORK Signed: _ , 9 , s o 90 Mechanical Permit Contractor EDD HELMS NC INC Contractor's Address: 17850 NE 5 AVENUE Local Phone: PB 42 -25 BAY BREEZE SEC MIAMI SHORES LOT 6 BLK 185 $9,000.00 k Do e) Total Fees: $0.00 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 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 responsibility for work done by his agents, servants or employees. (INSPECTOR) BY: 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 pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, secants or employ d: 6 ; � �t7 / 7 '_ ( / '� �: (Contractor or Builder) BY: / -7 • PAY TO THE ORDEILOF PERMIT ACCOUNT 17850 NE 5TH AVE. MIAMI, FL 33162 EDD HELMS AIR CONDITIONING, INC. 0.A tit 1/1j tt,(Ao METROBANK Dadeland Office • Miami, Florida 3.7156 FOR RAIN:a 01.)e6t_leon.Ory DATE 1 _?Ac 0 1:06701 / 7601: /016608100 ? 3013 63-1176 670 8 =ie.... DOLLARS on 41.1_,zbf, MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval 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 i3uilding 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 ..../ Disapproved, I , (Signed) - . Registered Architect and /or Engineer "._.,.- Name and address of licensed contractor _..r Locati and " 6' legal description of lot to be built on: ,q (� Lot/ r -1(4! ... F.•. %.7.. : Block of '� "4 Subdivision S � ?( J' � �/i c-J d. l.:a Street and Number where work is to be done L& A-L PEV `. k.:. State work to be done and purpose of building (by floors) -7�/S. - /- .L 1: <d44.Z:. mot. %>._.. /./ it , i ? . "1:� �.._ ._ ....1:et z.L'.:1...._. E4 ..g‹,/i.z !r• nil a 6, Le.E.Ic1:_,_, _ ees cos R / ,ii. G®2 (.,„ o (.,1 ell:! . I _ .�.__.... . and for no other purpose. New Building Remodeling t Addition Repairs No. of Stories 0 To be constructed of Kind of foundat . Roof Covering ........... --- Estimated Total cost of improvements $ / F% CO C Amount of Permit &. Zone cubage required d?lan Cubage a d Distance to next nearest building Size of Building Lot / '� k. 4 ® Maximum live load to be borne by each floor I hereby subTit all the glans and specifications for said building. All notices with reference to the building and its construction may /1 be sent to / A G- r 0 , �.1. .. tT � ... " ,, � : 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, Pernanent Sup )Ie luent, 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 th sft of the work s ch public notice or notices as are required by the Act. The undersigned agrees to employ only such su traFt9fs, op to be perfr ned under this pcnnit, as are licensed by Miami Shores Village. Cam � (� �P�� - , ,: Remarks (Signed) 1L� 7 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 sca . Permit No.._..__.......... ( Date n Read, Sworn to and Subscribed before me. 19 — No /° . Street.& . B© d 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 Notary Public, State of Florida to me well known, Building Inspector j ' Commission Expires PL !s�' INC BOARD _.._......DATE Chairman Member Mernber Member Member sass.. _....._..._._ ...._....._ Member -- -._ Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection at faulty materials and /or workmanship. JiV STATE OF FLORIDA, COUNTY OF DADE. Ss. Permit No Disapproved (Signed) MIAMI SHORES VI BUILDING INSPECTION DEP t � L ItAGE RTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval 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 4 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. / Date L 2 Y 19 / Owner's Name and Address . Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on Lot Block / Subdivision Street and Number ber where work is to be done • 2 y'7 - �41 State work to be done and purpose of building (by 1oors ) New Building Remodeling To be constructed of Kind of foundation Estimated Total cost of improvements $ •elj Zone cubage required Distance to next nearest building Date._ Chainnan Member Member Council Approved Date No. Street 47 - ,diV41/. and for no other purpose. Addition Repairs No. of Stories Roof Covering Amount of Permit $ Plan Cubage Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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. Remarks (Signed)._ j1f62,7 Before rue, 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 statt d are ter e. Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida or My Commission Expires Building Inspe PLANNING BOARD DATE Member Member Member Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No k Owner's Name and Address STATE OF FLORIDA, } COUNTY OF DADE. s' ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APrLICATION FOR ELECTRICAL PERMIT Date 4'// 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._ • ' R-0 O) D —t..: � No 1 L Street W& 1 t 1 Registered Architect and/or Engineer ▪ 1 ' r , Employing Electrician's Name...1.�.1..L.. J\f ''` .(..C..LL 't 4 No Y Y / '7 Street /v I kJ v ZAJD r Y ,j� " , Location and Legal Description Lot 1 Y Block Subdivision 1 Street and Number where work is to be performed —No 4 1 Street A) ... / O / State work to be performed and purpose of building (By Floors) 1,.11 &A.1 61...See --arc ., efi 1 et-4.112e4..4... 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 W B.X.L Metal Moulding Amount of Permit $ ° (Signed) (Signed) 4, V ,'Electrical nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- tractors 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. Gt�y+� -off 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 swor , upon oath deposes and says that he is the of the above described construction, and he has careful 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 negegsa by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RtCE'P'T's FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SIACC H ATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST t� CHECK Permit No k Owner's Name and Address STATE OF FLORIDA, } COUNTY OF DADE. s' ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APrLICATION FOR ELECTRICAL PERMIT Date 4'// 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._ • ' R-0 O) D —t..: � No 1 L Street W& 1 t 1 Registered Architect and/or Engineer ▪ 1 ' r , Employing Electrician's Name...1.�.1..L.. J\f ''` .(..C..LL 't 4 No Y Y / '7 Street /v I kJ v ZAJD r Y ,j� " , Location and Legal Description Lot 1 Y Block Subdivision 1 Street and Number where work is to be performed —No 4 1 Street A) ... / O / State work to be performed and purpose of building (By Floors) 1,.11 &A.1 61...See --arc ., efi 1 et-4.112e4..4... 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 W B.X.L Metal Moulding Amount of Permit $ ° (Signed) (Signed) 4, V ,'Electrical nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ' a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- tractors 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. Gt�y+� -off 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 swor , upon oath deposes and says that he is the of the above described construction, and he has careful 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 negegsa by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ DAT> ~= ELEcTRlcAu. El PERMIT' PLUMBING ❑ N° 8656 Contractors y License No. ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot BL Subdi- vision Sq. Ft Value of Project $ c Amt. of Permit $ 195 +. 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 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 responsibility for work done by his agents, servants or employees. Signed BY 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 pertaining thereto and in strict conformity with the plans, drawings, 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. CONTRACTOR OR BUILDER BY AUTHORITY Permit No 0 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Q Date (- 7-7 - s?cf 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. ' v Owner's Name and Address Ral �� Registered Architect and /or Engineer Employing Electrician's Name .. __ .�..._ No Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No / 4 7 Street ( / e 0 � State work to be performed and purpose of building (By Floors).. / "45 r4 e New Building Remodeling Addition Repairs No. of Stories Overhead Type of Installation — Conduit Amount of Permit $ STATE OF FLORIDA, } 3pb COUNTY OF DADE. ss. My Commission Expires Service mod- Size Feeders Conduit 1/4 ` / Main Sw Tubing 'HIC'h+ IvTrtel°4oftirerlelisig (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 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 , e work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on orkto performed under this permit, as are licensed by Miami Shores Village. $ (Signed).. No / 7 Street �'. Street. lY 7 Ae, Reee r et e Main Fuses Notary Public, State of Florida Master Electrician. Amps Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OU LET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR, LIST / 6 l a f5/ *" / ®" / .//rr • 0 7 - CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No 0 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Q Date (- 7-7 - s?cf 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. ' v Owner's Name and Address Ral �� Registered Architect and /or Engineer Employing Electrician's Name .. __ .�..._ No Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No / 4 7 Street ( / e 0 � State work to be performed and purpose of building (By Floors).. / "45 r4 e New Building Remodeling Addition Repairs No. of Stories Overhead Type of Installation — Conduit Amount of Permit $ STATE OF FLORIDA, } 3pb COUNTY OF DADE. ss. My Commission Expires Service mod- Size Feeders Conduit 1/4 ` / Main Sw Tubing 'HIC'h+ IvTrtel°4oftirerlelisig (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 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 , e work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on orkto performed under this permit, as are licensed by Miami Shores Village. $ (Signed).. No / 7 Street �'. Street. lY 7 Ae, Reee r et e Main Fuses Notary Public, State of Florida Master Electrician. Amps Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship.