Loading...
ELECTRICAL PERMITOwner / `L t PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date /6 s- 9 7� Job Address i42. /V 70/ �f I Legal Descriptions( / 2' 041/ t Zs Pct Owner's Address Aofft, ,6d�Gti Contracting Co.-0544. Qualifier 42 � Signature of owner and /or Condo President Date: Phone GZEr'� . LZ�7.2 /t. Addres /YET 99 s7' SS# . - Phone State #6 Municipal #/32. # Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING - 'CTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �l/ /C , ? Square Pt. Estimated Cost(value) 0,(5d 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 Co Date: /0/7/10 own Notary as to Owner and /or Condo President ar /as to r .h�� o o My Commission Expires: My Commission Expires: ** * * * * * * * * * * FEES: PERMIT 30412 RADON C.C.F. ST NOTARY APPROVED: Fire Other Zoning Building ` Electrical Mechanical Plumbing Tax Folio /I 3-"‹ PU a0" Master Permit # f3 °7of 7, 577 Ins.Co. 4 o i.` 7T. 1 7 - 10 JO EPJJINECHURCH it State of Honda stamp name of Notary Public DID rake an oath, or DID NOT take an oath. * * * r P. ri ef Y eoduce.: 5 t oe TOTAL DUE . , O ** Engineering J' Permit No Street and Number where work is to be performed —No Amount of Permit $ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 " No f... Street Registered Architect and /or Engineer Employing Electrician's Name. Location and Legal Description Lot Block Subdivision Street Street Ol 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 Underground l \ ''p h ype of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob g tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida 'ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontract rs 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 wor such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perform d under this permit, as are licensed by Miami Shores Village. materials and /or workmanship. ca Amps (Signed) Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. I 85' 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 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. ACE HATER STRIP HEATER TOTAL CONTR. LIST 7 -4J CHECK ENT. SW. D18T. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK J' Permit No Street and Number where work is to be performed —No Amount of Permit $ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 " No f... Street Registered Architect and /or Engineer Employing Electrician's Name. Location and Legal Description Lot Block Subdivision Street Street Ol 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 Underground l \ ''p h ype of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob g tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida 'ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontract rs 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 wor such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perform d under this permit, as are licensed by Miami Shores Village. materials and /or workmanship. ca Amps (Signed) Master Electrician. STATE OF FLORIDA, 1 COUNTY OF DADE. I 85' 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 Permit No Registered Architect and /or Engineer Location and Legal Description Lot.. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herivith 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. IA( Owner's Name and Address ...... ' t . ` 37) Employing Electrician's Name tom' f...o No Street Block..../ Subdivision. Street and Number where work is to be performed— No.. ._ _. ._ . /V.5 N Street_... 6./ State work to be performed and purpose of building (By Floors) '*ti..0 - New Building Remodeling Addition Repairs No. of Stories Service Overhead ee Size Feeders 1! U Conduit Main Sw.. . Amps Main Fuses Underground STATE OP FLORIDA, 1 COUNTY OF DADE. ! j 55. My Commission Expires Street.N 't /... )4eN5fJ...r Notary Public, State of Florida Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (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 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. �, r7 ‘, (Signed) \\(\ 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 $1.00 will be made when such re, inspection is made necessary by improper notice for inspection, or faulty materials a /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CDNTR. LIST 7....../...... 6 �0 (J"' r ... �e 1 �y q� /$,.Y� 1 '' / pJ 7 "� ..� G! 9, .L_ ,4 �q, 1 A. � CHECK sr ry: Q `/'tJ !T 3 B C �L • ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. , MOTORS' 0.1 HP M 1•5 H NEON TRANS. RADIO TOTAL CONTR. LIST . 30 (� / ` y / CHECK / tO /vv /PO / V • Permit No Registered Architect and /or Engineer Location and Legal Description Lot.. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herivith 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. IA( Owner's Name and Address ...... ' t . ` 37) Employing Electrician's Name tom' f...o No Street Block..../ Subdivision. Street and Number where work is to be performed— No.. ._ _. ._ . /V.5 N Street_... 6./ State work to be performed and purpose of building (By Floors) '*ti..0 - New Building Remodeling Addition Repairs No. of Stories Service Overhead ee Size Feeders 1! U Conduit Main Sw.. . Amps Main Fuses Underground STATE OP FLORIDA, 1 COUNTY OF DADE. ! j 55. My Commission Expires Street.N 't /... )4eN5fJ...r Notary Public, State of Florida Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (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 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. �, r7 ‘, (Signed) \\(\ 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 a /or workmanship. MIAMI SHORES VILLAGE 4 ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 3 .h - ��. /77 -J.r Date. Permit No 1 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 rr1 / "'r �`�' ".. No 1 �'� LV Street. .AP/.. s Registered Architect and /or Engineer Employing Electrician's Name No Street Location and Legal Description Lot Block 1 Subdivision. Street and Number where work is to be performed —No .l 7— ! J1V0 / . Street /j!/ State work to be performed and purpose of building (By Floors) New Building 4/" 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 (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 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 perf med under this pe it, as are licensed by Miami Shores Village. Amount of Permit $ ss. (Signed) Master Electrician. STATE OP FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. 1 Y' A OTORS 0.1 HP / /y , J��' MOTORS NEON 1.5 HP TRANS. J /v /91 �°AX /2 RADIO TOTAL 4Thle CONTR. CHECK H E C ___ c MIAMI SHORES VILLAGE 4 ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 3 .h - ��. /77 -J.r Date. Permit No 1 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 rr1 / "'r �`�' ".. No 1 �'� LV Street. .AP/.. s Registered Architect and /or Engineer Employing Electrician's Name No Street Location and Legal Description Lot Block 1 Subdivision. Street and Number where work is to be performed —No .l 7— ! J1V0 / . Street /j!/ State work to be performed and purpose of building (By Floors) New Building 4/" 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 (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 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 perf med under this pe it, as are licensed by Miami Shores Village. Amount of Permit $ ss. (Signed) Master Electrician. STATE OP FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. APPLICATION FOR ELECTRICAL PERMIT Permit No / " " — Dt/ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu;ida, 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. i 1 q, 1�Q�) \V ,4-- r�.11v — No....1XD Owner's Name and Address Registered Architect and /or Engineer 1l Employing Electrician's Name..CQf , ' Amount of Permit $ R i Aa Lbw Las MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) No 1 Da. ki 9 Street tY v I k Street IV r ST 3(11-1 Location and Legal Description Lot Block Su division Street and Number where work is to be performed— No....' /0 Street 101 E 1 State work to be performed and purpose of building (By Floors) New Building Remodeling 1 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 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and ccepts 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 f the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to e performed under this permit, as are licensed by Miami Shores Village. Master Electrician. STATE OF FLORIDA, ( COUNTY OF DADE. f 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• ••T'S FIXTURES NO LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE 14 STRIP HEATER TOTAL CONTR. LIST l f CHECK „( ��ff / �/t!� N U ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. ©,' 1 = (��J %IQV MOTORS O.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST ST CHECK APPLICATION FOR ELECTRICAL PERMIT Permit No / " " — Dt/ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu;ida, 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. i 1 q, 1�Q�) \V ,4-- r�.11v — No....1XD Owner's Name and Address Registered Architect and /or Engineer 1l Employing Electrician's Name..CQf , ' Amount of Permit $ R i Aa Lbw Las MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT (Signed) (Signed) No 1 Da. ki 9 Street tY v I k Street IV r ST 3(11-1 Location and Legal Description Lot Block Su division Street and Number where work is to be performed— No....' /0 Street 101 E 1 State work to be performed and purpose of building (By Floors) New Building Remodeling 1 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 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and ccepts 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 f the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to e performed under this permit, as are licensed by Miami Shores Village. Master Electrician. STATE OF FLORIDA, ( COUNTY OF DADE. f 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. Owner's Name and Address�' ' ` f L k L o r New Building Remodeling Remarks (Signed) Permit No. Disapproved (Signed) 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 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 the work. Registered Architect and/or Engineer 0 / / /� ��� G / /- 7 v .9 f c ��� , elt Name and address of licensed contractor .47e,-- .47e,-- / ML - C �'v/ `-�v 2 4A -- 5 r " A � / / �Q 0 . / / / AI . 7 7/ 6-9 Location and legal description of lot to be built on: Lot 01 Block / Subdivision • dv4 1/ V f t, P 1 01)-a 1 Street and Number where work is to be done /c2.5-0 N /0 / S\71-1L-f_-7- 1/ State work to be done and purpose of building (by floors), state exterior colors (submit samples) / s 7 12. /12; S ` i -4 cf S , ii/ ') lle_ A/4/1/ . 49 /(kJ Addition To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ /CP C d . Amount of Permit $ 1 1 Cli Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all 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 obligatons 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 cauusto be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees y mploy . t such subcontra r�, onbrk to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known. and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same. and that all facts therein by him stated are true. Date /4 /'r Read, Sworn to and Subscribed before me. Date Z Date / 19 No /7 N O Street We/ 0 / Cr Repairs 6 of Stories Notary Public. State of Florida and for no other purpose. e /1M qs7 Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 1 ate Disapproved Dr NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workman APPLICATION FOR BUILDING PERMIT Application is hereby umde 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 Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved 4 (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date r *XL V/ IY fl •e Building Inspector NoAt street Registered Architect and /or Engineer Name and address of licensed contractor /9■ —' Location and legal description of lot to be built on: Lot Block Subdivision _ Street and Number where work is to be done ./. 04" E / " -. r State work to be do e d purpose of building (by fl9ors) e t .4 t9 6 .r/ 3 7f /e 6 . .' .. '? ... . 'V ._.._.— 4..Oe... $toleoe, w If* . 41Ei 75 r .1 /6Ye /v41/A,,' /f,frk.J .-t0 4 _.._. and for no othh purpose. Ncw Building Remodeling Addition Repairs 1` No. of Stories To be constructed of Kind of foundation Roof Covering Estimate Total cost of improvements $ 6•671Y seAkwe eet) Amount of Permit $. Zone cubage required .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all 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 Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied sxith 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 arc required by the Act. The undersigned agrees to employ only such subcontractors n work to be performed under this pennit, as are licensed by Miami Shores Village. �, 1 Remarks (Signed )..• . ....' . _... �, Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 arse. ) V Permit No......_ ll..f .0 Date ......._._ Read, Sworn to and Subscribed before me. to me well known, Notary Public, State of Florida My Commission Expires 7 PLANNING BOARD DATE Chairman Member Member Member Member .. .. .. Member — .._..... Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application nfter approval has hecn obtained From the Pl. nnir,.t Board. A re- impection Ice of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspectirm or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.... 7. f° JO 7 Date... `' J 3 ' 1 97, Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida, 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 RDurri-1 No 1 ZO Street E 1 0 1 fi Registered Architect and /or Engineer Employing Electriciah's Name..! _,.� k N Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No /..25P/ h Street /0 / 57' E/ State work to be performed and purpose of building (By Floors) e-/ C% rOtVice' C R/`* 4 /Cf New Building Remodeling Addition Repairs 1.....------ 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 $ " ' STATE OP FLORIDA, COUNTY OP DADE. } No [ (Signed) (Signed) te N tAI•ID RY...... Street --( L NI 41 2 01, 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Muter 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 OUTLET[ LIGHT OUTLETS PLUG RECE'P'TS FIXTURES NO. LAMPS R[IRIG. OUTLET IRON OUTLET RANGE OUTLET RANG[ CONN. WATER H W. HEAT. CONN. SPACE H STRIP HEATER TOTAL CONTR. LIST � f , a 2 - 5 • /y�� Y • �� k "" B u".0 CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -8 HP NEON i/ /� -!> RADIO P 4 10 TOTAL CONTR. LIST - � �T� /�/� t{I01 J / ''� I ..0'.. 1/2.. 2q - 2-- - ` `^ �vTRRAAN�S. �J r 7/W ( � ° C HECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No.... 7. f° JO 7 Date... `' J 3 ' 1 97, Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida, 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 RDurri-1 No 1 ZO Street E 1 0 1 fi Registered Architect and /or Engineer Employing Electriciah's Name..! _,.� k N Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No /..25P/ h Street /0 / 57' E/ State work to be performed and purpose of building (By Floors) e-/ C% rOtVice' C R/`* 4 /Cf New Building Remodeling Addition Repairs 1.....------ 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 $ " ' STATE OP FLORIDA, COUNTY OP DADE. } No [ (Signed) (Signed) te N tAI•ID RY...... Street --( L NI 41 2 01, 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Muter 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. Owner's Name CITY F MIAMI, FLORIDA O ICE BUILDING INSPECTOR APPLICATIOIk FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. 711.E --J /0� / 9c FORM 78e (REV.) Owner's Address /,2 6 !V E Registered Architect and /or Engineer Date / / J,k: Licensed Contractor's Name Licensed Contractor's Address 6 .1 96 Legal description of Building Site: Lot Block Address where work is to be done Explain nature of work to be done and purpose of building (by floors) New Building To be constructed of THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No. C - 7 . � q Date Issued f t- ;-?, . Issued By Fee $ Remodeling Addition Subdivision /A 21. E• /o/ ., Kind of foundation Repairs Total Sq. Ft. Plumbing Yes Elect. No Alterations, Etc. $ Distance to next nearest building Size of Building Lot STATE OF FLORIDA 1 COUNTY OF DADE ss Before dersign ister oath . to ackno and fot no other purpose. /1;1 /icVV No of Stories Roof covering uthorized to admin- ersonally appeared who, after being firs':uly sworn, upon oath deposes and says that e is the appli..nt for a building permit and that he has mad:; and read the f.regoing application and that the statements therein contained are true and correct. Signed Sworn and subscribed to before me this day of , 19 Notary Public, State of Florida at large My Commission expires , 19 Puilding • Zoning Sewer Division Line ea Grade Survey i Plumbing)' Owner's Name CITY F MIAMI, FLORIDA O ICE BUILDING INSPECTOR APPLICATIOIk FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. 711.E --J /0� / 9c FORM 78e (REV.) Owner's Address /,2 6 !V E Registered Architect and /or Engineer Date / / J,k: Licensed Contractor's Name Licensed Contractor's Address 6 .1 96 Legal description of Building Site: Lot Block Address where work is to be done Explain nature of work to be done and purpose of building (by floors) New Building To be constructed of THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No. C - 7 . � q Date Issued f t- ;-?, . Issued By Fee $ Remodeling Addition Subdivision /A 21. E• /o/ ., Kind of foundation Repairs Total Sq. Ft. Plumbing Yes Elect. No Alterations, Etc. $ Distance to next nearest building Size of Building Lot STATE OF FLORIDA 1 COUNTY OF DADE ss Before dersign ister oath . to ackno and fot no other purpose. /1;1 /icVV No of Stories Roof covering uthorized to admin- ersonally appeared who, after being firs':uly sworn, upon oath deposes and says that e is the appli..nt for a building permit and that he has mad:; and read the f.regoing application and that the statements therein contained are true and correct. Signed Sworn and subscribed to before me this day of , 19 Notary Public, State of Florida at large My Commission expires , 19 TYPE INSPECTION DATE Initial DATE Initial DATE Initial DATE Initial SETBACKS PILING FOOTINGS STEM WALL CAP GRADE BEAM FLOOR SLAB LINTE L COLUMN TIE BEAM FRAMING LATHING COPING or RAKE ROOF: TIN CAP ROOF: FINISH OFF - STREET PARKING FINAL APPROVAL ALTERATIONS REPAIRS ADDITIONS AIR -COND. DUCTS INSPECTOR'S REPORT puddin Zoning Sewer Division Line & Grade Survey Electrical Plumbing Licensed Contractor's Name Lot FORM 788 (REV.) Owner's Name �. Owner's Address /oG 3 z7 'f E Registered Architect and /or Engineer Address where work is to be done New Building To be constructed of THIS SPACE REPRESENTS THE LOT: INDICATE THE BUILDING IN SPACE SHOWING THE DISTANCE FROM LOT LINES AND OTHER BUILDINGS. Permit No. C CITY OF MIAMI, FLORIDA OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT Application is hereby made for a building permit and the approval of the detailed plans and specifications herewith submitted for the building or other structure herein described. This application is subject to the Building Ordinance and all other Ord- inances of the City of Miami, Laws of the State of Florida and Rules and Regulations of the Building Division applicable thereto. A copy of approved plans and specifica- tions must be kept at building site during progress of the work. All employers of labor are subject to the provisions of the Florida Workmen's Compensation Act. 71(..2.44 J /96o Date / o/ Licensed Contractor's Address 1 6 3 96 ,5 Legal description of Building Site : Block Subdivision Signed /A6 il. g. /6( Explain nature of work to be done and purpose of building (by floors) Li4 D G/ 7te Total Sq. Ft. Plumbing Yes Elect. No Alterations, Etc. $ Distance to next nearest building Size of Building Lot Notary Public, State of Florida at Large and for no other purpose. Remodeling Addition Repairs No. of Stories Kind of foundation Roof covering STATE OF FLORIDA ss COUNTY OF DADE Before me,er : , gauth., p aut PP to admin- ister oaths an e a ed me er appeared who, afte being first dul Tsworn, upon oath deposes and says that he the applicant or a building permit and that he has made an read the foreg ng application and that the statements therein contained are true and correct. Swom and subscribed to before me this day of , 19 Date Issued Issued By Fee $ My Commission expires , 19 TYPE INSPECTION DATE Initial DATE Initial DATE Initial DATE Initial SETBACKS PILING FOOTINGS STEM WALL CAP GRADE BEAM FLOOR SLAB LINTE L COLUMN TIE BEAM FRAMING LATHING COPING or RAKE ROOF: TIN CAP ROOF: FINISH OFF- STREET PARKING FINAL APPROVAL INSPECTOR'S REPORT ALTERATIONS REPAIRS ADDITIONS AIR -COND. DUCTS Owner of Building •W MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL PERMIT 9 PLUMBING ❑ N - ROOFING ❑ Architect Contractor or Builder Legal Lot I) BI. Description Address of Building CONTRACTOR OR BUILDER Work to be performed under this Permit Signed- 9958 ca •',! 4 Subdi- vision Sq. Ft Value of Project $ DATE . s. $' 4 196 Contractor's , License No .; Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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. .ay _ 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, servarit or employee. BY AUTHORITY BUILDING ❑ ELECTRICAL ❑ o PLUMBING PERMIT ❑ N • ROOFING ❑ owner of Building Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Architect Contractor or Builder Legal Lot II Bl. Description I 9957 DATF 3 4 .. Contractor's � F No—L_' License No -- Work to be performed under this Permit Subdi- vision Signed: Sq. Ft 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 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. Amt. of °~ Permit $ 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. BY AUTHORITY Permit No �S MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT / Date o 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 No....I.a% Q Street ...1j 'l / 0 / 6 f ' Registered Architect and /or Engineer Employing Electrician's Name h 175.11..1 /` R- 5Y . l.Kl.I.IQ /e.e No../Y � Street .../- 7.:1��.�.L�:.Q /i, ve Location and Legal Description Lot Block Subdivision Street IV C . / C / ' Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) �[ New Building Remodeling 1 \ Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation —Co uit Tubing B.X.L Metal Moulding ri Ei4 D y i __./ i5. . ‹' 77 � ,-. Amount of Permit $ ' (Signed) / (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his o labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ectrical Inspector. gations as an employer of rmanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contr &fors 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. STATE OF FLORIDA, } COUNTY OF DADE. ss. 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. AC[ H EATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. ) pf1C. / c . �j O C CHECK Permit No �S MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT / Date o 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 No....I.a% Q Street ...1j 'l / 0 / 6 f ' Registered Architect and /or Engineer Employing Electrician's Name h 175.11..1 /` R- 5Y . l.Kl.I.IQ /e.e No../Y � Street .../- 7.:1��.�.L�:.Q /i, ve Location and Legal Description Lot Block Subdivision Street IV C . / C / ' Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) �[ New Building Remodeling 1 \ Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation —Co uit Tubing B.X.L Metal Moulding ri Ei4 D y i __./ i5. . ‹' 77 � ,-. Amount of Permit $ ' (Signed) / (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his o labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ectrical Inspector. gations as an employer of rmanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contr &fors 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. STATE OF FLORIDA, } COUNTY OF DADE. ss. 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.