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1301 NE 100 St (8)Date Type Insp'n Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil.ing Inspection Request Address Company Phone # 0 5 Inspection Date Approved Correction Re- Insp'n Fee / tr/k-' /i.e / ' i 67/KT 1 Feoew-s MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildipg Inspection Request C Date ,AX Type Insp'n ��// Permit No. _ �i'L O 6 Name Address /30/ 1■16 Compan Phone # Inspection Date Approved Correction Re- Insp'n Fee 4 7 4 7 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bui dig Inspection Request Date 7 1 I Os Type Insp'n W - W ' Permit No. j ( — Name 1'C.V1 r I s Address `)J N E t 00 s+- Company (Y)G r de t Phone # Inspection Date Approved Correction Re- Insp'n Fee Zy32 Ito (-Of . -- �►�I )Y) . Inspection Number: INSP -8027 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Miami Shores Village, FL Contractor: MARDECK ELECTRIC INC Building Department Comments Monday, March 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C►- Block: Permit Number: EL2005 -224 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 Page 2 of 2 Passed Ej Inspector Comments Failed /Y,,-196 Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -8027 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Miami Shores Village, FL Contractor: MARDECK ELECTRIC INC Building Department Comments Monday, March 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C►- Block: Permit Number: EL2005 -224 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 Page 2 of 2 Inspection Number: INSP -8002 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Contractor: MARDECK ELECTRIC INC Building Department Comments Monday, March 6, 2006 Miami Shores Village, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Ph n,: (305)795 -2204 Fax: (305)756 -8972 cL Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 `Permit Number: EL2005 -144 Page 2 of 2 Passed Inspector Comments A��v� Failed Correction Needed �,A Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -8002 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Contractor: MARDECK ELECTRIC INC Building Department Comments Monday, March 6, 2006 Miami Shores Village, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Ph n,: (305)795 -2204 Fax: (305)756 -8972 cL Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 `Permit Number: EL2005 -144 Page 2 of 2 l e mit wurnber EL2004 -369 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Contractor: Friday, March 3, 2006 Miami Shores Village, FL MARDECK ELECTRIC INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phon • (305)795 -2204 Fax: (305)756 -8972 Permit Type: Imported Permit Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 Page 2 of 2 Passed Inspector Comments 7 /7/ G ‘!2,,,,.‘• _..., ,a9j/ Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until l e mit wurnber EL2004 -369 Inspection Date: 03/07/2006 Inspector: Devaney, Michael Owner: MARGOLIS, PETER Job Address: 1301 100 Street NE Project: <NONE> Contractor: Friday, March 3, 2006 Miami Shores Village, FL MARDECK ELECTRIC INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phon • (305)795 -2204 Fax: (305)756 -8972 Permit Type: Imported Permit Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)859 -2112 Parcel Number 1132050140020 Lot: Phone: 954/888 -1765 Page 2 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2004 -369 Printed: 1/11/2005 Applicant: PETER Owner: MARGOLIS PETER JOB ADDRESS: 1301 NE 100 ST Contractor MARDECK ELECTRIC INC Local Phone: 954/888 - 1765 Parcel # 1132050140020 Signed: (INSPECTOR) Electrical Permit MARGOLIS Contractor's Address: 13750 SW 37 CT Permit Status: APPROVED Permit Expiration: 6/26/2005 Construction Value: $2,200.00 Work: NEW BATHROOM LIGHTS Page 1 of 1 Legal Description: GORDON TRACTS PB 55 -20 TRACT B LOT SIZE SITE VALUE OR 18814 -0493 Fees: Description Amount FEE2005 -371 Building Fee $225.00 FEE2005 -372 CCF $1.80 FEE2005 -373 Training and Education Fee $0.60 FEE2005 -374 Technology Fee $5.67 FEE2005 -375 Submittal Fee ($50.00) Total Fees: $183.07 Total Fees: $183.07 Total Receipts: $0.00 'AN 12 Ma 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, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATIO FBC 2001 Permit Type (circle): Building er's Name (Fee Sim .leeTitleholder) .[M I .,. Shone #�V J� S'oq ' .. � '� wner's Address , D '� (w I('"�� 5* Ci 11 G a State "PL Zip Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name 0/494.06: 6 6 - Cfrr) ( ./,K ,Phone # 9.77 - r Contractor's Address /3 o _re__ 2 7 City 06 L - State F/ Qualifier 'AO &—< /66- ,c,"4._ State Certificate or Registration No. - 00 /.ro o y Certificate of Competency No. 9 4-:7000/6 Architect/Engineer's Name (if applicable) slue of Work For this Permit Type of Work: Describe Work. Nf , ❑Addition 22ov. °° * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ' CCF S . CO /CC Notary $ Training/Education Fee $ Of n `� Technology Fee $ � • 6 7 Scanning $ Radon $ Zoning Bond $ Submittal Fee $10,1 Permit Fee $ z 7- -. 4- / Total Fee Now Due $ (Continued on opposite side) . fis Miami Shores Village Building Department bores, Florida 33138 : c 05) 756.8972 Phone # Code Enforcement $ Structural Plan Review. $ Permit No. Master Permit No.6P6 — 5 4 Plumbing Mechanical Roofing Zip ?MO Phone # Square Footage Of Work: ❑Alterati n ['New • ❑ Repair/Replace ❑ Demolition R YOC) i htS Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. is personally known t oduced Signaturel r 1, rs The fore day of NOTARY PUBL Own Agent g instrument was acknowledged before me this 20 by me or who has s identification and who did take an oath. //' i�>. �.�ill► ur($6a�tl • ` rcp l 2387 024 / 0-0 o Atlantic Bonding Co., Inc. ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 Signature NOTARY P L C Sign:�, Print: Contractor The fore oing instrument was cknowledged before me this day of , 20 by Mo r DrCKel born who is personally known to me or who has produced as identification and who did take an oath. My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** * * 0,1tH,Dr Fisher ** * * * * * * * * * ** My Commission DD366439 %a Expires October 27. 2008 ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM BATH TUB UNIT 4= FEE ' ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET -1.."- : LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION . GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY 7 OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER J I MATDRS 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 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET �. J 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 SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS :SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS r DRAINFIELD, 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 LAWN SPRINKLER SYSTEM GAS RANGE METER.SET (GAS) GAS PIPING _ (AN APPLItATION 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.) P - L U_MB-I ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Legal Description Qualifier APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date /G_ S ~ -9, Job Address /&/ Al • /06 C° Tax Folio / I0W5 // L6 " 0e6.405 � 4)454/O 6° Owner / nteS _ ,.Lt /r t Master Permit # 33 , 557105 Owner's Address/IS �L(i 7,7 /447 S' Aw. /0), Phone e2trf-7.€ er, Contracting Co.4 9 /4f �7.C%LT,QiC Signature of owner and /or Condo President Date: Zoning Buildin Address$8 /li 79 S7' SS# Phone 7S'4 State # Municipal # Competency #/ j. Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING 'LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION fWv /C4 ,( Square Ft. Estimated Cost(value) £ 4O O " ° 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. Notary as to Owner and /or Condo President / No f ry "s •�• `k6 kaI'bQ My Commission Expires: My Commission, xpires / f° 8�, : JOSE' HIIICHURCH —= _ —• r o,1 State of R h o nda Na $X197545 t ame of Notar Public Signatur o Cc Date: /o)9 qV, 0 DID take an oath, or -DID NOT take an oath. ** * * * * * * * * * * * * * * * ** FEES: PERMIT .6 0 40 ° RADON C.C.F. J NOTARY D N TOTAL DUOS Fire Other Mechanical Plumbing Engineering Permit No c /O Owner's Name and Address Li. /Z 4.BETN if o 8 LZ� 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, 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. No —7 Street , 30/ 4/, /0 Registered Architect and /or Engineer p abloying i Ejectpktp, N c 0/940.• E.S E LEcTR/G No a ,, L/ 0 0 tion Legal Descr tion Lot..,. .. � /� Block Street and Number where work is to be performed —No 30 1 ... /Pk - /00.4.7 State work to be performed and purpose of building (By Floors) N. /7»Seewiv .O/1 2- ' /I/ 444) 2 -41 New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P Type of Installation — Conduit Tubing.... B.X.L .Metal Moulding Amount of Permit $ Electrical Inspector. The undersigned applicant -for this building permit dots hereby certify that he understands and accepts his obligations u 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. STATE OP FLORIDA, COUNTY OF DADE. I se. (Signed) (Signed) Before me, the undersigned authority, a notary public, duly authorized appeared Charles-Fred. Fouse ._._...A.ugus>w..17.,...19.91 My Commission Expires NOTE: A re-inspection fee of $1.00 will be made when such re-inspection materials and /or workmanship. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he of the above described construction, and he has carefully read the foregoing application, and therein by him stated are true. Street to administer oaths and take acknowledgments, personally �c%{Prli /th Street 46 � p sW� e Subdivision iL i t � f G_o /x Muter Electrician. is the M4Ster ):i�.�Gti C.7 teik that he did sign the,;saxise, and”tha, :il .favts • Notary Public, Stateof,,Plnrid& is made necessary by improper noti..e fnr inspection oc `f;i ,� 1. SWITCH OU LIGHT OUTLETS PLUO RECE '►•T'8 FIXTURES M NO LA•• REP.RIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H W. HEAT. CONK. SPACE H STRIP. H C E'9L A 7 S TOTAL CONTR. LIST MeV o )( CHECK I N 1. ENT. SW. DIRT. CAB. SERVICE TEMP.. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 MP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No c /O Owner's Name and Address Li. /Z 4.BETN if o 8 LZ� 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, 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. No —7 Street , 30/ 4/, /0 Registered Architect and /or Engineer p abloying i Ejectpktp, N c 0/940.• E.S E LEcTR/G No a ,, L/ 0 0 tion Legal Descr tion Lot..,. .. � /� Block Street and Number where work is to be performed —No 30 1 ... /Pk - /00.4.7 State work to be performed and purpose of building (By Floors) N. /7»Seewiv .O/1 2- ' /I/ 444) 2 -41 New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P Type of Installation — Conduit Tubing.... B.X.L .Metal Moulding Amount of Permit $ Electrical Inspector. The undersigned applicant -for this building permit dots hereby certify that he understands and accepts his obligations u 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. STATE OP FLORIDA, COUNTY OF DADE. I se. (Signed) (Signed) Before me, the undersigned authority, a notary public, duly authorized appeared Charles-Fred. Fouse ._._...A.ugus>w..17.,...19.91 My Commission Expires NOTE: A re-inspection fee of $1.00 will be made when such re-inspection materials and /or workmanship. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he of the above described construction, and he has carefully read the foregoing application, and therein by him stated are true. Street to administer oaths and take acknowledgments, personally �c%{Prli /th Street 46 � p sW� e Subdivision iL i t � f G_o /x Muter Electrician. is the M4Ster ):i�.�Gti C.7 teik that he did sign the,;saxise, and”tha, :il .favts • Notary Public, Stateof,,Plnrid& is made necessary by improper noti..e fnr inspection oc `f;i ,� 1. "" � SWITCH OUTLETS LIGHT OUTLETS PLUG RECEIP'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN.. WATER HEATER W. HEAT. ONN. C � ' 1 SPACE HEATER l ® an STRIP HEATER 4 TOTAL / P t sCLSTR � / " /� // C./ t1 3,..„4-'--6_7___ ..11�. //��, — _ €) s 1 ! d ® N A/ • Li [6 2 d W CHECK ENT. SW. DIST. ' CAB. 'SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•5 HP NEON TRANS. RADIO TOTAL Y J A / � O ®� /y !'D b. Service Permit No 1 f 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 No Street Registered Architect and /or ngineer ' , Employing Electrician's Name d L0 a No.. ® ? Street 1 Y Location and Legal Description Lot Block Subdivision �. Street and Number where work is to be performed— No... .0 / ', • 1....g / 0 (S r 9 , .'' State work to be performed and purpose of building (By Floors) 4 e-V-- 1 1 W 6 7 New Building � Remodeling Addition Repairs No. of Stories. 1 ei Overhead 13trelergreentl Site Feeders 9 /0 Type of Installation— Conduit °'''' Tubing ' B.X.L Metal Moulding 1 Er „..1" .$1:2- mount of Permit $ •.• r + (Signed) 6 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of f or under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and `complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the rk 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 required by the Act. The undersigned agrees to employ only such sub-co • on w. k to be fperformed Aun46 this permit, as are ensed by Miami Shores Village. MIAMI SHORES VILLAGE Conduit 1 Main f l S w 0 Date. .. % ", / °/ -z 0#' Amps ?• 0 6 Main Fuses L ®® Amps Master Electrician. authority, a notary public, duly authorised to administer oaths '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. 11; OP FLORIDA, LQ OTY OF DADE: f ss. Before me, the undersigned c 1v and take acknowledgments, personally 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. 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 Mi.smi 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. Permit No. 1 Ly-v- if Owner's Name and Address.... Registered Architect and /or Employing Electrician's Name ngineer Street and Number where work is to be performed —No / 3a / State work to be performed and purpose of building (By Floors) New Building ✓ Remodeling Addition Overhead Service Underground Size Feeders CoErduit Type of Installation — Conduit Tubing S S. .No �W .No ain Sw Amps Date Street.. .?. Street...) V Location and Legal Description Lot Block Subdivision trees /0 Repairs No. of Stories Main Fuses Amps 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 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 to be performe ..under this permit, as are licensed by Miami Shores Village. Z(/ Master Electrici' STATE OF FLORIDA, , j COUNTY OF DADE: 11 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 lea are true. My Commission Expires Notary Public, State of Florida GTE: 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 1.5 HP N EON TRANS. • RADIO TOTAL CONTR. LIST CHECK 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 Mi.smi 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. Permit No. 1 Ly-v- if Owner's Name and Address.... Registered Architect and /or Employing Electrician's Name ngineer Street and Number where work is to be performed —No / 3a / State work to be performed and purpose of building (By Floors) New Building ✓ Remodeling Addition Overhead Service Underground Size Feeders CoErduit Type of Installation — Conduit Tubing S S. .No �W .No ain Sw Amps Date Street.. .?. Street...) V Location and Legal Description Lot Block Subdivision trees /0 Repairs No. of Stories Main Fuses Amps 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 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 to be performe ..under this permit, as are licensed by Miami Shores Village. Z(/ Master Electrici' STATE OF FLORIDA, , j COUNTY OF DADE: 11 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 lea are true. My Commission Expires Notary Public, State of Florida GTE: 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.