1301 NE 101 St (6),
Date Job Address /S /de CP/ Xr Tax Folio Y5 ,2 P.Z . S' /D 0 Z. a 4d /
Legal Description LdT 4/ /a '/k 2 $/td»? S 4dIYe a4�, fyHistorically Designated: Yes No
PAr e3ra err., Pb. sr f4. B3 aaz b 4.
Owner/Lessee / Tenant ti44/ ' 44,2 Jib,/ !f0/f /d.fPZ t Y/ Master Permit # ) L 4,
Owner's Address / 3 4/ ,t / v / , f / - . # 0 4 . , v ' 6 - 4 4 / 4 1 ' s
Contracting Co. �111v 0 12 l.t; Cyr CONY. Nc••
Qualifier f. • GAaTt) S
WORK DESCRIPTION
14 7 PeR. ecAn)s
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT // }' '✓ RADON
SS#
Notary as
My Commission
Phone Oa) 76 - F cP3
Address 1 1 1 . 0\ S' &
Ivr .w -02- Mittnl Ft..
Phone
I4)6J SEW C6.5 (abEP/ ROONJ Z 14( 1114 -T Lf SPoT 1.176g 35wacilE
State # ECM° 15 t 1 A- Municipal # Competency # Ins. Co. O) 1 t L
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING JECTRICi PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost (value) 5 � 000 00
3Q_C 6 --q L 3 3
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 AFTFJI)AV1T: 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
Electrical actor or
Si a : . of Con Owner- Builder
0//d /
Date
actor or Owner-Builder Date
g /v! a/ LAZARO PEREDA
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION 0 CC939201
EXPIRES 8/4/2004
BONDED THRU AM 1i88.NOTARY1
C.C.F G }i NOTARY — BOND
TOTAL DUE // , 312
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
PROOF OF RESIDENCE
OWNER
SECOND OWNER
THIRD OWNER ..
Name & Address of each owner not living on property: -
1
(
Social Security Number required for all owners living on
property: - - . • - .
C3': V 3 4 - 33.z 7 ,.
, ..6(1- ,f. - - /..) Li
When did you move to the State of Florida?
J�
c (te) 0
When did you move into this house
a fr .• /`.;f3£ )
Florida Drivers License Num ber
Date of issue & of Birth O G / `
y<_ ,
a:' y _ ‘,/ 3 - ; t •r
r f
S�
f s.� i ' / l �?(-:4 b (1'
! =fig--
.
..
r
Florida Vehicle Tag Number -• ,
, ae of Issue: : ` -
1-12 /4 / Z .. r
i ,; /- f ci,i'
.., ;2- ; a
r / -? �;tf j^,
Are y u a U.S. Citizen?
If , give .. .Florida Voter's Number & Registration Date:
If NO, Immigration Number(Green Card) & Issue Date:
y
v
r r
` - ._
it/
(- 1' -
OS- ',`L; . . tf,
'Other proofs of Florida Residency:
. .
Current Employer & :
w P umber „ -- ,,,,. t
AP:-, LSD
bi c .e : :�,- rJ,, F
"22:L5_.-7 _ � n L1
r
- 2, i ) ��, „ : ' 60 ,3
Address liste eturn: ~
d" on" " r test at 's'IRS R
Y� e
Y
'
SA O �ALY_r .�,.� / ..-
4
�)r.t o I* .1"3i' fr
PROPERTY ?OENTIFICATION NUMBER
PROPERTY DESCRIPTION
STREET.' 1301 tN E 101 5
CITY:
ZIP:
)' ROPERTY ADDRESS:
1301 N• 101 ST
°�pucKSRSxays- .L ^:_v.,T,rxsoe ai ...2 4.0E.DEED :. -. 4 /o
��
DATE RECORDED: i� 4." J` rL �.:. ?''Y �
RECORD: BOOK PAGE
ORIGINAL APPLICATION FOR TAX EXEMPTION Filing Deadline is March 1.
I-320'--023--0090 MIAMI -DADE COUNTY, FLORIDA YEAR ? : r l
' Office Use Only
. HEX: ADONL:
SHORES BAY P . STS
IL C T 4
LOT SIZE 109, &O0 `(
OR 192:32-3'910 09 - 20
AM S
=L
. n
33133
Social Security Disclosure Note: Disclosure of your
social security number is mandatory. It is required by Section
196.011, Florida Statutes. The social security number will be
. used to verify taxpayer identity information, homestead
exemption information submitted to property appraisers, and
intangible tax information.
OFFICE USE ON (WILL SUBMIT): ,
X t'
SIGNATURE OF APPLICANT (S)
'
DATE & PHONE NUMBER
- "
r: t
Did you own real property last year? Y F Yes [%] No [ ]
Previous Address ,', -
�' *� �' �+, a . • y A / / �� j �I I� #RESIDING OWNERS: • ' HEX •
i3 f K / ... ' 1 r d ." • (. D. LI 1 Was this property sold? Yes (y_,rDa -- ! , No [ ]
: 4J T & P: Other.
Did you receive tax exemptfon ortthis prop Yes ( IT No [ ] :. '
-Dow: '_ .
Marital Status: SINGLE [ ] MARRIED [ 6 [. ] r `
WIDOW' [ -.'.] WIDOWER l [ , :] DIVORCED [ "].. LPAOIerk,
*EXEMPTIONS APPLIED FOR:
[ NEW ] ' [CHANGE ] [ ADD]
Y •
Permanent Florida Residency Required as of January 1,'
$25,000 HOMESTEAD EXEMPTION
$500 WIDOWS OR WIDOWERS EXEMPTION
(MUST SUBMIT SPOUSES DEATH CERTIFICATE)
$500 VETJCIV. OR BLIND PERSON'S•DISABILITY EXEMPTION
SERVICE CONNECTED TOTAL & PERMANENT
DISABILITY EXEMPTION (Documentation Required)
DISABLED VETERANS confined to WHEELCHAIRS
EXEMPTION (Documentation Required)
CIy,ILIAN T-OTALA- PERMANENT.P Si�BIL)TY : _ :„
EXEMPTION (Documentation Required)
*EXEMPTION AMOUNTS APPLIED TOWARD ASSESSMENT VALUE
J understand that Section 196.131 (2) Florida Statutes provides that any person that shall knowingly give
false information for the purpose of claiming homestead exemption is guilty of a misdemeanor of the first
degree, punishable by a term of imprisonment not exceeding 1 year or a fine not exceeding $5,000 or both.
Further, under penalties of perjury, I declare that I have read the foregoing application and the facts in it are true.
J hereby authorize this agency to obtain Information. from utility companies or any other source,
necessary to determine my eligibility for the exemption(s) applied for. If all information is not received by
MARCH 1st, your application will be processed for whatever exemptions you qualify for on that date.
t) hereby make application for the exemptions Indicated and affirm that I do qualify for same under Florida
t u ? Tit ;air ✓,& y * z , tr if yl ? Ni..: a Statutes. 1 am a permanent resident of the State of Florida and I own and occupy the property described above.
You min ring aD Jnfor natl n and this completed form, UNSIGNED, IN PERSON, to the Property Appraiser's Office by March 1.
J r ' r '
IL 'w' G t t'�`�c t. -1 / ; l
DEPUTY'S SIGNATURE, INITIALS, & DATE
•
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 0 /3 i Job Address ).36/ fE /0/ 47 Tax Folio
Legal Descripti on e /A4( / £I2 �ci /Historically Designated: Yes No
/Y D � n �4�
Owner/Lessee / Tenant �Q 1 Master Permit # ` � J r 1
/3 /
/" /D 57-
Owner's Address
Contracting Co.
Qmlifier 1/(249 7 OPeAk---
state# go/' f 16
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ECTRICALLL)PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /4 7 T e7 17;. .9 4 kr le — l & • - 1 c }' / k � _ (gaffi
AsAkjel
Square Ft.
Municipal #
A c.
P h o n e Cdr) 7 5 ' % . C
Address A5 --- s --- /
SS# Phone ( ' a0 7$7 1 1 2
3 8�0$�S�
? 3 / (a'a competency # ,Setice Ins. Co. ArA F,f
3 /( cw
Estimated Cost (value) /ea
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR. LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT �t S ®" RADON
Signa..� - of Contractor o !awn I ilder Date
c���;�:- �(O( )quo p„. �-ooy
`�
otary a , ; �; , ., • Date
My Co i . ' ' `. ° l�N NO. CC7191Q3
Y • 1SSION EXP. MAR.1 _
C.C.F. ' 0 NOTARY BOND
TOTAL DUE _51/4_< 6o
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
ITEM
BATH TU3
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
c
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR CHAIN
SERVICE REPAIR/1E7ER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
:3
5.
PROCESS AND PRESS PIPING
INTERCEPTCR
RANGE TCP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTCRS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 CCMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIOENCE
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
MOTCRS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SLPPLY 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
ANNA •
RELAY
TELEVISION CUTLETS
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 APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS I.
OBTAINED, THE OwaER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
L3 /O/ e 021
Arr
\ '
4 -111r 4
T
\C,
I
-
"A,
__)
L3 /O/ e 021
Arr
P
,4Aie
/ ' _ CA'rC-
Q,467At ctel4 5
itAe
NOVE5:
- mea-Airements to be checked cn
-existing soffit to be modified according to kitchen design
- paitru size needs to be as large as possible
-electiclatiat to be redone acca-dingto kitchen design
-plumbing will remain as-is
-kitchen sink to be centered With window
posIble chha cabirwt
0
71-
scale: 1/ 4" 1
10"-7"
PA5SI. 1:5113NC
90-4?g,s- q/.51
30 SI 70' - 064
APPROVED
ZONING
STRUCTURAL
ELECTRICAL
PLUMBING
MECHANICAL
ROOFING
BLDG. OFFICIAL
m 1.11.11.1111111
■
SUBJECT TO COMPLIANCE' WITH ALL FEDERAL, STATE AND COUNTY
RULES AND REGULATIONS.
MIAMI SHORES VILLAGE ASSUMES NO RESPONSIBILITIES FOR ACCURACY
OF OR RESULTS FROM THESE PLANS.
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADO
MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB
CONTRACTORS ARE CHARGED WITH THE KNOWLEDGE OF PIED BY
PFGULATIDNS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN
EI9IA JI SHORES VILLAGE
i6D
ELECTRICAL INSPECTION DEPARTMENT
c� APPLICATION FOR ELECTRICAL PERMIT Date // , -6
/
Permit No � ` — . I — / � f
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
Registered Architect and /or Engineer
Employing Electrician's Name .. %�'�— , No. ..I _.1 � Street...Q" —�
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
No 3 d I' .. `. t Street.... O
g,, S twice Size Feeders,3 ^ b Conduit.a ... Main Sw
Underground
3 -c Type of Installation— Conduit Tubing B.X.L Metal Moulding
3.
Amount of Permit $ V (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. !t ss'
My Commission Expires
(Signed)
Amps.2.,_4 0
Main Fuses Amps
Notary Public, State of Florida
Ele ri al 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 Perman nt 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.
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fau
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
1 4/ / .
7
,
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
1
CHECK
7
g�
*0
�f
(t{}'fryr
i6D
ELECTRICAL INSPECTION DEPARTMENT
c� APPLICATION FOR ELECTRICAL PERMIT Date // , -6
/
Permit No � ` — . I — / � f
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
Registered Architect and /or Engineer
Employing Electrician's Name .. %�'�— , No. ..I _.1 � Street...Q" —�
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
No 3 d I' .. `. t Street.... O
g,, S twice Size Feeders,3 ^ b Conduit.a ... Main Sw
Underground
3 -c Type of Installation— Conduit Tubing B.X.L Metal Moulding
3.
Amount of Permit $ V (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. !t ss'
My Commission Expires
(Signed)
Amps.2.,_4 0
Main Fuses Amps
Notary Public, State of Florida
Ele ri al 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 Perman nt 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.
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fau
materials and /or workmanship.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL E
PLUMBING ❑ PERMIT N° 8091
ROOFING ❑
Owner of
Building Vs.
Architect
Contractor
or Builder it .,, ,,;, r t.: - +�_ " y ; '°°' 4. t G..' =»
Legal Lot
Description BI
Address of • ; 7
Building 4; Co t O. «.: . d c i •. t
CONTRACTOR or BUILDER
Work to be performed under this Permit
a<� � t / �/,tt �..w c" t. s , CJ rN
Subdi-
vision
Sq. Ft. . •‘
Value of II Amount of ps
Project $ I I 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 applica-
tion 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 respon-
sibility for work done by his agents, servants or empJlo • ti r °
Signe °' - - "t.. it r ' ?A — . 4 (II $ CTOR) BY
In consideration of the issuance to me of this permit I agre 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 responsibilit all work' done by either, myself, my agent, servant or employee.
4.; L_ C., 7 f ;, t
Date 1 ' ° " 19h..
a
Contractor's cf,
License No
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building /
Architect
Contractor
or Builder _.
Legal
Description
Address of
Building
Lot
PERMIT N° 14311
❑ Work to be performed under this 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.
Signed • BY ' 1
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 acceptin this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
;r,,r. •10
n Bl
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
BUILDING ❑
ELECTRICAL 4a PERMIT N°
PLUMBING ❑
ROOFING ❑
Owner of
Building
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot II BL
Description.
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
14353
Subdi-
vision
Value of
Project $
DATE J ' 2
Contractor's
License No
Amt. of
Permit $ Jl " --
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 aceept • this permit I assure spo4`sibility 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
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 d f
w Ing urtng progress o wo „,,
Owner's Name and Address.. { _1 No
Registered Architect and /or Eng
Employing Electrician's Name
Location and Legal Description Lot `� 1 / Block Subdivision
Street and Number where work is to be performed —No 3 0 I Street r /v 6 / Q 1 4
State work to a performed and purpose of building (By Floors)
New Building A Remodeling Addition Repairs No. of Stories
M
Service Size Feeders R / Conduit / Main Sw. Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ �1
(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 performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t
COUNTY OF DADE. 11
My Commission Expires
63.
We:kA;( No
(Signed)
Date
Street
Street
5
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer . oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re• inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
J Z
/
I
I
�q
/
ed+�
I
7
/
/60
/
l
lc
G�
J
CHECK
/ .
[�
0 S
y�
_US
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL.
CONTR.
LIST
_.
/
/
CHECK
/ ®e2
/ d c
Permit No / �S
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with whether herein - specified or not. A copy of approved plans and specifications must be kept at
building d f
w Ing urtng progress o wo „,,
Owner's Name and Address.. { _1 No
Registered Architect and /or Eng
Employing Electrician's Name
Location and Legal Description Lot `� 1 / Block Subdivision
Street and Number where work is to be performed —No 3 0 I Street r /v 6 / Q 1 4
State work to a performed and purpose of building (By Floors)
New Building A Remodeling Addition Repairs No. of Stories
M
Service Size Feeders R / Conduit / Main Sw. Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ �1
(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 performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t
COUNTY OF DADE. 11
My Commission Expires
63.
We:kA;( No
(Signed)
Date
Street
Street
5
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer . oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re• inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No
/ , L (f
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
Registered Architect and /or E ine r
Employing Electrician's Name..
Location and Legal Description Lot
Street and Number where work is to be performed —No .. / N C / 0
State work to be performed and purpose, of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Installation — Conduit
Amount of Permit $
STATE OP FLORIDA, 1
COUNTY OF DADE. I
ELECTRICAL INSPECTION DEPARTMENT
•
APPLICATION FOR ELECTRICAL PERMIT
es.
MIAMI SHORES VILLAGE
No Street
(Signed)
(Signed)
Date
2--Z s S 3
No Street F;ttle2...
Block 2.__ Subdivision
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses
Underground
Tubing B.X.L Metal Moulding
Street
Master Electrician.
Amps
0
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.
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.
ST
LIST
L
j
CHECK
.
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
I
/
i
CHECK
/ d O
/ b V
/ 0 O
Permit No
/ , L (f
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
Registered Architect and /or E ine r
Employing Electrician's Name..
Location and Legal Description Lot
Street and Number where work is to be performed —No .. / N C / 0
State work to be performed and purpose, of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Installation — Conduit
Amount of Permit $
STATE OP FLORIDA, 1
COUNTY OF DADE. I
ELECTRICAL INSPECTION DEPARTMENT
•
APPLICATION FOR ELECTRICAL PERMIT
es.
MIAMI SHORES VILLAGE
No Street
(Signed)
(Signed)
Date
2--Z s S 3
No Street F;ttle2...
Block 2.__ Subdivision
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses
Underground
Tubing B.X.L Metal Moulding
Street
Master Electrician.
Amps
0
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.
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.