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ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Dated l Job Address WIN) 01 I C 1 I Tax Folio Legal Description Owner / Lessee / Tenant mIQ.1_LP,R Master Permit # <3g27(9 Owner's Address 1.\I(C) N = In 1 S1 Square Ft. Estimated Cost(value) ' ► /.��,�� Phone Contracting Co. Jlf.1 L Qlc. LAC— Address LC' 140N0:ItL1A Qualifier \ )Y�iJ k 1 1EL k) SS# ( Phone L /M2l - 4 22- State Ik Municipal # Competency # (Mails) Ins.Co. TIVAeltA4 SLORL T Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDINe ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN • WORK DESCRIPTION ELGC-MkLkL - MRII) e AAA, 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 co ruction 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 My Commission Expires: ** * APPROVED: * * * FEES: PERMIT/ RADON Notary as tbuggatesaftbadore My Commission Expires: C.C.F. NOTARY TOTAL DUE /S Fire Other Zoning Building Electrica,W ' 9l Mechanical Plumbing Engineering ntractor or Owner- Builder THURSTON MAITRE I _b4i ,Stated Florida 22 flu ff der it ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT / 1. FEE ITEM SPACE HEATERS UNIT FEE BIDET _ LIGHT OUTLETS ,1p /*- CENTRAL HEATING DISHWASHER RECEPTACLES 35 A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) ' . DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/1IETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS 3 /33" PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP / JJ'2 UNDERGROUND TANKS LAVATORY _OVEN j ,35- ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER f ,5 U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS ).., 7/210, / l9 • 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 FIXTURES SEPTIC TANK ANTENNA ' RELAY TELEVISION OUTLETS 3 4/6 DRAINFIELD, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION / 1 SOAKAGE PIT CU. FT. CATCH BASIN / .mo 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 ow- ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Date Legal Description Owner / Lessee / Tenant/ e4,207),11:7, 8 Y . 9 Master Permit # Owner's Address /y)© , 4`r . /©/ �/'. ///4. 5e0 Phone 7 SI - Pe. 6 n Contracting Co. S 0 E E:!nri7C /,4JC. Address �v� 3D C� o°z r =z Qualifier ,64-A..> ./4• /1l'CSO/) State #;4262 Municipal # Competency # 69/g2 /6 Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING PENCE SIGN P ij�rrr 4 r.P.`!'} /SO fie SE6? /C E -9D• WORK DESCRIPTION Square Ft. Estimated Cost(value) / / 5 0-(1 V WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and . on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cons and zoning. urthermore, I autho e ,e -named contractor to do the work stated. ignature of owner Date: m om= l: Job Address 1 1f0 /4E Notary as to Owner and /o j ondo President My Commission Expires: agn77Trriiina Ia LJ `1 .... i n FEES: PERMIT3s 7 RADON APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ndo President SS# Phone 2 7 - C.C.F. Fire Zoning Building Mechanical Plumbing Tax Folio /7 1ZOS- - 0030 Contractor or Owner- Builder Notary MyCom� Co -Builder � ,L 122_ My Comm. Expires Mar. 22,1998 No. CC 358703 * / * 9ondekThru etttggal £ilatarg Prrv1ct * * ** NOTARY TOTAL DUE 3 b Other El ectrica :! Engineering PAC' 3 c V. MAN RIA o v R' H' f1 9 fRU A >U S�g- X g' cetPFR Se A RO. PAS (TYA) /SO 4mP M.48. PAar" L. 12o/zy SiNbia Af •2 L wia wverrenem f?obF L i - --� ce &0 r✓A7•6l..PiPa 1a$DC CSC acf( WALL ovc VIEt) 3' .0 (� �l er/r ELECTRICAL INSPECTION DEPARTMENT �9 APPLICATION FOR ELECTRICAL PERMIT Permit No / / -- ` Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be 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 /Vs �G�" 4 e V No / 7OU Street Amount of Permit S MIAMI SHORES VILLAGE /74-1 6. : _ Co. Street and Number where work is to be performed —No /7O0 (Signed) (Signed). No 7 / R Date /V e. /0/ - L - /reel' Registered Architect and /or Engineer Employing Electrician's Name Block Subdivision. .41.CX Location and Legal Description Lot A/ i Street / • 10.1 57' 5 /1" Street � � ,� irve (ai reef State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Overhead Service Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps 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 accepts his /0 igations 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 sub-con ctors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrician. STATE OF FLORIDA, l COUNTY OF DADE. I Ea' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by the first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T's FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H EATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS MOTORS 0.1 HP 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST 3 f�,. CHECK ' H ,y ELECTRICAL INSPECTION DEPARTMENT �9 APPLICATION FOR ELECTRICAL PERMIT Permit No / / -- ` Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be 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 /Vs �G�" 4 e V No / 7OU Street Amount of Permit S MIAMI SHORES VILLAGE /74-1 6. : _ Co. Street and Number where work is to be performed —No /7O0 (Signed) (Signed). No 7 / R Date /V e. /0/ - L - /reel' Registered Architect and /or Engineer Employing Electrician's Name Block Subdivision. .41.CX Location and Legal Description Lot A/ i Street / • 10.1 57' 5 /1" Street � � ,� irve (ai reef State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Overhead Service Underground Size Feeders Conduit Main Sw Amps Main Fuses Amps 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 accepts his /0 igations 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 sub-con ctors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrician. STATE OF FLORIDA, l COUNTY OF DADE. I Ea' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by the first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA BUILDING ELECTRICAL ® PERMIT N? PLUMBING ❑ N . '7 5 8 9 ROOFING ❑ ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. r Subdi- vision DATE Sq. Ft Value of Project $ Contractor's ti License No Amt. of Permit $ BY AUTHORITY / 195'1 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 st(ements or specifications and he assumes responsibility for work done by his agents, servants or employees. Signed • r�! .e 8Y '. 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. gr. 17 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Description. Lot II BL Address of Building ' 1 t r CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA ❑ DATE at',',' a 4 , 195_ Q PERMIT N? 15124 Contractor's ❑ License No ❑ Work to be performed under this Permit • Subdi- vision Value of Project $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application 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 P t I e 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 Amt. of Permit $ t AUTHORITY MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMI' ----- T -- Permit No../...5.7.24. .... Date a Application is hereby mSde 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 Eng er Employing Electrician's Name /..� K���" ✓L No Street Location and Legal Description Lot Block Subdivision ) L i 0 Street IVF C ) 0 Street and Number where work is to be performed —No \ — Ca t�,S'tate work to be performed and purpose of building (By Floors) l i tvew Building Remodeling Addition Repairs No. of Stories Service Underground Type Size Feeders / Conduit < Main Sw Amps Main Figs Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ STATE OP FLORIDA, COUNTY OF DADE I ss. l'o' My Commission Expires (Signed)..��� No Street Electrical Inspector. The undersigned applicant for this buildi permit does hereby certify tha . e understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensatio ct, being Section 596 •mpiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will req ffr`h • _ ompliance 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, licensed by Miami Shores Village. on work to be performed under this permit, as 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 Master Electrician. are 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 L3-0 REFRIO. OUTLET 1 IRON OUTLET RANGE OUTLET U RANGE CONN. WATER HEATER U W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL 1ST G' ' a c 5 50 ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL P CHECK / / :Y MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMI' ----- T -- Permit No../...5.7.24. .... Date a Application is hereby mSde 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 Eng er Employing Electrician's Name /..� K���" ✓L No Street Location and Legal Description Lot Block Subdivision ) L i 0 Street IVF C ) 0 Street and Number where work is to be performed —No \ — Ca t�,S'tate work to be performed and purpose of building (By Floors) l i tvew Building Remodeling Addition Repairs No. of Stories Service Underground Type Size Feeders / Conduit < Main Sw Amps Main Figs Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ STATE OP FLORIDA, COUNTY OF DADE I ss. l'o' My Commission Expires (Signed)..��� No Street Electrical Inspector. The undersigned applicant for this buildi permit does hereby certify tha . e understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensatio ct, being Section 596 •mpiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will req ffr`h • _ ompliance 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, licensed by Miami Shores Village. on work to be performed under this permit, as 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 Master Electrician. are 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.