237 NE 100 St (10)PERMIT / APPLICATION FOO13 MIAMI SHORES VILLAGE
Date / / C' 6 Job Address ;) ifJ ( 0 O // Tax Folio
Legal Description (/f�
Owner/Lessee / Tenant / 4 J ' V/c/
Owner's Address
Contractin Co. /4z' 2,,/eere;e_._
Qualifier •7 - 7 f 6®
State # EZOOOM Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILD
WORK DESCRIPTION
Square Ft. Estimated Cost (value)
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 perfommed 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 Al"PIUAVIT: 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.
1
Signature of owner and/or Condo President Date
otary as to Owner and/or Condo Presi
My Co
& OFFICIAL NOTARY SE,
NICOLE A BERGERT n
n COMMISSION NUMBER
... - ''�'II ' ,.
* CC661267
TA O
� Fl o� MY COMMISSION EXPIRES
FEES: PERMIT
APPROVED:
Zoning
Mechanical
Date
C.C.F.
110
Historically Designated: Yes No ik
Address
- 725,11 7 4
Master Permit # 75 ? 5
Phone - 25?
ss# - . .Phone W - 15 7�
Competency # Ins. Co. �� l
Address
Address
Address
LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Signature of Contractor or Owner- Builder
"ti
NOTARY • LI '— BOND
Notary as to Contractor or Owner- Build
My Commissiok Exoitisp q OFFICIAL NOTARY SEAL.
O %. NICOLE A BERGERT
Z 1 ^ 0 COMMISSION NUMBER
N, .�• �it. . Q CC661267
1!. ^ " � O MY COMMISSION EXPIRES
�O F\O JULY 2,2001
TOTAL DUE,
Building Electrical - /6 /
Date
Date
Plumbing Structural Engineer
Date 2- 9 7 Job Address 2 31 . •E ' /DO z
Notary
My Co
Legal Description
Lev)%eli
C a.,essee / Tenant Ail- ` 4)
Owners Address 2 31 kg - /0 o ST
Architect/Engineer /..)/4 ' Address
Bonding Company Address
FEES: PERMIT 1,3 / w RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
a -tZZ
Signature of owner and/or Condo President Date
�
I . �.� L. , , _
.. ' . • ,' . ` • 'r'"� }' v uq � , _.
t � t �
• ,t, ion D ri• CORY PATRICIA BRIGGS
1(. J *' COWMIf33IOI NUMBER
1`' '!' Q CC335250
. .._
Ya Q MY COMMISSION ern
e oF F\. JAN. 31,1998
/a-
Date
Tax Folio
Address
Address
Notary as t■ Contract
My Commission Exp
APPROVED:
Zoning
Mechanical Plumbing
Building
Historically Designated: Yes No
Master Permit #
P h o n e 7 5 1 — 4 9 7 f
Contracting Co. /1d D "CT72 /C C- •
Qualifier Oo -, J 119..0
State # eCo6Y // 99 Municipal # Competency # Ins. Co / f
ss# Phone .W/ —/ 0-71 4
Mortgagor
Permit Type (circle one): BUILDIN ELECTRICA ' LUMBING / MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /so a- -CEA�/ C v ?6'x'
Square Ft. Estimated Cost (value) /49a a '
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 Contractor or Owner -Buil
/4 /
® la . 4 L NOTARY SEAL
(i EBARY PATRICIA BRIGGS
t ) + *'' CO 31;7is IO NLICASER
'r CC33Z250
7f N : V P COMROSSION EXP.
OF F\- JAN. 39 9990
Date
l
2
C.C.F. J d NOTARY BOND
TOTAL DUE -? - 2-D
Engineering
MOODY# ELECTRIC, INC.
669 N.W. 90 STREET
MIAMI, FL 33150 -2166
TEL: (305) 891 -1374
FAX: (305) 758 -2000
RESIDENTIAL DEMAND
LOAD CALCULATIONS
3 W / SQ. FT /szrZJ• .¢: K.W.
REFRIGERATOR /•f K.W.
APPLIANCES „1.0 K.W.
DISHHWASHER /•2. K.W.
GARBAGE DISPOSAL K.W.
MICROWAVE .g K.W.
CLOTHES WASHER K.W.
DRYER .5%0 K.W.
RANGE /2.6 K.W.
WATER HEATER S K.W.
OVEN K.W.
FREEZER K.W.
TRASH COMPACTOR K.W.
GARAGE DOOR MOTOR K.W.
JACUZZI K.W.
JACUZZI BOOSTER HTR. K.W.
IRONING BOARD K.W.
POOL EQUIPMENT K.W.
SPRINKLER PUMP / Z•. K.W.
LANDSCAPE LIGHTS K.W.
SPARE CAPACITY J K.W.
K.W.
K.W.
TOTAL CONNECTED LOAD •Z K.W.
FIRST 10 K.W. @ 100 % 10.0 K.W.
REST @ 40 % H.3 K.W.
A/C @ 10 % -TO K.W.
TOTAL DEMAND LOAD 242 •3 K . W .
26.3 K.W. / 240 V. = 1043 AMPS
UN.) f 4 E-4--d=4"
2 l 6 t o m e ---
kJ,, 1
cq
5 MAF SeV.4
,s -4i - t - - 1-144,..1z:::..:
3
1 ksr2'' it 't
r .
L a GoeN,r; ---
>i
,
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
IT
Permit No � ` Date..le % JJ
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. ��rr
Owner's Name and Address ' /' No. p2 7
Registered Architect and /or Engineer f _
Employing Electrician's Name 1 .t fC� /./fal 1 �'�``�`LQ� '�?lf;T ���� �// �tE elf 3/
Location and Legal Description Lot Block
�) f
Street and Number where work is to be performed— No. - V ? '/ C
State work to be performed and purpose of building (By Floors)
Street
Subdivision
New Building Remodeling Addition "— Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
o �y
Amount of Permit $ S (Signed) Q.S.` .............
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of ' orida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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 OF FLORIDA, }
COUNTY OP DADE.
Before me, the undersigned authority, a notary public, duly authorized
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.
55.
My Commission Expires
to administer
(ISigned). ,f
Notary Public, State of Florida
aster Electrician.
oaths and take acknowledgments, personally
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.
A
H ATER
STRIP
HEATER
u
,N, ere
TOTAL
CONTR.
LIST
/
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CL
LIST
Jam,) .9
pc//(� /7
/
CHECK
,
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
IT
Permit No � ` Date..le % JJ
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. ��rr
Owner's Name and Address ' /' No. p2 7
Registered Architect and /or Engineer f _
Employing Electrician's Name 1 .t fC� /./fal 1 �'�``�`LQ� '�?lf;T ���� �// �tE elf 3/
Location and Legal Description Lot Block
�) f
Street and Number where work is to be performed— No. - V ? '/ C
State work to be performed and purpose of building (By Floors)
Street
Subdivision
New Building Remodeling Addition "— Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
o �y
Amount of Permit $ S (Signed) Q.S.` .............
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of ' orida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or 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 OF FLORIDA, }
COUNTY OP DADE.
Before me, the undersigned authority, a notary public, duly authorized
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.
55.
My Commission Expires
to administer
(ISigned). ,f
Notary Public, State of Florida
aster Electrician.
oaths and take acknowledgments, personally
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
12 PERMIT N° 9347
% i
/ Work to b
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORID
DAT E/
Contractor's
License No
perfo med under this Permit
Bl.
Subdi-
vision
Value of
Project $
v
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 foF' 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 r specifications and that he assumes responsibility for work
done by his agents, servants or employees. , /
i 6 � �{
Signed: --g. BY f _/ Q
INSPECTOR -
In consideration of the issuance to me of this permit I agree to pettorm the work covered hereunder in compliance with.-till oltlinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities 6f Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
195
Owner of
Building •
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
R R
BUILDING
ELECTRICAL • PERMIT N° 9542
PLUMBING
W to b • e - rm ler this Permit
a
Value of Amt. of
Projec $ II Permit $
Signed:
: b . ng or to install the equipment or device described in the a pp
st. ing that the work will be performed in compliance with any p
the proper municipal authorities. This Permit may be revoked at any
ged without authorization. A further condition upon which this permit u
s ponsibility for a thorough knowledge of the ordinances and regulations
onsibility for work
fL /Qc
This permit is gra to tie contractor or builder named ab.) to con
herefor in strict complian • with all ordinances pertaining thereto ! with
drawings, statements or specifications that may have been submit to and a
time if the work is not done in compliance with such ordinances or if the pia
granted is the understanding that the contractor or builder named above ass
pertaining to the work coy zed hereby whether sho or dra
re
done by his agents, se nts or employees.
In consideration of the issuance to me of this
pertaining thereto and in strict conformity with the plans.
In accepting this permit I assume responsibility "for all work `� one
Q ALALDSR
MIAMI SHORES VILLAGE, FLORIDA j /
DA t(.Q -O
Contractor's
License No
y
Subdi•
vision
/MPH
erform the work covered hereunder compliance
ents or _specifications submitted to the proper a
either, nn my,age servant or employee.
DT
195_0
11 ordinances and regulations
es of Miami Shores Village.
AunioRtry
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of -�
Building mac"
Lot
MIAMI SHORES VILLAGE, FLORID
DAT'
PERMIT • N° 9347
/ i
J orkto,pperfo � tfi `
Signed •
In consideration of the issuance to me of this permit I agree to
pertaining thereto and in strict conformity with the plans, drawings, eta
In accepting this permit I assume responsibility for all work done by eith
c r: i : rrli c ar ‘ I C.:
OR BUILDER
License No-
ed under this Permit
Subdi-
vision
Value of
Project $
BY
Contractor's
V
BY
INBPa QR
the work covered hereunder in complian
or specifications submitted to the proper au
myself, my agent, servant or employee.
Amt. of
Permit
$
195
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without au rization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above mes the responsibility fo a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawl, s or in the statements r specifications and that he assumes responsibility for work
done by his agents, servants or employees.
5 6
Registered Architect and /or Engineer _
Employing Electrician's Name___ (i f
Location and Legal Description Lot I_L2 L' Block
r. 3 7 A
Street and Number where work is to be performed —No
New Building Remodeling Addition
MIAMI SHORES VILLAGE /
I�Db✓
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PE
No.___ 7
'/ - �r
ate./
Applietion is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fjA= 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 t ry ° = e / No Street__
Street Z: _ �' '
Street_ -��/I
t___ _! L" '
Subdivision / '
State work to be performed and purpose of building (By Floors)
Repairs — No. of Stories
Service Overhead Underground Size Feeders Conduit ... ___________Main Sw. _____________________Amps Main Fuses Amps
Type of Installation—Conduit_ Tubing B.X.L._______ Metal Moulding
Amount of Permit $ ..... ( Signed) ' — CU, —
Electrical Insp ctor.
The undersigned applicant for this buildin '.permit does hereby certify that he understands and accepts his obligatrOiis as an a ployer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl lent, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im in the
work to be performed under this permit; and will post or cause to be p osted 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.
STATE OF FLORIDA,
COUNTY OF DADE. I
ss.
Master Electrician. •
Before me, the undersigned authority, a notary public, duly a uthorized 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
r
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
/
RANGE
CONN.
WATER
HEATER
/
�' LF '_s
W. HEAT.
C
/
SPACE
HEATER
i
STRIP
HEATER
TOTAL
CONTR.
LIST
Lr
r
CHECK
/
1
J /
/ �?
-
ENT. DIST. 5RVICE
SW. CAB. TEMP.
SER ICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CLIST
LIST
€ VCS A !
1
G
CHECK
to c _pc
5 6
Registered Architect and /or Engineer _
Employing Electrician's Name___ (i f
Location and Legal Description Lot I_L2 L' Block
r. 3 7 A
Street and Number where work is to be performed —No
New Building Remodeling Addition
MIAMI SHORES VILLAGE /
I�Db✓
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PE
No.___ 7
'/ - �r
ate./
Applietion is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fjA= 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 t ry ° = e / No Street__
Street Z: _ �' '
Street_ -��/I
t___ _! L" '
Subdivision / '
State work to be performed and purpose of building (By Floors)
Repairs — No. of Stories
Service Overhead Underground Size Feeders Conduit ... ___________Main Sw. _____________________Amps Main Fuses Amps
Type of Installation—Conduit_ Tubing B.X.L._______ Metal Moulding
Amount of Permit $ ..... ( Signed) ' — CU, —
Electrical Insp ctor.
The undersigned applicant for this buildin '.permit does hereby certify that he understands and accepts his obligatrOiis as an a ployer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl lent, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im in the
work to be performed under this permit; and will post or cause to be p osted 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.
STATE OF FLORIDA,
COUNTY OF DADE. I
ss.
Master Electrician. •
Before me, the undersigned authority, a notary public, duly a uthorized 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.
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__ - °-' cz`� il_ _ _ No. _- — - Street_-
Registered Architect and /or Engineer
Employing Electrician's Name___ e_,.e1 _L_•. _ L f� * - : .______ No JY /1 / C-- Street " if '
Location and Legal Description Lot_ _j ‘ v /7 __ Block 3 ey Subdivision_ 07
Street and Number where work is to be performed —No. �_� 1 __ -_._ Street_ -- / ICI- t.t�' •
State work to be performed and purpose of building (By Floors)___ _ _i___, ^ - ,t -4
New Building________ Remodeling Addition Repairs No. of Stories
Amount of Permit $_
APPLICATION FOR ELECTRICAL PERMIT
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
Date
Service Overhead Si Fd
z e eeers__________________ Conduit_____________Main Sw._________ —____ Amps Underground P Main Fuses______ ________ ___Amps
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 sub - contractors employed by him in the
work to be performed under this permit; and will post or cause to be p osted 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.
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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.
Master Electrician.
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
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
CHECK
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__ - °-' cz`� il_ _ _ No. _- — - Street_-
Registered Architect and /or Engineer
Employing Electrician's Name___ e_,.e1 _L_•. _ L f� * - : .______ No JY /1 / C-- Street " if '
Location and Legal Description Lot_ _j ‘ v /7 __ Block 3 ey Subdivision_ 07
Street and Number where work is to be performed —No. �_� 1 __ -_._ Street_ -- / ICI- t.t�' •
State work to be performed and purpose of building (By Floors)___ _ _i___, ^ - ,t -4
New Building________ Remodeling Addition Repairs No. of Stories
Amount of Permit $_
APPLICATION FOR ELECTRICAL PERMIT
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
(Signed)
Date
Service Overhead Si Fd
z e eeers__________________ Conduit_____________Main Sw._________ —____ Amps Underground P Main Fuses______ ________ ___Amps
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 sub - contractors employed by him in the
work to be performed under this permit; and will post or cause to be p osted 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.
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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.
Master Electrician.