1411 NE 101 St (5)ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No J 7° !/
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 wo
Owner's Name and Address. /f<i1' No Street
Registered Architect and /or En ijnneeer
Employing Electrician's Name..,�1..
Location and Legal Description Lot
Amount of Permit $
erground
Size Feeders
SS.
I1
MIAMI SHORES VILLAGE
Conduit Sy /
No r/
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
Date
Street
Street
Block Subdivision
Street and Number where work is to be performed —No 4 /
State work to be performe and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amps /€ 0 Main Fuses
Amps
Type of Installation — Conduit Tubing 0" B.X.L Metal Moulding
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub - contractors employed by him in the
of the work such public notice or notices
be performed utf this permit, as are
II /
(Signed) 4 f
(' J
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE: I
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
N4I'E: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
mkt als 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
. -/
/
/O
CHECK
_
^ \
1)
1 61)
S
S s
y
MMM1
7
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM
�'
' ( Vj
V4414 � .. /,(
___41kg
/\
1� / Vo
MOTORS
0.1 HP
MOTORS
1.0 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
)
! ii
I (�
`15
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No J 7° !/
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 wo
Owner's Name and Address. /f<i1' No Street
Registered Architect and /or En ijnneeer
Employing Electrician's Name..,�1..
Location and Legal Description Lot
Amount of Permit $
erground
Size Feeders
SS.
I1
MIAMI SHORES VILLAGE
Conduit Sy /
No r/
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
Date
Street
Street
Block Subdivision
Street and Number where work is to be performed —No 4 /
State work to be performe and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amps /€ 0 Main Fuses
Amps
Type of Installation — Conduit Tubing 0" B.X.L Metal Moulding
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub - contractors employed by him in the
of the work such public notice or notices
be performed utf this permit, as are
II /
(Signed) 4 f
(' J
Master Electrician.
STATE OF FLORIDA, 1
COUNTY OF DADE: I
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
N4I'E: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
mkt als and /or workmanship.