151 NE 101 St (2)Date i 2-11 ' Job Address /J/ %J /d/ ,5'7 Tax Folio
Legal Description
.5)
Z L. t,pa� Master Permit # ?,T
Owner�t— - ,1K�- . .
Owner's Address J / Jd/ Phone 7 3 -7 cral
Contracting Co. f=
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING 1 LEC ' ' PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION S'eq(1).J K
c } v� F 1 - �=
Square Ft.
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 cert �j� e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. F thn:.,, the a -nam co ntr ac t o r to do the work s tat e d
3
otary as
My Commission Expire
FEES: PERMIT
APPROVED:
Zoning
Mechanical
�. •
'V rn,
,
atig M :EC '∎
COMMISSION NUMBER
CC7d6697
w e
� CE MY COM7 SSION EXPIRES
4F F�° NOV. 15,2002
/56"/6
Historically Designated: Yes No
Address
f N ,FAcvot' ) t -t i
1 � �a / � -- vs
Estimated Cost (value) )/ 7 5
Signature of Contractor or Owner- Builder
Notary as to Contractor or Owner- Builder
My Commission Expires:
RADON C.C.F. . 0 NOTARY 5- 0 V BOND
Electrical
TOTAL DUE
Date
Date
Structural Engineer
I OC
t
- z . d . 3 `
3 Z , t
Z� ?ti 1
►
N
• "1 .1.-3/ •
ELECTRICAL INSPECTION DEPARTMENT
_ / • a PLICATION FOR ELECTRICAL PERMIT
Permit No "1' Date —~ J .
Application is hereby made for !�e royal of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This lication 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...._ -41
Registered Architect and /or Engineer / '
Employing Electrician's Name C os I I te! 1 / El / edw c G e • No 7 Pe a 4.1E / ,(Q¢ Street—
Location and Legal Description Lot Block Subdivision
sr
Street and Number where work is to be performed —No 1
IAMI SHORES VILLAGE
Street /I/.E /D/ g- Vet,7 4
A � f ►
Street /�l•L. .1 0 / S ahe�
State work to be p erformed and purpose of building (By Floors)
New
Building g Remodeling
Service Overhead's
Underground Size Feeders Conduit Main Sw r9- Amps 0 Am s Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
-
SS.
Addition Repairs No. of Stories 1
(Signed) ( e •
(Signed)
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 lorida 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.
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.
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
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'PP''T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
1,.,
Lim
TOTAL
CONTR.
LIST
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a
c a
3 `
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a
1
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CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
t(
M i
al$6OS
I
Prier
1
MOTORS
0.1 HP
4
MOTORS
1.5 HP
de
UMy•
NNEEQCgg
TR7r�S.
tt µ8'
RADIO
TOTAL
CONTR.
LIST
/
X ocv3
(
CHECK
I OC
t
- z . d . 3 `
3 Z , t
Z� ?ti 1
►
N
• "1 .1.-3/ •
ELECTRICAL INSPECTION DEPARTMENT
_ / • a PLICATION FOR ELECTRICAL PERMIT
Permit No "1' Date —~ J .
Application is hereby made for !�e royal of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This lication 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...._ -41
Registered Architect and /or Engineer / '
Employing Electrician's Name C os I I te! 1 / El / edw c G e • No 7 Pe a 4.1E / ,(Q¢ Street—
Location and Legal Description Lot Block Subdivision
sr
Street and Number where work is to be performed —No 1
IAMI SHORES VILLAGE
Street /I/.E /D/ g- Vet,7 4
A � f ►
Street /�l•L. .1 0 / S ahe�
State work to be p erformed and purpose of building (By Floors)
New
Building g Remodeling
Service Overhead's
Underground Size Feeders Conduit Main Sw r9- Amps 0 Am s Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
-
SS.
Addition Repairs No. of Stories 1
(Signed) ( e •
(Signed)
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 lorida 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.
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.
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.