205 NE 101 St (12)Permit No
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 of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fite :ida,
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 //��'n �] R
Owner's Name and Address. ... [ ( 1:1 No Street
Registered Architect and /or Engineer yy,,
Employing Electrician's Name45:���4.>.4�✓49. , ? ,5 K
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 42OS A) 4
State work to be performed and purpose of building (By Floors)
e e" .&JO" No 5 S e
New Building .x 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
LUSTALLL Ff1,F61A1? fitAgm t ...l vlirceNl,. 6 /e.
Amount of Permit $..
(Signed).
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. f es.
Before me, the undersigned authority, a notary public, duly authorized
The undersigned applicant for this building permit does hereby certify that he understands
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General
has complied with the provisions thereof, and will require similar compliance from all contr work to be performed under this permit; and will post or cause to be posted for inspectio11 as are required by the Act. The undersigned agrees to employ only such subcontractors, w .
licensed by Miami Shores Village.
tikkA 13)
to administer
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Date "' f
Street
Street VC/ S7:
Subdivision
/ A/ Sr.
Electrical Inspector.
and accepts his obligations as an employer of
Laws of Florida Permanent Supplement, and
rs or s contractors employed by him in the
to e work su public notice or notices
performed der this permit, as are
Muter Electrician.
oaths and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of 51.00 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
REIRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
Q�anQ
F �W rNI
n / M OTORS
T0 CAI& 0.1 HP
MOTORS
1•5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
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 of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fite :ida,
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 //��'n �] R
Owner's Name and Address. ... [ ( 1:1 No Street
Registered Architect and /or Engineer yy,,
Employing Electrician's Name45:���4.>.4�✓49. , ? ,5 K
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 42OS A) 4
State work to be performed and purpose of building (By Floors)
e e" .&JO" No 5 S e
New Building .x 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
LUSTALLL Ff1,F61A1? fitAgm t ...l vlirceNl,. 6 /e.
Amount of Permit $..
(Signed).
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. f es.
Before me, the undersigned authority, a notary public, duly authorized
The undersigned applicant for this building permit does hereby certify that he understands
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General
has complied with the provisions thereof, and will require similar compliance from all contr work to be performed under this permit; and will post or cause to be posted for inspectio11 as are required by the Act. The undersigned agrees to employ only such subcontractors, w .
licensed by Miami Shores Village.
tikkA 13)
to administer
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, and he has carefully read the foregoing application, and that he
therein by him stated are true.
Date "' f
Street
Street VC/ S7:
Subdivision
/ A/ Sr.
Electrical Inspector.
and accepts his obligations as an employer of
Laws of Florida Permanent Supplement, and
rs or s contractors employed by him in the
to e work su public notice or notices
performed der this permit, as are
Muter Electrician.
oaths and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of 51.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.