ELECTRICALDate M-2.4-58 Job Address z.410 N , / Of sr. Tax Folio / -3ZO - 01"3
Legal Description (DP) l 3 l`U S - ''+ r5N Historically Designated: Yes
1
f Owner/Lessee / Tenant J 4 id 4 - 0 I of e lJ �
Owner's Address _ Z4. (O ' t/St, '-1 . m"S
State # Cc /
e of owner an • r • - , • i • President Date
*`75 -53 -O "
_40
/:i 4 .
nt
sion E D S
NOTAR PUBLIC STATE OF FLORIDA
COMMISSION NO. CC727979
MY COMMISSION EXP. MAR'
1v
4
Sign
Notary as t
My Comm
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
FEES: PERMIT
.7_/ RADON
ate
Building Electrical
No��
Master Permit #
Phone rr II
.3 91S I IV. I1 t 4 . 1 -
Contracting Co. %ra. S E C-, Address
Qualifier 0Erzovxkl ' SNk1 P-S SS# Phone 1 ) ( -1 - 1 003
Municipal # 30-11 '13 Competency # ('7'3 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION H-I Wh ikiG .D. kit' TTZ.t Y f %I D ( Z_.) 15L� 'f`I -1 ZCOrr1
Tora L- U0 M1 5E12.- OF Uo - us - r Fcra SVa -ES/ Lkt( 1 pr EtHT Cg
Square Ft. Estimated Cost (value) 17_00, 60
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 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 forELECTRICALjPLUMBING, 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 re: • ting construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Si a e of Contracto. Owner Builder
Date
OYARYSEAL
It
�� Qy�� C.1•l
• on acto tuVl "AKY • • 11; 0 y `. ATE OF FLORIDA
s: COMMISSION NO. CC714
P.
1
Notary as t
My Co mmission xprr
t/4
FOi_ S536- 32q- t/- ,2a9 -o
Date
C.C.F. / . 0 NOTARY c BOND
TOTAL DUE `a /• °).°
Plumbing Engineering
r ,
NO. OF
STORIES
JOB ADDRESS 2:.4(o
v
mil. C� 2±C_& ' LD Q - PIA► S
OWNER 1-1tsLAI C.Aniz- •
1 Di 5i;
NO.OF LIVING
UNITS
• c % IJ J 1 lc y �1
1Y1 I A tv\ 1J0. -b1
• PROFESSIONAL ENGINEER'
OR QUALIFYING '. AGENT
SEAL,SI.GNATURE DATE
APPROVED
ZONING -I-
BY
DATE
- -i
- - - - --
L STRJCTVRAL �
ELECTRICAL
-
- -- -
%!/
1
PLUMBING
- ���:I
MECHAITCAL
ROOFING
-
- -- -
■ BLDG. OFFICIAL
_ -
-- _
1 _
-
- -- - -
I
r
SUBJECT TO COMPLIANCE WITH AU. FEDER , STATE AND COUNTY
RULES AND REGULATIONS.
MIAMI SHORES VILLAGE ASSUMES NO RESPONSIBILITIES FOR ACCURACY
OF OR RESULTS FROM THESE PLANS.
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY
MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB
CONTRACTORS ARE CHARGED WITH THE KNOWLEDGE OF ALL BUILDING
REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.
NDANg SHORES VOLM E
ITEM
BATH TLB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
Z
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
4
CENTRAL HEATING •
OISHWASHR
RECEPTACLES
Z_
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
_
SERVICE SIZE IN AAPS
OLCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
�
RANGE TOP
UNDERGROUND TANKS
LAVATORY
_
OVEN
ABOVE MHO TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER .
MOTORS OVER 1- 3 If
HOT WATER BOILERS
SINK. POT/3 COMP.
MOTORS OVER 3- 5 HP
WECHANICAL VENTILATION
SINK. RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEM6LIES
SINK. SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TE.WORARY 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 WIDOW
REINSPECTION
WATER SLPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSEt11IERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
OUTLETS COMMERCIAL
SWIMMING POOL
'
WATER SERVICE
."
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFQ'MERS
.... . .
UTILITY-SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
.
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
'
GRAINFIELD, 4' TILE/RES.
VIOLATION
.
PUMP & ABANDON SEPTIC TANK
RE INSPECTION
•
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA CRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
•
"
LAWN SPRINKLER SYSTEM
.
GAS RANGE
MET SET (GAS)
GAS PIPING
.
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN * APPLICATION TOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. Ir A MASTER PERMIT HAS B_
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
9
MECHANICAL
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description.
Address of
Building
❑
Le PERMIT 1ST? 13798
11
❑ Work to be performed under this 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 _t Lie contractor L _ or t ..:i fo e d a1111 n
vp ?ASmes 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 assumes responsibility for work
done by his agents, servants or employees.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Bl.
Signed
Subdi-
vision
Value of
Project $
. `
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' / 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.
INSPECTOR
DATE
Contractor's
License No
BY
Amt. of
Permit $ 4
f r
BY AUTHORITY
195
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
Permit No
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.
ELECTR ICAL INSPECTION DEPARTMENT
A
Owner's Name and Address No Street
Registered Architect and /or Engineer
Employing Electrician's Name
r^
9 ? ^
No
t
Date
e I ,e
' f
1 ' " Street
Location and Legal Description Lot Block .
).Street
Street and Number where work is to be performed —No C"
State work to be performed and purpose of building (By Floors)
New Buildin g Remodelin .... < Addition Repairs
4,..h Remodeling
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
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I ss.
(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 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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)...
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
aterials and /or workmanship.
SWITCH
OUTLETS
<' "
WOW - ='
QUTLLIS
U 7 ,,
}
PLUG
RgCE'P'T'S
5.
L ./
FIXTURES
NO. LAMPS
4
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
D
CHECK
MIAMI SHORES VILLAGE
APPLICATION FOR ELECTRICAL PERMIT
Permit No
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.
ELECTR ICAL INSPECTION DEPARTMENT
A
Owner's Name and Address No Street
Registered Architect and /or Engineer
Employing Electrician's Name
r^
9 ? ^
No
t
Date
e I ,e
' f
1 ' " Street
Location and Legal Description Lot Block .
).Street
Street and Number where work is to be performed —No C"
State work to be performed and purpose of building (By Floors)
New Buildin g Remodelin .... < Addition Repairs
4,..h Remodeling
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
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I ss.
(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 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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)...
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
aterials and /or workmanship.
Permit No ____
g`_3_______
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte building 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 Buildin 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.
�fi�n
Owner's Name and Address�!XI!_-� _ __ rn —•__ __ _�___ No. �5!_ r_____�__ —___ _ Street_! J�t__
Registered Architect and /or E er
Employing Electrician's Name
Location and Legal Description Lot
Amount of Permit $_
MIAMI SHORES VILLAGE �s
APPLICATION FOR ELECTRICAL PERM i� / 7 \ \�
Date_ _
d for tife
ss.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
/__ __ __ Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) ..
New Building Remodeling Addition.. Repairs
Service Overhead Size Feeders Conduit_ Main Sw.
Underground
Type of Installation— Conduit Tubing _ B.X.L. Metal Mould'
(Signed)
Street
(Signed) — _— __ —_ —_�,
Master T.ctrlcan.
Notary Public. State of Florida
3
1 00
6 No 3 3_/ lO— — Street , —'1 O --- — — •
No. of Stories
Amps. Main Fuses_ —______— ____Amps.
Elecal Inspect r.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer f labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and h s com-
plied 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 ublic notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be perfo ed un er this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
COUNTY OF DADE.
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, that he has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
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
O UTLETS
PLUG
R ECE . P'T'S
FIXTURES
NO.LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H EATER
W. H EAT.
CONN.
SPACE
HEATER
STRIP
H EATER
TOTAL
CL
LIST
/
7e5
/
50
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 No ____
g`_3_______
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte building 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 Buildin 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.
�fi�n
Owner's Name and Address�!XI!_-� _ __ rn —•__ __ _�___ No. �5!_ r_____�__ —___ _ Street_! J�t__
Registered Architect and /or E er
Employing Electrician's Name
Location and Legal Description Lot
Amount of Permit $_
MIAMI SHORES VILLAGE �s
APPLICATION FOR ELECTRICAL PERM i� / 7 \ \�
Date_ _
d for tife
ss.
My Commission Expires
ELECTRICAL INSPECTION DEPARTMENT
/__ __ __ Block
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) ..
New Building Remodeling Addition.. Repairs
Service Overhead Size Feeders Conduit_ Main Sw.
Underground
Type of Installation— Conduit Tubing _ B.X.L. Metal Mould'
(Signed)
Street
(Signed) — _— __ —_ —_�,
Master T.ctrlcan.
Notary Public. State of Florida
3
1 00
6 No 3 3_/ lO— — Street , —'1 O --- — — •
No. of Stories
Amps. Main Fuses_ —______— ____Amps.
Elecal Inspect r.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer f labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and h s com-
plied 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 ublic notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be perfo ed un er this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
COUNTY OF DADE.
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, that he has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
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
PLUMBING
•
•
:
•
•
ELECTRICAL :
•
•
•
•
•
•
•
•
Inspector's Report: •-
JOB ;.�[ � . " ADD: -L-L`6 ( 6 1
•
The following is \eady for Inspection:
NOTE: REQUESTS FOR INSPECTIONS MUST BE MADE BY THE CONTRACTOR
PERFORMING THE WORK„
: WORK
: DONE BY:
• REQUEST FOR
• INSPECTION
• WAS MADE • WILL BE READY
•
•
•
•
(
1
Permit No./1_
of Miami Shores Village shall be complied
building during progress of work.
Owner's Name and Address
Registered Architect and /or Enginee
Employing Electrician's Name
Location and Legal Description Lot
New Building
• c.
Service Overhead
Underground
Amount of Permit $_
Size Feeders
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date _ c
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
whether herein specified or not. A copy of approved plans and specifications must be kept at
with,
�r A
2 s 2 treet__
•
No:_ LJ ,C! td Street__ " '
Subdivision f'
Street and Number where work is to be performed—No Street___ L ® s�
State work to be performed and purpose of building (By Floors) � ,f_L
Block____!
(Signed)
(Signed
Conduit___ _ Main Sw._
Remodeling Addition Repairs
Notary Public. State of Florida
No. of Stories
>
Amps.s_ Main Fuses _OD 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 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 com-
plied 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 under signed agrees to employ only such sub - contractors, o . work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Electrican.
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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
HEATER
TOTAL
CONTR.
LIST sr
/0
fi
/g
9
/
/
/
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
, '
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
.fig'
/
,/
/
CHECK
Permit No./1_
of Miami Shores Village shall be complied
building during progress of work.
Owner's Name and Address
Registered Architect and /or Enginee
Employing Electrician's Name
Location and Legal Description Lot
New Building
• c.
Service Overhead
Underground
Amount of Permit $_
Size Feeders
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date _ c
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
whether herein specified or not. A copy of approved plans and specifications must be kept at
with,
�r A
2 s 2 treet__
•
No:_ LJ ,C! td Street__ " '
Subdivision f'
Street and Number where work is to be performed—No Street___ L ® s�
State work to be performed and purpose of building (By Floors) � ,f_L
Block____!
(Signed)
(Signed
Conduit___ _ Main Sw._
Remodeling Addition Repairs
Notary Public. State of Florida
No. of Stories
>
Amps.s_ Main Fuses _OD 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 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 com-
plied 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 under signed agrees to employ only such sub - contractors, o . work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Electrican.
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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
•
Inspector's Report: -
REQUEST FOR
INSPECTION
WAS MADE
The following is ready for Inspection: -
NOTE: REQUESTS FOR INSPECTIONS MUST BE MADE BY THE CONTRACTOR
PERFORMING THE WORK.
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: WORK
DONE BY:
t,1
WILL BE READY
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Permit No. _ /2 Date `' ' )! «mil.
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 ___ _____
I-
Registered Architect and /or Enginee _ 4 L
Employing Electrician's Name r�€' = „ y-,[''' '-= —
Location and Legal Description Lot s ��_i__ «___ ___ _Block
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building
Service Underground Overhead Size Feeders Conduit___'_ Main Sw._�?
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $
APPLICATION FOIR ELECTRICAL PERMIT
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. f
ss.
materials and /or workmanship.
4
Remodeling
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
•
No._d / J L _.!./ °J Street__l �}
Subdivision_ /A 7!i!
Addition Repairs No. of Stories
(Signed)
Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed)
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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
.2.71 hoxatreet q
Street_
Amps. ____ ,t___ _ Main Fuses
Notary Public, State of Florida
Master Electrican.
•
Amps.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE' WT S
FIXTURES
NO. LAMPS
REFRI G.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H EATER
STRIP
H EATER
TOTAL
CONTR.
LIST
/0
9
-le
�y
X
7
ifif
/
/
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
IST
/
CHECK
Permit No. _ /2 Date `' ' )! «mil.
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 ___ _____
I-
Registered Architect and /or Enginee _ 4 L
Employing Electrician's Name r�€' = „ y-,[''' '-= —
Location and Legal Description Lot s ��_i__ «___ ___ _Block
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building
Service Underground Overhead Size Feeders Conduit___'_ Main Sw._�?
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
Amount of Permit $
APPLICATION FOIR ELECTRICAL PERMIT
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. f
ss.
materials and /or workmanship.
4
Remodeling
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
•
No._d / J L _.!./ °J Street__l �}
Subdivision_ /A 7!i!
Addition Repairs No. of Stories
(Signed)
Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed)
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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
.2.71 hoxatreet q
Street_
Amps. ____ ,t___ _ Main Fuses
Notary Public, State of Florida
Master Electrican.
•
Amps.
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(7 t71-
7'
7/ 7
MIAMI SHORES VILLAGE
Office of Electrical Inspector
CERTIFICATE OF INSPECTION
PERMIT
No f
THIS CERTIFIES THAT the wiring and apparatus installed at
by Address
for owner, and occupied as
has been inspected and current is authorized to be turned on, until otherwise notified, for:
1Y
Size of Service Number of Lighting Circuits
Range watts. Water Heater watts
Power: Connected load H P. Space Heaters x watts
Other Apparatus
7
/ ELECTRICAL INSPECTOR.
MIAMI SHORES VILLAGE
Office of Electrical Inspector
CERTIFICATE OF INSPECTION
THIS ERTIFIES THAT the wiring and apparatus installed at 2 4
by t (' 7, I, Address
for—
ilf A • �/
inspect and
owner, and occupied as
has bee nins p current is authorized to be turned on, until otherwise notified, for:
Size of Service
Range
Power: Connected loa H P. Space Heaters
Other Apparatus
C /Jew
PERMIT
NO / /`
Number of Lighting Circuits
watts. Water Heater
ECTRICAL INSPECTOR.
watts
BUILDING A �T
ELECTRICAL PERMIT A N° 818 BUILDING INSPECTION DEPARTMENT
PLUMBING _" 1 " 4 t
ner of Building-- * y • ` c tt ° - . -s i►- s,r „ - --
o NAME ADDRESS LICENSE NO.
chitect and /or Engineer____ ` `-
NAME ADDRESS
c ontractor or Builder - - 4-4, 2_ 4 -e_ t 1 . e e i 4 1,4_44:_: -
NAME ADDRESS LICENSE NO.
$
AMOUNT
Proposed Location __ C/ _ - --- - -�-�L -j
NO. STREET
To.__ _,
filed in this office. This permit is granted upon the express condition
that all facts stated in the application are true and that the construction complis's strictly with the plans and specifications submitted, and in accordance
and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and
regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said
laws, ordinances or rules and regulations, or upon any change in the plans and specifications unaut razed by the biding inspector.
SUB -DI ISION
This permit is issued to 4 ik `
the building above described, as per application, Plans and Specifications heretof
LOT BLOCK
s.. . f r
RECD. PAYMENT ACCT. DEPT.
MIAMI SHORES VILLAGE
i -1
. 19
INSPECTOR
In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of al building laws of the State of Florida, all the
I I building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the builing department of Miami Shores Village.
Dated 4 e. 19_ = • _
(SEAL)
1 NOTE: A cha a of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
.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.