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253 NE 101 St (14)Date / Legal Description Historically Designated: Yes No Owner/Lessee / Tenant / rJdQlr"'i 4f7- ?! r r) vli Owner's Address ? S 3 /VG' !Ov S'T Phone 76 a F✓ 8 Contracting Co. 6 Address / 2 ?-4y SiSc, &GVO i24 7 Nt'3? . Pt. . Qualifier R 6 r SS# 8-9 Z 2- 6 7 State # E/ 0 G / 36 7 Municipal # 3 0 - 33 7 3 S5" Competency # 9LJ i✓ 000 35V Ins. Co. ,4-t Architect/Engineer Address Bonding Company Address Mortgagor �� Address Permit Type (circle one): BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION SC VZ e- /1/42-e:73-(19 'r/ 2-d 0 A /l- - C /}pa?,V7 (a &o'v G44 i c= Nor og - Aeon r /sce- '7`0 his , Square Ft. I6SS 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 owner and/or Condo President Notary as to Owner and/or Condo President My Commissio , Expires: e5� y `�Vi eu.)71 /4 ,-/,'4a,-; , / /6 p ' /v ,b FEES: PERMIT 3 s''e PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 15 3 ,i L . /Ow Sr Tax Folio X7 7 Date //75/9, Date CC,1.,`u P.. rile. ,!F : *: I Cdi. lSSIUN # Joe 5, 2GCO ,,• ,,,,,, ROMSWD T NAU TROY FAR! ieSUPJi'.CL, G:'. RADON C.C.F. NOTARY APPROVED: Zoning Mechanical Plumbing Building Master Permit # Estimated Cost (value) ' Z-0 Signatur.f Contractor or Owner- Builder ary as to Contractor or Owner - Builder My Commission Expires: ROBERT S. SIMONS ,�, MY COMMISSION # CC358488 EXPIRES * :1; Match 18,1998 gtq p ThRI,I TROY MN INSURANCE, INC. Electrical TOTAL DUE Date Engineering ITEM BATH TLB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS 2 D DUCT WORK FL00R GRAIN SERVICE REPAIR/AETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNOERGROUIO TANKS LAVATORY OVEN EVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 f'P MECHANICAL VENTILATION SINK. RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY 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 wINDOw REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS ' HEATER -NEW INST. GENERATORS TRANSFORMERS _ . HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PLRPOSE SWIMMING POOL OUTLETS COM,ERCIAL 1 WATER SERVICE SIGN T1EES SEWER CONNECTIONS SIGN TRANSFORMERS , UTILITY -SEWER _ SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIEL0, 4' TILE/RES. VIOLATION - PUMP 3 ABAIOON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. . CATCH BASIN . DISCHARGE WELL ' DOMESTIC WELL ' AREA DRAIN ROOF INLET ' SOLAR WATER HEATER " FIRE STANDPIPE POOL PIPING ' LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) -' GAS PIPING Zs 7 /�0 - ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL gi op -) I tjost-- Bi 8 2- - 0 fit L . 0 . 3 6 $ 1-4///e i ci-el : e ,,,Aetai-o‘7 , 61/ 9 ( 1 , r - ••• t. ''' ' "... . / a (9-0 sc.w. REFRIGERATOR • 6 — KAL ApPumas 3. KW. • 06RWASNER GARBAGE DISPOSAL KW. MICROWAVE / • 5 KW. KW CLOTHES WASKER . DRYER . . KW. RANGE +5 • KW. MAD ER MAUR x.ve. FROMM KW. KW. WSW COMPACTOR GARAGE DOOR MOTOR JACUZZI JAC= ROOSTER MR. IRONING BOARD POOL MIKADO SPRIketER PIMP lARDSCAPE LITES SPARE CAPACITY TOTAL CONNECTED LOAD . 6 K.W. KW. KW. K.W. KW. KAL KW. KW. KW. K.W. g • RRST 10 KW. • 100 10.0 K.W. tea 4o lc wc eloos KW. 2? TOTAL crod o Amo LOAD 1t.W. K.W. / 240 V. IMPS s • • • . 6 4"tedaze , 4 ' 14 / 6a . ; 1 (17 • ■ • UM moms MUM FRUCTURAL ELECTRICAL PLUMBING M1CI'ayICAL ROOFING BLDG. OFFICIAL SUJJECC TO COPi1PLIANCEMY AU. FEDERAL, STATE AND COUNTY RULES OD RUULAT!Oti S. MIAMI SHORES VILLAGE ASSUME". ?1O RESPONSIBILITIES FOR ACCURACY OF OR RE °SUDS MOM THESE PLANS. ODE AS ADOPTED BY COMPLIANCE T C "6iiiii TEE .1)11111 rL4R1DA `�iliLBifdG �:' P1!AC`1I SHOR S VILLAGE Is REOUIRED. IRE ARCHITECT, BUILDER & SUB CONTRACTORS ARE CHARGED t` Th ME KNOWLEDGE OF ALL BUILDING REGULATIONS WRENER OR NOT SFECIF!CAI Y INDICATED HEREIN. MIAMI SHORES VILLAGE FLORIDA BUILDING ❑ DATE 1 s , /`.. tw19 ELECTRICAL PLUMBING ❑ PERMIT N? 6 429 Contractor's ROOFING ❑ License No t /1 0 7 - f ❑ Work to be perforraned under this Permit i _i _ Owner of Building Architect Contractor or Builder Legal Description Lot ACTOR' OR BUILDER R `dnell " E o+ t - i 1.6 Subdi- Bl vision Address of . ,� Value of ( Amount of 4, Building ;; f. . a 1 ( 1 Project $ I 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 applica- tion 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 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 he assumes respon- sibility for work done by his agents, servants or employees. q Signed }.. -.' r.— .l`r — ` s_INSPECTOR L In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with d1 ordinancgulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. t> BY AUTHORITY ABBOT* APPLICATION FOR ELECTRICAL PERMIT Permit No (l' Date I/ � — I 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.. .. No f� Registered Architect and /or Engineer Employing Electrician's Name.. Location and Legal Description Lot Block Subdivision , a o� �m 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 sr Repairs No. of Stories /P `� Service Underground Site Feeders Z Conduit Main Sw Amps Main Fuses.. / .b tt Amps c Type of Installation -nduit Tubing B.X.L .Metal Moulding MIAMI SHOIRES VILLAGE ELECTRICAL INSPECTION DEPARTMENT tA No be4 Amount of Permit $ (Signed) . c�.1 Eleet�r eal 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 subcontractors, on work to be, ormed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed) /re Street V Street 14 10 h;Y✓l.. ° Street k ) t71 5 r. Notary Public, State of Florida Master Electrician. STATE OF FLORIDA, l 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. 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 H EATER W. HEAT. CONN. gp ACE HEATER STRIP H EATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS RANT. RADIO TOTAL. CONTR. LIST 7 /(� F=Y / / l � {��1� C�° CHECK APPLICATION FOR ELECTRICAL PERMIT Permit No (l' Date I/ � — I 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.. .. No f� Registered Architect and /or Engineer Employing Electrician's Name.. Location and Legal Description Lot Block Subdivision , a o� �m 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 sr Repairs No. of Stories /P `� Service Underground Site Feeders Z Conduit Main Sw Amps Main Fuses.. / .b tt Amps c Type of Installation -nduit Tubing B.X.L .Metal Moulding MIAMI SHOIRES VILLAGE ELECTRICAL INSPECTION DEPARTMENT tA No be4 Amount of Permit $ (Signed) . c�.1 Eleet�r eal 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 subcontractors, on work to be, ormed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed) /re Street V Street 14 10 h;Y✓l.. ° Street k ) t71 5 r. Notary Public, State of Florida Master Electrician. STATE OF FLORIDA, l 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. 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 No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date 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 d �� t' Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description, Lot New Building Remodeling Addition Block Street Street..4..c v Subdivision...i' Street and Number where work is to be performed —No Street...; - J / .l State work to be performed and purpose of building (By Floors) 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 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE ) ss. (Signed) 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. • 0 r .' Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (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 NOT A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty material: nd/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. H EAT., CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST ` c � CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 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 Date 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 d �� t' Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description, Lot New Building Remodeling Addition Block Street Street..4..c v Subdivision...i' Street and Number where work is to be performed —No Street...; - J / .l State work to be performed and purpose of building (By Floors) 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 Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE ) ss. (Signed) 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. • 0 r .' Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (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 NOT A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty material: nd/or workmanship. BUILDING ELECTRICAL PLUMBING A ROOFING Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA ct PERMIT N° 15194 ❑ Work to be performed under this Permit Owner of Building CONTRACTOR OR BUILDER 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 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 he assumes responsibility for work done by his agents, servants or employees. Signed• Subdi- vision Value of Project $ INSPECTOR 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 or 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. BY DATE ' ' 195 Contractor's License No Amt. of Permit $ BY i. AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Et PERMIT N? 15517 ❑ Work to be performed under this Permit Owner of Building 'l Architect Contractor or Builder Legal Lot II BI. Description Address of Building .. ? .l. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of Project $ DATE 1 195 Contractor's License No 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 ;hanged without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes 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 he assumes responsibility for work done by his agents, servants or employees. {• r Signed BY . . s INSPECTOR 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, state„urents or 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. BY. AUTHORITY Permit No.-1–` 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 Registered Architect and /or Engi Employing Electrician's Name Location and Legal Description Lot Amount of Permit $ STATE OF FLORIDA, ss COUNTY OF DADE.. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT --- - - - - -- - -- Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that be has carefully read the therein by him stated are true. My Commission Expires ___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 .-- ....... ____________ No. of Service Underground Size Feeders Conduit._ Main Sw._ Amps. Main Fus es______________________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 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, on work to be performed under this permit, as are licensed by Miami Shores Village. I -' Date Street_. Master Electrican. .authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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 ins materials and /or workmanship. tie, faulty SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO.LAMP8 REPRIO. OUTLET IRON OUTLET RANOE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ////���� 7 sr ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. • MOTORS O -I HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST , CHECK I fi) r - Permit No.-1–` 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 Registered Architect and /or Engi Employing Electrician's Name Location and Legal Description Lot Amount of Permit $ STATE OF FLORIDA, ss COUNTY OF DADE.. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT --- - - - - -- - -- Before me, the undersigned authority, a notary public, duly appeared to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that be has carefully read the therein by him stated are true. My Commission Expires ___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 .-- ....... ____________ No. of Service Underground Size Feeders Conduit._ Main Sw._ Amps. Main Fus es______________________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 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, on work to be performed under this permit, as are licensed by Miami Shores Village. I -' Date Street_. Master Electrican. .authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts 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 ins materials and /or workmanship. tie, faulty