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374 NE 100 St (6)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /e .0- Type Insp'n / 4e Permit No. AZT — Name et-/ /1,3 Address 3 >L/ it-/F- /®© 5 Company Phone # ® P — ?' 6 3 y3 For Inspector: Name & Date Approved Correction Re- Insp'n Fee it/ i eftc7 - e , z MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /e 42P- '0 4 4 4 ZTime Type Insp' n " 49(4 '1 44 Permit No. L I ` 0 — )s Name gPy /(6 Address 3 XL/ / ®G'' 5 Company �" Phone # 0 .?" — P; 6 Y3 For Inspector: Name & Date Approved Correction ❑ /ef Re-Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ime Type Insp'n ` . Permit NE L OO 3 ,C Name �� Address . 3 qv, 11 v ` . / 06, �, Company p, 1 " \ eks,,'7 ��"" Approved Correction Re-Insp'n Fee Phone # 0 S^ `I � ^ b ;12 For Inspector 1 1 � & Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2002 -325 Printed: 10 /8/2002 Applicant: HARRY DOUKAS Owner: DOUKAS HARRY JOB ADDRESS: 374 NE 100 ST Contractor P & M ELECTRIC INC Local Phone: 305 - 949 -6373 Parcel # 1132060135420 Electrical Permit Contractor's Address: 1936 NE 148 ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 3 & E1/2 LOT 4 BLK 40 LOT SIZE P-0-A_A;Let- 6a, op S -o a U 1 Total Fees: WOO Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 4/6/2003 Construction Value: $940.00 Work: INSTALLING 2 OUTSIDE LIGHTS & SWITCH RELOCATING NC OUTLET If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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: 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 responisibility for all work done by either myself, my agent, ser�apts or employes. ,/Mota6441-- NSPECTOR) BY: (Contractor or Builder) BY: PAY TO THE ORDERfOF MEMO P & M ELECTRIC, INC. 1936 N.B. 148TH STREET NORTH MIAMI, FL 33181-1137 Bank of America ACH R/T 063100277 voo 73S 211' 1:0630000471: 00 L S9 S 29 20 L LH° Au I 7352 63-4/630 FL ic? 1348 DOLLARS , CONTRACTOR Name D u K 6 r Name '.ry Al a ) - eG+Yl C ` 1 • License No. CGD 1l 5 -1 J Address l -1 /_ v E 14-g -g s[-, N - ; a w l ; ) ' 33i 8( Telephon� nS _ 11.Y 3 q1-1-? [LGy C y Qualifier Name U I R ` S °eV PROPERTY OWNER Name D u K 6 Address -37 / Al )49 75r, m; d vvl; s hores�fz. 33 S Home Telephone 30 - - i i.5i:9 Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other • Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the proper y owner and qualifier. Both signatures must be notarized, Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLICATION Job Address: 37 I v i . Address DO SS - , Apt. Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. (- `" 103 Subsidiary Permit City �(� State Description of Work —1---72 5 / K l f r _e, Zip 1 i s d / zl pit t� re/0 Ct h of 4ktkt Zoning Linear Feet Square Feet Units Floors Value of Work g6O4,0 0 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IIIPORi'A1T NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. A FFI D:1\'I'I' - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of 0 Cr SEAL: P 1 • P15 nt Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida • Personally known OR, Produced Identification Type of Identification Produced: C A U OF MI I -DADE Sigpatnof Contractor /Qu iffier < .1 c 4 I {� . te subscribed before me this (F day ') C'T Print Name SEAL: ature of No ry Public - Pla n. PERMIT APPLICATION to of o 'da Personally known OR, Produced Identification Type of Identification Produced: ELECTRICAL 'fl•1'1:. Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair Q I'1'. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch / Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light 6 'R Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window / FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New i1ECHANICAL TY Minimum Fee QTY. TYPE Condensate Drain Q'I'1'. T1'PI? Q'I'Y. Generator TYPE QTY. Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUNIB1NG 7'1'1'1: A/C Condensate Q7'1'. TYPE Drains, Roof Q7'Y. 7'1'1'1: Miscellaneous Fixture Q7'Y. 7'1'I'E Soakage Pit Q Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST U OWNER - BUILDER FORM (Attach) U FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond State DCA (Radon) Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) O IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ A ® Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000 x0.60) Inspector State Educational Fund $ (¢.005 /sq.ft.) $ ($.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OF A PPRO\'A L Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com • MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No i �� v 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 oSGAaP rn.k No 3 P Street.. / 0 fT Registered Architect and /or Engineer Employing Electrician's Name AV FlL �7.� /G �Q No / 9 PO L✓ Street utte-r Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories bJ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L .Metal Moulding 7 s Amount of Permit $ (Signed) STATE OF FLORIDA, i COUNTY OF DADE. I 88. Date 33 Electrical Ins ector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an, / ployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su ement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employe y 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. (Signed)...✓.c>�.. �` s -.1 " t 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 LIGHT OUTLETS PLUG RECE'P'7'8 FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CLier LIST 2 2 8 CHECK 1.7.4 1,7T ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. AJR C MOTORS 0.1 HP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL CONTR. LIST / F L (IN �4, CHECK • MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No i �� v 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 oSGAaP rn.k No 3 P Street.. / 0 fT Registered Architect and /or Engineer Employing Electrician's Name AV FlL �7.� /G �Q No / 9 PO L✓ Street utte-r Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories bJ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L .Metal Moulding 7 s Amount of Permit $ (Signed) STATE OF FLORIDA, i COUNTY OF DADE. I 88. Date 33 Electrical Ins ector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an, / ployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su ement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employe y 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. (Signed)...✓.c>�.. �` s -.1 " t 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. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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 A t - -- Registered Architect and /or Engin Employing Electrician's Name - ,...� >O �� /!„. �iG ,1 / 6 Street lstl, / 7 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 3..' 0 .. Street 55. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition No a. 7.. Street / ® e / • Service Overhead Size Feeders Conduit Main Sw Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (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 subcontractors, on work to licensed by Miami Shores Village. Repairs No. of Stories (Signed). Main Fuses Amps Electrical Inspector. ccepts his !rations as an employer of of Flori ermanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are Master Electrician. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apreared 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 LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER 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 ltd ,�G A 6 . CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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 A t - -- Registered Architect and /or Engin Employing Electrician's Name - ,...� >O �� /!„. �iG ,1 / 6 Street lstl, / 7 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 3..' 0 .. Street 55. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition No a. 7.. Street / ® e / • Service Overhead Size Feeders Conduit Main Sw Amps Underground Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (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 subcontractors, on work to licensed by Miami Shores Village. Repairs No. of Stories (Signed). Main Fuses Amps Electrical Inspector. ccepts his !rations as an employer of of Flori ermanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are Master Electrician. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apreared 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 4•-• r c MIAMI SHORES VILLAGE, FLORIDA ❑ DATE - 19 : ❑ PERMIT N9 283 Contractor's , License No. 3 0 ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER B1 Subdi- vision Value of Project $ Amount 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 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. Signed. BY • 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT PRINT BVIL= ELECTRICAL PERMIT A N° 92 ntlweifit •ner of Building NAM iii • ns it Architect aat4 ig4reer Contractor vr- BtrrM'Ier_. )/4/ NAM Proposed Location j • 4 / BLOCK Dated_____ —_ LOT SU , 19 - DIVISION c?„ y ADDRESS MIAMI SHORES BUILDING INSPECTION )1‘ ADDRESS f/io t5:id. //A ADDRESS y LICENSE N • b y t /e' NO. / BTREE To LICENSE NO. This permit is issued to the building above described, as per application. Plans and Specifications heretofore filed in this office. This permit is granted upon the express that all facts stated in the application are true and that the construction complies 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 Villag and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any t upon t k violation of any ov ions of said laws, ordinances or ru and regulations, or upon any change in the plans and specificatio naut z ,t by the i ng jtts ecto� 01 e AMOUNT RECD. PAYMENT ACCT. Y $ T. DEPT. VILLAGE EPARTMENT 19 In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and an s and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances a zoning lade of Miami res Village and all rules and regulations of the building department of Miami Shores illage. - ) (SEAL) NOTE: A charge 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. condition INSPECTOR NO Motors Receptacles Generators STREET STR PART OF LOT LOT BL'K Other Apparatus SUBDIVISION ''''.•! �J T I /� J/ 1 / 0 0; 11.,t,..( 11 .,t,..( ,4 X 1 , S f � J 4 . s..r'' .... ..... Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee ..... ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. • ." 11 . l t Owner of Building .+�,,F'� re Contractor or Electrician A'i. - L - ~t 4•� 7liami Jhores OFFICE OF ELECTRICAL DEPARTMENT " ;� Miami Shores Village, Fla , - 19.. LOCATION F L 0 R D A DESCRIPTION OF WORK NUMBER OF N° 742 This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies trictl with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical 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•unauthorized by this Department. ., , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami Shores Village. Dated 19 (Seal) B* EL Owner of Building 2 k NAME PERMIT A N? 92 LOT Architect amOiermilayltrer 1 / ADDRESS .. j , Contractor o B der'_)- 2 141 -X - �L:.E ' - / j _ _ ,t-- _ _!� 6.1 -- NAME r ADDRESS Proposed ,�^ 11 posed Location ___1 t3 - -- BLOCK ti SU - DIVISION . % NO. RECD. PAYMENT ACCT. DEPT. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ADDRESS LICENSE NO. // LICENSE N E ® /I at STREE This permit is issued to----- --- ___________________ - ----- -_ )1 e --L-- l i __ t To ' 1.t tt the building above described, as per application, Plans and Specifications heretofore 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 complies 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 regplation_s of the building department of Miami Shores Village. This permit may be revoked at any tip a upon tae violation of any provisions of said upon any change in the plans and specifications unautbo 'z78 by the il ng specto t er , 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 all building laws of the State of Florida, all the building ordinances ajd zoning l of Miam Dres Village and all rules and regulations of the building department of Miami Shores Village. • 1000 f i ! (SEAL) NOTE: h charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. 1 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. ' NO. STREET PART OF LOT LOT BL'K SUBDIVISION � ,. Of" A / „oe ,c . ii, ,i© Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee yrp / 7 . 2 ”' • ELECTRICAL PERMIT II N. B. —This Permit must be on display on the premises during the construction. Owner of Building_ _ actor or Electricia Dated dr ,19_1 ariami cfhores91llage F L o A ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , NUMBER OF LO CATI 0 N DESCRIPTION OF WORK This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies Srtrictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical 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 plan d specifications unauthorized by this Department. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree tit do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical. Department of Miami Shores Village. N° 742 , Electrical Inspector. (Seal) • MIAMI SHORE Office of Electric 1 CERTIFICATE OF N VILLAGE ri spector PERMIT N o. , CER SPECTION THIS CERTIFIES THAT the wiring and apparatus installed at • ! �� 1 ` by I Address i . , for 11 �* c owner, and occupied as has been inspected and current is authorized to be turned on, until otherwise notified, for: Size of Service e":. .. '°s. o 4 Number of Lighting Circuits Range t watts. Water Heater / watts Power: Connected load Y H P. Space Heaters ® " watts Other Apparatus A ELECTRICAL INSPECTOR. OUTLETS MMORS RECEPTACLES ..GGNLRATORIII. STOVES WATER H'TERB OUTLETS BILLBOARDS OTHER APPARATUS MAIN SUB BRANCH Basement ao M 1IJtj#f 11 FLOOR 1 Orr I ( NUMBER OF SIZES OF INSULATION OPEN OR CONCEAL'D NUMBER OF CIRCUITS OUTLETS MOTOR GEN. MAIN SUB BRANCH Basement First Second Third Fourth Other Floors APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for issuance of permit for electrical installation as described below, and for inspection of same after installation: Owner Address Building Contractor Electrical Contractor Location of proposed work: Lot Block Details of proposed work: Number of Motors Work begun Work finished l iami Aores9 llage F L 0 A 1 D A tt Subdivision Building: Old or new Number of stories Used as Description of proposed work H P Volts Amps Phase Additional Information Signature of Applicant Address (if other than owner or contractor) PACE BELOW FOR INSPECTOR'S USE ONLY) Inspected / 1 • / Final inspection /1 ! ', , f Date 1 93_ r !. , Inspector Permit 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 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. d Owner's Name and Address / , / > -�',. . - — No. Registered Architect and /or Engin ;er ___ —_— r s+ Employing Electrician's Name _=,'.L ' ____.,_L� #' - --__ - t Location and Legal Description Lot_ Block_ Street and Number where work is to be performed— No.___: ' State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. SS. Street__ Street New Building Remodeling Addition Repairs ® Date__ '► My Commission Expires Notary Public, State of Florida' 1 -:_'_ j2-' e Street- = — JL Subdivision_____ Service Overhead Size Feeders Conduit Main Sw. Amps. __ Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding No. of Stories Amount of Permit $ 4- (Signed) .42 { " 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 , /'X' , r t "- - (Signed) : �� ` ;.-_,,,t -- — 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'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 j "r'- " ?•1` .r.. ' - -g"n, CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit 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 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. d Owner's Name and Address / , / > -�',. . - — No. Registered Architect and /or Engin ;er ___ —_— r s+ Employing Electrician's Name _=,'.L ' ____.,_L� #' - --__ - t Location and Legal Description Lot_ Block_ Street and Number where work is to be performed— No.___: ' State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. SS. Street__ Street New Building Remodeling Addition Repairs ® Date__ '► My Commission Expires Notary Public, State of Florida' 1 -:_'_ j2-' e Street- = — JL Subdivision_____ Service Overhead Size Feeders Conduit Main Sw. Amps. __ Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding No. of Stories Amount of Permit $ 4- (Signed) .42 { " 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 , /'X' , r t "- - (Signed) : �� ` ;.-_,,,t -- — 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. Permit No. I � MIAMI SHORES VILLAGE ELECTRICAL INSPECT.R NIDEPARTMENT APPLICATION FOR EIF EFTRICAL PERMIT 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 a d x i — eer _ __ Employing Electrician's Name ____'• rte__ _ _ Location and Legal Description Lot_ Street1and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building y' Remodeling Amount of Permit $ ss. My Commission Expires • No. _ Street t - -_�_ le_ �e � s �� N o.— ---- �-- `�- -- -� - - = -- - -- Street- - - - - - -- �--- � - - - - ------- - - - --- Block ;c— Subdivision___ �___ -%' 41 1 „,.,. ,s Street - Addition Repairs No. of Stories `r Service Overhead Size Feeders. Conduit _____ Main Sw Amps. _ Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) '3 )1 Date (Signed) Electric 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 licensed by Miami Shores Village. Notary Public, State of Florida Master permit, as are i Electrican. STATE OF FLORIDA, 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 be 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'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H EATER STRIP HEATER TOTAL CONTR. LIST A CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -9 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No. I � MIAMI SHORES VILLAGE ELECTRICAL INSPECT.R NIDEPARTMENT APPLICATION FOR EIF EFTRICAL PERMIT 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 a d x i — eer _ __ Employing Electrician's Name ____'• rte__ _ _ Location and Legal Description Lot_ Street1and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building y' Remodeling Amount of Permit $ ss. My Commission Expires • No. _ Street t - -_�_ le_ �e � s �� N o.— ---- �-- `�- -- -� - - = -- - -- Street- - - - - - -- �--- � - - - - ------- - - - --- Block ;c— Subdivision___ �___ -%' 41 1 „,.,. ,s Street - Addition Repairs No. of Stories `r Service Overhead Size Feeders. Conduit _____ Main Sw Amps. _ Main Fuses Amps. Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding (Signed) '3 )1 Date (Signed) Electric 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 licensed by Miami Shores Village. Notary Public, State of Florida Master permit, as are i Electrican. STATE OF FLORIDA, 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 be 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. Permit No /3- Amount of Permit $.. 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 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 Mein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. -- � -; _ I4 4 a' �Q �f i Owner's Name and Address _ ' No CJ___!___ _ _ _-. Street / t Registered Architect at.614au.gag4tleer ��1% P __ Cam' Employing Electrician's Name _ � — � � No.__ ___ __!1__ Stteet___ —_/ !_. Location and Legal Description , ~_ 2 _ Block _42 Subdivision__ � St re�l 4 �✓ qt 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 Service Overhead Size Feeders Conduit Main Sw Amps. Main Fuses Amps. Underground P P Type of Installation— Conduit Tubing B.X.L. Metal Moulding My Commission Expires Repairs (Signed) ____ lectrical 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. n , - "' • (.(:- / (Signed) • I. i '' ` t4 _,, ' , 4 ` ‘, Master Electrican. STATE OF FLORIDA, } ss. a : COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Date — -- i // `CV Notary Public. State of Florida No. of Stories 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'T'S FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. T ` SPACE H EATER 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 CHECK Permit No /3- Amount of Permit $.. 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 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 Mein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. -- � -; _ I4 4 a' �Q �f i Owner's Name and Address _ ' No CJ___!___ _ _ _-. Street / t Registered Architect at.614au.gag4tleer ��1% P __ Cam' Employing Electrician's Name _ � — � � No.__ ___ __!1__ Stteet___ —_/ !_. Location and Legal Description , ~_ 2 _ Block _42 Subdivision__ � St re�l 4 �✓ qt 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 Service Overhead Size Feeders Conduit Main Sw Amps. Main Fuses Amps. Underground P P Type of Installation— Conduit Tubing B.X.L. Metal Moulding My Commission Expires Repairs (Signed) ____ lectrical 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. n , - "' • (.(:- / (Signed) • I. i '' ` t4 _,, ' , 4 ` ‘, Master Electrican. STATE OF FLORIDA, } ss. a : COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Date — -- i // `CV Notary Public. State of Florida No. of Stories 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.