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429 NE 101 St (3)ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other structure herein described. This application is made in compliance and conformity with the - Building Ordinance of Miami Shores Village, Fiu :Ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work Owner's Name and Address e Registered Architect and /or E nnj e er Employing Electricia6's Name. c�C/ TiCf .L�C 6 /e /G Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Z' Street /.D/ State work to be performed and purpose of building (By Floors).. New Building Remodeling I run r ' Repairs No. of Stories Service Overhead Site Feeders Conduit Underground Type of Installation — Conduit Tubing 'V Amount of Permit $ STATE OF FLORIDA, } COUNTY OF F . MIAMI SHORES VILLAGE No Main Sw Amps Main Fuses . Amps B.X.L . Metal Moulding (Signed) �a No./,6 Street ‘-,.'?‹ / E (Sign Before me, the undersigned authority, a notary public, duly authorized appeared , (/ E t o / S� . Street Date 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 to licensed by Miami Shores Village, to administer oaths and 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 therein by him stated are true. 73 ectrical Inspector. ccepts his obliga ons as an employer of of Florida P' anent Supplement, and sub- contractors employed by him in the of the work such public notice or notices be performed der this permit, as are Master Electrician. take acknowledgments, personally sign the same, and that all facts Notary Public, State of Florida My Commission Expires 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 AV PLUG RECE•P'T'S FIXTURES NO. LAM S REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. 157 ueT 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 — .. ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building o: other structure herein described. This application is made in compliance and conformity with the - Building Ordinance of Miami Shores Village, Fiu :Ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work Owner's Name and Address e Registered Architect and /or E nnj e er Employing Electricia6's Name. c�C/ TiCf .L�C 6 /e /G Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Z' Street /.D/ State work to be performed and purpose of building (By Floors).. New Building Remodeling I run r ' Repairs No. of Stories Service Overhead Site Feeders Conduit Underground Type of Installation — Conduit Tubing 'V Amount of Permit $ STATE OF FLORIDA, } COUNTY OF F . MIAMI SHORES VILLAGE No Main Sw Amps Main Fuses . Amps B.X.L . Metal Moulding (Signed) �a No./,6 Street ‘-,.'?‹ / E (Sign Before me, the undersigned authority, a notary public, duly authorized appeared , (/ E t o / S� . Street Date 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 to licensed by Miami Shores Village, to administer oaths and 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 therein by him stated are true. 73 ectrical Inspector. ccepts his obliga ons as an employer of of Florida P' anent Supplement, and sub- contractors employed by him in the of the work such public notice or notices be performed der this permit, as are Master Electrician. take acknowledgments, personally sign the same, and that all facts Notary Public, State of Florida My Commission Expires 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, FLA. 10B VSPECTOR REMARKS: N? 6250 DATE Amount of Permit $.......0 Permit No ?V IAM SHD RES VI LILA i : E ELECTRICAL IN$P';I CTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date 6 -4 Application is hereby made for the approval of the detailed statement of the plans .:n::i specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with ele Building Ordinanc: 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 :rush be kept at building during progress of work. Q �Q , / q y� Owner's Name and Address 7' ���4 .e.,_ �`' "�- �"`°'� r 7`O2/ v '' • Street / 0 / Registered Architect and /or Engineer p � Employing Electrician's Name. . . 4,4 Street Location and Legal Description Lot / Block Subdivision Street and Number where work is to be performed — �` 42 No '/ Q C • State work to be performed and purpose of building (By Floors) • New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.L .Metal Moulding . (c) (Signed) J' Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of F orida 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 performed under this permit, as are licensed by Miami Shores Village. (Signed) Street 10./ Master E rician. STATE OF FLORIDA, COUNTY OF DADE. I 6e' 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 iraproper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLET&, PLUG RECE'P'T'8 FIXTURES No. LAMPS REPRIG. OUTLET IRON OUTLET RANGE OUTLET (t NGE CONN. y WATER HEATER W. HEAT. CONN. SrACE HEATER STRIP HE.&TER TOTAL CONTR. LIST . CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST /50 / - • CHECK Amount of Permit $.......0 Permit No ?V IAM SHD RES VI LILA i : E ELECTRICAL IN$P';I CTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date 6 -4 Application is hereby made for the approval of the detailed statement of the plans .:n::i specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with ele Building Ordinanc: 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 :rush be kept at building during progress of work. Q �Q , / q y� Owner's Name and Address 7' ���4 .e.,_ �`' "�- �"`°'� r 7`O2/ v '' • Street / 0 / Registered Architect and /or Engineer p � Employing Electrician's Name. . . 4,4 Street Location and Legal Description Lot / Block Subdivision Street and Number where work is to be performed — �` 42 No '/ Q C • State work to be performed and purpose of building (By Floors) • New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Conduit Tubing B.X.L .Metal Moulding . (c) (Signed) J' Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of F orida 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 performed under this permit, as are licensed by Miami Shores Village. (Signed) Street 10./ Master E rician. STATE OF FLORIDA, COUNTY OF DADE. I 6e' 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 iraproper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building �"° • Address of Building { Z. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 5665 Architect Contractor ,, _ c or Builder w - �; _ P Legal Lot Description Bl. Work to be performed under this Permit o Subdi- vision Value of Project $ 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. r o Signed _. �; _ INSPECTOR / In consideration of the issuance to me of this permit I agree to perform the work co red 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 es ,iv! P t11 .72 e DAT 195 Contract •is License No / :' ¢. Amount of Permit $ AUTHORITY BUILDING ❑ ELECTRICAL PERMIT N? PLUMBING ❑ ROOFING ❑ Owner of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA 14642 Work to be performed under this Permit Architect Contractor - or Builder ... Legal Lot II B1. Description Address of Building t - i 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: a BY �. J INSPECTOR Subdi- vision Value of Project $ DATE � ° /1- � 195 Contractor's License No Amt. of Permit $ / :.• 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 AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building 1' Contractor - or Builder -� Legal Lot Description. 2 N° 9757 ' CONACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DAT ..y 195 Wo to be performed under this Permit Bl. Signed: Subdi- vision BY Contractors License No Building of Value of Amt. of 1 x t f Pro ect / .5 g i' ,, 1 $ 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 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 ( specifications and that he assumes responsibility for work done by his agents, servants or employees. BY "r INSPECTOR In consideration of the issuance to me of this permit I agree to'pe form the work covered hereunder in compliance with all o ;d i ances and regulations pertaining thereto and in strict conformity with the plans, drawings, 4'taten ents 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. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 9485 Work to be performed under this Permit I 717 Architect contractor j 1 or Builder Legal , Lo 1 Bl. Description/ Address of `/ Building ti 1 7 done by his agents, servants or employees. ! Signed: Subdi- vision CONTRACTOR OR BUILDER BY Value of Project $ DATE fu 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 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 drawyFlgs or in the statements pr specifications and that he assu mes responsibility for work INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all �or nances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. i/ i( AUTHORITY BY l 195 r- . - MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No._ /r3 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__ Registered Architect and /or Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed— No._ X011_ �‘le40 No Block ! Subdivision____ State work to be performed and purpose of building (By Floors) _________________ _______ ____Remodeling__ ____— Addition Repairs No. of Stories Service Overhead Size Feeders Conduit _____________Main Sw._.______________________Amps Main Fuses___ Underground Type of Installation — Conduit_ Tubing____ _B.X.L. —._._ Metal Moulding Amount of Permit $__ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he derstands and accepts his db gations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp M d General Laws of Florg ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. , , STATE OF FLORIDA, COUNTY OF DADE. } ss. (Signed) _4 i.e7 _ (Signed) y Stree Master Electrician. Amps 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 $LOO 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 LUG •, 'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET R' O &IQ RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H EATER STRIP HEATER TOTAL CONTR. LIST IST CHECK � ENT. SW. DIST. CAB. SERVI TEMP, v/ SERVICE PERM. MOTORS 0.1 HP MOTORS 1-5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK CHECK r- . - MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No._ /r3 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__ Registered Architect and /or Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed— No._ X011_ �‘le40 No Block ! Subdivision____ State work to be performed and purpose of building (By Floors) _________________ _______ ____Remodeling__ ____— Addition Repairs No. of Stories Service Overhead Size Feeders Conduit _____________Main Sw._.______________________Amps Main Fuses___ Underground Type of Installation — Conduit_ Tubing____ _B.X.L. —._._ Metal Moulding Amount of Permit $__ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he derstands and accepts his db gations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp M d General Laws of Florg ermanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. , , STATE OF FLORIDA, COUNTY OF DADE. } ss. (Signed) _4 i.e7 _ (Signed) y Stree Master Electrician. Amps 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 $LOO will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. 1! Date -- - Y 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. 20 * P4i Owner's Name and Address__ ---- /'� �4�`�- - - - - -_ 0 Registered Architect and/or 'Engi Employing Electrician's Name__ Location and Legal Description Lot ew Building STATE OF FLORIDA, l COUNTY OF DADE. 1? MIAMI SHORES VILLAGE Street and Number where work is to be performed— No.__ 12_ State work to be performed and purpose of building (By Floors) - -- 6 e-trt e te- -No Block Subdivision / __Q1 &7 S - eet___ __Remodeling_____________ —_ Addition_______ Repairs No. of Stories__ Overhead) / y Service U nderground Siz Feeders__ i / ConduitX/ __Main Sw.__1PP Type of Installati __________B.X.L. —____ Metal Moulding__ Amount of Permit $ t` / � ` '� t --- -- --- -- -_ (Signed) ;#.r — - The undersigned applicant for this building permit does hereby certify that,he understands and accepts his obations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Clint iled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. ss. (Signed) Street - — — - -- Amps Main Fuses electrical Inspector. Master Electrician. - Amps 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'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER „ �T � /J CONTRT . LIS ET / I /✓ TS J., // 5-- / / / / / / / 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 `/ ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No. 1! Date -- - Y 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. 20 * P4i Owner's Name and Address__ ---- /'� �4�`�- - - - - -_ 0 Registered Architect and/or 'Engi Employing Electrician's Name__ Location and Legal Description Lot ew Building STATE OF FLORIDA, l COUNTY OF DADE. 1? MIAMI SHORES VILLAGE Street and Number where work is to be performed— No.__ 12_ State work to be performed and purpose of building (By Floors) - -- 6 e-trt e te- -No Block Subdivision / __Q1 &7 S - eet___ __Remodeling_____________ —_ Addition_______ Repairs No. of Stories__ Overhead) / y Service U nderground Siz Feeders__ i / ConduitX/ __Main Sw.__1PP Type of Installati __________B.X.L. —____ Metal Moulding__ Amount of Permit $ t` / � ` '� t --- -- --- -- -_ (Signed) ;#.r — - The undersigned applicant for this building permit does hereby certify that,he understands and accepts his obations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Clint iled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be p osted 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. ss. (Signed) Street - — — - -- Amps Main Fuses electrical Inspector. Master Electrician. - Amps 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.