ELECTRICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7 #97 Job Address / 4.1E 101 .ST7 Tax Folio
Legal Description Historically Designated:
Owner/Lessee / Tenant M r rcl-f (.L F� O CA-AJs(d---L,K
Owner's Address
41 Iu lot s
Contracting Co. MDQGTYJC /NC
Qualifier a t J
State # EC o // 9/ Municipal #
Architect/Engineer :fed) Gc)
Bonding Company
Signature o
otary
My Co
� n NOTAR SEAL
4 , ,. / , -,R9ARY PATRICIA BRIGGS
( V; ;' COMMISSION NUMBER
1 Q CC335258
- q' MY COMMiSStON EXP.
or ft.° JAN. 31.1998
FEES: PERMIT 3g /s RADON
Date
SS#
Mortgagor
Yes No ✓
Master Permit # 4/51/
Phone 755
Address ,Ct9 .0 Al 74 '
Phone g9/ — /.8*
Competency # Ins. Co. �J�l P450 (/
Address //
Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 66 9 -6 fr', q- 6 d TTE 2 tTGC- S
1 - (a 11ArTE-e._ (- # �L (— W v /->— ,4-
Square Ft. Estimated Cost (value) a 6 V
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.
AP
4110y
a ! , 1,S.
1 it'
•
• •■•er •••
n Date
• a ature of Contractor or Owner -B
it
er
Date
7� q
\p-RY Poo OFFICIAL NOTARY SEAL
O �i R9aRY PATRICIA BRIGGS
COMMISSION NUMBER
` - Q CC335258
� / F Q> CSY COMM/5310N EXP.
Of OP JAN. 31 1998
Notary as to • ontractor or Owner - Builder
My Commission
7///97
Date
C.C.F. / - g C3 NOTARY BOND
TOTAL DUE yv
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
� r&//t /7
NI 1
(T�1
3ATri 113
UNIT
FEE
ITE11
S7TITC4 CUTLETS
UNIT
FEE
ITE3(
SPACE WATERS
UNIT
FEE i
I
3IDET
LIGHT OUTLET
1s
CENTRAL HEATING
" `
OISn1YASHE.R
! REcTACL`.S
1 A/C MIND/
O I SPOSAL I SERVICE TQARY
r SERVICE
A/C (CENTRAL)
DRINKING FOUNTAIN 1 SIZE IN WS A2
1 / IG):r'
UT MIK
FLCCR DRAIN 1 SERVICE :AeAJTL1€ T C. CHANGE
I
RE=RIGERATION
LEAS TRAP 1 . APPLIANCE OUTLETS
2 k2
PRO =SS AN7 PRESS PIPING
I NTERD., I L ( RAkM TOP
UNDERCROJ O TANKS
LAVATORY I OVEN
ABOVE GRa o TAMES
L UNCRY TRAY WATER HEATER
U.:. PRESSURE VESSELS
�—
C.OTnES WASHER ( ILA T CAS 0- 1 HP
STEAM d0 ugs
Si-MR MOTORS OVER 1- 3 HP
FAT WATER BOILERS
SINK. POT /3 CCIP. I MOTORS OVER 3- 3 w
MECHANICAL VENTILATION
SINK. RESIDENCE I 4ATCRS OVER 5- 3 P
TRANSPORTING ,ISS 6LIES
SINK. SLOP 1 MA T CRS OVER 3- 10 FP
EL AT1IRS/ESCALAirRS
TaF^.RARY ?LATER C,CEE i 1 %G T CRS OVER 10- Z5 FP
FIRE SPRINKLER SYSTNS
U U1AL NOBS OVER 2 25-103 HP
L I NG TIMERS
WA's CLOSET MOTORS OVEN ilb HP
VIOLATION
INDIRECT WASTES 1 A/C WINDOW
RE ? TI0N
WATER LPP! ' R3: 1 AIR «tO I T IONERS
1 rT HILLY
_. _
(AN A2BLICAT=ON FOR BUILDING PERM MUST ACCOMEANT THIS ADDENDCM. IF A MASTER BERRMIT EtS 3c.
OBTAINED, TEE OWNER'S NOTARIZED SIGNATURE NEED NOT HE PRESENT ON SUBSEQUENT A2!LICATIONS. )
^l VIM
:IRE SPRINKLER
fEArc INST.
HEATER-REPLACE
1 _471N S?R I NKL R- NELJ..
SrTIAiI NG POOL •
?LATER SERVICE
SERER CONNECTIONS
UT 11. i f- SETTER
UTILITY -WATER
SEPTIC TANK
RELAY
0RAINF1ELD. 4' Tlti/RES.
?1.W S ABANDON SEPTIC TANK
SOAKAG &PIT CJ.
CATC1 3AS IN
OISCHARIGE. ME.'!
CCMESTIC WELL
AREA MAIN
ROC= INLET
SOLAR WATER HEATER
MCI_ :C:
GAS P!P!NG
PLUMBING
fl
=IRE STAXPIFE
• PCL ?'P!NG
LIAN PINKLER S.STEA
GAS .74X7
ADDENDUM TO BUILDING PERMIT APPLICATION
•
•
STR ;era
'E.RATCRS iRAWCPJERS
GENERAT(RS TRAIiSFDRiE,RS
GENERATORS TRA 17CRUERS
SPEC 1AL P1. RPOSE
CUTLETS =MEM Ltl
S iGN Rt.EES
SIGN TRANVIN 11:RS
S CLa7(
F IXT[RES
ANTENNA
TELEVISION CURETS
VIOLATION
RE Iti FWT 1ON
ELECTRICAL
1'
(
MECHANICAL
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL DATR 195
PLUMBING ❑ PERMIT N? 8593 Contractor's
License No "
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
B uilding yt ' <'j' el•
Architect
Contractor
or Builder
Legal
Description
Lot
Address of
Building ( /
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 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTORVOR BUILDER
BI.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
BY AUTHORITY
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
O.? a i 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.
Owner's Name and Address ' f� / F / a-1-0 No
Permit No
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
SS.
(Signed)
(Signed)
4
Date
et
Registered Architect and /or eer q
Employing Electrician's Name e-� rJ o°` � 4 - ee'rrl 4, No ?coca Street
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
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P p
Type of Installation— Conduit Tubing B.X.L Metal Moulding
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, pn work to
licensed by Miami Shores Village.
Ele// rival Inspector
ccepts his obligati fi an employer of
of Florida Per mnent Supplement, and
subcontractors ployed by him in the
of the work such public notice or notices
be performed under this permit, as are
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'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
CHECK
ENT.
S W
CAB.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O.1 HP
MOTORS
1.3 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
�'
�''( a
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
O.? a i 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.
Owner's Name and Address ' f� / F / a-1-0 No
Permit No
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
SS.
(Signed)
(Signed)
4
Date
et
Registered Architect and /or eer q
Employing Electrician's Name e-� rJ o°` � 4 - ee'rrl 4, No ?coca Street
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
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P p
Type of Installation— Conduit Tubing B.X.L Metal Moulding
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, pn work to
licensed by Miami Shores Village.
Ele// rival Inspector
ccepts his obligati fi an employer of
of Florida Per mnent Supplement, and
subcontractors ployed by him in the
of the work such public notice or notices
be performed under this permit, as are
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.
FLOORS
F XTURES ONLY
NUMBER OF
TOTAL
OUTLETS
SIZE OF
SIZE SERVICE
CONDUIT
No.
CIRCUITS
LIGHTS
' CEILING
BRACKETS
MAINS
SUBS
BRANCHES
BASEMENT_
FIRST
SECOND
THIRD
FOURTH
Form 246
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION
WILL BE RETURNED.
LOT NUMBER �� BLO,L
STREET AN •,
OWNER
OCCUPIED As
BUILDING —NEW OR OLD (UNDERLINE WHICH)
SIDF
OCCUPANT ' ^- -
H. P. OF EACH MOTOR VOLTS
LIGHTS
REMARKS
CONTRACTOR
BY
CEILING .
KIND OF INSTALLATION OPEN OR CONCFeI En
PROGRESS
WILL INSPECT AGAIN
9
RECEIVED BY INSPECTOR
APPLICATION No 30 Z
DATE ; ' 1931_
ELECTRICAL DEPARTMENT OF THE • ITY OF MIAMI
Desiring your Certificate of Approval, application is hereby made for an inspection of
the electric installation in the premises stated below, for which undersigned agrees to correct
any infractions of the National Electrical Code and the City Ordinance pointed out by Inspector.
BRACKETS
ROUGH WIRING
FINAL V No
CORRECTED
TEMPORARY DAYS.
DATE ISSUED
RECEPTACLES
WORK — ADDITIONAL, NEW, ALTERATION OR
SPECIFICATIONS
SWITCHES
FEE REMITTED I 7
_ UBDIVIS10
STOVES
TOTAL AMPS PHASF
KNOB, RX., BX., MLDG. CONDUIT
WATER HEATERS
SIGNS
REPAIR.
f -4
INSPECTION WANTED
ADDRESSj CFJ a �
OTHER APPARATUS
SPACE BELOW FOR INSPECTOR'S USE ONLY
(� �'
"� r' / INSPECTED r
c� A
REMARKS V ` ' '^ti.." r'St',e J '/.p „ �;J
, 't wee- f?f -, /t 4 rs 9,A. .2. f' < 6
,c4 <4 *--r �IS,401
INSPECTOR
FLOORS
F XTURES ONLY
NUMBER OF
TOTAL
OUTLETS
S IZE OF
SIZE SERVICE
CONDUIT
No.
CIRCUITS
LIGHTS
CEILING
BRACKETS
MAINS
SUBS
BRANCHES
BASEMENT_
FIRST
SECOND
THIRD
FOURTH
LIGHTS
CEILING
REMARKS
CONTRACTOR
RECEIVED BY INSPECTOR
PROGRESS
WILL INSPECT AGAIN
BRACKETS
ROUGH WIRING
FINAL NO
CORRECTED
TEMPORARY DAYS.
DATE ISSUED
RECEPTACLES
1
APPLICATION
SPECIFICATIONS
SWITCHES
CernW; INSPECTION WANTED
BY ADDRESS
•
DATE 1931_
ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI
Desiring your Certificate of Approval, application is hereby made for an inspection of
the electric installation in the premises stated below, for which undersigned agrees to correct
any infractions of the National Electrical Code and the City Ordinance pointed out by Inspector.
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION ALL SPACES MUST BE FILLED OR APPLICATION
WILL BE RETURNED.
I
4 CIJPANT
S DIVISION
H. P. OF EACH MOTOR VOLTS TOTAL AMPS
•
r
STOVES WATER HEATERS
LOT NUMBER `'UN LBLOCK NUMB
STREET AND
OWNER
OCCUPIED As
BUILDING —NEW OR OLD (UNDERLINE WHICH)
SPACE BELOW FOR INSPECTOR'S USE ONLY
SIDF
WORK — ADDITIONAL, NEW, ALTERATION OR
SIGNS
REPAIR.
PHASF
i t�
9 0 \w/ 4 H -"
OTHER APPARATUS
KIND OF INSTALLATION OPEN OR CONCEALED KNOB, RX., BX.. MLDG. CONDUIT
INSPECTED
REMARKS
FEE REMITTED
INSPECTOR
Street and Number where work is to be performed —No
STATE OF FLORIDA, l
COUNTY OF DADE. j
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
85.
9Z/
New Building Remodeling Addition
Amount of Permit $ (Signed)
(Signed)
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 ppe44fG . e)Ib No Street . ,k /
/
Registered Architect and /or Engineer • Employing Electrician's Name P ; V/9 e/V ' e? /1 - No V 7- 7' Street .'xi/ £2- d t)
Location and Legal Description Lot Block Subdivision
Street A'AF sr
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
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elect
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work s
al Inspector.
as an employer of
ent Supplement, and
mployed by him in the
h public notice or
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit,
licensed by Miami Shores Village.
Master Electrician.
Amps
notices
as are
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
therein by him stated are true.
sign the same, and that all facts
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
180
CHECK
- _ _,
-
-
_
_
,+-q
- ell
.
Street and Number where work is to be performed —No
STATE OF FLORIDA, l
COUNTY OF DADE. j
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
85.
9Z/
New Building Remodeling Addition
Amount of Permit $ (Signed)
(Signed)
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 ppe44fG . e)Ib No Street . ,k /
/
Registered Architect and /or Engineer • Employing Electrician's Name P ; V/9 e/V ' e? /1 - No V 7- 7' Street .'xi/ £2- d t)
Location and Legal Description Lot Block Subdivision
Street A'AF sr
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
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Elect
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work s
al Inspector.
as an employer of
ent Supplement, and
mployed by him in the
h public notice or
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit,
licensed by Miami Shores Village.
Master Electrician.
Amps
notices
as are
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
therein by him stated are true.
sign the same, and that all facts
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.