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501 NE 101 St (10)MOODY ELECTRIC, INC. www.moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax (305) 754 -1333 0100 Mc. 3 I 9f 6 v 10eAt1A to e Li e /7.64z.de-ee / /SS .4440-071" 5/7e,/igo g -44 4 'a a . cVoo M.G.o �o�cLT ,0 9500 c . 0Acd ��' ea V ��, 8ce gARY PAS BRIGGS Notary Public - State 01 Florida ' �ieaMay 11.2008 .? 10487 CommBsNa�nal Notary fin. Bond:: By .. .. 1 DY ELECTRIC, , INC. www.moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax (305) 754 -1333 TOTAL CONNECTED LOAD avo Fee. i "7-7 / / 7 RESIDENTIAL DEMAND LOAD CALCULATIONS W / SQ. FT REFRIGERATOR APPLIANCES DISHWASHER GARBAGE DISPOSAL MICROWAVE CLOTHES WASHER DRYER RANGE WATER HEATER OVEN FREEZER TRASH COMPACTOR GARAGE DOOR MOTOR JACUZZI JACUZZI BOOSTER HTR. IRONING BOARD POOL EQUIPMENT SPRINKLER PUMP LANDSCAPE LIGHTS STEAM SHOWER A/C WALL UNIT SPARE CAPACITY SPARE CAPACITY /• 5 K.W. 7S -e K.W. K.W. K.W. -g K.W. K.W. K.W. 1.5 K.W. K.W. t•5" K.W. . �S K.W. K.W. •�' K.W. K.W. g K.W. K. K.W - K.W K.W at K.W. / —K.W. K.W. NARY PAT BRIGGS Notary Poetic - State of Florida -","2 MyCommitsicnExpiresMei11,2006 Commisslan 0 DD 104873 Bonded By f; • al'taty ABM. FIRST 10 K.W. @ 100% I II -0 10.0 K.W. REST @ 40% S . • v /3•Ro K.W. A/C @ 65% / HEAT @ 100% /' 26th /0.0 K.W. TOTAL DEMAND LOAD /49 - c 1111• '53 / 240 VOLT = •-a . AMPS /e7 . (9 60 483 At,o r,11:;;::?m St.10. S '4 1 1 , ,INC••••••• ,..11.11 , ..... 07.36.Tar.rammouSr.irallwrormireal.E.I. 1 c•';'t Crt ;1; arnurr : t 1 ci:415.;‘,1;f:■11.(.',A1 , , OP SCECT 10 TS C 1;17.12 T:1,:f1; eOUNIN ki SliORLS !;:-..Zfg`'Y'S:TIJIT.S. FOR 14C,CiiPN OF OR -‘•"21.11-."-CE CtV.)A Sti101.1 !!,S. 100V1I.O BY StiORE-",i VIL1161:. ftE.O.UiR0). BLPAVER SUB CONIRAOTORS CHNRCIED TriE AU Of . BUILDII1G REGUtATIONS \NliETHER ilOT SPECIfiCALLY Ii1DICAIED EREL Type Insp'n Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques ' S � Date 6 - 19 1- 03 Time J t����� — /S/ Address 522,' /1/F r o i s Compan DO 41 e° a Phone # 305" 1 75 . cl ° For Inspector: 4-m-03 Name Approved Correction Re- Insp'n Fee ❑ /9767.--07 Permit No. a. Z O O ^ � S / Type Insp' Name Address 50 I 11 • e . 1 0 1 J2j Compa Dat MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Requ Time Phone # nc For Inspector' / l 'q EName & Approved II' Correction ❑ c_�uf aJ Re- Insp'n Fee ❑ Date .0 Job Address SO \ �. (0 S Tax Folio Legal Description Historically Designated: Owner /Lessee/Tenet J� f"'N. E_ CV` Owner's Address SC) (� �_ k_ d < / Contracting Co. P \ C� �CY� 2' (2C ` . l 1 ''1 C Address (o 9 W 9 Cs S` J 7 '-�" - Qualifier PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305 - 756 -8972 \ .C3C.)CiLC.c State # €cda)( (. t S Municipal # IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 850.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING WORK DESCRIPTION: cri-C a. S2 CO t CSL Square Ft. Estimated Cost (value) /4 C/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 ANY 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 all disciplines. OWNERS 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. Sigr}ap{re of owner and/or Condo President otary as to My Commis ,9 pp/I i.ee APPROVED: Mechanical Plumbing SS# S �acl 63 Date Master Permit # Phone — Phone -(s— "75S;- -D"dcYa Competency # Ins. Co. FEES: PERMIT r00 RADON C.C.F ( a 0 Yes CE9VEt) MAY 2 8 no g S_ 7$ ( ( c)D "S PLUMBING MECHANICAL ROOFING Signature of Contractor or Owner Builder No ary as to My Commis 9 MAS PAT BRIGGS may- My State Florida Commission 00 104873 Bonded By National Notary Assn. rn TOTAL DUE Zoning Building Electrical Structural Engineer EN TN TL8 UNIT FEE ITEM • SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT CET -- L IGrff CUTLETS . CENTRAL HEAT I NG WASHER -_ RECEPTACLES A/C (WINO) S?OSAL SERVICE TEMPCfARY A/C (CENTRAL) INKING FOUNTAIN SERVICE SIZE IN AMPS _ EMT WORK ,REFRIGERATION OCR CRAIN Eli U:Ti.: #DAL►._LIMMILI EASE TRAP -_ APPLIANCE CURETS PROCESS ANO PRESS PIPING TERCEPTCR RANGE TOP UNDERGROUND TANKS VATORY OVEN ABOVE GROUNO TANKS .UNDRY TRAY WATER HEATER U.F. PRESSLRE VESSELS OTHES WASHER MOTCRS 0- 1 HP STEAM BOILERS AWER MOTORS OVER 1- 3 FP HOT WATER BOILERS NK, POT /3 COMP. -_ MOTCRS OVER 3- -5 IP MECHANICAL VENTILATION HK, RESIDENCE MOTCRS OVER 5- 8 FP TRANSPORTING ASSEMBLIES INK, SLCP MOTCRS OVER 8- 10 H' ELEVATORS/ESCALATORS :MPORARY WATER CLOSET MOTORS OVER 10- 25 FP • FIRE SPRINKLER SYSTEMS IINAL MOTORS OVER 25-100 FP COOLING TOWERS ;TER CLOSET MOTORS OVER 100 FP VIOLATION .DIRECT WASTES A/C WINDOW _ REIHSPECTION ;TER SLFPLY TO: AIR CONDITIONERS . • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFCR1 RS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATC S TRANSFCPMERS LAWN SPRINKLER -WELL SPECIAL PLRPOSE SWIMMING POOL • CUTLETS CCMYERCIAL WATER SERVICE • SIGN TLBES :hER CONNECTIONS SIGN TRAlSFCA.4ERS ILITY -SEWER SIGN TIME CLOCX "ILITY -WATER FIXTLRES :PT IC TANK ANTENNA • :LAY TELEVISION CURETS uINFIELO, 4' TILE/RES. VIOLATION ;IP E ABANDON SEPTIC TAM( REINS?ECTION )AKAGE PIT CU. FT. ■TON BASIN SCHARGE WELL :STIC WELL = IEA CRAIN :OF IhtET - IRE STAMP IP HEATER XI P SPRINKLER • ON SYSTEM S RANGE :TER SET (GAS) S PIPING - y . i N APPLICATION FOR BUILDING PERMIT MUST ACCOH ANT THIS ADDENDUM.. IF A MASTER PERMIT RA ;3TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIO PLUMBING ELECTRICAL MECHANICAL 14-A `d) Work: 0 rn Miami Shores Village 10050 NE 2nd Avenue Phone: 305495 -2204 Printed: 6/3/2003 Applicant: Owner: EDIE JOB ADDRESS: 501 NE 101 Contractor MOODY ELECTRIC INC Local Phone: (305)758 -2000 Fees: FEE2003 -3355 FEE2003 -3356 Signed: Description Building Permit Application Fee CCF Total Fees: Electrical Perrnit Permit Number: EL2003 -151 FRANCINE ST Contractor's Address: 669 NW 90 ST Amount $60.00 $1.20 $61.20 Permit Status: APPROVED Permit Expiration: 11/24/2003 Construction Value: 200 AMP SERVICE UPGRADE Page 1 of 1 Parcel # 1132060171080 Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOTS 13 & 14 BLK 94 LOT SIZE Total Fees:. $61.20 0 Total Receipts: $$ .00 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, servants or employes. (Contractor or Builder) BY: LA' . DATE . / _ _ TO THE ORDER OF . • ACCTS. PAYABLE DISC. OTHER CHECK NUMBER (0 1 6 1 ° b . 0 111AN 4 Malt! ii 131 , NA,04,1,t fb* MOODY ELECTRIC, INC. 669 N.W. 90TH STREET MIAMI, FL 33150 (305) 891-1374 AMOUNT rh,,v-7 / ../ 9 /14 #k „. 7, / a 49 PAY TOTAL BANK MIAMI, FLORIDA 41,1 maw% "06356" 1:066009L55C a ORIGINAL DOCUMENT PRINTED ON CHEMICAL REACTIVE PAPER WITH MICROPRINTED BORDER - SEE REVERSE SIDE FOR COMPLETE SECURITY FEATURES a MOODY ELECTRIC, INC. 669 N.W. 90TH STREET MIAMI, FL 33150 (305) 891-1374 k E ? -K/ TOTAL BANK MIAMI, FLORIDA 11'0 L634611 1 .1066009,A55C EXPLANATION AMOUNT 3 5 LO 30 791106 EXPLANATION AMOUNT JI AMOUNT a.&4. d-o7/00 OF PAY 35 L03079006 DOLLARS] DOLLARS 63-915/660 16356 CHECK AMOUNT 63-915/660 CHECK AMOUNT 16346 DATE. TO THE ORDER OF ACCTS. PAYABLE DISC. OTHER CHECK NUMBER ii 131 , NA,04,1,t z mob MOODY ELECTRIC, INC. 669 N.W. 90TH STREET MIAMI, FL 33150 (305) 891-1374 AMOUNT rh,,v-7 / ../ 9 /14 #k „. 7, / a 49 PAY TOTAL BANK MIAMI, FLORIDA 41,1 maw% "06356" 1:066009L55C a ORIGINAL DOCUMENT PRINTED ON CHEMICAL REACTIVE PAPER WITH MICROPRINTED BORDER - SEE REVERSE SIDE FOR COMPLETE SECURITY FEATURES a MOODY ELECTRIC, INC. 669 N.W. 90TH STREET MIAMI, FL 33150 (305) 891-1374 k E ? -K/ TOTAL BANK MIAMI, FLORIDA 11'0 L634611 1 .1066009,A55C EXPLANATION AMOUNT 3 5 LO 30 791106 EXPLANATION AMOUNT JI AMOUNT a.&4. d-o7/00 OF PAY 35 L03079006 DOLLARS] DOLLARS 63-915/660 16356 CHECK AMOUNT 63-915/660 CHECK AMOUNT 16346 BUILDING ELECTRICAL PLUMBING ROOFING - - -- Owner -of Building Architect Contractor or Builder Legal Description Address of Building Lot Ezi PERMIT IV? 11561 n fi Value of C > I �6 + Project $ CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE / 0./ 195 Contractor's License No ❑ Work to be performed under this Permit Subdi- vision Amt. Permit of $ � 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 neat hage 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 su ch ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor? of .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. BY . In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a$ .' `nances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities •f Miami Shores Village. In accepting this permit I assume responsibili for all work done by either, myself, my agent, servant or employee. ,'t AUTHORITY MIAMI SHORES VILLAGE. FLORIDA BUILDING I 1. DATR 7- '" ' 4" 195 ELECTRICAL PERMIT IV? 11737 Contractor's PLUMBING I License No ROOFING I I Work to be performed under this Permit Owner of �' Building v V • 1 f + Architect Contractor r 4 or Builder i Legal Lot I Bl. Description Address of Building Std it . , E'/ .. cONIRACTOR OR BUILDER _ 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 •ertaining to the work covered hereby whether shown on the plans or drawings. y in he state ents or specifications and that he assumes responsibility for work ne by his agents, servants or employees. Signed. !' 40, Amt. of Permit $ f` j . • dew BY a' INSPECTOR f 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 ping thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. opting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ' I ..+0, • 1 0 BY ^'A _ A AUTHORITY Permit No ,` ( STATE OF FLORIDA, I 1 COUNTY OF DADE. 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. 1. 1 • Owner's Name and Address . Registered Architect and /or Engine Employing Electrician's Name Location and Legal Description Lot ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J Street and Number where work is to be performed —No / State work to be performed and purpose of building (By Floors) :.�G!G... No... Q/ Street. . )7.. C.. ./ ei av New Building Remodeling Addition Repairs No. of Stories Block 9 Amount of Permit $ 1 4—&2••• (Signed) (Signed) No 0 7 /71 '...-- Street f Street. `,�_ Subdivision „ 1 • Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground 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 subcontractors, on work to licensed by Miami Shores Village. Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are 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. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No ,` ( STATE OF FLORIDA, I 1 COUNTY OF DADE. 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. 1. 1 • Owner's Name and Address . Registered Architect and /or Engine Employing Electrician's Name Location and Legal Description Lot ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT J Street and Number where work is to be performed —No / State work to be performed and purpose of building (By Floors) :.�G!G... No... Q/ Street. . )7.. C.. ./ ei av New Building Remodeling Addition Repairs No. of Stories Block 9 Amount of Permit $ 1 4—&2••• (Signed) (Signed) No 0 7 /71 '...-- Street f Street. `,�_ Subdivision „ 1 • Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground 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 subcontractors, on work to licensed by Miami Shores Village. Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are 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. Permit No./ / 7 1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, 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 of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be building during progress of work. Owner's Name and Address.. Registered Architect and /or Engineer. Employing Electrician's Name.. Location and Legal Description Lot i . a -/ Y Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building 1/ Remodeling Addition Repairs Service Overhead Size Feeders Underground Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I t/r MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ss. * No 7J? Date 1 � .J7 No 9' / 7 , Street...' Block % V Subdivision.,! 're) . Z. Street ,1.. (Signed) 7- 3 -, i f Street. 711 . or other Florida, Division kept at No. of Stories Conduit ./ , Main Sw._ > / /.`- Amps Main Fuses ,404`7!!f Amps Type of Installation — Conduit Tubing B.X.L .Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. aster 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 / /7 .3 gi b ! 7 7 4•/• /. / O. / 7� / xi> / .7f / „co /C, 011.1.10 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./ / 7 1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, 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 of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be building during progress of work. Owner's Name and Address.. Registered Architect and /or Engineer. Employing Electrician's Name.. Location and Legal Description Lot i . a -/ Y Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building 1/ Remodeling Addition Repairs Service Overhead Size Feeders Underground Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I t/r MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ss. * No 7J? Date 1 � .J7 No 9' / 7 , Street...' Block % V Subdivision.,! 're) . Z. Street ,1.. (Signed) 7- 3 -, i f Street. 711 . or other Florida, Division kept at No. of Stories Conduit ./ , Main Sw._ > / /.`- Amps Main Fuses ,404`7!!f Amps Type of Installation — Conduit Tubing B.X.L .Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. aster 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.