ELECTRICAL PERMITPermit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT p
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, 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 tC/ No ,/ O / / Street U
Registered Architect and /or Engineer
Employing Electrician's Name .r117.. �/ c/tG. /.lI.at No a ..... `.Q
. Street al C
Location and Legal Description Lot Block
,y� /
Street and Number where work is to be performed —No /..I 'G. 0 / Street
STATE OP FLORIDA,
COUNTY OF DAD[ It
sa.
(Signed)
Subdivision
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs L/ No. of Stories
poi?) 4') .,r G' /' ' C N4 T
Service Overhead Size Feeders ..T y � ' Conduit Main Sw /P " Amps Main Fuses � Amps
. Underground
Type of Installation -- Conduit 1 -""*" . Tubing B.X.L Metal Moulding
Amount of Permit $ "c' (Signed) tine yl VOW
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.
Muter 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 81.00 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.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
IS
L IS T
/ 0
/ 0
/ 1 �
A
^ r,
i „( J �
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
//
/vi G4
CHECK
Permit No
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT p
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, 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 tC/ No ,/ O / / Street U
Registered Architect and /or Engineer
Employing Electrician's Name .r117.. �/ c/tG. /.lI.at No a ..... `.Q
. Street al C
Location and Legal Description Lot Block
,y� /
Street and Number where work is to be performed —No /..I 'G. 0 / Street
STATE OP FLORIDA,
COUNTY OF DAD[ It
sa.
(Signed)
Subdivision
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs L/ No. of Stories
poi?) 4') .,r G' /' ' C N4 T
Service Overhead Size Feeders ..T y � ' Conduit Main Sw /P " Amps Main Fuses � Amps
. Underground
Type of Installation -- Conduit 1 -""*" . Tubing B.X.L Metal Moulding
Amount of Permit $ "c' (Signed) tine yl VOW
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.
Muter 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 81.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
ELECTRICAL PERMIT A ■9 180
..,PLUM- tNs-
AMOUNT
Owner of Building
Architect and /or Engineer
Contractor or Builder • •
Proposed Location / t
Dated
1r `r
NAME
NAME
NAME
/ r r'
BLOCK
SUB - DIVISION
LOT
This permit is issued to `-•-% g • r , • • •
RECD. PAYMENT ACCT. DEPT.
ADDRESS
ADDRESS
ADDRESS
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
NO.
r•
To____:
1 ' �" , 19 +.1>
{ Lr I '
LICENSE NO.
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
regulations of the building 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 the building inspector.
$ • ".J
LICENSE NO.
STREET
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 and zoning laws of Miami Shores Village and all rules and regulations of the building department of. Miami Shores Village.
f
, 191.,
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.
(SEAL)
NO.
STREET
PART OF LOT
LOT
BL'K
SUBDIVISIO
7 F/
Y8 /
f ir!
// 0'�ie
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the . nstru n.
Owner of Building
tractor or Electricia
Outlets
This Motors
Receptacles
/frif •-•
Generators
Stoves
l
,19 -= /f
OFFICE OF ELECTRICAL DEPARTMENT
ami Shores Village, Fla ,
re
DESCRIPTION OF WORK
Water Heaters
aianii Jhores9Illage
F 1. 0 A 1 D A
NUMBER OF
LO CATI 0 N
Signs
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 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 r yoked at any time
upon the violation of any provisions of said laws, ordinances, or rules and regulations, or u. • . any chime in the plans an specific . x`ons unauthorized by
this Department.
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.
Billboards
Other Apparatus
N° 818
Permit Fee
, Electrical Inspector.
(Seal)
NO.
Motors
STREET
Generators
PART OF LOT
LOT
BL'K
Billboards
Other Apparatus
SUBDIVISION
' Y
1.
; + � k
S
, , .i
4 � /
,}V ,S 4y < /�
4
,,jy PS.
.
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.
Owner of Building
Contractor or Electrician
OFFICE OF ELECTRICAL DEPARTMENT
lami Shores Village, Fla ,
aiami fhores9 llage
F L 0 R 1 D A
NUMBER OF
r
LO CATI 0 N
DESCRIPTION OF WORK
N9 818
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 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. • �R ".,, #' «►
, 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 = E t (Seal)
-- B'fLFG
ELECTRICAL PERMIT A N9 180
•er of Building '
Proposed Location _
$
AMOUNT
Dated — — — --
d
1
LOT
NAME
Architect and /or Engineer
NAME
Contractor or Builder
NAME
BLOCK SUB - DIVISION NO
19
ADDRESS
ADDRESS
ADDRESS
_R consideration of the issuance to me of this permit I hereby agree to the proposed construction
plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all
building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the build
NOTE: A charge of $1.00 will be made for making corrections or changes to this application
A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
To c.w _ ac
This permit is issued to + >`y " Y % -s
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
regulations of the building 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 h6 plans and specifications unauthorized by the building inspector.
RECD. PAYMENT ACCT. DEPT. ; f,', s
Gi
/ �` y C 194
LICENSE NO.
LICENSE NO.
f
STREET �n
INSPECTOR
in strict conformity with the application and
building laws of the State of Florida, all the
'ng department of Miami Shores Village.
V
A
(SEAL)
royal has been obtained from the Planning Board.
ins ion or faulty materials and /or workmanship.
THIS CERTIFIES THAT the wiring and apparatus installed at
by . + . 4 . 14
for
MIAMI SHORES VILLAGE
Office of Electrical Inspector
CERTIFICATE OF INSPECTION
Size of Service ` `
owner, and occupied as
PERMIT
No. / r e "
Address
has been inspected and current is authorized to be turned on, until otherwise notified, for:
Number of Lighting Circuits
Range : ='t'` watts. Water Heater X watts
Power: Connected load H. P. Space Heaters X watts
Other Apparatus
ELECTRICAL INSPECTOR.
L.w u• •, er •
Permit Nol _
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.
rr
Owner's Name and Address ___ * #1
Registered Architect and /or Engineer
Employing Electrician's Name ____r+ '3<nt* _az' 'i e
My Commission Expires
1 0
No
Amount of Permit $ -_ _________ ___ (Signed)
(Signed)
Date_j_ - - .t.: • 0v. f
Street
Location and Legal Description Lot _________ __
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building` Remodeling Addition Repairs
Street
Street__ $ " 1 =
Block 11 Subdivision_! 4 ~"_
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
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.
STATE OF FLORIDA, k
ss.
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 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.
Notary Public. State of Florida
Master Electrican.
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
p
N /
^
d r
8 4W
CHECK
1!!
I11
!l(
1 •
/
(�
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
L.w u• •, er •
Permit Nol _
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.
rr
Owner's Name and Address ___ * #1
Registered Architect and /or Engineer
Employing Electrician's Name ____r+ '3<nt* _az' 'i e
My Commission Expires
1 0
No
Amount of Permit $ -_ _________ ___ (Signed)
(Signed)
Date_j_ - - .t.: • 0v. f
Street
Location and Legal Description Lot _________ __
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building` Remodeling Addition Repairs
Street
Street__ $ " 1 =
Block 11 Subdivision_! 4 ~"_
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
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.
STATE OF FLORIDA, k
ss.
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 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.
Notary Public. State of Florida
Master Electrican.
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.
7
•
.00HS
FIXTURES ONLY
NUMBER OF
TOTAL
OUTLETS
SIZE OF
SIZE SERVICE
CONDUIT
No.
CIRCUITS
LIGHTS
CEILING
BRACKETS
MAIN
SUBS
BRANCHES
ENT
X Io o
a®
M I 6
I� '
—_
D
H
• M ..
A -89
LOT NUMBE
OWNER
OCCUPIED As
F
BASEM
FIRST
SECON
THIRD
FOUR
MASTER ELECTRICIAN
BY
BLOCK NUMBER
BUILDING - -NEW OR OLD (UNDERLINE WHICH)
CEILING BRACKETS
1 0
o
NO 1/ f
193
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 In-
spector.
RECEPTACLES
ROUGH WIRING
FINAL NO
CORRECTED
TEMPORARY DAYS.
DATE ISSUED
/
SWITCHES
APPLICATION
LOCATION
AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION
WILL BE RETURNED.
!u
SUBDIVISION
STREET AND NUMBER_ : 412 Q 4 SIDE
KIND OF INSTALLATION 9 , 7"; OPEN OR CONCEALED
61 7
O
OCCUPANT
SPECIFICATIONS
WORK -- ADDITIONAL. NEW. ALTERATION OR REPAIR
H. P. OF EACH MOTOR VOLTS— TOTAL AMPS PHASE
STOVES
WATER HEATERS
REMARKS
INSPECTION WANTED
DDRESS
SPACE BELOW FOR INSPECTOR'S USE ONLY
RECEIVED BY INSPECTOR INSPECTED
PROGRESS REMARKS Ur -j' / .
WILL. INSPECT AGAIN
of
DATE
SIGNS
O
OTHER APPARATUS
KNOB. RX.. BX., MLDG.. CONDUIT. METALLIC TUBING
?C -e- I -� °��'
FEE REMITTED
INSPECTOR
4 Permit No _L '% _________
• 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 wor
.
•
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address
Registered Architect and /or Engine__
Employing Electrician's Name ____ ___ __
11,, 1 I
Location and Legal Description Lot____ _ t % ° Block 11 Subdivision ain�
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building
ervice Overhead Size Feeders
Underground
tT'ype of Installation— Conduit
Amount of Permit $
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
Tubing B.X.L. Metal Moulding
My Commission Expires
Conduit Main Sw. Amps.
(Signed)
(Signed)
Date_+
e�
No L — — — Street_ 4 _ '-° J O' i_`"?
Remodeling Addition Repairs No. of Stories
Main Fuses _____________
_______Amps.
Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
7,
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.
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
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
?HECK
4 Permit No _L '% _________
• 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 wor
.
•
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Owner's Name and Address
Registered Architect and /or Engine__
Employing Electrician's Name ____ ___ __
11,, 1 I
Location and Legal Description Lot____ _ t % ° Block 11 Subdivision ain�
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building
ervice Overhead Size Feeders
Underground
tT'ype of Installation— Conduit
Amount of Permit $
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
Tubing B.X.L. Metal Moulding
My Commission Expires
Conduit Main Sw. Amps.
(Signed)
(Signed)
Date_+
e�
No L — — — Street_ 4 _ '-° J O' i_`"?
Remodeling Addition Repairs No. of Stories
Main Fuses _____________
_______Amps.
Electrical Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
7,
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.
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.
Date 1
Legal Description IA
Owner ' ari
Owner's Address
Job Address
•
Contracting C
Qualifi
State # ' («/ 7 Municipal #
PERMIT APPLICATION FOR MI MI SHORES VILLAGE
/ 4/
e of owner and/or Condo President Date
2/25/1?
nn
Ue F Fer y t-F. 5 p
Notary as to Owner and/or
My Commission Expires:
10(5 Tax Folio I 3 Z OA 0(3 13q
O
Historically Designated: Yes No
Master Permit #
t/0
Phone 305 0 -75g g'‘C3
Address /7a,e4 `/
-0Z6Phone ( V 77 7D
Competency #
Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING
WORK DESCRIP'T'ION
(P c722�5
Square Ft. Estimated Cost (value) /9 39 / () CJ
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 MEC
rk will be done in co .liance
to do the work stated.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate
laws regulating constructs and z• i g. Furthermore, I authorize the abov
FEES: PERMIT 33' ' eld RADON C.C.F. NOTARY
CAL ROOFING PAVINFENCE SIGN
Ade
Notary as to Contract r , _` _ 4:: • 7 O. CC75 • 1
y Commission Ex.
e AY COMMISSION EXP. UNE 15
BOND
TOTAL DUE
th all applicable
Date
Date
APPROVED: C�
Zoning Building Electrical
Mechanical Plumbing Engineering