1170 NE 102 St (11)Permit No
1.0 3
ss.
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 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 7 ���. -� No
/ /7a
Registered Architect and /or Engineer
Employing Electriciaft's Name ` . .... �... . �....(! ..!:.
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 No. of Stories
// 7G'
(Signed)
a
Amount of Permit i (Signed)
Date
Street.
Street. . /O
Subdivision
Street 7 /- °? •
Service Overhead
Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
ectrical Insp
The undersigned applicant for this building permit does hereby celtify that he understands and accepts his o• tons as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida 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 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.
Master Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and Bays that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship. •
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
' STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE SERVICE
TEMP. PERM.
MOTORS MOTORS
0.1 HP 1.5 HP
NEON RADIO
TRANS.
TOTAL
CONTR.
LIST
/ G.�- .- L�/O
/
j
� �G.�' �
CHECK
Permit No
1.0 3
ss.
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 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 7 ���. -� No
/ /7a
Registered Architect and /or Engineer
Employing Electriciaft's Name ` . .... �... . �....(! ..!:.
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 No. of Stories
// 7G'
(Signed)
a
Amount of Permit i (Signed)
Date
Street.
Street. . /O
Subdivision
Street 7 /- °? •
Service Overhead
Size Feeders Conduit Main Sw Amps Main Fuses . Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
ectrical Insp
The undersigned applicant for this building permit does hereby celtify that he understands and accepts his o• tons as an employer of
labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida 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 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.
Master Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and Bays 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 /
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....4.,. /q,./�,0/../ ' . No /./.7.0 Street,,� .r
Registered Architect and /or Engineer
Employing Electrician's Name ....A (1
Location and Legal Description Lot Block Subdivision
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 No. of Stories
Service Overhead Size Feeders
Underground
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 7 2..Q p. 7
3 , oa
SS.
070
No (5 ..0 Street/7'1V 0 °f..... d
Conduit Main Sw Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
(Signed)
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
Street...
NIP
577
Electrical I spector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
ter 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.
M OTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
ye 0�
1 //
P i
5
/ /
! /
//J
_ "/
1
�7�
... fi
s. OIN
CHECK
Permit No /
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....4.,. /q,./�,0/../ ' . No /./.7.0 Street,,� .r
Registered Architect and /or Engineer
Employing Electrician's Name ....A (1
Location and Legal Description Lot Block Subdivision
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 No. of Stories
Service Overhead Size Feeders
Underground
Amount of Permit $
STATE OF FLORIDA, l
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 7 2..Q p. 7
3 , oa
SS.
070
No (5 ..0 Street/7'1V 0 °f..... d
Conduit Main Sw Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
(Signed)
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
Street...
NIP
577
Electrical I spector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
ter Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires
•
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No. �________
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 14-_. 4.-_ CL' B. riE__ ___________.___________________ No.___________________ Street
Registered Architect and /or Engineer
Employing Electrician's Name H• & H. Electric Co Ina• No 320 - Street N.W. 71et• St.
Location and Legal Description Lot_ _5_ _Block
Street and Number where work is to be performed —No 1170__ia .4_a- _ Street 102wi
State work to be performed and purpose of building (By Floors)
New Building Z. Remodeling Addition.. Repairs
Service Underground Size Feeder 1 Conduit 1' Main Sw._______ — Amps. Main Fuses__________Amps.
Type of Installation— Conduit Tubing ]L______ B.X.L. Metal Moulding
Amount of Permit $ 2 `) (Signed)
Date _liar 1
No. of Stories
ice•
ctrical Inspector.
The undersigned applicant for this building permit does hereby certify that he y r derstands and accepts his efigations 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,
COUNTY OF DADE. ss'
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.
My Commission Expires
(Signed)
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.
T r
Sy _
Master Electrican.
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 LIST
13
14
24
14
1
1
1
1
2
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
L IST
-1,-_
-1--
CHECK
MIAMI SHORES VILLAGE
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 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 14-_. 4.-_ CL' B. riE__ ___________.___________________ No.___________________ Street
Registered Architect and /or Engineer
Employing Electrician's Name H• & H. Electric Co Ina• No 320 - Street N.W. 71et• St.
Location and Legal Description Lot_ _5_ _Block
Street and Number where work is to be performed —No 1170__ia .4_a- _ Street 102wi
State work to be performed and purpose of building (By Floors)
New Building Z. Remodeling Addition.. Repairs
Service Underground Size Feeder 1 Conduit 1' Main Sw._______ — Amps. Main Fuses__________Amps.
Type of Installation— Conduit Tubing ]L______ B.X.L. Metal Moulding
Amount of Permit $ 2 `) (Signed)
Date _liar 1
No. of Stories
ice•
ctrical Inspector.
The undersigned applicant for this building permit does hereby certify that he y r derstands and accepts his efigations 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,
COUNTY OF DADE. ss'
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.
My Commission Expires
(Signed)
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.
T r
Sy _
Master Electrican.
BUILDING
ELECTRICAL
PLUMBING
Work to be performed under this Permit
Owner of
Building
Architect
Contractor t,/
or Builder
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE _- 194_
PERMIT N? 8883
Contractor's
License No.
Legal Lot Bl. Subdi-
Description f vision
Address Building of / / / �1 / I y Project of 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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 ox in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. / .. ,r'
/
Signed: ! /per '
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 acceptin> • ythis permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Y�r!'i,,„yv, i I
;.e
BY AUTHORITY
Own r of
Buil ' g
Arcl test
man ctor
or B ilder
D 'ptiort
Address of
Building
BOLDING
CA. PERMIT N° 9037
G
"/ 'r
Lot
/1
MIAMI SHORES VILLAGE, FLORIDA
Work to be performed under this Permit
.-t. 4- -P�
f ry C'
Bl.
Subdi-
vision
Value of
Project $
DATE 00 1 , r 195____
Contractor's
l icense No
•
of
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
in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
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
is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
g 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
is agent_ servants or employees.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with ail ordinances and regulations
--ing thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR VOILDER BY
AUTHORITY t/
Permit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
}
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.
ss.
_OA04^
,ll,•---------- No ._----- ...... _____ ......... — ----Street-
Owner's Name and Address______
Registered Architect and /or En 'n er _ _ _
Employing Electrician's Name__ _- �__ 1��T _ ___ e{` __! " __k__.____— No Street_ _______________
Location and Legal Description Lot_ Block Subdivision
Street and Number where work is to be performed —No. ___ '2 _LI. Street_ N__
State work to be performed and purpose of building (By Floors)
New Building _____— — __Remodeling ____ — _ Addition _____— _____________________ Repairs
(Signed)
(Signed) _
Date._
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that understands and accepts is obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co • .iled General Laws of Fl a 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.
No. of Stories
Service Overhead Underground _— Size Feeders_ Conduit_ Main Sw. —_ —___ — ________Amps Main Fuses_______________Amps
Type of Installation— Conduit _________Tubing —___— B.X.L._ _________ Moulding
Master Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized 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
MilielF
.. A,
' \-1/.1.-.e_..
CHECK
Permit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
}
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.
ss.
_OA04^
,ll,•---------- No ._----- ...... _____ ......... — ----Street-
Owner's Name and Address______
Registered Architect and /or En 'n er _ _ _
Employing Electrician's Name__ _- �__ 1��T _ ___ e{` __! " __k__.____— No Street_ _______________
Location and Legal Description Lot_ Block Subdivision
Street and Number where work is to be performed —No. ___ '2 _LI. Street_ N__
State work to be performed and purpose of building (By Floors)
New Building _____— — __Remodeling ____ — _ Addition _____— _____________________ Repairs
(Signed)
(Signed) _
Date._
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that understands and accepts is obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Co • .iled General Laws of Fl a 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.
No. of Stories
Service Overhead Underground _— Size Feeders_ Conduit_ Main Sw. —_ —___ — ________Amps Main Fuses_______________Amps
Type of Installation— Conduit _________Tubing —___— B.X.L._ _________ Moulding
Master Electrician.
Before me, the undersigned authority, a notary public, duly a uthorized 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.