ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date � 5/ G C I' Job Address / t� 3 0 N /OA S4 Tax Folio
Legal Description ,, 11 .. II Historically Designated: Yes No J /
Owner/Lessee / Tenant h't ( PI Cs 0 0 U �t7 k Master Permit # & 3 ' 7 `�' 5W zY
Owner's Address I 3 0 A. )E / Oa S + Phone
Contracting Co. One \ C& G �C4(le / Z nc Address c9 C / 10 50 0) Ave . Waal
Qualifier L e 51-e i ss# Phone ( 30 S)
state# t= R- 000aco5 Municipal# 30 °303 -81 b Competenc C ( 3 EOOOI igis. Co. U 0 o , (4 4
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELE CTRICAi)PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ET l'eC l CO LAY) C k ne.,uo G. 8 o- z
Square Ft. Estimated Cost (value) 40 / 5b
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.
' 14ct/o . t .
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT) / / ?, I RADON
APPROVED:
Zoning
Mechanical
Building Electrical
Signature ofT',6rftractor or Owner- Builder
otary as to ontractor : • - .r':_
My Commission Expires:
er
// 6/ 9 q
Date
;� MY COMMISSION / CC 497 to
• EXPIRES: December 13, 1999
Banded Thm Notary Pubic IMideredims
C.C.F. was / NOTARY --6 --- BOND
TOTAL DUE 1 13
\ ; / r J1 q
Plumbing Engineering
ITEM
BATH TLB
UNIT
FEE
ITEM
SWITCH CUTLETS
UNIT
) 0
FEE
28
ITEM
SPACE HEATERS
UNIT
FEE
BIOET
LIGrFT CUTLETS_
25
3i-pc
HEATING
D I SHWASrE.R
RECEPTACLES
10
/f
At (W I M))
0ISPCSAL
SERVICE TEMPORARY
a�
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
OLCT WORK
FLOOR IMAIN
SERVICE REPAIR/METER GiA E¶i
(,
35"
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS ANO PRESS PIPING
INTERCEPTOR
RANGE TOP _.
UNDERGROUPO TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSLRE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTCRS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT/3 COMA.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK. RESIOENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
1
MOTORS OVER 100 HP
VIOLATION
INOIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SLPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
'HEATER -NEN INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
•
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
•
OUTLETS COI4 RCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY-SEWER
SIGN TIME CLOCK
UTILITY -HATER
F IXT1. ES
SEPTIC TANK
ANTENNA .
RELAY
TELEVISION OUTLETS
ORAINFIELO, 4" TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
,6rn
0 ke )e- lea -rocs
Al
CATCH BASIN
DISCHARGE WELL
.
DOMESTIC WELL
AREA CRAIN
-
ROOF INLET
SOLAR WATER HEATER
.
FIRE STANDPIPE
POOL PIPING
•
-
LAWN SPRINKLER SYSTEMI
GAS RANGE
METER SET (GAS)
_
GAS PIPING
"
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMP 1NT THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER' S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
ELECTRICAL INSPECTION DEPARTMENT
1 APPLICATION FOR ELECTRICAL PERMIT
Permit No Date 7 f 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:lda,
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.
k . M . /n � l /
Owner's Name and Address... EP /7/9/A /i4 2 , / No /Q263D Street ,/
Registered Architect and /or Engineer �Q r C
Employing Electriciafi's Name / / ,e I CTiC S'F eiliL No /* p Street A/W / /y s� 7/ 7-
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /s; 3'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Service Overhead Size Feeders. f� E2 a
.? in Sw
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
88.
MIAMI SHORES VILLAGE
(Signed).... .‘"
The undersigned applicant for this building permit does hereby cei tify that he understands and accepts his og1 gations 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.
Street 4 /O 3
Amps Main Fuses . Amps
/O . 5i :
No. of Stories
lectrical In
Master Electrician.
STATE OF FLORIDA,
COUNTY OP DADE. I
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.
Notary Public, State of Florida
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made w;sen 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
F IXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
wiiiMININ
HEATER
TOTAL
CONTR.
LIST
/
I. 7 .(
CHECK
ENT.
SW.
D1ST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
``
Iv
1
MOTORS
0.1 HP
MOTORS
1.3 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
_to—
2
! r,` °
r
I . 1 4
CHECK
ELECTRICAL INSPECTION DEPARTMENT
1 APPLICATION FOR ELECTRICAL PERMIT
Permit No Date 7 f 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:lda,
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.
k . M . /n � l /
Owner's Name and Address... EP /7/9/A /i4 2 , / No /Q263D Street ,/
Registered Architect and /or Engineer �Q r C
Employing Electriciafi's Name / / ,e I CTiC S'F eiliL No /* p Street A/W / /y s� 7/ 7-
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No /s; 3'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Service Overhead Size Feeders. f� E2 a
.? in Sw
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
88.
MIAMI SHORES VILLAGE
(Signed).... .‘"
The undersigned applicant for this building permit does hereby cei tify that he understands and accepts his og1 gations 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.
Street 4 /O 3
Amps Main Fuses . Amps
/O . 5i :
No. of Stories
lectrical In
Master Electrician.
STATE OF FLORIDA,
COUNTY OP DADE. I
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.
Notary Public, State of Florida
My Commission Expires
NOTE: A re-inspection fee of $1.00 will be made w;sen such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
vki.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contracr
or Builder
Legal
Description
Address of
Building
In consideration of the issuance to me
pertaining thereto and in strict conformity with
cepting this permit I assume responsibility for
MIAMI SHORES VILLAGE. FLORIDA
DATE
PERMIT N? 2440
CONTRACTOR OR BUILDER
Lot
Signed.
195
Contractor's
License No.
Work to be performed under this Permit
B1
Subdi-
vision
Value of Amount of
/ '�- Project $ Permit $ t .el f :
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.
BY t'"
INSPECTOR
of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
all work done by either, myself, my agent, servant or employee.
BY AUTHORITY °41190
Permit No c‘/-4
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 compli l with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer _
Employing Electrician's Name /e4t t 1. 1
Location and Legal Description Lot ^ Block
I
Street and Number where work is to be performed —No / c .
State work to be perform and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Servic
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
Size Feeder / Conduit / .Main Sw./
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
N 1'i -
Amps....
Date
Street
Street.... %i( 9- f
Street
Subdivision
Main Fuses / 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 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.
(Signed)
Master Electrician.
STATE OF FLORIDA, l
COUNTY OF DADE. I
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.
Commission Expires Notary Public, State of Florida
NOTE: re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
mater' Is d /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.
ACE
HATER
STRIP
HEATER
` �y ,
/ I <. l (,,1,
TOTAL
CONTR.
LIST
- ®
-
{ ..
7e L
7
/ gr
// )
/�` i\
V V
(/ ✓
/
� ,f
V
I'l
f/
�/ 1
` �/
/ 5
CHECK
ENT.
SW.
DIET.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
11pp
I /I 'F�
MOTORS
O.1 HP
MOTORS
1.0 HP
NEON
TRANS.
' 3
RADIO
1 /
TOTAL
LIST
r
��U
l
�/�
/(/ V
' 1
/ ✓ v 7_Y
! '
�✓
CHECK
/
Permit No c‘/-4
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 compli l with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer _
Employing Electrician's Name /e4t t 1. 1
Location and Legal Description Lot ^ Block
I
Street and Number where work is to be performed —No / c .
State work to be perform and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Servic
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
Size Feeder / Conduit / .Main Sw./
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
N 1'i -
Amps....
Date
Street
Street.... %i( 9- f
Street
Subdivision
Main Fuses / 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 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.
(Signed)
Master Electrician.
STATE OF FLORIDA, l
COUNTY OF DADE. I
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.
Commission Expires Notary Public, State of Florida
NOTE: re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
mater' Is d /or workmanship.