171 NE 102 St (4)appeared
Permit No ....�
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
t> crud ..
> " Date 6 1 9� �
Application is hereby made for the �E'roSzal- 'the de a("ikd ement of the Tans and specifications herewith sub 'fitted for the building of other
structure herein described. This application is made irk compliance and- confoirmity with the Building Ordinance of Miami Shores Village, Fivada,
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 L - Lg•-)41 1 ' L No t ) Street
Registered Architect and /or En sneer C
Employing ElectriciaA's Name 4I C. r W �zi�ozr� r ' U rt ' eP " 1 o S
Location and Legal Description Lot (2 ]. 7/) . .............Block Subdivision
Street and Number where work is to be performed—No .11. " . -. -. .. 411 . • 11 2-A Street ,(j
State work to be performed and purpose of building (By Floors) �t- N5�79•z� C 4 ^ / '�� . /� 60")0
New Building Remodeling ' Addition Repairs No. of Stories
Overhead
Service Underground Site Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)..
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 • ction on the site of the w. such public notice or notices
as are required by the Act. The undersigned agrees to employ only such s contracto on work to be pe ormed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and
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
therein by him stated are true.
V-71461
Electrical Inspector.
Master Biwselisimc
4-,e�pNo. cJAJf►1fVIST'D
take acknowledgments, personally
the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made %hen such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'PT•S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
�0 4)
CHECK
/,
/°
%
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
•
I
CHECK
7,
appeared
Permit No ....�
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
t> crud ..
> " Date 6 1 9� �
Application is hereby made for the �E'roSzal- 'the de a("ikd ement of the Tans and specifications herewith sub 'fitted for the building of other
structure herein described. This application is made irk compliance and- confoirmity with the Building Ordinance of Miami Shores Village, Fivada,
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 L - Lg•-)41 1 ' L No t ) Street
Registered Architect and /or En sneer C
Employing ElectriciaA's Name 4I C. r W �zi�ozr� r ' U rt ' eP " 1 o S
Location and Legal Description Lot (2 ]. 7/) . .............Block Subdivision
Street and Number where work is to be performed—No .11. " . -. -. .. 411 . • 11 2-A Street ,(j
State work to be performed and purpose of building (By Floors) �t- N5�79•z� C 4 ^ / '�� . /� 60")0
New Building Remodeling ' Addition Repairs No. of Stories
Overhead
Service Underground Site Feeders Conduit Main Sw Amps Main Fuses . Amps
Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)..
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 • ction on the site of the w. such public notice or notices
as are required by the Act. The undersigned agrees to employ only such s contracto on work to be pe ormed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and
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
therein by him stated are true.
V-71461
Electrical Inspector.
Master Biwselisimc
4-,e�pNo. cJAJf►1fVIST'D
take acknowledgments, personally
the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made %hen such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Owner's Name and Address .
STATE OF FLORIDA,
COUNTY OF DADE. j ss
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
ing 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 the work.
Date..._.. :.L! :. _...._._....... 19...__
._ No sass. Street—
Registered Architect and/or Engineer . > r
Name and address of licensed contractor o ��9 . l Y.'..4 , ..L " "T _ r.Z. 4�✓j44
Location and legal description of lot to be built on:
Lot Block S ivision sass.__..___
Street and Number where work in to be done ? �I fl°} --r----- _. ` '' '
` _ . _
/A
State work to be done and purpose of building (by floors)... = rf" � ` � %/ � JV //� .rf�_ _,, ,.. ' , ..
Notary Public, State of Florida
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof CQvering —
Estimated Total cost of improvements $ ,amount of Permit S.
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to •• ••• - - -- - --
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, Pennant np element,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors reel •ed by him
in the work to be performed under this permit; and will post or cause to be posted fo tnspe '.n on the site of the wor sue public notice
or notices as are required by the Act. The undersigned agrees to employ only such bcon• 'et.rs, on work to be pe fo ed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)...
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No � te ( Date. .Q 7 ?• -• - -- Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Building nspector My Commission Expires
to me well known,
PLANNING BOARD DATE
Chairman Member
Member Member
Member sass.. _ .._._..._._._._._ .___sass__ Member
Council Approved _... -.Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from
the Planning Board.
A re inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.