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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.