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560 NE 102 St (13)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 74:14 Job Address .5 L © K ,L . ©u 1M- Tax Folio Legal Description Master Permit # 3 75/ IEEED/ Lessee / Tenant C / El" 2. 1.E.Q Owner's Address 3 lA ® N • G . `® Phone 7 5 / 7(Y7( Contracting ColINLmftrratt C .q.A, Address (-O tt.t.g4 r Qualifier N Q. State 0311121eAli vs Municipal A '1I'Vmpetency 4bmana3tns.Co. Architect /Engineer Bonding Company Mortgagor \'‘Ateu ' , \t $ Address Address Address Permit Type(circle one): BUILDING q.ECTRICA' PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION V.A.A.• 3 Sie:ACAL,4:4 Ike. T Nt=)\1 S vtotb .$0th,:ktip.. Att, Gat& N.Con. t!LA,I;Sty4 (10 Square Ft. Estimated Cost(value) .". Zett ® WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. 4 �► i Signature of owner and /or didndo President Date: Notary as to Owner an ** * RADON esident Mechanical Plumbin& z .11inature of Cori /Date: My Commission ExpiiiimItY PUBLIC MY COMMISSION EXP. Au BONDED THRU GESIERA1 IFS. Mad FEES: PERMIT `,,..,. C.C.F. APPROVED: Fire Other Zoning Building Electric Engineering ta.— or Owner- Builder M.. Notary as to Contractor or der My Commission Expires: TARY PUBLIC STATE FUNUCAt MY COMMISSIOU EXP. AUS 20916$ BONDED THRU GEW. . Imo WA * * * * * * * ** v "' o — NOTARY TOTAL DUE 5 _ Permit No 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. Owner's Name and Address / _r MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT LL A. J A R 'e . No S-670 Street IU f' l O '2 " `C I_ Registered Architect and /or Engineer Employing Electrician's Name, G 14 % �-' 'E ( ("L' No "V 6 Cf% 'fo fl Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs s No. of Stories Date a © C Service Overhead Size Feeders Conduit Underground Type of Installation— Conduit Tubing Amount of Permit $ 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 subcontractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths appeared SS. Main Sw Amps Main Fuses Amps 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 therein by him stated are true. B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed).. .4 Master Electrician. and take acknowledgments, personally did sign 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 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. FACE HEATER STRIP HEATER TOTAL CONTR. LIST • / CHECK ENT. SW. DIST. CAD. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.0 HP NEON TRANS. RADIO TOTAL CONTR. LIST 4 �( /CJ 0 /4_ •� -fJ.. CHECK Permit No 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. Owner's Name and Address / _r MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT LL A. J A R 'e . No S-670 Street IU f' l O '2 " `C I_ Registered Architect and /or Engineer Employing Electrician's Name, G 14 % �-' 'E ( ("L' No "V 6 Cf% 'fo fl Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs s No. of Stories Date a © C Service Overhead Size Feeders Conduit Underground Type of Installation— Conduit Tubing Amount of Permit $ 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 subcontractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths appeared SS. Main Sw Amps Main Fuses Amps 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 therein by him stated are true. B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed).. .4 Master Electrician. and take acknowledgments, personally did sign 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 when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship.