ELECTRICAL■1
II , Permit No. __._
Service Overhead Underground Size Feeders
Amount of Permit $
appeared -
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
- Z
D ate ...,
Application is hereby made for the approval of the detailed statement of the plans and specifications hetewith 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 Buil'iag 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 .,��- '_ _.__. No.- -' No.
Registered Architect and /or Engineer // ;; ' '!!! 2
Employing Electrician's Name Gel'.!.____ . g-)/ .
_ No.__- ..._ -_0 ? Street_
Location and Legal Description Lot Block _.__...._ ... Subdivision- _._.�-- ....._� �....
Street and Number where work is to be performed —No 14 q
. 131 J. .�L -'� Street
State work to be performed and purpose of building (By Floors) _.. °- ° ----- :_ .__....-.-_...-._..._.------- --.—____- ......-- ---
New Building
Street.
Remodeling Addition Repairs — No. of Stoll- .®..._..
/ Conduit._. Main Sw.___..J_.gS�... Amps. .. Main Fuses --. - -f e— ....Amps.
Type of Installation -- Conduit ✓ Tubing__ ..... B.X.L. Metal Moulding
My Commission Expires
(Signed)
Elect cal 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 comp
plied with the provisions thereof, and will require similar compliance from all contractors or sub =contractors employed by hint 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,
ss
COUNTY OF DADE..
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is Vie ............._..... �.._ o .,�_
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.
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,
materials and /or workmanship.
•
SWITCH
OUTLETS
S
LIGHT
OU T
PLUG
RECE'P'T'S
FIXTURES
NO.LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CO
YVR,TER
HEATER
' iflf. HEAT.
C ONK.
SPACE
HEATER
STRIP
HEATER
R.'
TOTAL
C
LIST
LIST
! {./
/ LETS
/
!
/ K
i
/ NN.
CHECK
//
ENT. DIST.
SW. CAS.
SERVICE
TEMP.
SERVICE
PERM.
I
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
L.�
CHECK
II , Permit No. __._
Service Overhead Underground Size Feeders
Amount of Permit $
appeared -
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
- Z
D ate ...,
Application is hereby made for the approval of the detailed statement of the plans and specifications hetewith 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 Buil'iag 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 .,��- '_ _.__. No.- -' No.
Registered Architect and /or Engineer // ;; ' '!!! 2
Employing Electrician's Name Gel'.!.____ . g-)/ .
_ No.__- ..._ -_0 ? Street_
Location and Legal Description Lot Block _.__...._ ... Subdivision- _._.�-- ....._� �....
Street and Number where work is to be performed —No 14 q
. 131 J. .�L -'� Street
State work to be performed and purpose of building (By Floors) _.. °- ° ----- :_ .__....-.-_...-._..._.------- --.—____- ......-- ---
New Building
Street.
Remodeling Addition Repairs — No. of Stoll- .®..._..
/ Conduit._. Main Sw.___..J_.gS�... Amps. .. Main Fuses --. - -f e— ....Amps.
Type of Installation -- Conduit ✓ Tubing__ ..... B.X.L. Metal Moulding
My Commission Expires
(Signed)
Elect cal 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 comp
plied with the provisions thereof, and will require similar compliance from all contractors or sub =contractors employed by hint 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,
ss
COUNTY OF DADE..
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is Vie ............._..... �.._ o .,�_
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.
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,
materials and /or workmanship.
•
4 0
410
0
I/