No Permit NumberMIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERM TC
Permit No Date.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi au witted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida,
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
Reatrl
Registered Architect and /or Engineer.
Employing Electriciafi's Name
Location and Legal Description Lot Block Subdivision
No (2 Street kl l
No
2025
Street 1` 15
Street and Number where work is to be performed
State work to be performed and purpose of building
New Building
—No 12! 45 Street LE
(By Floors) �\.
Al P— H
leLdr.kemodeling Addition Repairs No. of Stories
service Overhead Site Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep 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 subcontractors 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 tp be performed under pe ,. - %; as are
licensed by Miami Shores Village.
(Signed)
Master Electric n.
STATE OF FLORIDA, }
COUNTY OF DADE. ss'
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 , IP i sdajel nd' e is the
of the above described construction, and he has carefully "ii ;fea r pli�cibl t he did sign the same, and that all facts
Publics " a
therein by him stated are true. . . M y Comm Q '
NDE
My Commission Expires Notary Public, State of Flo
NOTE: A re•inapection fee of $1.00 will be made when (Ruch re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECET•T'S
FIXTURES
NO LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANOE
CONN.
WATER
NEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
Cowrie. S T
LIaT
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
AAOTORS
1•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR. ST
LI ST
L�
n 2)
CHECK
service Overhead Site Feeders Conduit Main Sw Amps .Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
(Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep 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 subcontractors 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 tp be performed under pe ,. - %; as are
licensed by Miami Shores Village.
(Signed)
Master Electric n.
STATE OF FLORIDA, }
COUNTY OF DADE. ss'
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 , IP i sdajel nd' e is the
of the above described construction, and he has carefully "ii ;fea r pli�cibl t he did sign the same, and that all facts
Publics " a
therein by him stated are true. . . M y Comm Q '
NDE
My Commission Expires Notary Public, State of Flo
NOTE: A re•inapection fee of $1.00 will be made when (Ruch re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
cResicienLiat Jfirt 2onditioninfJ
20250 NORTHEAST 15th COURT
DADE 652 -6040
MIAMI, FLORIDA 33179
BROWARD 764 -0489
•
PURCHASER M Uts 11001TiATE
ADDRESS
I14Y! i stioR�s
•
11111111111111MFMMINIRIORIVIS s ee,.:e:� .,����"F�e:-
�er aeeeo'eeam e �� a•
igiii=
moorml I 111111111
• � 1 "Elm IIUIHHOF o
imppipioldi
�eeee1�ee0M91 33�
urthimundmi
wompowirmaiimilidgm.
Nuirlsire.tium mmemmummomm
�e9' 2�� II 1991019 011611E9i1e11M;1a11