15371MIAMII', SHORES VILLAthE
BUILDING INSPECTION DEPARTMENT
APPLICATI IN FOR BUILDING P RMIT
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.
Owner's Name and Addr "V
;off
' Registered Architect and /or Engineer
Name and address of licensed contractor ..�
Location and legal description of lot to be built on:
Lot
Block Subdivisi n
Street and Number where work is to be done 6 `®'
State work to be done and purpose of building (by floors)
) 7 an for no other pure
No of',',Stori �s f
New Building _ Remodeling Addition r Repairs_
To be constructed of Kind of foundet t� ; `� Roof Covering_
Estimated Total cost of improvements $ l 6 Amount of Permit $
Zone Cubage required_
Plan Cubage diohe
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby sub ie plans and ratio or 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 5968, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and wil require similar compliance from all contractors or sub - contractors employed loyed by him
in the work to be performed under performed 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 undersigns dd agrees to employ only such subcontr ctorS, on work to be perfumed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed )- .z'[��'�;
STATE OF FLORIDA,
COUNTY OF DADE. ss•
t,t
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
{ to me well known,
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.
peered
and who, being by me first duly sworn, upon oath deposes and "says that he is the
Permit No.
Disapproved
(Signed)
Date
Date
Chairman
Member _
Member
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Eire
PLANNING BOARD _DATE
Member
Member
Member
Disapproved
Council Approve&L Tate
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by
materials and /or workmanship.
or changes to this application after approval h
Date
as been obtained from
improper notice for inspection or faulty
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
Value - of
Project $
This permit is granted to the contractor or builder named above to construct the building or to install the .e quipment or dew deec bed €n the application
,erefor in strict compliance with all ordinances pertaining thereto and with the understanding that, the work wil be performed in complias�5e with 1
ravings, statements or specifications that may have been submitted to and approved by the proper municipal t
ue if the work is not done in compliance with such ordinances or if the plans are changed without authorization. Aofurthcr condom •off wi�leh itniss
anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of .the or.t , anees and , atitms
riaining to the work covered hereby whether shown on the plans or ravings or in tte statements or specifications and. tlriat he
ne by his agents, servants or employees.
fined•
In consideration of the issuance to me of this it I agree to
iaining thereto and in strict conformity with the pla drawings, s
accepting this permit I assume responsibility for all work done by
f rm the work covered hereunder in compliance d
is or specifications submitted to the proper nut
r, myself, my agent, servant or ehiployee.
gufations
Village.
o Tli "r' RT 02; BUrLDIR
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No I �' 7( Date 11-
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 1
Registered Architect and /or Engineer
Employing Electrician's Name .f.....No Street
No Street
Location and Legal Description Lot dock
j
Street and Number where work is to be performed —No Gft. 62
State work to be performed and purpose . of building (By Floors)
New Building Remodeling .Addition
T
Subdivision
Street
Repairs No. of Stories
Service Overhead Size Feeders Conduit .Main Sw Amps .Main Fuses .Amps
Underground
Type of Installation— Conduit. Tubing B.X.L .Metal Moulding
Amount of Permit $
4
(Signed)
Electrical 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 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 to be performed under this permit, as are
licensed by Miami Shores Village.
7
5� (Signet!)
STATE OF FLORIDA, Master Electrician.
COUNTY OP DADE.
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, 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 the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE. A reinspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
material /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.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
•.
_
CHECK
ENT.
SW.
GIST.
CAS.
SERVICE
r TEMP.
SERVICE
` PERM.
^
-
-
MOTORS
. 0.1 HP
'
MOTORS
. 1.8 HP
NEON
TRANS.
--«- -o
RADIO
p ^i ,. 2r
l
'TOTAL,
CONTR.
LIST
.-
CHECK
/
_
p�4 ®y
d
/6 a
Service Overhead Size Feeders Conduit .Main Sw Amps .Main Fuses .Amps
Underground
Type of Installation— Conduit. Tubing B.X.L .Metal Moulding
Amount of Permit $
4
(Signed)
Electrical 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 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 to be performed under this permit, as are
licensed by Miami Shores Village.
7
5� (Signet!)
STATE OF FLORIDA, Master Electrician.
COUNTY OP DADE.
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, 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 the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE. A reinspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
material /or workmanship. �