19-1419, 1460 NE 101st StPERMIT #: c� J I !) 9
I
(Name)
❑ Contractor
❑ Owner
❑ Architect
Picked up 2 sets of plans and (other)
Address: ( q 11�
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
DATE: �' I
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Villa uilding De artment to conti p rmi 7roc
Signature: Q
(SIGNATUR
PERMIT CLERK INITIAL: ' -7
RESUBMITTED DATE:
PERMIT CLERK INITIAL: : <�