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pl i,MIAMI SHORES VILLAGE
il)e) UILDING DEPARTMENT
- 605-795-2204 1'
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MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date f f `7f ft 'J
Type Insp'n I t- ■../
Permit No. Al ' J — ®.S
Name
Address 0 #0
Company
Phone #
Inspection Date
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Correction ❑ g ?'7,J2 mr
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11IAMI SHORES VILLAGE
BUILDING DEPARTMENT 6
`305- 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No. i G'l/J
Name
Address ,ate
Company
Phone #
Inspection Date
r �
Approved "1
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Correction ❑ e 77; �..i -
Re- Insp'n Fee 71
BUILDING
PERMIT APPLICATIO
FBC 2001
Job Address (where the work is being done) S 6 0 E. c3 110
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Ivfiami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
ReCti :ED
FE3 2
Electrical
Structural Plan Review. $
Permit No. 0 6A 5 �
Master Permit No.
Permit Type (circle): Building
Owner's Name (Fee Sim le Titleholder) - 1.. " U
Owner' Address 3_ 0 E
cit " L 1Ctt "\ 5h0100 State zip 23 136
Tenant/Lessee Name v , Phone #
{�\/ • � Plumbing n Mechanical Roofing
�41I\hOl 0/ Phone # �7� � . ! -3 13.-g00 a9
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City Miami Shores Village County Miami Dade Zip 331
Is Building Historically Designated YES NO >(--
ContractU Company N a m e / O Q - ca th . P h o n e # ( D ) 2A6 _ gct
Contractoti Address '8C01-- -e 1'2- ."r.. cJ -& 4 -i-k, -
City � A'3 _ . State L. Zip 3 .
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Qualifier �{
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State Certificate otRegistralion No 'E?X? O V
Archittcf/Engmeer''■ame (if applicable) Phone #
$ Value of Work For this Permit ' 00 P v
Certificate of Competency No. CibE 6(S
Square Footage Of Work: r
Type ❑Addition Alteration ❑New ❑ Repair/Replace ❑ Demolition ,
DcscrlbeWork: rrNONTC. 0 V 1oe S. e...(e t c , aet (e ® E - P ( '
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Submittal Fee $ • '� Permit Fee $ /-4 70° - e'''' CCF $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
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il SHORES VILLAGE
eb BUILDING DEPARTMENT
Date
Type Insp'n
Company
Bui mg Inspection Request
Re- Insp'n Fee ❑
305- 795 -2204
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Permit No. '6 1 2f ° 3
Name EA ci c' c( LAC Q I 1
Address QC, C I ' '
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Phone # 2
Inspection Date j "> l .
Approved
Correction ❑ ./f et
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