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AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
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DATE
PERMIT NO. 0 ,4 1 _3/
RE- INSPECT
BY
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BY
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$
DATE
FEE
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FIXTURES
FINAL
$
$
CLEAN -UP
DATE
BY
RE- INSPECT
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PLUMBING PERMITS & INSPECTIO
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PERMIT NO. • I DATE 7, e�
FEE $ (17a
NEW BLDG. ?jC 1 ALTERATION I ADDITION
F{t'PAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
' FEE
TEMPORARY SERVICE
'H. W. HEATER CONK.
$
SEPTIC TANK rN40.fleir
5 $ 1 8
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$
SOLAR HEATER
$
GAS
$
FIXTURES & FINAL ���/� y
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INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
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FEE $
PERMIT NO. 0 ,4 1 _3/
DATE
NEW BLDG. x ALTERATION
100
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
S
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
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BUILDI
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE /9/4../41 BY E�af,
�� OWNER'S NAME
I .1 ) . .)iici- eT
JOB LOCATION (ST. OR AVE.)
.53 , ': 1 ='® '
NEW CONSTRUCTION
REPAIRS
ALTERATION
ADDITION
GENERAL CONTRACTOR
CBS
SUBMITTED TO PLANNING BOARD
RESUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
PRESENT ADDRESS
X12 ,L
LOT BLOCK
ADDRESS
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BUILDING PERMIT NO. ,..;A5S DATE 4N47 PERMIT FEE $ 213-el
# !
ZONE / P EQUIREMENTS 7, 6®0 CU. FT.
LICENSE NO.
SUBDIVISION
# /d9,Y/ .5i)/4e,ES .�e'cT•.L'
PHONE NO. LICENSE NO.
,eQS, BUILDER'S BOND
NO. 570 DATE
PLAN CUBE eA CU. FT. ES T. COST S_/‘61:01:9
DATE
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: .L - lam /' �•
TYPE STORIES ROOF CONSTRUCTION
DESCR IPTION
INTERIOR CONSTRU51J0
feiN4 /MY4,e f'o4es /a..0
ha+I. JJY.,&, lcH- ✓ugalii a 3& Acrd f Avzitocd €,w_
APPROVED REJECTED
REJECTED
DESCR,PTION
REFERRED TO COUNCIL
REMARKS
REASONS
CERTIFICATE OF OCCUPANCY NO �/ ISSUED. � �/
� BY '�� TO
BUILDING PERMIT AND I CTION RECORD -MIAMI SHORES VILLAGE
PHONE NO.
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