1270 NE 94 St (8)_3uyer
Comments:
APPLICATION FOR CER ni4ICATE OF RE-OCCUPANCY
to re- occupy the single family residence known as : (address)
1 ° 1\-) q L/ s (. kl . ,1 r
t c ae 5 ,1dami Shores, Florida.
Legal Description:
Lot: Block PB & PG:
I hereby certify that I understand that the zoning of the property is for sinale-family
and that it is unlawful for more than one Tnnly to reside therein. I also understand that use
Certificate of Re- Occupancy that may be issued by Maui Shores
referenced property is being used for single- Village, certifies only that the
constitute single-family and that such Certificate does not
any representation, warranty or cation as to the condition of the dwel mg or other
structures on such property.
Applicant .N xricti
Print Name' / a tits OO ore
** * * * * * * * * ** * * ** * ** ************************* ******** *********** **** *** * * ***
For purposes of conducting the inspection regirired by Section 902 of the 3liami Shores Land
Development and Zoning Code, please contact:
Contact Name: �4N l ,4.4 Lb /Z. { T ho
Application Fee (S50) paid Cash
PAGE I OF 2
Date 2.
he e y apply for a certificaxe
Company Name
Check No- 6(0Q,2 /
% Denied
Date 2/22/99
7j SY5
-t��_ zy
CER'11.b1CATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property
described in the above application has been inspected for purposes of re-occupancy pursuant to
Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for single - family residential purposes.
THIS CERTIFICATE VERIFIES TEAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI' SHORES _ -
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH itit, SCHEDULE OF REGULATIONS OF ' LE W,
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOT .FLY TO THE REQUIREMENT THAT EACH
ONE- FAMILY DWELLING IS USED AND INTENDED TO BE
USED FOR A ONE-FAMILY DWELLING PURPOSE ONLY;
HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON T _
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITION;A.14INTERESTED PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF ' itiE
PREMISES IN ORDER TO DETERMINE THE CONDITION,
THEREOF.
PAGE 2 OF 2
MIA ME SHORES VILLAGE, FLORIDA
By.
Date of Certification: 2/22/99
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
PERMIT N? _ 3666
cm
MIAMI SHORES VILLAGE. FLORIDA
Lot
I ?. ' :1 1 o .i,
Work to be performed under this Permit
Subdi-
vision ' - A: .
Value of
Project $
Contractor's
License No. r A•
v
DATE / . 195
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed. BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
OWNER'S NAME
Thos. W. Jones
PRESENTADDRESS
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
1270 N.E. 94th St.
LOT
.. 18
BLOCK
SUBDIVISION
MS Bay View
' GENERAL CONTRACTOR
Geo. Duvall
,ADDRESS --
PHONE NO.
LICENSE NO.
)�
BUILDING PERMIT NO. 1 3 2 3•
� . /�
9- 5- - - 4-0,31.-
PERMIT FEES . 19.00
BUILDER'S BOND 00 _ j _
NO. 3.411.6 ATE
-`
Lj DATE •� -26 -52 •
25,000
ZONE REQUIREMENTS CU. FT.
2.5,501
PLAN CUBE CU. FT.
15,000
EST. COST 5
DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY:
DATE
x
NEW CONSTRUCTION
CBS
CBS
STORIES
1
ROOF CONSTRUCTION
tile
INTERLOR CONSTRUCTION
oak and terrazzo floors, plaste
REPAIRS
DESCR IPTIONirSllS and etil.LI1tL:J
3 bdrm.- 2ibaths- living room - jalousie porch- dining room- kitchen -2car Ge
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
�_•
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
0
CERTIFICATE OF OCCUPANCY NO. I 1 0
ISSUED\ t Cr
BYBY.,./
TO +111,.."
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
r
INSP6cTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
, )404..?'"
,{•�
FEE
TEMPORARY SERVICE
FEE
BEAMS & LINTELS
l e /5 i`�
7v■N-&`• < % ^'_„.4i -]
\
5 1 I , (e)(4 F'2
SEWER
FRAMING
pp
`/- -
SOLAR HEATER
RANGE CONN.
$
GAS
MOTORS
$
$
$
FINAL
, � ,C • \'' \i�‘1•
:t - y
RE- INSPECT
BY
RE- INSPECT
BY
CLEAN -UP
1.%
1
DATE
BY
RE-INSPECT
BY
CONTRACTOR t. ,'G +�-� jti k�J• c.:, •
PHONE
PERMIT NO. P 3 S, 3 DATE • a • c -
���J
FEE $ //, "j/
NEW BLDG. ALTERATION
L
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
FEE
$
�
SEPTIC TANK
7v■N-&`• < % ^'_„.4i -]
\
5 1 I , (e)(4 F'2
SEWER
$
SOLAR HEATER
RANGE CONN.
$
GAS
MOTORS
$
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
g' ,b
--
1 ,'
DATE
BY
RE-INSPECT
BY
GAS
BY
TEMP. SERVICE
\ ^ ,, ^
y rwr -
U \ (CU
q„,.- 6
SEWER
e
ROUGHING
C ./' "
SEPTIC TANK
` P' z : F
H. W. HEATER CONN.
SOLAR HEATER
RANGE CONN.
FIXTURES
9 .. I "V
r)\
CONTRACTOR `'7 �-�`" t'
PHONE
- O
2 2
PERMIT NO. I c3 / DATE 1 3 — ': )----
—
FEE $ / U S
NEW BLDG. I ALTERATION I ADDITION
REPAIRS /
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
Mi, c) , '
( (i- - �? 1 '7
$ / 4 0
.H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE-INSPECT
BY
RE-INSPECT
BY
TEMP. SERVICE
\ ^ ,, ^
y rwr -
U \ (CU
q„,.- 6
' 3. 5
e
ROUGHING
C ./' "
H. W. HEATER CONN.
RANGE CONN.
- -o1
rIXTURES & FINAL
(�
` 16,'S,-
.p ` -
- BUILDING NSPECTIONS
PLUMBING PERP4!TS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE ,.A
N9 1610
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
1® °1 ® °.b
Owner, Agent or Tenant of Building 1 a. \ i �`5 � \ /
Lot 1 IS Block Subdivision �/Y�� % (6 V
Street Address ol o f)- 'Q , S q,
Approved use by occupancy
r`
Remarks.
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known a s the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
J
la� 1St T^r�' V
t W BUILD NG DIVISION
OWNER'S NAME
.WI
PRESENT ADDRESS
LICENSE NO.
PHONE N9.
( I
JOB LOCATION (ST. OR AVE.)
1270 N.E. 94th Street
LOT
18
BLOCK
SUBDIVISION , J :
Miami Shores Bay View
GENERAL CONTRACTOR
ADDRESS
4-4 aLtA. '1 It „Q.,.
PHONE NO.
BUILDER•S
NO. DATE
LICENSE NO.
BOND
\
BUILDING PERMIT NO. 26
,DATE 4 ' -12_54
PERMIT FEE $ 5
ZONE R EQUIREMENTS CU. FT.
PLAN CUBE $500 TAX VAIegEF
EST. COST S 1000
DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY:
DATE
NEW CONSTRUCTION
TYPE
STORIES
ROOF CONSTRUCTION
INTERIOR CONSTRUCTION
REPAIRS
DESCRIPTION
screened in patio
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
•
nR fin,) " D REMARKS
n ; 1 A ` ° 1 1 - S
CERTIFICATE OF OCCUPANCY NO.
ISSUED 4
I BY
TO
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
i_ /Y
FEE
TEMPORARY SERVICE
TEMPORARY SERVICE
$
BEAMS & LINTELS
jjjj
$
SEWER
RANGE CONN.
FRAMING
SOLAR HEATER
MOTORS
$
GAS
FIXTURES
5
$
INSPECTIONS
FINAL
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
CLEAN -UP
:7' /nZ -s
GAS
CONTRACTOR
. PHONE
PERMIT NO. I DATE
FEE $
NEW BLDG. 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
TEMPORARY SERVICE
$
SEPTIC TANK
H. W. HEATER CONN.
$
SEWER
RANGE CONN.
5
SOLAR HEATER
MOTORS
$
GAS
FIXTURES
5
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
TEMP. SERVICE
GAS
ROUGHING
SEWER
H. W. HEATER CONN
SEPTIC TANK
RANGE CONN.
.
SOLAR HEATER.
E
FIXTURES
FIXTURES & FINAL
CONTRACTOR
PHONE
PERMIT NO. DATE
FEE $
NEW BLDG. 1 ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
.
E
FIXTURES & FINAL
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECT!
ELECTRICAL PERMITS & INSPECTIONS
APPRrNAL TO POWER CO. FOR SERVICE DATE
BY
N9 1976
Street Address
Approved use by occupancy
Owner, Agent or Tenant of Building 7 4)
Lot J � Block Subdivision
Remarks-
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla , • .%)/
This Certificate of Occupancy is issued to the above named
e (71
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection nstruction, al eration � or �� rem � remodeling of buildings or structures.
UILDING DIVISION
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot / K Block Subdivision
Street and Number where work is to be done / Z 7 0
State work to be done and purpose of building (by floors) !C
STATE OF FLORIDA,
COUNTY OF DADE. ss
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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.
. „/
Ai
/ Date
y en t. N Owner's Name and Address ..o ' ' w
Registered Architect and /or Engineer //4 /J A.) C +/�
L �J� /L_n �� , S
Street
/1.1-E
3 t
s1�- r • 4/ —� ,S/
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation C O N Roof Covering
Estimated Total cost of improvements $ 3 Z . • J-. Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pennit 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, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspectioon. • - site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon affors, on .rk to rformed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) , �'✓rr =
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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, 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. ta�
Permit No -C. & e.. Date - - -, '/ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
;UILDING
:LECTRICAL
LUMBING
:OOFING
- rchitect
contractor
r Builder
sgal
)escription
address of
uilding
Lot
MIAMI SHORES VILLAGE. FLORIDA
0
PERMIT N° _ .3406
0
❑ Work to be performed under this Permit
)wner of
: uilding"
/
1 f
CONTRACTOR OR BUILDER
Bl
Subdi-
vision
Value of
Project $
DATE' �� 195
Contractor's
License No.
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
me if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
panted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and at he assumes responsibility for work
one by his agents, servants or employees. "frk
Signed � BY -?
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
-pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY 6 y
of Miami Shores N° 4303
' JOB (aC lokre'S_
ADDRESS / Z 6 V R) . ( S7
INSPECTION - —
TIME READY 2- : iZ
REMARKS
INSPECTOR DATE 1°4
nit* r 'Miami . ne N? 429 11 // '�
O
JOB 0 i e Aid S
�p L�
ADDRESS /a ,-Y-,(''V 5�
INSPECTION , , -a _-7 ^—,—
TIME READY
REMARKS
O fd _
INSPECTOR
DATE r'1
Village of Miami Shores N° 3719
JOB k)--1t C. S ®!J
ADDRESS ) O w - t
INSPECTION l0 e-o
TIME READY 1
INSPECTOR
REMARKS
DATE
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot 0/r,fx
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IT? 13234
n
❑ Work to be perfgrmed under this Permi
.6 /Z,114e,
itieT
Irr
tiVAL La.
BL
This permit is gra ed to the contractor or builder named abovr to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and app5pved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans aaitegchanged without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumet the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans Vor drawings$i in the staxements or specification last he assumes responsibility for work
done by his agents, servants or employees.
Signed.
Subdi-
vision
Value of
Project $
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in ( compliance with,(all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, Statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY
DATE
,,
Contractor's �
License No
Amt. of
Permit $
AUTHORITY
r
MIAMI SH RES V ILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR :WILDING PERMIT
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. / ' , 19_
Date 'id!) _! ^a—
Owner's Name and Address CO, t e Pi c S r 11 / P AZE2/rE S . No ' Street
Registered Architect and /or Engineer d=.2F_ in)
Name and address of licensed contractor Q v q L 4
Location and legal description of lot to be built on:
Lot / Zt Block
Street and Number where work is to be done
�Q
Subdivision - /8 4
State work to be done and purpose of building (by floors) ,l2_r.?r_ C_ �� QJ' •
P
and for no other purpose.
New Building____.. Remodeling Addition Repairs No. of Stories ____/
To be constructed of___L'__ Kind of foundation R A (MC Roof �2 W.
Estimated Total cost of improvements $___ 'p_
l ___ C 7 Amount of Permit $
Zone cubage required .,,,2,. 0 0 / -Plan Cubage 1,
Distance to next nearest building ' Size of Building Lot 2_d_ °_A1!,
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for 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 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on t :.f the work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, o work . be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) r , -s c _ e-0 -� � - i. --
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, be g by me first duly sworn, upon o deposes and says that he is the
of the above described construction, that he h refully read tteeregoing application, and that he did sign the same, and that all facts
therein by hi state are true)
Permit No.__ ____ Date V 5 bead, Sworn to and Subscribed before me.
Disappr d / • Date
(Sign , 4 1 )
ui = ing Inspector — My Commission Expires
PLANNING BO RD_. DATE
Chairin Member
Membe Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by .improper notice for inspection or faulty
materials and /or workmanship.
Notary Public, State of Florida
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT �
305- 795- 2204\
B tilding Inspection Request
Date \1 12
Type Insp'n On DUI/
60 145i
Name G
Address 1 2:7G Nj ` 4
Company
Phone #
Inspection Date ‘ ( 19
Approved
Correction Se,
Re- Insp'n Fee ❑
Permit No.
DatM "
Type Insp'n 71 — r ti m Drw
Permit No. 6P —1
Name POI KO OthC,
Address 12 (G N C1 s 1
Company
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
'A5-795-2204 \)k4)
B ilding Inspection Request
CI