950 NE 95 St (4)MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby umdc for the approval of the detailed statement or roe plans and specifications herewith submitted for the build •
ine or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florid.t, 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, whcther 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 Address /r /4n
Registered Architect and /or Engineer_.... • Brq Pa/ Q/�;�/ j pp /ipn
Name and address of licensed contractor 6- o1/4 5- 111
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done _. /. .._.....�_.'. Q�
State work to be done and purpose of building (by floors) 1.�'/tf �UlI7y.` ..
Disapproved ... . Date
(Signed)
Building Inspector
BUILDING INSPECTION DEPARTMENT
Date..._. l /�._ ..... _. __.....__ _...._",., .... 19 ..J_
Notary Public, State of Florida
My Commission Expires _
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation r Roof Covering
Estimated Total cost of improvements $ (3.00. Amount of Permit $..(9.4.1)
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 uniiersigncd applic for this building per:nit does hereby certify that he understands and accepts his obligations ;is an employer
of Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup element,
and has complied s.ith the provisions thereof, and will req'uire similar compliance from contractors or sub - contractors employe by him
in the work to be performed under this permit; and will post or cause to be posted fo pection on t ite of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such s ; •ntractor cork to ! performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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, 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, sod that all facts
therein by him stated are true. true.
Permit No a a4-1A pate �' ' Q — �� Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Chairman Member
Member Mcmbcr
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 hecn obtained fmus
the PL Lu.rrd.
A re Ice of $1.00 will be charged when such re inspection is made necessary by Improper notice for inspection or faulty
materials and /or workmanship.
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
-- — Application is hereby mode for- the—approval of the detailed statement us the plans and specifications herewith submitted for the build •
— inc 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 alt rules and
'regulations of the duildinc 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 Address . .�. 1�',t .f �' !. t R:uG a•10_!!v„
Registered Architect and /or Engineer .•
Name and address of licensed contractor e�-- - ■
Locati • n and le al description of lot to be built on:
Lot
Zone Cubage required
mock._.
Street and Number where work is to be done
State work to be done and purpose of building (by floors) .-
(e,,, `. -. , A l C ci z d u (PM N T w1 I j 4 raw A 4 t v v A c P p /111. CAae.4�;_ 3,
-5 L...i.!,1 .._ Gtc L( /S ........ 0••••0 000 _and for no other purpose.
New Building Remodeling..._ ...._.. Addition — Repairs.._..._ .........:....... No. of Stories•..... • :_...._........
To be constructed of Kind of foundation....... .........._ Roof Covering--- ........_
-• -- - _Estimated Total cost of improvements $ •.._.... —. 2 5 0 Amount of Perntit Z 7 f ' Z $ _
_ _.,._ Plan Cubage
Distance .to next newest building ..... Size of Building Lot_.
Maximum live load to be borne by each floor
Remarks
STATE OF FLORIDA, ss.
COUNTY OF DADE.
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
besent 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 Cenral Laws of Florida, Permanent Sup dement,
and has complied %s it', 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 inspeetio on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub�{t� work • � perforrncd under this
pcnnit, as are licensed by Miami Shores Village.
(Signed)
- II° dor:As
Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally ap-
peared ----
Coalman
Member
Member
MIAMI SHORES VILLAGE
f 6c1 Y v, t SKc2 s
Subdivision4
Disapproved .._... — D to
(Signed) .._.
Building Inspector
• 000E00000
Date
No. S o Street is
/R
UE
11066 CV E'T 0/ 11/4 I
7 co 3
Aff
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
Permit No.._. .!_L`? —• Date.�0.1 _ Read, Sworn to and Subscribed before me.
Notary Public. State of Florida
My Commission Expires
PLANNING BOARD..._. ._ ........... .. ........... _.__. DATE
.. ..........._......._..._�.. Member
... Member _ •.._ .. _ ..•■
_. Member _ _
Council Approved — — Date Disapproved _. _ .......... ..... Date
\U: E: A charge of 31.00 will be made for making corrections or changes to this application after approval has been obtained trout
the I'l.innu:. liu.ud.
A re-Inspection fce of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspe twin or faulty
materials anulor workmanship.
LAW OFFICES
STARR W. HORTON
Mr. Charles H. Markel
Director of Building & Zoning
10050 N. E. 2nd Avenue
Miami 38, Florida
Dear Mr. Markel:
SWH: nd
Encl:1
Re: 950 N. E. 95th Street
Miami Shores, Florida
Thanking you for your courtesy,
Your;' very tru
ARR W. HOR
502 INDUSTRIAL NATL. BANK BLDG.
25 W. FLAGLER STREET
MIAMI 32, FLORIDA
FRANKLIN 7 -1627
July 17, 1962
In accordance with your telephone conversation with my
secretary, I am enclosing herewith my Affidavit in con-
nection with my application for building permit.
I shall await your advice as to whether or not Mr.
Bradford has received the Memorandum of Insurance as
issued by National Casualty Company through House of
Insurance, Inc.
STATE OF FLORIDA) SS
COUNTY OF DADE )
STARR W. HORTON of the Village of Miami Shores, County
of Dade and State of Florida, being duly sworn, doth depose and say, that under the
provisions of Ordinance No. 185, dated June 1p, 1948, amending paragraph (d) of
Section B -368 of Ordinance No. 97 of the Building Code of Miami Shores Village, he
desires to build a 2 -story residence on LatPortionsaboxlcxxxxx
of Secs 5 & 6 TWP am 53S , R 42E , ubd orbs th e iz the ofm of said property,
and will be the owner of said vi a t�ount l
,a . will
ory residenceD e , that he rill
do the work personally, and that he will, at such times as are required by the
Zoning and Building Director: - -
1. File plans and specifications and obtain approval of the
Planning Board and the Building Inspector.
2. Apply for and secure a Permit.
3. Pay the required fees.
4. Execute the work in accordance with the provisions of this Code.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision has
been made to carry the necessary Workmen's Compensation, Public
Liability and Property Damage insurance.
7. File with the Building Inspector as the job progresses certificates
showing the payment required by the Federal Social Security Act
to the State of Florida or the United States of America.
8. Assume the responsibility of not employing other than properly
licensed contractors by Miami Shores Village for any part or
portion of the work.
9. Not set himself up as a "contractor ".
10. Sign an affidavit before commencing work to the effect that he has
read this Article and will do the work personally and observe all
of the requirements of the Building, Electrical, Plumbing and
Zoning Codes of Miami Shores Village. Such affidavit to be
properly notarized upon blanks to be supplied by the Building
Inspector.
11. In order to prevent abuses and subterfuge the right of such
owner - builder as herin provided, is limited to but one oTmer-
builder permit each 2 years, and where an owner - builder has
once exercized the privilege herein conferred no second applica-
tion for owner- builder permit shall be anted in less than 2
years, unless the applicant is qualifi: as a licensed Ge_;eral
Contractor under the applicable Ordin.p ces of said Village.
J o r AA,
1,
And Further this Deponent says not:
SUBSCRIBED AND SWORN TO BEFORE ME this 17th
195' 62.
A F F I D A V I T
6
day of
OWNER
July
D
NOTARY PUBLIC , STATE OF
FLORIDA AT LARGE
My Commission Expires:
A.D• ,
c6 6
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE 195
PERMIT N9 9888 Contractor's
PLUMBING ❑ License No = • d t
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
This permit is granted to the contractor or builder named above 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 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
17
D E S C R I P T I O N O F A U T O M O B I L E
Year and Make
Body Type
Motor Number
Serial Number
NATIONAL
CASUALTY
D E T R O I T
NAMED INSURED STARR W. HORTON & CHARLOTTE C. HORTON
COVERAGES
COMPREHENSIVE PERSONAL LIABILITY
(a)
ATTENTION: BUILDING DEPARTMENT
1
Name and address
Countersigned at
Form ML 248A
( BI & PD )
President
MIAMI, FLORIDA
Certificate of Insurance
NATIONAL CASUALTY COMPANY
(Hereinafter called the Company)
M I C H I G A N
Certifies that: As of the effective date of this certificate insurance is afforded for the coverages listed, with
respect to the automobile and the Named Insured described below.
POLICY NUMBER
LIMITS
100,000 EACH OCCURRENCE
( "ACV" means Actual Cash Value)
The Company agrees to mail to the certificate holder namedjhereon at the address indicated:
at (east ten days' prior notice of cancellation of the policy or this certificate; except that if an expira-
tion date is shown below, this certificate shall expire on the expiration date without such notice; and
(b) notice of any other material change in the policy.
This policy contains a standard Loss Payable Clause, specimen of which is printed on the reverse of this certificate.
If this certificate is issued to a Iienholder, loss or damage under the policy is payable to said lienholder in accord-
ance with the terms of said Loss Payable Clause and this certificate.
Certiflcateholder:
MIAMI SHORES VILLAGE Certificate effective: 12:01 A M 7/23/62
10050 N. E. 2nd AVENUE
MIAMI SHORES, FLORIDA Certificate expires: 12:01 A M 10/23/62
(Certificate is continuous if no expiration date is specified)
NATIONAL CASUALTY COMPANY
DETROIT MICHIGAN
.
�
By
HOUSE OF INSURANCE, INC.
H 331385
tary
Loss or damage, if any, under the designated policy shall be
payable as interest may appear to the lienholder and this
insurance as to the interest of the lienholder shall not be invali-
dated by any act or neglect of the Lessee, Mortgagor or
Owner of the within described automobile nor by any change
in the title or ownership of the property; provided, however,
that the conversion, embezzlement or secretion by the Lessee,
Mortgagor or Purchaser in possession of the property insured
under a bailment lease, conditional sale, mortgage or other
encumbrance is not covered under such policy, unless specifically
insured against and premium paid therefor; and provided,
also, that in case the Lessee, Mortgagor or Owner shall neglect
to pay any premium due under such policy the Lienholder shall,
on demand, pay the same.
Provided also, that the Lienholder shall notify the company of
any change of ownership or increase of hazard which shall
come to the knowledge of said Lienholder and, unless. per-
mitted by such policy, it shall be noted thereon and the Lien -
holder shall, on demand, pay the premium for such increased
hazard for the term of the use thereof; otherwise such policy
shall be null and void.
The company reserves the right to cancel such policy at any
time as provided by its terms, but in such case the company
shall notify the Lienholder when not Tess than ten days there-
LOSS PAYABLE CLAUSE
after such cancellation shall be effective as to the interest of
said Lierholder therein and the company shall have the right,
on like notice, to cancel this agreement.
If the Insured fails to render proof of loss within the time granted
in the policy conditions, such lienholder shall do so within sixty
days thereafter, in form and manner as provided by the policy,
and, further, shall be subject to the provisions of the policy
relating to appraisal and time of payment and of bringing suit.
Whenever the company shall pay the Lienholder any sum for
loss or damage under such policy and shall claim that, as to the
Lessee, Mortgagor or Owner, no liability therefor existed, the
company shall, to the extent of such payment, be thereupon
legally subrogated to all the rights of the party to whom such
payment shall be made, under all securities held as collateral
to the debt, or may at its option, pay to the Lienholder the
whole principal due or to grow due on the mortgage with
interest, and shall thereupon receive a full assignment and
transfer of the mortgage and of all such other securities; but no
subrogation shall impair the right of the Lienholder to recover
the full amount of its claim.
Nothing herein contained shall be held to vary, alter, waive or
extend any of the terms, conditions, agreements or limitations of
such policy, other than as above stated.
THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE
A PENALTY IS IMPOSED FOR FAILURE TO KEEP THIS LICENSE EXHIBITED AT YOUR ESTABLISHMENT OR PLACE OF BUSINESS
•
MSV/f88f
Village
THIS LICENSE EXPIRES ' N9 5 6 4 9
In consideration of the sum of
Fivo and a0/100 *************************U***** T)ollars ($ 25,00
Paid to Miami Shores Village, Dade County, State of Florida,
s TARtt '• liaitra R ic - 0* 95o a4E. 9Stil St.
is hereby licensed to engage in or operate the business of
C • truct 2 s • ion at
'r
Date Issued 743.62
t
MIAMI SHORES VILLAGE, FLORIDA
By
THIS LICENSE NOT TRANSFERABLE +WIITHOUT THE APPREVAL OC THE VILLAGE MANAGER.
Svc e
4
J
LEGAL DESCRIPTION
That part of Lot "F ", as shown on plat of Govern-
ment Lot 4, of Section 5, and the North Half of
Northeast Quarter (NE %) of Southeast Quarter (SE %)
of Section 6 of Township 53 South, Range 42 East,
recorded in Plat Book 5, Page 90 of the Public
Records of Dade County, Florida, described as fol-
lows:
BEGIN at a point on the North boundary line of the
said Lot "F" 208.5 feet East of the Northwest cor-
ner of said lot; thence run in a Southerly direction
parallel to the West line of said Lot "F" a distance
of 220 feet; thence in an Easterly direction paral-
lel to the North line of said Lot "F" a distance of
108.5 feet; thence in a Northerly direction parallel
to the West line of said Lot "F" a distanl2 of 220
feet, more or less, to a point on the North line of
said Lot "F ", which point is 108.5 feet East of the
Point of Beginning; thence Westerly along the North
line of said Lot "F" a distance of 108.5 feet to the
point of BEGINNING.
•
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 Mianii
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 Mianii 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 Address._ STARR W. HORTON N 950 Street N. E. 95th
Registered Architect and /or Engineer MANFRED M. UNGARQ
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision. SEE ATTACHED
Street and Number where work is to be done 950 N. E. 95th Street
State work to be done and purpose of building (by floors)
New Building Y .s Rerno ling
onry an
To be constructed of____t_r_alile Kind of foundation PQure
Estimated Total cost of improvements $ 30,000.00 Amount of
Zone cubage required 25,000 c u , f t .
Distance to next nearest building 20 feet
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 STARR W. HORTON, 950 N. R; 95th Street, Miami Shores , Florida
MIAMI SHORES VILLAGE
Owner - Builder
2 -story residence
Addition Repairs No. of Stories 2
Permit $
Plan Cubage 31,000 cu , ft,
Size of Building Lot 100' X 220'
The undersigned applicant for this building permit does hereby certify that he unders
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compile
and has complied with the provisions thereof, and will require similar compliance from
in the work to be performed under this permit; and will post or cause to be posted for i
or notices as are required by the Act. The undersigned agrees to employ only such su
permit, as are licensed by Miami Shores Village.
Remarks Waiver is sought on a frame (Signed).
second story with aluminum siding.
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 STARR W. HORTON
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 thai all facts
therein by him stated are true.
Permit No 1
Disapproved \\ nn a
(Signed) �,►. -
Buildir Inspector
Date 1- — L'Z
Chairman
Member
Member
Council Approved Date
Date
PLANNING BOARD DATE
/ /C..
boq
"Cil-44.4. J-
d
LEGAL DESCRIPTION
Roof Covering Tile
ds and accepts his obligations as an employer
neral Laws of Florida, Pennanent Supplement,
contractors or sub - contractors en ployed by him
spection on the site of the wo, s ` i ublic notice
actors, on work to be 'erf e. under this
to me well known,
owner - builder
Sworn to and Subsc 'bed before me.
Notary Public, State of Florida
My Commission Expires 3 - e--0" 4 / 7 to 6
June 26, 19 62
and for no other purpose.
Member
Member
Member
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.
/
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IT) ,13
1. ntet" 3411 .
N° 1403
Owner, Agent or Tenant of Building S t ^.rY
Lot See ti u ry e Block Subdivision
Street Address 95 tb
Approved use by occupancy
Remarks
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
3091 „ -3340
Cube - 29403 3091
1717 3340
T?.:. 31120
Tote]. T Velue m 15,560
Miami Shores Village, Florida, 1/1E/63
4 :,,ed:rooir i r 1
This Certificate of Occupancy is issued to the above named o`:'n E r
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, construction, alteration or remodeling of buildings or structures.
a
BUILDING DIVISION
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.
Date
Owner's Name and Addres /` J' 4 gaei—o,J
Registered Architect and /or Engineer
Name and address of licensed contractor___ _ /!°'�6 e'C _ 6 ? 1 ___ ` ? 90 C • ›—ydc orodd ‘`A 4149 gi
Location and legal description of lot to be built on:
Lot_____________ Block Subdivision_
Street and Number where work is to be done SZ N Q5 C-7 – State work to be done and purpose of building (by floors) _______(t " eibx F L `J Fe-At
2--f Tom,
— – - -- – and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering__________
Estimated Total cost of improvements $ _ ____Amount of Permit $
Zone cubage required_ _ flan 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 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 the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcoirs, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks_______ (Signed) _
STATE OF FLORIDA,
COUNTY OF DADE. j 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, 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. � l P
Permit No ` 5 Date � Read, Sworn to and Subscribed before me.
Disapproved I S, Date
( Signed)
Chairman
Member
Member
Council Approved
NOTE: A charge of $1.00 will be made for making
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLANN G BOARD DATE
Date
,19
No._ 9-S Street_4_ fs .s -
Notary Public, State of Florida
Building Inspector J My Commission Expires
Member
Member _
Member
Disapproved Date
corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper n )tice for inspection or faulty
,
,
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat. ) ___ ime
Type Insp'n
Permit No.
Name
Address
Company
Phone # � ) J S -
For Inspector: / ) )
Approved
Correction
Re- Insp'n Fee
o