1096 NE 97 St (6)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date V - Time A i r
Type Insp'n , - r/�i�.�-. s„-? , ye i9 p d r
Permit No. _1):(2___/22
Name /) /& V 44.
Address __ 1e.> 4t C? 5 7
Company r .✓
Phone # <- � � S ._ � , ��- )11
For Inspector:
Approved
Correction
Re- Insp'n Fee
Name & Dat
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
PERMIT N2 5754
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot BI.
Description
Address of
Building permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil 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 rev° d
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 's
p ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances
regulations pertaining to the work covered hereby whether shown on the plans or in the statements or specifications and b tt ne assttr spcy-
sibility for work done by his agents, servants or employees.
Signed. By
INSPECT0
IR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance withrallerdinances Inc' egulativs
pertaining thereto and in strict conformity with the _plans, drawings, statements or specifications submitted to the proper authorities of Miami Shor ..
In accepting this permit I assume, responsibility for all work done by either myself, my agent, servant or employee.
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of ,
Project
DATE
Contractor's
License No.
Amt. of
Permit
4 % 7
CONTRACTOR OR BUILDER � BY AUTHORIT'i
M
t