262 NE 97 St4 J
Date i� Time
Type Insp'n Fd �����
Permit No.
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Address r2 r� /� e 92 S f
Company
Phone # .3 °'('
For Inspector: o / Name & to
Approved t/&
Correction ❑ ���
Re- Insp'n Fee ❑