1177 NE 100 St (6)D
Type Insp'n
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bµilding Inspection Request
Time
51
Permit No. B P
I �
Name P �
Address )171 1 0 0 .4 -
Company (S")kI`i'sQ-k/
Phone # 3 O� - 7
For Inspectoj j 2 6- 3-- gName & Date