BP-04-1134312.9 0)140)
MIAMI SHORES VILLAGE i�1
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BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Dater/2.5 /05
e Insp'n CI
Pe it No. i PO4 - 134
Name
Address (4O N. C.0 1 1 5 51—
Company r
Phone# C 3c36)9.84 - ar22
Inspection Date _i / 2 ' 1(.5
Approved
Correction
Re- Insp'n Fee