FW-13-2141 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INS P-199635 Permit Number: FW-9-13-2141
Scheduled Inspection Date: October 22,2013 Permit Type: Fence/Wall
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: OSTROWSKI, NICHOLAS Work Classification: Wood Fence
Job Address:185 NE 107 Street
Miami Shores, FL 33161-7031
Phone Number
Parcel Number 1121360070320
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
5'TALL WOOD FENCE ON THE EAST SIDE OF THE Infractio Passed Comments
HOUSE INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 21,2013 For Inspections please call: (305)762-4949 Page 17 of 42
Miami I� a Shores Village
age
Building Department SEP 2 3 2013
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
I �6 Tel: (305)795.2204 Fax: (305)756.8972 BY
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.a ) l,_3 — 21111
Permit Type: BUILDING ROOFING
JOB ADDRESS: 155 p 1 0_7
City: Miami Shores County: Miami Dade Zip: .'2j I
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Sim le Titleholder): M� � ��"' Phone#: ';0'5 -742—^
Address: 0 E3 (P 7+�
City: 1"`c(�:kw�^ s State:
Tenant/Lessee Name: A Phone#:
Email:
CONTRACTOR:Company Name: mc— Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ � 0 b Squ /Linear Footage of Work: �7
Type of Work: ❑Addition ❑Alterration ew ORep ir/Replace ODemolitioln
Descri tion ® ��tl � � �`
Color thru tile:
Submittal Fee$ C)r\ Permit Fee$ CCF$ CO/CC$
_� 12 6D
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
Bonding Company's Name(if applicable)
Bonding Company's Address ..
City State zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will qot be a proved and a reins ecti n fee will be charged.
r
Signature V Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20 ,by Al f &I .Kfl Qkf W U(Al-�la day of ,20_,by ,
who is personally known to me or who has produced El t/C• who is personally known to me or who has produced
X 3 WX 6As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: , 13l yes% NOTARY PUBLIC:
Sign: =b: Ss. �+:: - Sign.
Print: s '.,��1�� _,��1�� Print:
My Commission Expires: ',� 9 S�,�� O�\��� My Commission Expires:
APPROVED BY Plans Examiner zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Miami Shores Village
u + ig Department
r 610
10050'N.E.2nd.Avenue
Miami Shores Florida 33138
Tel: (305) 795.2204
Fax: (305)758.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: DATE•
ADDRESS:
Do hereby peiittori the village,of Miami Shores to ac#aq my own contractor pursuant to tine taws of the State of Florida,F.S 489.103(7).
And I have read and understood the,foltowing disctosn re stafement wchich e01i11"r , to work as my own contractor;I further
understand that I as the owner must appear In person to complete all applications.
State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The
exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must
supervise the construction yourself.You may build or improve a one-farm'ly or two-famfly residence.You may also build or improve a
commercial building at a cost of$251000.40 or iess(The new form states-75,000).The building,must be for your own use and
occupancy.It may hot Wbulft for orlesse.if yowsell or le e a building yod have built yourself within ortieym— after the
construction is cditefe Maw wiiltp Wine thatryolr IJUIt for sale of 1e86e;which is'a i iblatlon W illhWeiteft#on.You may not hire
an unlicensed person as a contractor.it is your responsibility to make sure the people employed by you have licenses required by state
law and by county or municipal licensing ordinances.Any parson working on your building who is not licensed must work under your
supervision and must be employed by you,which means that you must deduct F.I.CA and with-holdings tax and provide workers'
compensation for that employee att`as prescribed bylaw.Your t onstnrctioir must complywith all applicable laws;ordlnsncus,
buildings codes and zoning regulations.
Please read and inhial each paragraph.
1. 1 understand that state law requires construction to be done by a licensed contractor and hove-applied for an owner-builder
permit under an exemption from the law.The exemption spsift that I,as the owner of the property listed,may act as my own
contractor with certain restrictions even though I do not have a license.
2. t understand that building permits are not required to be signed by s property owner unless he or she Is responsible for the
construc�lioq end k nqt hiring a licensed contractor to assume responsibUity.
tnih
3. 1 understand that,as an owner builder,I am the respo�slbte party of record on a permlt I understand that I may protect myself
from potential tTnenclal risk by hiring a licensed contractor and having the permit filed In hk or her name Instead of my own
name I.also understand that the contractor is required by law to be licensed In Florida and to W his or nsec numbers on
and
permits contracts.
InRW_/ V,
4. 1 understand that I may build or Improve a one himily or two-family residence or a farm outbuilding.I may also bgHd or improve
a commercial building If the costs do not exsaad$75,000.The building or residcinoe must tie for my use or occupancy.it may
not be Wit or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself Is sold or leased within 1 year after the construction Is complete,the law will presume that 1 built or substantially
Improved it for sale or lease,which violates the exemption. tnitiev V:
5. 1 understand that as the owner-builder,I must provide direct,onske supervision of the construction, �
Initial2 `/-11
6. 1 un demstand that I may not hire an unlicensed person to act as my contractor or to supefte persons working on my building or
residence.It Is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance.
Initial
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that
ermneddsiy i that the property owner is providing his or her own labor and materials.I,as an ovmer4xAderr m be field
liable and subjected to serious financial risk for any Injuries sustained by an unlicensed person or he or erri +hOe ti
working'on my property.My homeowner's insurance may not provide coverage for those Injuries.I am wiflfu0y aCdrig as an
owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial� `°
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to
s perform the work bel.ng-done.Any person working on my buikting who is not.licesrsed must work under my direct supervision
and must be empl8yed by me,which"ft that I mist comp) ib laws`Alq'r ug the withholding of federal income tax and
social sec urky contributions under the Federal Insurer=Contributions Act(FICA)and must provide workers compensation for
the employee.I understand that my failure to follow these may suWact to serious financW risk.
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable
Jews and*ukemant ft-govern owns%builders-as well as employers.I also understand that'#*
Conskuctibh mustcorrrply wfth an epplcable laws,ordinanoes,-building codts, Wand zonlr�regulations. �`
10. 1 understand that I may obtain more Information regarding my obligations as an employer from the Internal Revenue Service,the
Uniled States Small Business Administration,and the Florida Department of Revenues.I also understand that l may contact the
Florida Construction Industry Licensing Board at 850.487.1395 or ft www.mvftWolicense--CQn dbnrloro/ci1 A d
Initial. 'O, Cf°
11. 1 ern aware of,and consent to,an owner-builder building permit app led for in my name and understands that I am the party
+ally and finanda0y,responsible for the proposed construction activity at the fo0owirtg address:
Initial �` c✓
12: 1 agree to notily Miami Shores Village immediately of arty additions,deketbrs,or changes to any of the lnfo on that I
have provided bn the disclosure.
in
Licensed contractor are regulated by laws designed to protect the public.H you contract with a person who does not have a
license,the Constriluction Industry Uc ensing Board and Department of Business and Protessional Regulation may be unable to
assist you with any financial loss that you sustain as a result of Mlisctor may be in civil court It le also krip"d for you to
understand that,if an unlicensed contractor or employee of-an individual or flnm Is Injured while working 6n your property,you may
be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor;you will be responsible for
verifying Whether the contractor Is properly licensed and the status of the contractor's workers compensation coverage.
Babe a building permit can be issued,this disclosure statement must be completed anti signed by the properly owner and
retumed to the Wed permittieg agency responslble for wring the permtt.A copy of the property owniei'driv er Odense,the
nom signature of the property owner,or other type of*Ration acceptable to the local pemtitOng'agency Is required when
the permit is issued.
Was
acknowledged befog me this day of 22��20
� I ; I/
ey 1 y who was personally known to me or who has
Produced there License or F C 7 identlffcadon.
)Ar
i
OWNER ,
`t uu�ssiwu+o� ,
�I1�Od ti�Y10� Z
. 96021901€0 :'
'jai
Property Search - Report Page 1 of 2
t� MIAMI-DADE COUNTY
(f OFFICE OF THE PROPERTY APPRAISER
PROPERTY SEARCH SUMMARY REPORT
Carlos Lopez-Cantera
Property Appraiser
Property Information:
Folio 11-2136-007-0320 \
Property Address 185 NE 107 ST �
Owner Name(s) NICHOLAS P OSTROWSKI ,£
Mailing Address 185 NE 107 ST
MIAMI FL "•',
33161 -
Primary Zone 1000 SGL FAMILY-2101-2300 SQ °
Use Code 0001 RESIDENTIAL-SINGLE FAMILY
Beds/Baths/Half 3/2/0
Floors 1
Living Units 1
Adj.Sq.Footage 1,467 N
Lot Size 9,300 SQ FT r
Year Built 1940
Full Legal Description 36 52 41 PB 42-33
DUNNINGS MIAMI SHORES EXT NO 3 a Aerial Photography 2012
LOT 16 BLK 209 N-
LOT SIZE 75.000 X 124
OR 15414-650 0292 4 Taxable Value Information:
Assessment Information: Current Previous Previous 2
Current Previous Previous 2 Year 2013 2012 2011
Year 2013 2012 2011
Exemption/ Exemption/ Exemption/
Land Value $88,004 $75,848 $84,275 Taxable Taxable Taxable
Building Value $99,911 $111,949 $111,954 County $0/$187,915 $0/$187,797 $0/$196,229
Market Value $187,915 $187,797 $196,229 School Board $0/$187,915 $0/$187,797 $0/$196,229
Assessed Value 1 $187,9151 $187,7971 $196,229 City $0/$187,915 $0/$187,797 $0/$196,229
Benefits Information: Regional $0/$187,915 $0/$187,797 $0/$196,229
Current Previous Previous 2
Sale Information:
Benefit Type 2013 2012 2011
Date Amount OR Book-Page Qualification Code
11/2011 $215,000 27914-0331 Sales qualified as a result of
examination of the deed
7/2011 $100 27774-4299 Transaction involving affiliated
parties(family,corporate,
business,landlord-tenant).
2/1992 $0 00000-0000 Sales which are disqualified as a
result of examination of the deed
1/1987 $75,000 13165-3441 Sales which are qualified
Disclaimer:
The Office of the Property Appraiser and Miami-Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information
and GIS positional accuracy.No warranties,expressed or implied,are provided for data and the positional or thematic accuracy of the data herein,its use,or its
interpretation.Although this website is periodically updated,this information may not reflect the data currently on file at Miami-Dade County's systems of record.The
Property Appraiser and Miami-Dade County assumes no liability either for any errors,omissions,or inaccuracies in the information provided regardless of the cause
of such or for any decision made,action taken,or action not taken by the user in reliance upon any information provided herein.See Miami-Dade County full
disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp.
Property information inquiries,comments,and suggestions email:pawebmail @miamidade.gov
GIS inquiries,comments,and suggestions email:gis @miamidade.gov Generated on:Mon Sep 23 2013
http://gisweb.miamidade.gov/PropertySearch/printMap.htm 9/23/2013
`SNORES Gil
Miami Shores Village
Building Department Bo ., ��_= 11111M
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 �FNr �y�
Tel: (305) 795.2204 �IORiDA
Fax: (305) 756.8972
September 24, 2013
Permit No: FW13-2141
Building Critique Review
PROVIDE DETAIL AND SPECIFICATION FOR THE WOOD FENCE.
Ismael Naranjo
Building Official
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
SNORES Gil
Miami shores Village
Building Department logo , 1 11111M
10050 N.E.2nd Avenue L� y�
Miami Shores, Florida 33138 Tee 1 y0
Tel: (305) 795.2204 FLORIDA
Fax: (305) 756.8972
September 24, 2013
Permit No: FW 13-2141
Planning Critique
Please provide detail to show that the following conditions have been met.
(7) On corner plots.
b. On all other corner plots, walls and fences in the following areas shall be
ornamental metal, ornamental masonry or picket fence as defined in Section
518(b). Any wire fence is specifically prohibited.
1 . In any front yard or side yard the property line of which borders a side
right-of-way other than an alley, including the margining thereof.
Definition of Picket fence as referred to above: Picket fences of wood, composite
board or composite material may be permitted in the front yard provided the
pickets are two inches to four inches in width with a spacing between pickets of
not less than one inch and not more than two inches.
David Daquisto
305-762-4864
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
PROPERTY ADDRESS: 185 NE 107th STREET, MIAMI SHORES, FLORIDA 33161
LEGAL DESCRIPTION: LOT 16, BLOCK 209, OF"DUNNING'S MIAMI SHORES EXTENSION NO. 3", EXISTING WALL TO
ACCORDING TO THE IA THEREOF,AS RECORDED IN PLAT BOOK 42, AT PAGE 33, OF THE REMAIN
PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. P.R.M.AS,
WALL ASPHALT ASPHALT (PEl PIAT* RECORD SURVEY 9'-4"
020' CL PAVEMENT 15' WIDE ALLEY PAVEMENT F.I.P. Up SCALE I"= 20'
'-UP
OF _T0E OF WALL,/
I CONC. N 89-46-47"W 75 0' 0,05, ENCR. FIRE
0.1w
CL -40.00! C>
lb,
rr OE
WIRE FENCE rt
Cc
EXISTING CONCRETE /m/
FENCE WALL TO CID
REMAIN /z/
CL
ul
cc
CONC. LOT 16,
BLOCK 209
0
ur uj
HYD
C)
4"x4" PRESSURE
-
cy)
Nil AC WALL C'4 TREATED POST
V)
0.20' Bal V) AND FOOTING a.
LLH STEPS Lu z 0
�4 ui SEE DETAILS .;r
ci 35.,V — > BELOW
Q
<
w 6
jk
2t
00
170
ALIGN
RESIDENCE all a
#185 (L 4'-6' 3'-4-cV
ON
PL 0.33' F.I.P.
I PARTIAL PLAN
37' oil, UJI
:PORCIR.".1, 10,
wi (PC) Z NEW PICKET FENCE LAYOUT
CONC, 1&6' ;�up Y8. 1-0.
nil
--40,00'
z 0
F.I.P.
01" (PC)_ 4ROPOSED LOCATION FOR NEW PICKET FENCE.
-4
F.I.P. NOTES:
SIDEWALK N 89* '32"W 75.00 1.THE 40'-0"SET BACK FROM THE CENTERLINE 01 NE 2ND AVENUE
e4, TO THE PROPERTY LINE SHALL BE MAINTAINED.THE OUTSIDE
(FINISHED)FACE OF THE NORTH-SOUTH PORTION OF THE NEW 1"x4" PRESSURE
PICKET FENCE WILL NOT ENCROACH ON THE PROPERTY LINE.
2'THE OUTSIDE(FINISHED)FACE THE EAST-WEST PORTION OF THE TREATED PICKETS
yr NEW PICKET FENCE WILL FACE SOUTH AND ALIGN WITH THE SOUTH FIXED TO RAILS WITH
FACE OF THE EXISTING BUILDING. 2 No. CORROSION
0 ce PARKWAY i z 3.NE 107TH STREET DOES NOT INTERSECT WITH NE 2ND AVENUE RESISTANT FASTENERS
a. THUS ENDS IN A CUL-DE-SAC. PER CONNECTION. 2"
MAXIMUM SPACING
BETWEEN PICKETS.
(TYPICAL)
ASPHALT PAVEMENT END OF
NE 107th STREET PAVEMENT
(75' TOTAL R/W) 2" x 4" HORIZONTAL
PRESSURE TREATED
DATE OF FIELD WOR�__jj,:_�FOR: U RAILS FIXED TO ICHOIAS P. OWSKI >< POSTS WITH 2 No.
ROS R. VAZQUEZ, ESO. 0 CORROSION RESISTANT
0 REPUBUC NATIONAL TITLE FASTENERS PER
LEGAL NOTES 2URANCE COMPANY __j CONNECTION.
TN**IS SURVEY DOES N 9
I TM BE MADE TO DMRM4't* RECORDED MICHIGAN MUTUAL INC., (TYPICAL)
EXAMNIA11C)N OF THE _01`,�v a4 uj
C-)
,45TRUMENTS, IF ANY, W. CT TO DEDICATONS &/OR ASSIGNS
Tto,%S OR MWT5;pb FM.I OE fmp
R�SPRtCTI S. R SE
lAh 4' x 4" PRESSURE
PRO&DED By CIIENT. TREATED POST
04DERGRIOLIND ENCR I A&L O. SHOWN F RM PAS NOT TiEMPT ED P-.LS,M 5105
_CCATE FCOTMG 00/1 0 ROVE 14T ftfiL RE N thl I OVITHOUT llf S�CFIAIUK Ahl) rff. DRONk EMBEDDED 2'-0"
StOwk BEARINGS 0 DEEP IN CONCRETE
E REFERRED TO AN A'S U w SEAL 4 A FLOROA uVASED 3URVIYOR M0 RDER NO. 11-0344
R.:-' To IN.G.V13, op 9,mr-, nr-r-)-r il��R f
/ANI�AAB FOOTING. POST
SPACING SHALL NOT
ARC ss whOw-0MOVIC pi, �"OKA OR PLA"c k-R*Los. Sill. 40.1�pt."
V PA PROPERTY iO4 0".
yy& I (R) RECORDED OWIEM�ON. 0.C�P EXCEED 5'
9 Xw N'T 11 OATOM
Ali: P Al,L;wa==4 r WAY, — A T's. 0,01 To Al k4m.
A vm%"'AM walm 114:Z.
VFEW�,4%EW
's, C L OR t.COMA A s
m., VO OR III �% X_j (TYPICAL)
Sr aLOC. FENCE ELEV -[krWiall E uwf WnhAwt rum,or OVEww uti.sy�i,INU, %Ikim. &W" RES AESWNCE Sri slcq�'
= - - I Awo� fl N. O&A NAND. Poe POINT or WOINIvW, WA PANU, �'.w SIDE
"NO. p
BU .KNC�MAR, [WING=- I%. L ftwAI&LE O/s 0"su PON OF ComuructIAN, A L 6 RMSTER-0 LAND tik!`401
9 ,
OF OEAINNO� CONC -G.'CRETE F 0 FOUND OR MEASURED 04ENSt N D'R'B. ECm UWA,P At POIL Of RMASC CURVE, s RWYOR
Nt V
eA 's P P A v PERMANENT KFMNCERP- W-us ro.Ni UE LIMITY XAV-W 10"0 x 2'-0"
f.F.E.-FING...qEu f Cc 4 AS PLAT WOK
CURVE, IN E P.C.. POINI O.P CURVATURE MID UMENt R R. -PAL ROA0,. ij P po'z
CAUMIAM,OurNsi Vc .pROKM C Upk 9,1*. P4471 Of IVAY rI%Irl DEEP
DRANAGE f:V.�.==A,P,E C 3 ;iOx, - Po.,of umPoAc,PRO ow vTY, I: C"
CATOR SA&N.
Nis -CORO"eLxg SIR Lew CCa CONCRETE FOOTING.
,Ecwff,. C)vkvt PON,04'TANUNCY S swTH west.
casw 00ACRETE aM,(WAU,D,M E MAIRAOIE A, rh FOLho w PVmf PAVEMENT WCONDS, Wid!)FENCE
PWy W M .**TEA Ai EP Li (TYPICAL)
A CENTRAL.ANCU "WENINCE EASEMENT FEET yv-v"� wow FENCE PAR—WAY sf:cmq *WV WATER vAiVE
PROPOSED ELE)'AnON X000 E"1:14.'ELEVATION A X -ciI4JN LINK FENCE. C 6 S WALL OE PIEA"Vila POINT
7
4" TYP.
L.
2 MAX. SPACING BETWEEN PICKETS x
1"x4" PRESSURE TREATED PICKETS
'c" FIXED TO RAILS WITH 2 No.
CORROSION RESISTANT FASTENERS
PER CONNECTION. (TYPICAL)
al
LAJ
LLJ
L.) ---
X
LLJ
2"x4" HORIZONTAL PRESSURE
TREATED RAILS FIXED TO POSTS
WITH 2 No. CORROSION
RESISTANT FASTENERS PER
CONNECTION. (TYPICAL)
LLJ
X
4'x4" PRESSURE TREATED POST in'
EMBEDDED IN 10'0 x 2'-0'
— — — — — — CONCRETE FILLED HOLE. DETAIL SECTION THROUGH
/ PICKET FENCE
X/
IP 1-0.
X", DETAIL ELEVATION PICKET FENCE
X2.
_J_
mot►♦58 R9S L
Eggs Miami shores Village
Building Department
ZORIDA 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
—�1 ( 2-7 ao I �
PERMIT#: � � �GI f✓
4 � DATE.
Contractor
;Owner
o Architect
Picked u 2 sets of plans an
p p d (other)
Address: f q CT NE f®`7-611 ST,
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by: IXIIA c
PERMIT CLERK I
RESUBMITTED DATE:
PERMIT CLERK INITI