366 NE 93 STMIAMI SHORES VILLAGE
BUILDING DEPARTMENT t`b'
305- 795 -2204 Q'�
Building Inspection Request
Date / __ Time
Type Insp' n � 1
Permit No. /J 0 3 - / Y 3 /
Name
Address 6 g e q3 sT •
Company
Phone # "365.— t ' r
For Inspector: //'' Name & Date
Approved
Correction
Re- Insp'n Fee ❑