Application for Plan Review — Richard Brown, Street Permit 2005-090762 (2005)

MIAMI-DADE COUNTY BUILDING DEPARTMENT 1100 S.W. 2nd St., Miami, FL 33130-2171 C 2006026478 APPLICATION FOR PLAN REVIEW *** PLEASE FILL OUT THIS FORM *** *** USE BLUE OR BLACK INK *** *** DO NOT USE PENCIL *** Street Address: 2085 Okeechobee City: Miami State: FL Zip Code: 33135 Owner's Name: Richard Spade Owner's Address: 2085 Okeechobee City: Miami State: FL Zip Code: 33135 Owner's Phone: 305-604-2672 Qualifier's Name: J.D. Kuhn Qualifier's Address: 3200 SW 22nd Ave City: Miami State: FL Zip Code: 33145 Qualifier's Phone: 305-854-1656 Residential Single Family or Duplex [x] Commercial [ ] Application is being made for the purpose of: [x] New Construction [ ] Addition [ ] Alteration Is this a revision to a permit issued by the Building Inspector? Yes [ ] No [x] If Yes, give permit number: In this is revision to a permit issued by the Building Inspector, give permit number: Is this a revision to a permit issued by the Building Inspector? Yes [ ] No [x] If Yes, give permit number: [ ] Building [ ] Plumbing [x] Electrical [ ] Mechanical [ ] Fire [ ] Public Works [ ] Swimming Pool (For South Florida Building Code Persons Only) Date: May 20, 2005 Signature: Richard Spade Print Name: Richard Spade Title: Owner STATE OF FLORIDA, COUNTY OF MIAMI-DADE Sworn to and subscribed before me this 20th day of May, 2005. (SEA) Alex Rodriguez Personally known or Produced Identification Type of Identification Date: May 20, 2005 Signature: Richard Spade Print Name: Richard Spade Title: Owner STATE OF FLORIDA, COUNTY OF MIAMI-DADE Sworn to and subscribed before me this 20th day of May, 2005. (SEA) Alex Rodriguez Personally known or Produced Identification Type of Identification 27