PL-15-2303 (3) Permit NO. PL-9-15-2303
,SNoars t, Miami Shores Village Permit Type:Plumbing-Residential
10050 N.E.2nd Avenue NW
Pen
� ' Work Classification:Repair
- Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
FLORLOp` 04/18/2016
Issue Date: 1012112015 Expiration:
Project Address Parcel Number Applicant
64 NW 99 Street 1131010330060
THOMAS TELESCO JR.
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
THOMAS TELESCO JR. 64 NW 99 Street (305)216-6161
MIAMI SHORES FL 33150-
64 NW 99 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone Valuation: $ 1,750.00
ELITE PLUMBING SEPTIC&SEWER 1 (305)224-4401 Total Sq Feet: 900
Type of Work:NEW ROUGH LAUNDRY ROOM AND RELOCATE Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:
Final
Bond Return
Review Plumbing
Classification:Residential Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-9-15-57035
DBPR Fee $3.38 09/10/2015 Check#: 11259 $50.00 $193.96
DCA Fee $3.38
Education Surcharge $0.40 10/21/2015 Check#: 1238 $ 193.96 $0.00
Permit Fee $225.00
Scanning Fee $9.00
Technology Fee $1.60
Tota I: $243.96
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above-named contractor to do the work stated.
�T _ October 21, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 21, 2015 1