PL-10-2966 £MT
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Miami Shores Village # ��Iglu i�i1�
10050 N.E.2nd Avenue NE " ' '
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Miami Shores,FL 33138-0000 _
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a Phone: (305)79522049 .
` Expiration: 07123/2017
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Project Address Parcel Number Applicant
428 NE 91 Street 1132060190060 RAYMOND CARABOTTA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
RAYMOND CARABOTTA 3466 N MIAMI AVE
MIAMI FL 33127
Contractor(s) Phone Cell Phone Valuation: $ 500.00
MG PLUMBING&SPRINKLER SERVI( (305)525-9236 Total Sq Feet: 0
Type of Work:CODE VIOLATIONS CORRECTIONS ONLY RE Available Inspections:
Type of Piping: Inspection Type:
Additional Info:CODE VIOLATIONS CORRECTIONS ONLY RE Top Out
Bond Return: Final
Classification:Residential Scanning:1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# PL-10-16-61851
DBPR Fee $2.25
DCA Fee $2.25 01/24/2017 Credit Card $ 109.10 $50.00
Education Surcharge $0.20 10/31/2016 Credit Card $50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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.
January 24,2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 24,2017 1