PL-18-2270 (2)`geoaes Miami Shores Village
10050 N.E. 2nd Avenue NE
r
Miami Shores, FL 33138-0000
Phone: (305)795-2204
FCORiDQ'
Permit NO. PL-8-18-2'270
Permit Type: Plumbing - Residential
Per
it
Work Classification: Gas
Permit Status: APPROVED
Issue Date: 8/30/2018 1 Expiration: 02/26/2019
Project Address Parcel Number Applicant
1199 NE 102 Street 1132050190010 ANELIA SHAHEED
Miami Shores, FL 33138-2649 Block: Lot:
Owner Information Address Phone Cell
NIHAR PATEL 1199 NE 102 Street (248)561-1523
MIAMI SHORES FL 33138-2649
1199 NE 102 Street
MIAMI SHORES FL 33138-2649
Contractor(s) Phone Cell Phone
SUNGAS SERIVCES COMPANY (305)635-8682
Type of Work: INSTALL GAS LINE AND TANK PER PLANS
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$175.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$185.83
Valuation: $ 1,200.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due I
Invoice # PL-8-18-68667
08/30/2018 Check #: 8182
08/23/2018 Check #: 3107
$ 135.83 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Press Test
Review Plumbing
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
constructio oning. thermore, I authorize the above -named contractor to do the work stated.
'9,1 evti G August 30, 2018
Owner
r / Agent
Building —Department Copy
August 30, 2018 1
q�gSU-Sq�-Zu&`3
Miami Shores Village RScE1VED
` Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
(� INSPECTION LIN PHONE NUMBER: (305) 762-4949
$ ��
�lr FBC 20/7
BUILDING Master Permit No.
ec 5 191245
��
PERMIT APPLICATION ZAG Sub Permit No. flu 13- 2-C-Po
F-IBUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
LP6. CONTRACTOR DRAWINGS
JOBADDRESS: Iyd nc/ :�M�
City:_ Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11,3205C 19--)01(D Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): k int'r, 1 Lt 1 ° 1%e II G %ft"CrPhone#: qg7 Ao S 2 I
Address: /4 qq A)C 100#q
City: M) CM i S nu S State: 110f) 10 Zip:
Tenant/Lessee Name: tiA Phone#: %-4 a10I `J a Ice
Email: _(�I I�(11;1 lase �P �Ia i'1.ccm
CONTRACTOR: Company Name: (SLnQCks S e ro C aS Phone#: 366— 05 - <?(V Z
Address: 2ch-D ULW ALl 5�_
City: In CM I State: floAc 1CG zip: 3 9l Lfa.
Qualifier Name:
ne#:
State Certification or Registration #: lJ Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
City:
Zip:
Value of Work for this Permit: $ If Z 60 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: _-b%tQJ 1 n015 hO r? CrY I IML Pee ,0fW Q7)r, n )e-0S PC' �" It ' 1 a 4 5
V
:fir 14Ile i )P�
Specify color of color thru tile:
Submittal Fee $ 15W Permit Fee $ 1 q
Scanning Fee $ Radon Fee $ Z • 0Q)
Technology Fee $
Structural Reviews $
Training/Education Fee $
CCF $
DBPR $ L • G3
CO/CC $
Notary
Double Fee $
Bond $ II
TOTAL FEE NOW DUE $ 1� —
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
/y day of ,0vCr0t l— , 20 by
h-J-X ,w -d , who is onally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: 1 O'2
Seal:70�
w�o1FNW." Public StM od
nieeBoolm, My Cmitin"m 30 408
~09
Signature
CONTRACTOR
The foregoing instrument was acknot, ledged before me this
day of 20 L by
.l Z-41!,! rr-L who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
r
Sign:
Print:
Notary PublState of Florida
Seal:ComMission NGG1090d1
4 w !Y My Comm, Expires Apr 18, 2022
lorded through National Notary Assn.
*************************************************************************
APPROVED BY Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)
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APPROVED BY DATE
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SUBJECT TO CCNIpUANCF \mTH ALL FEDERAL
STATE AND CCUM y RuL-=S AND REGULATIONS
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LEGEND
ABBREVIATIONS:
URTIT`011 DF ADTND42ATi09 J t9-IFUS
Survey Pros, Inc.
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8300 MILLS DRIVE SUITE 148, MIAMi, FL. 33183
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Tel: 106, 767.8802
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(N) - MEASURED
MOCK ,• MIAMI-DARE COUNTY RECORDS
PROPERTY ADDRESS:
MN ^ MAN HOLE
FIT,. MO\UV.ENT LINE110
NE 102NO STREET, VIAMI SI/ORES. Ft- U138
(P) - PIAt
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PC - POINT OF CURVATURE
PCP PERMANENT CONTROL POINT
PE POOL CQUIPMENT PAD
LEGAL DESCRIPTION:
PG ^ PAGE
LOT 1. OLOCK 175. Or REUSED PLAT OF MIAMI SHORES, SECTION S, ACCORDING TO
PI PQNV7 OF INTERSECTION
pL -PLANTER
THE PLAT iHEREOF, AS RECORDED IN PLAT BOOK 43, PACE 87, OF THE PUOIJC
t><III „PORT OF OECSANINO
HE CORDS OF MIAMI•.DADE COUNTY, FLORIDA.
oOC ^ PONT OF .COMMENCEMENT
PRC „ POINT Or REVERSE CURVAtURE
PAM a PERMANENT REFERENCE
MONUMENT
PT - POINT OF TAbNOCNCY
FLOOD ZONE INFORMATION:
11 ^ RADIUS DISTANCE
(R) •, RECORD
A/W RIGHT-OF-WAY
BASED •ON 111E TLOOD INSURANCE RATE MAP W 114E rEOERAL EMERGENCY
TIES RESIDENCE
MANACEMENT AGENCY REVISED ON 09/11/09 AND INDEX MAP REVISED QV
SIP - SIP 1.0/8023
09/11/09 THE GRAPHICALLY DEPICTED111JILDING(S) SHOWN ON THIS MAP Or
SND . SET NAIL k DISK LO/0923
SURVEY iS WITHIN ZONE X BASE FLOOD ELEVATION Dt/A COMMUNITY NAVE h
S1L .SURVEY TIE LINE
5" - SIDEWALK
NUMijER W uy Alta 5 j200D2 MAP it PANEL NUNUC1l 120806m SUER% L
(TVP) •• TYPICAL
SURVEYOR181`101M
Un ly Box
U.L.--UUTILITY EASEMENT
1. ELEVA110\S ma SHOWN REFER TO 1920 NATIONAL GEODETIC VERTICAL DATUM
W/r - W000 FENCE
(NGVD 1929).
2. NO ATTEMPT. N'AS VATIC 10 LOCATE roolmo5/rCuNDARONS. OR UNOERGROUNO
SYMBOLS:
UTILITIES UNLESS OAtERWSE NOTED.
THE SHOWN IIEREON HAK FACT OLEN ABSTRACTED IN REGARDS TO
M TELEPHONE RISER
3. LANDS
MATTERS OF INTEREST BY 01I1ER PARTIES, SUCH AS EASEMENTS, RIGHTS Or WAYS,
p CABLE TV RISER
RESERVATIONS, ETC, ONLY PLATTEb EASEMENTS ARE SHOWN.
II • WATER METER
4, Ti4S SURVEY WAS PTB;PARED FOR'AND CERTIFIED 10 111E PARTY(ICS) INDICATED
)< 0.00 •ELEVATION
HEREON AND IS NOT TRANSfERADLE OR ASSCNAOIF. WITHOUi WRITTEN CONSENT or
(BD) - ORIGINAL LOI DISMNCE
RRS FIRM. IES IS
THESURVEy AS ATED By TIC CTHIIS Fito
A ^CENTRAL ANGLE
EAL-CSTATENT TE iRIIS
FOR AHSACT ON OR MORTGAGE REFIw%cmG SURVEY IS S NOT
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10 HE USED FOR ANY OIVER PURPOSE Wt IIARIY(II.S) WITHOUT THE WRITTEN
wV
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AUIHORIZATIOV OF THIS FIRM.
8. ,,,IS SURVEY IS N01 IKIEWED rGR NEIIHLR OL9QV NOR COYSTRUCHOV
PURPOSES. FOR 114M PUHPOSES, A TOPOGRAPHIC SURVEY MAY Fit REQUIRED.CURB
IDNI CURB INLET
7. ALL BOUNDARY LIMIt rtNICATORS SET ARE SIAVPLD LO( 8073.
9. THE 'BOUNDARY L•MITS ESTADLISIICO QV THIS SURVEY ARE BASED ON 111E LEGAL
n FIR£ HYDRANT
DESCRIPTION PROYDCO BY 11ir. CUE141 OR ITS fILPRESENtA11VL
L
j 1 LIGHT POI F.
0, rENCE'.OWNERSHIP IS NOT DETERMINED.
T0. • ADDITIONS OR OEt.EIFONS 10 TNTS SURVEY MAP AND/OR REPORT BY SOVLDNE
CONSENT Of
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OTHER THAN THE SIGNING PARTr(ICS) IS PROHIBIiEO NITIOUT WRHiEN
a . CATCH BASIN
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THE SIGNING PARTY(IES)•
11• BEARINGS WHEN SHOWN ARE TO AN ASSUMED MERIDIAN AND BASED ON PLAT.
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CORETITLE LLC
NORTH AMERICAN 11IIt INSURANCE COMPANY
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ASPHALT CONCRETE. PAVERS H;.iS COVER
SURVEYOR'S CERTIFICATE_:
I Crj,!r 1 1 IIII$ SURVEY 15 TRUE. AND C04RECT
10 THE BEST .Or MY NNO'ALLOGE AND OCLICT AS
DATr aF /min MW;
T7/TB/17
IiCRED,
RL'CEtiTLY SURVEYED AND ORAWI, UNDER VY DIRECT104 AND MEETS TI,E VNIMUM IEC14MCAL STANDARDS SET
THE FLOR.DA STATE BOARD OF SURV:Yois AND MAPPERS •N CHAPTER 5�:_±7 1'L04.f7A ADVIV151RAtIVE
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FORTH BY
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ORIGINAL SIGNATURE AND
NICOL,AS UEL. VENTO
RAISED SFAL OF TIfF
PRCFESSIONAI. SURVEYOR & MAPPER
AI ILSIING RLCISiEREO
STATL: OF ILOTiIDA UC, 9 6945
SURWYOR AND !ANIiIER
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Florida Department of Agriculture and Consumer Services
Division of Consumer Services
2005 Apalachee Pat'icway
Tallahassee, Florida 32399-6500
Master Qualifier Mailing Address
JOSE A. IZAGUIRRE
SUNGAS SERVICES COMPANY
2950 NW 24TH ST
MIAMI, FL 33142-7008
Certificate Number
09726
Licensed Location Address
SUNGAS SERVICES COMPANY
11710 WILES RD
CORAL SPRINGS, FL 33076-2159
License Number
13545
This Master Qualifier Certificate is issued pursuant to Chapter 527, Florida Statutes. This certificate
is valid only for the person and licensed holder listed. Any changes to the Master. Qualifier status
(such as transfer or termination of employment) must be reported to the Bureau.of Compliance
at (850) 921-1600 immediately.
The Master Qualifier Certificate is valid only through the date noted on the Certificate. A notice of
renewal will be sent to you in advance of your expiration date. A Master Qualifier Certificate may be
renewed if certification of a minimum of 16 (sixteen) hours continuing education is provided along with
the renewal form. If training cannot be documented, an examination must be taken.
If there are any errors on the certificate, please submit all changesin writing to:
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
2005 Apalachee Flarkway
Tallahassee, Florida 32399-6500
Cut Here
t ,
State of Florida
41
Department of Agriculture an4,.Donsumer Services
Division of Consumer Services Certificate No: 09726
e f Bureau of Compliance Exam Date: October 28,1983
(850) 921-1600 Wsue Date, 13,2017
Expiation Date: February 12, 2020
Tallahassee, Florida Exam: 0601
MASTER QUALIFIER CERTIFICATE
This Certificate is issued under authority of Section 527.02, Florida Statutes, to:
JOSE A. IZAGUIRRE
Valid for
License Number: 13545
SUNGAS SERVICES COMPANY ADAM H. P
UTNAM
11710 WILES RD COMMISSIONER OF AGRICULTURE
CORAL SPRINGS, FL 33076-2159
Florida Department of Agriculture and Consumer Services
P.O. Box 6700
Tallahassee, Florida 32399-6700
License Number: 13545
Business Mailing Address Licensed Location Address
SUNGAS SERVICES COMPANY SUNGAS SERVICES COMPANY
29M NW 24TH ST 11710 WILES RD
MIAMI, FL 33142-7008 CORAL SPRINGS, FL 33076-2159
Thn liquefied aetm-leli n gag licenses at the hnttcxn rA thip form is valid ONLY frN the CO-uany located at the address
on the license. Each business location of a company must be licensed. All LP Gas licenses must be renewed
annually. Any license allowed to expire shall become inoperative because of failure to renew. The fee for
restoration of a license is equal to the original license fee and must be paid before the licensee may resume
operations.
IN THE EVENT OF AN OWNERSHIP CHANGE AT THIS F-.USINESS LOCATION: This license may be
transferred to any person, firm or corporation for the remainder of the current license year upon written request to
the department by the original license holder. License transfers must be approved by the depart-- 'Ail licensing
requirements must be met by the transferee and a transfer fee of $50 will apply. To apply for a transfer, contact the
Bureau of LP Gas Inspections at (850) 921-1600.
Pursuant to Chapter 527, Florida Statutes, LP Gas licensees must present proa�f of licensure to any consumer,
owner, or and user upon request when engaged in the business of servicing, testing, repairing, maintaining or
Installing LP Gas systems and/or equipment.For future changes
and/or yourrllicennssed I cation a resslease ske and rrnetu the UPPER PORneeded co-rections TION Jth corrections our to ss mailing address
POST LICENSE
CONSPICUOUSLY
Florida Department of Agriculture and Consumer Services
P.O. BOX 6700
Tallahasc-se, Florida 32399-6700
Cut Here
State of Florida
Department of Agriculture and Consumer Services
k�
Division yof Sonsumer Services License Number: 13545
Bureau of Liqud ied Petrolqum Gas -Inspection �rDate: August 018�of bar 1
17
(850) 921-0600 License Fee: $426.00
Tallahassee, Florida Typp and class: 0601
Liquefied Petroleum Gas License
CATEGORY I LP GAS DEALER
GOOD FOR 014E LOCATION ONLY
ANY CHANGE OF OWNERSHIP OR SALE OFA HLID I BUSINESS RENDERS THIS LICENSE
This license Is issued under authority of Section 627.02, Florida Statutes, to:
SUNGAS SERVICES COMPANY
11710 WILES RD COMMISSIONER OF AGRICULTURE
CORAL SPRINGS, FL 33076-21.69
B
�R Y INSURANCE CERTIFICATE OF LIABILITY
�+,
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPO ANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsernen s .
PRODUCER BiIlle Tucker
,lamerson McLean Corporation "II E •80039"M FA't g07�58 8508
P.O. Box 621149 IL bUli mcleaninsurance com
825 Executive Drive INSURIR(S)AFFDROINGCOVERAGE
INSURED
Sungas Corporation of Florida
Sungas Services Company, Grill N Propene
2950 N.W. 24th Street
OCVIAEAM MIIaaRFR•
GOVERAGEa vrr%r.rr.^--..v.nw. —
POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
THIS IS TO CERTIFY THAT THE
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
INDICATED. NOTWITHSTANDING
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR D B POLICY EFF POLICY EXP LIMBS"
IMMODWYM
LTR TYPE OF INSURANCE —NUMBER
DOO
GENERAL LIABILITY OCCURRENCE a IA
DAMAGE TO RENTED s<1
A X COMMERCIAL GENERAL LIABILITY
508.890537--2 0910=7 09J03i1Q18 MED E XP M ono 5 0
CLAIMS4AADE XC� OCCUR
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GENERAL AGGREGATE 2 O00 OOO
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GEN•L AGGR TE LIMIT APPLIES PER:
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52W016.4
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AND EMPLOYERS! LIABILITY yI
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ZM8182715
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E.L. DISEASE - POLICY LIMIT
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEISCLES (Attach ACORD IM, AddM*nal RwnWa 8dredule Ir more epau a rewind)
LP Gas State Contractor 013545
Village of Miami Shores
Building Department
10050 NE 2nd Avenue
Miami Shores. FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRE3MATIVE
'100P*1*-0did J► wownwhooft
01988.2010 ACORD CORPORATION. All rights reserved.
ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD
To: Page 8 of 9 2018-08-23 16:43:59 (GMT) 18668155763 From: The Permit Professionals / Danto El
115 S. Andrews Ave., Rm, A-100, Ft, Lauderdale, FL 33301-1895 — 9.54-831-4000
VALID OCTOBER 1, 2017 THROUGH SEPTE.MBE.R 30, 2018
�s
{'A Receipt #:1 s 9 - 412 2
x DBA: ALL OTHER TXPZS CONTRAC R
Business Name: SUNCAs SERVICES COMPANY Business Type:
l Owner Name: josE IZAGUIRRE Gm Business Opened, 04./2"2/1.959
Business Location: 11.710 WILES RD State/County/Cert/Reg:13545
CORAL SPRINGS Exemption Code:
Business Phone: 954-752-8885
P Roams Seats Employees Machines. Professionals.
s 2 l
For Vending Business Only
Number of Machines: Vending Type:
Tax Amount
Transfer Fee
NSF Fee
Penalty
Prior Years
Collection Cost
Total Paid
27.00
0.0.0
7.00
t
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A'TAX RECEIPT This tax is levied for the privilege.of doing business within Broward County and is
non -regulatory in nature. You must meet all County andfor Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. Thisreceipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
DOSE IZAGUIRRE GM Receipt #10B.-16-00002036
j!j1Q WILES RD Paid 07/13/2017 27.00
CORAL SPRINGS, FL 33076
2017 - 2018