PL-19-1475Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Dais-07/03/29 9
Location Address Parcel Number
270 GRAND CONC, Miami Shores, FL 33138 1132060136210
:ontacts
Permit NO.: PL-06-19-1475
Permit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: Approved
Expiration: 12/23/2019
JODIE BLUM Owner WALTER PLUMBING CORP Contractor
270 GRAND CONC, MIAMI SHORES, FL 33138 WALTER GUTIERREZ
Home: 4154125469 4054 SW 113 AVE, MIAMI, FL 33165
Business:3059707116 WALTERPLUMBING@BELLSOUTH.NET
Other:7862342816
Description: replace gas line from tank to range Valuation: $ 1,800.00 Inspection Requests:
7i2-4949
Total Sq Feet: 4,120.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
06/26/2019 $50.00
Credit Card
07/03/2019 $61.10
Amount Due:
$0.00
Building Department Copy
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.
OWNPTS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regul ng construcftl4nd z Fut ermore, I authorize the above named contractor to do the work stated.
Autholized Signature: Owner / Applicant / Contractor / Agent Date
July , 2019 Page 2 of 2