PL-17-211 (3)REsy, Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
FLORtDp
Permit No. PL-1-17-211
Permit Type: Plumbing - Residential
Per
' Work Classification: Addition/Alteration
Permrf Status: APPRO'�ED
Issue Date:2/1012017 1 Expiration:08/09/2017
Project Address Parcel Number Applicant
515 GRAND CONCOURSE 1132060171340
GREGORY PALMER
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
GREGORY PALMER 5F1L GRAND CONCOUSR (305)220-7663
Contractor(s) Phone Cell Phone
PSG PLUMBING SERVICES, INC (305)796-7304
Type of Work: NEW BATHROOM AS PER APPROVED PLANS
Type of Piping:
Additional Info: NEW BATHROOM AS PER APPROVED PLANS
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Amount
CCF
$4.80
DBPR Fee
$4.35
DCA Fee
$4.35
Education Surcharge
$1.60
Permit Fee
$290.00
Scanning Fee
$9.00
Technology Fee
$6.40
Total:
$320.50
Valuation: $ 7,300.00
Total Sq Feet: 300
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-1-17-62737
02/10/2017 Check #: 2815 $ 270.50 $ 50.00
01/26/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Underground
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.
February 10, 2017
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
ry 10, 2017 1