PL-04-339Type Insp'n
Permit No. q
Name 'raeS-
Address IvF . t o 5
Company n-ew m0 CSI , )f$f
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee
AF f,-'30
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date la S
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date ` 0 S
Type Insp'n � i a
Permit No. �"s i O1 "
Name EY s1
Address 1 9 CY 5+
Company (WLa Cra 5rc tkor
Phone #
Inspection Date J e
Approved
Correction ❑
Re- Insp'n Fee ❑
1
Plumbing Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2004 -339
Printed: 12/8 /2004
Applicant: ERNEST
Owner: UPTHEGROVE
JOB ADDRESS: 38 NE 109
Contractor MIAMI SHORES PLUMBING
Local Phone: 305/751 -2446
Parcel # 1121360110370
UPTHEGROVE
ERNEST
ST
Legal Description: 36 52 41
Contractor's Address: 900 NW 144 ST
Permit Status: APPLIED Permit Expiration: 5/29/2005 Construction Value: $2,400.00
Work: REPLACE SANITARY LINES UNDER HOUSE EXTERIOR TO SEPTIC
Page 1 of 1
PB 52 -33 DUNNINGS MIAMI SHORES EXT NO M LOT 5
Fees:
FEE2004 -12315
FEE2004 -12316
FEE2004 -12317
FEE2004 -12319
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$190.00
$1.80
$0.60
$4.75
$197.15
Total Fees: $197.15
Total Receipts: $0.00
DEC 1 3 PAID
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
aECEIVE
40V 3 0 200&
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee S le Titleholder) f
reholder) / l 1 : k ge
Owner's Address �3 N V q
Cit ii9 r PO/ r St) 0 2Q4 State f Lam
Tenant/Lessee Name Phone #
l
Job Address (where the work is being done) a 0 �, � /61‘?
City Miami Shores Village County Miami-i -Dade Zip
Is Building Historically Designated YES NO 1/
Contractor's Company Name an ' / ,° mL /v
Contrac Address / q09 / q09 A.) /`/ I ��
city l`� IOII
Qualifier .179,1.5
State Certificate or Registration No. ef (-f1•/ e Certificate of Competency No.
Architect/Engineer's Name (if appli « ' le) Phone #
$ Value o1 Vork Ihmtbitre j § - Square Footage Of
it . n
Type of Vi ork ,� Addition Q on :New 0 Repair/RReplace : [] De olition
SAM 1A4ms NI
****************************F
Submittal Fee $ Permit Fee $ / �' CCF $ /" U" CO/CC LA TV -- -�
Notary $ _ Training/Education Fee $ Or 4 Technology Fee $
Scanning $ C Radon $/ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ # ■
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Plumbing
State
Zip
Permit No. F 104 33c4
Master Permit No.
hone #
Mechanical Roofing
Phone # e ` 4 l
Zip 12F
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