PL-15-398 (5) � 3
sKo'tEs y,� Miami Shores Village xis f�tf�7"�eaUtt1�i1�= eSEl11t��
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10050 N.E.2nd Avenue NW
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Miami Shores, FL 33138-0000
Phone: (305)795-2204
�'ermit 5ta�s APPAGVE1
IrCOR'LI
�t5 Expiration: 11129I 15
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Project Address Parcel Number Applicant
166 NW 100 Terrace 1131010230280
Miami Shores, FL 33150- Block: Lot: ILEANA GODOY GONZALEZ
Owner Information Address Phone Cell
ILEANA GODOY GONZALEZ 166 NW 100 Terrace (786)390-9503
MIAMI SHORES FL 33150-
166 NW 100 Terrace
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone Valuation: $ 600.00
EDWARD ROJAS PLUMBING CORP (305)944-6788 F Total Sq Feet: p
Type of Work:REPLACE 4 FIXTURES ONLY.
PLUMBING W Available Inspections:
Type of Piping: Inspection Type:
Additional Info: 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-2-15-54576
DBPR Fee $2.25
DCA Fee $2.25 06/02/2015 Credit Card $ 109.10 $50.00
Education Surcharge $0.20 02/24/2015 Cash $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 ELEC ICAL, PLUMBING,MECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFI IT: I certify hat a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction a oning. Futhe I thorize the above-named contractor to do the work stated.
June 02, 2015
A orized Sig tures Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 02, 2015 1