RC-15-816 Miami Shores Village _ j F \ Pit T ttttt�
` 10050 N.E.2nd Avenue NE v
- Miami Shores,FL 33138-0000
Phone: (305)795-2204MR '
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1 Expiration: 10/20/2015
Project Address Parcel Number Applicant
171 NE 102 Street 1132060131840
Miami Shores, FL 33138- Block: Lot: STEPHEN C MUMBYJTRS
Owner Information Address Phone Cell
L!TEPHEN C MUMBY JTRS 171 NE 102 Street (646)246-3448
MIAMI SHORES FL 33155-
Contractor(s) Phone Cell Phone
Valuation: $ 20,275.00
INDIVIDUAL (954)678-7580
Total Sq Feet: 00
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved: : In Review
Final PE Certification
Date Denied:
Window Door Attachment
Type of Construction:KITCHEN CABINET REPLACEMENT Occupancy:Single Family Framing
Stories: 1 Exterior: Insulation
Front Setback: Rear Setback: Drywall Screw
Left Setback: Right Setback: Fill Cells Columns
Bedrooms:3 Bathrooms:2 Window and Door Buck
Plans Submitted:Yes Certificate Status: Review Planning
Certificate Date: Additional Info: Review Electrical
Review Electrical
Bond Return: Classification:Residential Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt DueReview Plumbing
CCF $12.60 Review Building
DBPR Fee $9.12 Invoice# RC-4-15-55132 Review Building
DCA Fee $9 12 04/09/2015 Credit Card $50.00 $622.09 Review Structural
Education Surcharge $4.20 04/23/2015 Credit Card $622.09 $0.00 Review Mechanical
Permit Fee $608.25
Scanning Fee $12.00
Technology Fee $16.80 72
Total: $6 .09
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 sume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRIC PLUMBING,MECHANICAL,WINDOWS, DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: certify)thtall t e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin Futher , I horize the above-named contractor to do the work stated.
April 23, 2015
Authorized S nature:0y6ner / Applicant / Contractor / Agent Date
Building Depa` opy
April 23, 2015 1