MC-15-1089 Q A;y� vy(6y�
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10050 N.E.2nd Avenue NE
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Miami Shores,FL 33138-0000 of '
tm Phone: (305)795-2204 ' 1lSlRK
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Expiration: 11/28/2015
tsi Date:�/1/ t P�
Project Address Parcel Number Applicant
290 NE 98 Street 1132060134150
Giselle Kovac
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
Giselle Kovac 290 NE 98 street 828 230-5395
Miami Shores FL 33138
Contractor(s) Phone Cell Phone Valuation: $ 300.00
HAVANA AIR CONDITIONING, INC (305)558-9136
_.._........,. _. ... ...._..m .... ....._ ._ _... ... ._ ,,... __ ._..... •,. Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:ELECTRICAL POOL HEATER Inspection Type:
Classification:Residential
Final
Approved:In Review Review Mechanical
Comments: Date Approved::In Review
Date Denied: Type of Work:
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# MC-5-15-55466
DBPR Fee $2.00 06/01/2015 Check#:12796 $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 05/07/2015 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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:rKcertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning uthermor ,.I uthorize the above-named contr?ctor to do the work stated.
June 01, 2015
Authorized Sig ature:Owner / Applicant / Co ctor / Agent Date
Building Department Copy
June 01,2015 1