PL-15-2879 (2) Miami Shores Village
10050 N.E.2nd Avenue NE ' EEy+;€ "
E
••I Miami Shores,FL 33138-0000
Phone: (305)795-2204rat
a
Expiration: 05/15/2016
Project Address Parcel Number Applicant
280 NE 91 Street 1132060190410
NATIONAL CAPITAL ENTERPRI:
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
NATIONAL CAPITAL ENTERPRISES 9500 N MIAMI Avenue
- MIAMI SHORES FL 33138-
9500 N MIAMI Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 3,500.00
G WHITAKER INC (954)658-9119
�... �. N....._�a_�... Total Sq Feet: 00
Type of Work:INSTALL LAUNDRY AND KITCHEN PLUMBIN Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
Top Out
Bond Retum: Final
Classification:Residential Scanning:3 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# PL-11-15-57762
DBPR Fee $3.38 11/13/2015 Check#:1583 $50.00 $197.16
DCA Fee $3.38
Education Surcharge $0.80 11/17/2015 Check*1585 $197.16 $0.00
Permit Fee $225.00
Scanning Fee $9.00
Technology Fee $3.20
Total: $247.16
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 an Fut I au rite the above-named contractor to do the work stated.
November 17,2015
Autho Signature. er / Applica / Contractor / Agent Date
Building Departm t Cop
November 17,2015 1