MC-16-1174 XI
Miami Shores Village B *Cfth;lri G
10050 N.E.2nd Avenue NE �b � 1Attl�
a
Miami Shores,FL 33138-0000 ir \
Phone: (305)795-2204 "` dit
PeZORL ' a
Expiration: 11/21/2016
Project Address Parcel Number Applicant
9942 NE 4 Avenue Road 1132060171220
WARREN WILSON
Miami Shores, FL Block: Lot:
Owner Information Address Phone Celt
WARREN WILSON 9942 NE 4 AVE RD
MIAMI SHORES FL 33138-2480
Contractor(s) Phone Cell Phone Valuation: $ 850.00
BELOW ZERO A/C INC (561)300-3103
Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:MECHANICAL FOR BATHROOM REMODELING. Inspection Type:
Classification:Residential
Final
Approved:In Review Rough Duct
Comments: Date Approved::In Review Review Mechanical
Date Denied: Type of Work: Underground �JE
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# MC-4-16-59606
$2.25 05/25/2016 Check#:4069 $164.10 $0.00
DCA Fee $2.25
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.60
Total: $164.10
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 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 a z ning. Futhermorr ,I auth iz the Bove-named contractor to do the work stated.
wall".,,, 17 . ���,� May 25, 2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 25,2016 1