PL-15-2408 OEM
#
saO s a,� Miami Shores Village � ip id
�n 10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204 ��
Expiration: 04811/2016
Project Address Parcel Number Applicant
1201 NE 101 Street 1132060171470
Miami Shores, FL 33138-2608 Block: Lot: MICHAEL JOSPEH NUNZIATA
Owner Information Address Phone Cell
MICHAEL JOSPEH NUNZIATA 1201 NE 101 Street (352)682-8303
MIAMI SHORES FL 33138-
1201 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 4,500.00
INTEGRITY PLUMBING CORP (954)472-5767
Total Sq Feet: 0
Type of Work:NEW ADDITION&NEW PLUMBING. 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 $3.00
DBPR Fee Invoice# PL-9-15-57168
$3.38 10/14/2015 Check#:298 $242.76 $0.00
DCA Fee $3.38
Education Surcharge $1.00
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $4.00
Total: $242.76
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 ELECTRIC , LUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFF AVIT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructio nd i Futhermore,I authorize the above-named contractor to do the work stated.
October 14, 2015
or 1 ature- er / Applicant / Contractor / Agent Date
Building Department Copy
October 14,2015 1