MC-16-802 Permit NO. MC-3-16-$a2
s"oR us o,� Miami Shores Village Permit Type:Mechanical-Residential
10050 N.E.2nd Avenue NE Work Classification:Pool Heater
Miami Shores,FL 33138-0000 Penni'tPermit Status:APPROVED
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Phone: (305)795-2204
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Issue Date:5/12/2016 Expiration: 11/0812016
Project Address Parcel Number Applicant
1086 NE 96 Street 1132060143480
Miami Shores, FL Block: Lot: ANA ROJAS
Owner Information Address Phone Cell
ANA ROJAS 1086 NE 96 Street
MIAMI SHORES FL 33138-2552
Contractor(s) Phone Cell Phone Valuation: $ 3,500.00
ESSIG POOLS INC 305-949-0000
Total Sq Feet: 0
Tons: Available Inspections:
Additional Info: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 $2.40
Invoice# MC-3-16-59157
DBPR Fee $2.00
DCA Fee $2.00 05/12/2016 Check#:300578 $85.90 $50.00
Education Surcharge $0.80 03/25/2016 Check#:300467 $50.00 $0.00
Permit Fee $122.50
Scanning Fee $3.00
Technology Fee $3.20
Total: $135.90
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 and zoning. Futhermore,I authorize the above-named contractor to do the work stated.
May 12, 2016
Aut ignature / Contractor / Agent Date
Building Dem ��icant
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May 12, 2016 1
.'%.ZCEIVED
Miami Shores Village MA 25 016
Building Department BY:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Ll
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201 `+
BUILDING Master Permit No. `'l \ l�
PERMIT APPLICATION Sub Permit No-" j C-)a 02,-
F-]BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL
PLUMBING)(MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I.c)a(0 f co ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1132 CYLo OI 34EC D Is the Building Historically Designated:Yes NO
Occupancy Type: Load: /Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 4y--)C-1 R-4cD 5 Phone#: aC)�5 2-'Z-541
Address: 14:DB to NE c""::1 Q0 ST
City: M I cIrv-1 » �� State: �L- Zip: 33 13`2n,
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: ESSIG POOLS, INC Phone#: 305-949-0000
Address: 1800 NE 151 ST
City: NORTH MIAMI State: FL Zip: 331625
Qualifier Name: DANIEL ESSIG Phone#: 305-949-0000
State Certification or Registration#: CPC052505 Certificate of Competency#:
DESIGNER:Architect/Engineer: �� '�I=-- Nd_C21✓I� P-)c::[/vPhone#:
Address: �« S- � cry *-t,q I'1 W�`-'� City �f State: F-1— Zip: I 4-4-
Value of Work for this Permit:$ 3' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: POOL HEATER
Specify color o(f�colrorrtthru tile: c
Submittal Fee$ �v W Permit Fee$ 1 F$ 0 `-fC,\� CO/CC$
Scanning Fee$ 3• Radon Fee$ Q -Ck DBPR$ ^L ) Notary$
Technology Fee$ _23 ' Training/Education Fee$ (3 - Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS,TANKS,AIR CONDITIONERS, ETC.....
OWNER'S 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 and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature V"/"l
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OWNER or AGENT CO OR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
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I C day of F GIo_ 20 I �-P by :ZE> day of r,-- 1-1 20 l C by
AYE c. K-pi C:-' S who is personally known to DANIEL ESSIG who is personally known to
me or who.has produced as me or who has produced �(ORLE/���
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identification and who did take an V M.HFR'•., identification and who did take an oath. :� �I c0rt4,l7,s
''Vq�L�•,� : �eptefib``',I 0*0
NO Y PUBLIC: �` N NOTA PUBLIC: -1
ber F •F`''
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Sig # 0221OR Sign:
Pr' t: i �i,aa'+"a.'��� Print: OF FL��`\
Seal: ,STATEsO„`��� Seal:
*s************ss*****r*s****************s**********m********srs*********************************************
APPROVED BY QZ `Puns Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)