REV-16-2901 X� Miami Shores Village
Building Department BY.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
v INSPECTION LINE PHONE NUMBER:(305)762-4949 5
FBC 20 1(1
BUILDING Master Permit No. BPP-3-16-799
PERMIT APPLICATION Sub Permit No. Pty ((0'Zg0
BUILDING ❑ ELECTRIC ❑ ROOFING ❑■ REVISION EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1086 NE 96 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-014-3480 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):ANA ROJAS Phone#:
Address: 1086 NE 96 ST
City: MIAMI SHORES State: FL Zip: 33138
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: 33162
Qualifier Name: DANIEL ESSIG Phone#:
State Certification or Registration#: CPC052505 Certificate of Competency#:
DESIGNER:Architect/Engineer: PFEIFFER ENGINEERING Phone#: 786-235-2435
$765 SW 206 LANE City: CUTLER BAY State: FL Zip: 33189
Address,.
„Value r"ki or this Permit:$ 0 Square/Linear Footage of Work:
'ypnq b'f Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace ❑ Demolition
REVISE POOL WALL AND FLOOR THICKNESS (STRUCTURAL)
Description,of Work.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ � CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ 0 Bond$
op
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.
i
Signature 4 Signature
OWNER or AGENT C TRA
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2-4- day of 20 ) (-,-- , by 2-1 day of 0f--T'�Lo1=r 20 1 ( , by
who is personally known to DANIEL ESSIG who is persona+( known'`to
me or who has produced -- as me or who has produced as
identification and who did take a oat `t���tyt�►i��pN��� identification and who did takeho ,�� oW-E`�St .jCR1 ENy ��ArNO Y PUB 10
C: t ��=°•O•• � f/iT RY PUBLIC: �,•'r��pMAI�,~'s-
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Sign: �'o "� : i
a \`•we . - •fit
Print: �'' '• t I •
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Seal: '•��•:;• R_..+��\`mSeal. "'A sE0F
(� Gs
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
6�
(Revised02/24/2014)