MC-16-2813 nM NO1 6=28
Leh y,� Miami Shores Village per"* J�w hanlar "�id,err�at
10050 N.E.2nd Avenue NE
. Itt oj*(Ia iSF Troia.=Po + i�M 3
Miami Shores,FL 33138-0000 Perr0'S! #U5:
y og Phone: (305)795 2204
p1� Expiration: 4/29/2017
Project Address Parcel Number Applicant
9730 NE 5 Avenue Road 1132060171470
Miami Shores, FL Block: Lot: JOHN MARIE PERIKLES
Owner Information Address Phone Cell
JOHN&MARIE PERIKLES 9730 NE 5 Avenue Road (786)236-0254
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone $ 3,500.00
Valuation:
ESSIG POOLS INC 305-949-0000
_.. ,,... .. Total Sq Feet: 1062
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:POOL HEATER
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40
Invoice# MC-10-16-61679
DBPR Fee $2.00 10/17/2016 Check#:300946 $50.00 $85.90
DCA Fee $2.00
Education Surcharge $0.80 10/31/2016 Check*301019 $85.90 $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 thveap the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. , ut r authorize the above-named contractor to do the work stated.
October 31,2016
Authori ed Signature:Owner / Applicant / Contra r / Agent Date
Building Department Copy
October 31,2016 1
Miami Shores Village acT 1 7 111
Building Department -__-
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 �..{J►_
INSPECTION LINE PHONE NUMBER:(305)762-4949
FRC 201Q
BUILDING Master Permit No. apP ((D
PERMIT APPLICATION Sub Permit No. M C I Co - 3
r-JBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-JPLUMBING Q MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores Countv: Miami Dade Zip:
Feiio/Parcei#J S 3 20(p - ®1-7 r l 4- -7 C) is the Building iiisioricaiiy Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): C1 ✓; PG&,- K I c-- -%c-- -% Phone#: 2-5 -C)ZS4-
Address;=7 ® NE- S h As (2-A= I
City:1 F 11 C4 YYl i ®Y C--.5 State. 47L Zip: Z-XS)1-56
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. Wn�VA-r-- MSV laC I/1 Gt(�Y7 ��1'l e t-T Phone#: 9Sl- 'al 5 3$Z5
Address:2Co5 - s- r-�-e ra N-i l-i wee City. Dcr-y(. (dStateY1 FL zip:33 44 l
Value of Work for this Permit:$ Squar%Linear Footage of Work: ( , U(a Z
Type of Work: E-1Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: POOL HEATER
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ •q O CO/CC$
Scanning Fee$ Radon Fee$ Z.• +, DBPR$ 2 •®� Notary
2 2 '
Technology Fee$ J• Training/Education Fee$ g® Double Fee$
Structural Reviews$ Bond$ Aer
TOTAL FEE NOW DUE$ fS .
(ReAsed02/24/2014) "�
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 !�
OWNER or AGENT CONTRA
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
f
p� Orth day of 5T 20 �P ,by 2 "day of `��L'� - 020 L P,by
"y IG �c+' CJ who is personally known to DANIEL ESSIG ,who is personally known to
me or who has produced as me or who has produced as
identification and who did take oath. 2A-.�—&&-identification and who did take an oa
NOT PUBLI � NOT RY PU C:
` l+ HERgj�!•
Sign oo°^ siO.N •% , Sig
11_:t._.':.+.-.�✓...�_:�.__.:=,_T_i��
Print: ®� " ��m°: Print: , Y°� ZRLENY M.HERNANDEZ
000my
a Se I• �- EXPIRES:September 2?,?017 !
$e I: o orf Q22108 o per` ";e uF nq' Bonded Thru Notary Public Uncle ers
%9'•°�¢i °ondad kW� •0'-' Gam`
�� •o,l�d�litUnda` • �ti��
APPROVED BY an aminer Zoning
Structural Review Clerk
(Revised02/24/2014)