REV-16-3378 Miami Shores Tillage CF,
�s Building Department ®EC zi 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 .
Tel:(305)795-2204 Fax:(305)756-8972--'---'
- —� � INSPECTION LINE PHO 2-494
$5n FBC 201ti
BUILDING Qst
er Per it No. ►� Pte— i®-- I - Z�1 I
PERMIT APPLICATI sub Permit No:Re\j I(jo d 3:9-1 V
FE-1131.111-DING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF F-1 CANCELLATION ❑ SHOP
1 //`` CONTRACTOR DRAWINGS
JOB ADDRESS: 9 7 3C N F � Hy C jr-- P— ,L-j-
City Miami Shores County Miami Dade Zip: �� 1
Folio/Parcei#: 1 13 2— ®U, ® I -7 1 4- - is the Building Historicaiiy Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):J-1 G d ' C-- Phone#: Z 3(`�2 4
Address: '1 -7 ?S e--'::) t—J E: S In,,v
City: i a ,e,i S1�Gl J e----,., State F Zip: 13
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: ESSIG POOLS, INC Phone#: 305-949-0000
Address: 1800 NE 151 ST
City: NORTH MIAMI state: FL Zip: 331625
Qualifier Name: DANIEL ESSIG Phone#: 305-949-0000
State Certification or Registration#: CPC052505 Certificate of Competency#:
DESIGNER:Architect/Engineer: ���+�'^� 1�1�'" �` 0�' 6r--'—y--)c—fPhone#: '1 8 15 3� Z�
II ff ,Qcc�rF,�l�
Address: �. -c�C►�ot rnG �xNa� Cty: t��Gr a� State: ' — Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ Zt CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ I U °
(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 G L
OWNERorAGENT CO CTOR
The forego! g instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
—day of �R'20 ` by �� gday of a!20 L ,by
who is personally known to DANIEL ESSIG ,who is personally known to
me or who has produced as me or who has produced as
identi cation and who did take a ath. identifi tion and who did take th. `o%iiW►114111I01t10
N Y PUB NOT Y PU LIC: ����`��y•i gS ONNq
_ \
Sign Sign: �"
Pri t: Prin
pita �;t
p��v�A.4EA"J.4N^ Z o,
Se I: r= rr!.OMMiSS!Oy�f=r Seal• J
a EXPIRES:September 27.2,,17
yet rc.
jd ayd' Bonded Tin No"Public undeiwtiter,
V /d�
APPROVED BY Plans Examiner Zoning
/ v Structural Review Clerk
(Revised02/24/2014)