MC-14-833Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-220330
Permit Number: MC -4-14-833
Scheduled Inspection Date: September 29, 2014
Inspector: Perez, JanPierre
Owner:
Job Address: 271 NE 95 Street
Miami Shores, FL
Project: <NONE>
Contractor: ESSIG POOLS INC
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: Pool Heater
Phone Number (704)408-0784
Parcel Number 1132060133950
Phone: 305-949-0000
Building Department Comments
POOL HEATER
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
13)PP-
-31
September 26, 2014
For Inspections please call: (305)762-4949
Page 21 of 29
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: MECHANICAL
JOB ADDRESS: 1 M
FBC 20
Permit No. MC 4/ —4 SE 3•
Master Permit No./5/7)% (^ S3/
City: Miami Shores County: Miami Dade
Folio/Pa1
rcel#: 1 " az =PG loi - 3' - . .
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): 14\/4=+i "'1t1=51 M'`S., Phone#: / ICAO .4-O7a4-
Address %% y K1r
Zip: %.
City: tdeApneviii moi)4=-1- , State: TY—
Tenant/Lessee Name: Phone#:
Zip:
Email:
I ' IIS
CONTRACTOR: Company Name:. ‘.-212;14.1 �--�— / t✓711C-
Addr / 11
Ci
CF -:0104 �ij 1 l State:
ty:
Phone#:�
ty:
Qualifier Name: L. 21 •• ,, �.-0.. l�
y—
State Certification or Registration #: er�. Certificate of Competency #:
Q
Zip: Z
Phone#:
Contact
411'1 ail Address:yl
DESIGNER: Architect/Engineer: 1p/ '•7
Phone#:
Value of Work for this Permit: $ V V Square/Linear Footage of Work:
dew ORepair/Replace
Type of Work: OAddres OAltcration
Description of Work:
ODemolition
********************************* *
********, ***************************
Submittal Fee $ Permit Fee $ V / ' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ `�
Boning 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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 b appro 'd and a reinspection fee will be charged.
Signature
The fore
day of
Owner or Agent
oing intrument was acknowledged before me this The foregoing instrui was acknowledged before me this
�► t , 20 /by WALTER DE WEERDT day o , 20 14; by DANIEL ESSIG
who is personally known to me or who has produced
�— \�\\aN1u11N ti
As identificatiROVEtAtt 49jce an oath.
\ �.• GpMM18si ..1(.7� ,
* l e,‘) cc' y"..1%.1;
NOT RY ' UBLIC:
Sig
Pri t.
My Co
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o
PA 02 o �
///ii / TATE aaoi``�*!
**************************************
APPROVED BY
who is personally known to me or who has produced
as identification and who did take an oath.
NOT . r • PUB IC:
Sign:
Print:
My Co
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*F FLOWA°
Structural Review
(Revised 3/12/2012)(Revised 07/10107)(Revised 06/10/2009)(Revised 3/15/09)
Clerk