PL-18-1109Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Perrnit NO. PL-4-18-1109
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
PermitStatus: APPROVED
Issue Date::5/22/2018
Expiration: 11/18/2018
Parcel Number
Applicant
10525 NE 2 Court
Miami Shores, FL
1122310130610
Block: Lot:
BENNY NEWBY
Owner Information
Address
Phone
Cell
BENNY NEWBY
10525 NE 2 Court
MIAMI SHORES FL 33138-
(305)336-0676
Contractor(s)
ESSIG POOLS INC
Phone
305-949-0000
Cell Phone
Valuation:
Total Sq Feet:
$ 1,500.00
0
Type of Work: PLUMBING FOR POOL AND HEATER
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$3.38
$2.25
$0.40
$225.00
$3.00
$1.60
$236.83
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-4-18-67313
04/26/2018 Check #: 302255 $ 50.00 $ 186.83
05/22/2018 Check #: 2306 $ 186.83 $ 0.00
Available Inspections:
Inspection Type:
Main Drain
Final
Rough
Review Plumbing
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 22, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
May 22, 2018
1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
XPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
Ord JOB ADDRESS: /OS a & C.7
City:
i Miami Shores County:
FBC 20a
Master Permit Noel 2 4 iW
Sub Permit No.
❑ REVISION
❑ CHANGE OF
CONTRACTOR
Miami Dade
❑ EXTENSION ❑RENEWAL
❑ CANCELLATION
❑SHOP
DRAWINGS
zip: 33/38
Folio/Parcel#: ✓l�1 G c.3)—O0-06/0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
OWNER: Name (Fee Simple TitleholdeJr):
Address: SOS &JL 2 V"
City: Miami s h OY`.S
Construction Type: Flood Zone:
l�Pan(v /U ecv Lcf
c-r
State: r-Z
-
BFE: FFE:
Phone#: 3O 33 - `'%
zip: 33 "13S
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ESSIG POOLS, INC
Address: 10111 BUSINESS DR
City: MIRAMAR State: FL
Qualifier Name: DANIEL ESSIG
Phone#: 305-949-0000
zip: 33025
Phone#:
State Certification or Registration #: CPC052505 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $
I °
Type of Work:
Description of Work:
Zip:
Square/Linear Footage of Work:
❑ Addition ❑ Alteration n New
V`44.i,k c,r e,,, \ 1}4,a-,.✓
,r
❑ Repair/Replace
❑ Demolition
Specify color of color thru;
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
tile:,
•
w•
Permit Fee$ J2r
Radon Fee $ !'1 • a5
Training/Education Fee $
CCF $
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ �� `�
Bondi^ng,C�oympany;s;Name'(if applicable)
Bonding Company'sAddress t
City. ,,i,t. 3 s`4{,, 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 compiiarice° with alPl
applicable laws regulating construction and zoning:
1
"WARNING TO OWNER: YOUR FAILURE TO RECORD A. NOTICE OF COMMENCEMENT MAY
RESULT IN YOOR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULTVJITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR. NOTICE OF COMMENCEMENT."
Notice to Applicant: I 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 7 , 20 1 , by
6 Prily uthy, who is personally known to
rod
me or who has puced as
identification and who did take an oath.
NOTARY ' • B IC:
ofiferi-' -*maw r
Jo, iriv-rASUMIPW
AfWv
rint:
Seal:
**********
**
APPROVED BY
Notary Public State of Florida
Estrella Gonlez
My Commission GG 162104
Expires 11/21/2021 "
7-10+1
*
Signature
The fore
oing instrument was a knowledged before me this
r' day of , p , 20 An , by
DANIEL ESSIG
, who is personally known to
me or who has produced PERSONALLY KNOWN as
identification and who did take an oath.
TARP Py�,�l
S'Aftimek
••• -ice
NO
Sig
Pr'
t:
eal:
1
6I�.
ip N.
Notary Public State of Florida
,F 'Estrella Gomez
g My Commission GG 182104
,j Expires 11/21/2021
****r********
Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)