PL-19-3Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
70 NE 99TH ST, Miami Shores, FL 33138 1132060131050
Contacts
Permit No.: PL -al -19-3
Permit Type: PkmWng - Residential
Work ClassiJhcccrb'on: Pool - Private
Permit Status: Approved
Expiration: 07/15/2019
Description: PLUMBING FOR POOL AND HEATER Valuation: $ 1,500.00 Inspection Requests:-
; 762-449
Total Sq Feet: 342.00
Fees
JAY YAGODA Owner
70 NE 99 ST, MIAMI SHORES, FL 33138
Other: 3056577859
ESSIG POOLS INC Contractor
DANIEL ESSIG
10111 Business DR, MIRAMAR, FL 33025
Business: 3059490000
$50.00
CCF
$1.20
Description: PLUMBING FOR POOL AND HEATER Valuation: $ 1,500.00 Inspection Requests:-
; 762-449
Total Sq Feet: 342.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Plumbing - Pool - Residential
$100.00
Scanning Fee
$3.00
Technology Fee
$3.75
Total:
$162.35
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$162.35
Check # 2806
01/16/2019 $112.35
Check # 2732
01/02/2019 $50.00
Amount Due:
$0.00
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
regulati Aconstrue 'on a oning. Futhermore, I authorize the above named contractor to do the work stated.
h �
Owner /
Contractor / Agent
Date
January 16, 2019 Page 2 of 2
0
Miami Shores Village
RF-CEIVED
Building Department JAN 022019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305):762-4949 0
FBC 201 1�
BUILDING IViaster Permit No. v I
PERMIT APPLICATION Sub Permit No. —
BUILDING ❑ ELECTRIC ❑•ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
OP/LUMBING [] MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION 0: SHOP
'' \\ CONTRACTOR DRAWINGS
JOB ADDRESS: :7-0N S
City: Miami Shores County' Miami Dade Zip: 330;
Folio/Parcel#: 1 �� (' O (� �� SO Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �u-%A �-'54 ^ Phone#: 3bS "hyo ' 333 I
Address: E 01,1
City: --4- S State: r Zip: 33 (3 P
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ESSIG POOLS, INC
Address: 10111 BUSINESS DR
City: MIRAMAR
Qualifier Name: DANIEL ESSIG
State Certification or Registration M CPC052505
DESIGNER: Architect/Engineer:
Add
FL
ne#: 305-949-0000
Zip: 33025
Certificate of Competency #: _
Phone#:
State:
Value of Work for this Permit: $ 70 V Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New
` _ ❑ Repair/Replace
Description of Work: g2tc V.,\ `.
Specify color of color thru tile:
Submittal Fee $,
Scanning Fee $ .
Technology Fee $.
Structural Reviews $
(Rev1sed02/24/2014)
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
0-3
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 NOTICE0F 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
—94�O NE or AGENT
The foregoing instrument was acknowledged before me this
day of 20 � J by
�41 �'i a r ,'t", who is -personally (mown to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Signature v
CONTRACT
The foregoing instrument was acknowledged before me this
-- day of �C�.�,.\-c i —,20.. ) t by
DANIEL ESSIG who is personally known to
me or who has produced PERSONALLY KNOWN
as
identification and who did take an oath.
k+k
•'11111111► -_.....b
(Revised02/24/2014) Structural Review
Clerk