PL-19-710Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 05/02/2019
Parcel Number
500 NE 96TH ST, Miami Shores, FL 33138 1132060140700
Contacts
Perm NO.: PL -04-19-71 0
Permit Type: Plumbing - Residential
Work Classification' Pool - Private
Permit Staters: Approved
Expiration: 10/29/2019
CAROLINA HENAO Owner ESSIG POOLS INC =Contractor
500 NE 96 DANIEL ESSIG
10111 Business DR, MIRAMAR, FL 33025
Business: 3059490000
Description: NEW SWIMMING POOL AND HEATER Valuation: $ 1,500.00 Ins ecti-4 Requests:
F%
30,5-762-444949
Total Sq Feet: 628.00 11 1
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 # 3009
05/02/2019 $112.35
Check # 2870
04/02/2019 $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 t at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating cory�tru ion and oning. Futhermore, I authorize the above named contractor to do the work stated.
�� �
/ Applicant / Contractor / Agent
May 02, 2019
Page 2 of 2
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
Miami Shores Village APR 02 1019
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 l
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305);762-4949
FBC 20� ►Q� �'(�
Master Permit No, EQ
Sub Permit No.
ROOFING ❑ REVISION ❑ EXTENSION ❑'RENEWAL
PLUMBING F-1MECHANICAL ❑PUBLIC WORKS E]CHANGE OF ❑ CANCELLATION ❑'SHOP
1�z _ CONTRACTOR DRAWINGS
JOB ADDRESS:
Folio/Parcel#:. Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee S
Address: v M
city: 11 1 �L-4 ( Y
Tenant/Lessee Name:
Email:
n
CONTRACTOR: Company Name: ESSIG POOLS, INC Phone#: 305-949-0000
Address: 10111 BUSINESS DR
City: MIRAMAR State: FL Zip: 33025
Qualifier Name: DANIEL ESSIG Phone#: _
State Certification or Registration M. CPC052505 Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#: _
Address: City: State:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair /eplace
Description of Work: Ail � 10.6 oun 1 ; +�LoCh+6
Specify color of color thru tile:.
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Rev1sed02/24/2014)
Zip:
Demolition
Permit Fee $ CCF $ 1 CO/CC $
Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $
Bond $ r� 2
TOTAL FEE NOW DUE $ f G_ 3
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
Zi
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 'FI NIANCING, 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 ap� �fd and a reinspection fee will be charged.
Signa
ER or AGENT
The foregoing instrument was acknowledged before me this
� day of _ iyt� rG�^ 20 111 by
A who is -personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: ,,`,�HN1IC'0i
Print: h
Print: (�•vr
Seal: - Co�. PUBLIC - -;
:REG # GG 157200 ; m = Seal: = PUBLIC =
- s ION : r n : : REG # GG 157200: z
v : MY COMMISSION = : v : MY COM
MISSION ; r
EXPIRES r = EXPIRES
**xa*xax:**:kxe**x:x<x<:k*x:x:#xa*:k�ex: '�Kx:»1�iFfl! � Nom•,.
�'�� ��xO.`` xa x:x: x::lax:ekx:ol:+kx::kx:xex:8ex:ok+k:k:k ek ek 8:+k:k:k xc x::k8:x:8a>k:k:k xa�el:N�a�e7kl�y��,'yk�pi � �
i '9 .. •' .'`Z� *�i�+Y �7qa xa ek Xa �e xe x::k
APPROVED BY ' ' ••�F•F�
OF •• 6.••. O ``�
F�
a
Plans Examiner
Zoning
Structural Review
Clerk
(Revised02/24/2014)
Signature
CONTRA
The foregoing instrument was acknowledged before me this
"71 day of )ho -,&(\ 20 /1 by
DANIEL ESSIG who is personally known to
me or who has produced PERSONALLY KNOWN
as
identification and who did take an oath.