PL-19-1595Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 07/25/2019
Parcel Number
10816 NW 2ND AVE, Miami Shores, FL 33168 1121360020160
Contacts
Permit NO.: PL-07-19-1595
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: Approved
Expiration: 01/21/2020
FLOYD MARTINEZ Owner
10816 2 AVE, MIAMI SHORES, FL 33168
Other: 2023094959
ESSIG POOLS INC Contractor
DANIEL ESSIG
10111 Business DR, MIRAMAR, FL 33025
Business: 3059490000
Inspection Description: PLUMBING FOR NEW SWIMMING POOL & DECK Valuation: $ 1,500.00 Inspection Requests: 4949
TotalSq Feet: 0.00
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 # 3121
07/11/2019 $50.00
Check # 3140
07/25/2019 $112.35
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 ce ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating co ru tion and J\ z ing. Futherm e, I aut orize the above named contractor to do the work stated.
7 �2-1 l C7
Authorized ign ture: Owne / Applicant / Contractor / Agent Date
July 25, 2019 Page 2 of 2
- 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: (30S) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
1.5
FBC 20 Master Permit No.��— 0 %— I1
1
Sub Permit No. L. o-7 -) t I I Sr
❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑SHOP
CONTRACTOR DRAWINGS
�
JOB ADDRESS: O O` W N w /7 6s �
Folio/Parcel#:1 i
Occupancy Type: (2 C
OWNER: Name -(Fee Simple Titleholder):
Address: W
City: Q�
Tenant/Lessee Name:
Email:
1.� Is the Building. Historically Designated: Yes NO
Construction Type: Flood Zone: BFE: FFE:
�ZAou d o►.� �e,2, Phone#: (Jv Z L)()l
JS State: VL Zip: 1
Phone#:
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 #: CPC052505 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: -City: State Zip:
Value of Work for this Permit: 1 boo Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration Dg.New ❑ Repair
/Replace Demolition
Description of Work: ` t—N-
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 112 • 3 S
(Rev1sed02/24/2014)
r
Bonding Company's. Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
City State 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 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
--z
OWNERorAGENT
The foregoing instrument was acknowledged before � this
day of_wl lJl.� 20 by
��� Is personally known to
me or who has producedV?,,'�c.7 11743Ak`\-� as
identification and who did take an oath
Signature
/ CONTR
The foregoing instrument was acknowledged before a this
. n day of 20 _ by
DANIEL ESSIG who is personally known to
me or who has produced PERSONALLY KNOWN
as
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Si
Print: Print:
Seal: Y v� , KAREN RODRIGn".
�►R B`.
;�: Notary Public State o��jir vu •.; KAREN RODRIGUEZ
,af Commission # GG 3'= Notary Public State of Florida
'� M Comm. Expires Feo Commission x GG 304504
ovrti:: Y����'
**� **y * *** I Dl�tYdh�ltu #':iAt •'.For N My Comm. Expires Feb 21, 2023
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:*sk�l�bYi�'cat#ir"bt��fM9�1°dlWtl�aRnycY��
APPROVED BY �•��' Zy� Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)