PL-18-2034LT
T
y'c['pR DA
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-7-18-2034
Per
Permit Type: Plumbing - Residential
m' work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 8/21/2018 1 Expiration: 02/17/2019
rrotec[ Aaaress Parcel Number Applicant
1450 NE 103 Street 1132050310040
Miami Shores, FL 33138-2626 Block: Lot: PETRA MIROVA
Owner Information Address Phone Cell
PETRA MIROVA 6538 COLLINS Avenue
MIAMI BEACH FL 33141-
6538 COLLINS Avenue
MIAMI BEACH FL 33141-
Contractor(s) Phone Cell Phone
ESSIG POOLS INC 305-949-0000
Type of Work: RE PLUMB POOL EQUIPMENT
Type of Piping:
Additional Info: RE PLUMB POOL EQUIPMENT
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$175.00
Scanning Fee
$9.00
Technology Fee
$1.60
Total:
$191.83
Valuation: $ 1,500.00
Total Sq Feet: 648
Pay Date Pay Type Annt Paid Amt Due
Invoice # PL-7-18-68384
07/31/2018 Credit Card $ 50.00 $ 141.83
08/21/2018 Check #: 2484 $ 141.83 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Underground
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 wi the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibO It for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, M HAN'CAL' WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAV71 I certify that all t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo in Futti[more, a orize the above -named contractor to do the work stated.
August 21, 2018
/ Applicant / Contractor / Agent
Building Department Copy.
1
Miami Shores Village RECEIVED
Building Department JUL 31 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 (�.�1
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BC 201-4
BUILDING Master Permit No. a Y-L IQ — 1<�Dci
PERMIT APPLICATION Sub Permit No. Ir—' I I2"3 u
❑BUILDING' ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: IySD N[- �p2> S;MEE`i
City: Miami Shores County: Miami Dade Zip: 33� 38
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): P�Ii2a M I ROVA Phone#: � . �3-j• Q'ooB
Address: H iM N ' tol smcr--r
City: H IAM I �OQrs State: FL zip: 3313t3
Tenant/Lessee Name: Phone#:
Email: PCMACER MIAMI MIRA C-0"
CONTRACTOR: Company Name:
ESSIG POOLS, INC Phone#: 305-949-0000
Address: 10111 BUSINESS DR
City: MIRAMAR State: FL
Qualifier Name: DANIEL ESSIG Phone#:
State Certification or Registration #. CPC052505 Certificate of Competency #: _
33025
DESIGNER: Architect/Engineer: Phone#:
Address: City: i State: Zip:
n
Value of Work for this Permit: $ 1yz) - 6 o Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Permit Fee $ ) '5- CCF $ CO/CC $
Radon Fee $ 2 IbO DBPR $ 2 - ---1 Notary
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding 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 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 Signature v
OWNER or AGENT ���?CONTRACTO
The foregoing instrumeemot was acknowledged before me this
i day of 20 by
0.- N`/6z who is personally known to
me or who has produced JQ— )9(l as
identification and who did take an oath.
NOTARY PUBLIC:
Q�>, , (
Seal: �.•��••' Notary Pr:blic - State of Florida
''C• My Comm. Expires Oct 16, 2018
Commission N FF 135660
Boned Through National Notary Assn.
***********
APPROVED BY
The foregoing instrument was acknowledged before me this
da of i() 20 �J by
DANIEL ESSIG o is personally known to
me or who has produced PERSONALLY KNOWN as
identification and who did take an oath.
NOTARY PUBLIC:
CI YA-C
Seal:
�p , Notary Public State of Florida
Estrella Gomez
1s• My Commission GG 1621 o4
OF Expires 11/21/2021
***********************************s
=•--�-� �� `�/' Plans Examiner
Structural Review
**********
_ Zoning
Clerk
(Revised02/24/2014)