PL-18-1212�` 5NortFs y,`�
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-5-18-1212
Permit Type: Plumbing - Residential
en m Work Classification: Pool - Private
Permit Status: APPROVED
Parcel Number
Issue Date: 5/22/2018 1 Expiration: 11/18/2018
Applicant
671 NE 105 Street 1122310120100
CAROL INVEST USA INC
Miami Shores, FL 33138-2053 Block: Lot:
WmMmunamw
Owner Information Address rnone ceu
CAROL INVEST USA INC 671 NE 105 Street (305)747-3098
MIAMI SHORES FL 33138-
671 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
ESSIG POOLS INC 305-949-0000
Type of Work: NEW SWIMMING POOL AND HEATER
Type of Piping:
Additional Info: NEW SWIMMING POOL AND HEATER
Bond Return
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$1.20
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$0.40
Permit Fee
$225.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$236.83
Valuation: $ 1,500.00
Total Sq Feet: 1224
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-5-18-67457
05/22/2018 Check #: 2304 $ 186.83 $ 50.00
05/07/2018 Check #: 2271 $ 50.00 $ 0.00
Avauaole Ins
Inspection Type:
Main Drain
Plum
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 h'-. = , 'Er
Building Department MAY 07 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 1
INSPECTION LINE PHONE NUMBER: (305) 762-4949
qBC 20k'-:N
BUILDING Master Permit No. -
PERMIT APPLICATION Sub Permit No. —
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
1 \ �-{- CONTRACTOR DRAWINGS
JOB ADDRESS: �� ` Iv C t D 5 s`
City i Miami Shores County: Miami Dade Zip:
Folio/Parcel#: -(- — 2-23 1 —0 ( 2 (!) d Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: ( Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): CAeOL-IVUGS� "SA J-K)(-.Phone#:
Address: q c Lc r-� 15C A" tiJL � ym 602-H S
City: k-�1 OK State: "C L012 I C) A Zip: 3 3 l 32
Tenant/Lessee Name: Phone#:
Email:
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: $ I ADO O C) Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: I V l -� S W �1 iJL-� ��xSt-- b3b
4
Specify color of color thru tile:
Permit Fee $ CCF $
Radon Fee $ �
DBPR $�
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Training/Education Fee $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Rev1sed02/24/2014)
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 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
OWNER o AGENT
The foregoing instrument was
acknowledged before me this
Q3 day of 20 1 by
HGACOwho is personally known to
me or who has produced as
identification and who did take an oath.
Signature l/
CONTRACTO
The foregoing instrument was acknowledged before me this
C) :3 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 P C: NOTARY P IC:
S' S•
rint: 5,1't?��G mP� �� ( re
Print:
Seal: Seal:
Lx-4=
tate of Florida
`�z
No
GG 162104i*1*************s*************r
APPROVED BY l Plans Examiner
Structural Review
Notary Public State of Florida
Estrella Gomez
a p• My Commission GG 162104
p mod' Expires 11/21/2021
*******ss**
Zoning
Clerk
(Revised02/24/2014)