MC-19-2386Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
1041 NE 96TH ST, Miami Shores, FL 33138
Contacts
Issue Date:10/15/2019
Parcel Number
1132060143720
Permit No.. MC-10-19-2 86
Permit Type: Mechanical - Residential
Work Classification: Pool Heater
Permit Status: Approved
Expiration: 04/13/2020
VALERIE GREENBERG Owner
ESSIG POOLS INC Contractor
DANIEL ESSIG
10111 Business DR, MIRAMAR, FL 33025
Business: 3059490000 permits@essigpools.com
Description: POOL HEATER Valuation: $ 500.00 Ins ection Requests:
305-762-4949
LLL] Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$110.30
Check # 3285
10/15/2019 $110.30
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
regulaopg cgnstructio4 and zoning. Futhermore, I authorize the above named contractor to do the work stated.
I t7
Signature: ()vner / Applicant /
r / Agent
Date
October 15, 2019 Page 2 of 2
Miami Shores Village
Building Department LLjVCu ,
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
OCT
Tel: (305) 795-2204 Fax: (305) 756-8972 91019
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201`7
BUILDING Master Permit No. W?"-0q - va 21(3S
PERMIT APPLICATION Sub Permit No. hrc- 1 2
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING IECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Folio/Parcel#: \\3 Z 0 (0 0 1 L4 3 41 d Is the Building Historically Designated: Yes
Occupancy Type:` , — Load: Construction Type: Flood Zone: BFE: _
OWNER: Name (Fee Simple, Titleholder):
Q'\ br (- C9 ,ruelA
lrl Arrccc• In L'N ) 1 ; 1 lY �
- e
City: M1 (A-1M of " S. State: r� Zip:
Tenant/Lessee Name: Phone#:
Email;
CONTRACTOR: Company Name: ESSIG POOLS, INC
A,,,,re«. 10111 BUSINESS DR
City: MIRAMAR State: FL
Qualifier Name: DANIEL ESSIG
State Certification or Registrati �
DESIGNER: Architect/ gi r: �
Address:
Value of Work for th�
Type. of Work: ❑
Description of Work:
Permit: $
addition ❑ Alte
ne#: 305-949-0000
Zip: 33025
Phone#:
Certificate of Competency #:
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
❑ New . ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ � Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ 2
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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
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 bui ng permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy he notice of com ncement and construction lien law brochure will be delivered to the person
whose property is subject to att ent. Also, a ce ' ied copy of the recorded notice of commencement must be posted at the job site
for the first inspection whic curs seve s after the building permit is issued. In the absence of such posted notice, the
inspection will not be appr d and a spe on ee will be charged.
Signatu
The foregoing instrument yfas 4e<<nowledged before me this
day of
20 l "b/ by
Q&-NL 1 �. (O1`�lJl �hrc
, who is personally known to
J
me or who has produced
���"""��•,. as
identification and who did take
an p'at�.•••'•• �� '�
NOTARY .•• y�i
NOTARY PUBLIC:
• PUBLIC %
157200 ; m
# GG
_ : REG MMISSION : N
•• MY rO
•
:
SignA4
" v
'•, EXPIRES
Print: i'i''►y`� �'+� n�nc/
�,1tlltir.''�. O�
Seal:
���''�•••••••�`'�,
APPROVED BY
Signature
6 CONTRACT
The foregoing instrument was acknowledged before me this
day of . 20 ' by
DANIEL ESSIG who is personally known to
me or who has produced PERSONALLY KPtlC7V'` k, as
identification and who did take an oath` ;:? ....
pQ NOTARY ; 9 '
NOTARY PUBLIC: PUBLIC •�'�� %
t 157200 ; Z "
o: ;REG#GG m
= t, MY COMMISSION : ry
v EXPIRES ,
Sign:
Print
• F .•
Seal: ��'''�••••••••.��
IL'PI ns Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk