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PL-19-1867Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Dabe: 09/28/2019 Location Address Parcel Number 250 NW 93RD ST, Miami Shores, FL 33150 1131010331110 Contacts Permit NO.: PL-0849-1867 Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: Approved Expiration: 02/24/2020 ASHLEE THOMAS Owner 25093 ESSIG POOLS INC Contractor DANIEL ESSIG 10111 Business DR, MIRAMAR, FL 33025 Business: 3059490000 permits@essigpools.com Description: NEW SWIMMING POOL, DECK & SPA FOR Valuation: $ 1,500.00 Inspection Requests: PLUMBING 762-4949 Total Sq Feet: 0.00 305- 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 Payments Date Paid Amt Paid Total Fees $162.35 Check # 3141 08/14/2019 $50.00 Credit Card 08/28/2019 $112.35 Amount Due: $0.00 Building Department Copy 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 c, tractor to do the ork stated. J 2� Authorized Signature: Owner / Applicant / Contractor / Ag nt D to August 28, 2019 Page 2 of 2 Miami Shores Village Building Department -: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fan: (305) 756-8972 INSPECTION LINE PHONE NUMBER• 1305V7fi2-4949 FBC 20 14* BUILDING Master Permit No. W- d?) ` `111 A66 PERMIT APPLICATION Sub Permit No. L-6'8 - ' BUILDING' ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑;SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ;AD O N W City: Miami Shores County Miami Dade Zip: 133 1 J U Folio/Parcel#:((���� d:z j Q Is the Building Historically Designated: Yes NO Occupancy Type:K-Ilf-s Load: Construction Type: MIA) Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):'Oe-N o► N i Y �.0 �-� Phone#: Address:;) 4'�y N W 45-1 City: �,\ G��.� �Y1.C�r'� State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ESSIG POOLS, INC Phone#: 305-949-0000 A 4,4roec. 10111 BUSINESS DR City: MIRAMAR state: FL ZI Qualifier Name: DANIEL ESSIG Phone#: _ State Certification or Registration #: CPC052505 Certificate of Competency #: — DESIGNER: Architect/Engineer: Phone#: _ Address: City: State: Value of Work for this Permit: $ ' ��� V ,-y� Square/Linear Footage of Work: Type of Work: ❑ Addition •��❑ *; Alteration New ❑ Repair/Replace ❑ D molition Description of Work: �-�lJ✓ ` N> - -v p: 33025 Zip: Specify color of color,]thru stile: Submittal Fee .$ 56 t7 qT1 �1 Permit Fee $ Scanning Fee $ Radon Fee $ CCF CO/CC $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ 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 commenced prior to the issuance of a permit and that all work will be performed to Application Is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has 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. Signatu OWNER or AGENT The foregoing instrument was acknowledged before me this — 7772_ day of 20 , by MIA 't C- who is'Personally knqWn to me or who has produced f as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: k rv-4 Oft f Seal: 1►Jn °�e •.. KAREN RODR U Z Notary Public - State of Florida Commission # GG 304504 'oFn My Comm. Expires Feb 21, 2023 Bonded throw h National Notary Assn. APPROVED BY (Revised02/24/2014) Signature CONTRACT The foregoing instrument was a knowledged before m this day of 20, by L ESSIG A ho is personally known to me or who has produced PERSONALLY KNOWN as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: oi��P�sL, KARENRODRIGUE]FIorida ? Notary Public - State of s`= Commission GG 304Natiora: Nota Plans Examiner Zoning Structural Review Clerk