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