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MC-15-67 '18rp Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-226425 Permit Number: MC-1-15-67 Inspection Date: December 07,2015 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: WALLACE,JOHN Work Classification: Pool Heater Job Address:518 NE 106 Street Miami Shores, FL 33138-2046 Phone Number Project: <NONE> Parcel Number 1122310140211 Contractor: ESSIG POOLS INC Phone: 305-949-0000 Building Department Comments POOL HEATER Infractio Passed Comments, INSPECTOR COMMENTS False Inspector Comments Passed Failed E] Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 December 04,2015 Page 1 of 1 No �s ws- Miami Shores Village , �"Mechanic . Residential 10050 N.E.2nd Avenue NE Woo*C40$8000crtt:Pool Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit status:APPRo Expiration: 10/10/2015 1ue 1 'Q'ir Project Address Parcel Number Applicant 518 NE 106 Street 1122310140211 JOHN WALLACE Miami Shores, FL 33138-2046 Block: Lot: Owner Information Address Phone Cell JOHN WALLACE 518 NE 106 Street MIAMI SHORES FL 33138-2046 Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 ESSIG POOLS INC 305-949-0000 Total Sq Feet: 00 Tons: Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Approved:In Review Comments: Date Approved::In Review Date Denied: Type of Work:POOL HEATER Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 DBPR Fee InvOICe# MC-1-15-54127 $2.00 04/13/2015 Check#:99482 $72.80 $50.00 DCA Fee $2.00 Education Surcharge $0.60 01/13/2015 Check#:99271 $50.00 $0.00 Permit Fee $105.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $122.80 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 zonin uthermore,k- thorize the above-named contractor to do the work stated. April 13,2015 Authorized Signature:Owner / -Applicant / Contractor / Agent Date Building Department Copy April 13,2015 1 4miami Shores Villa �, 30 � � ���4 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20/a BUILDING Diaster Permit N®.ap , °- PERMIT APPLICATION Sub Permit No." !c Zy— 6 Z ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING Q MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION 0 SHOP CONTRACTOR DRAWINGS JOB ADDRESS:S 1jE—'D NF— I C:x' -c City Miami Shores County: Miami Dade Zia: I �� Folio/Parcel#: ` l ZZ E-' l gn=)2— ) i Is the Building Historically Designated:Yes NO Occupancy Type: Load: I Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Jo�� �� f I �L Phone#�—� ~" 1 cc Address: City:.N Ci �%� J State: � Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ESSIG POOLS, INC Phone#: 305-949-0000 Address: 1800 NE 151 ST City: NORTH MIAMI State: FL Zip: 33162 Qualifier Name: DANIEL ESSIG Phone#: State Certification or Registration#: CPC052505 Certificate of Competency#: DESIGNER:Architect/Engineer: P h o n e#.,-5 Address 87-ff5� Cil Zip: 1� Value of Work for this Permit: �� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Repair/Replace ❑ Demolition _YP _ _• ❑ Alteration �New • Description of Work: Specify color of color thru tile: Submittal Fee$ f— Permit Fee$ CCF$ �f`• ® CO/CC$ Scanning Fee$ (�k •006D Radon Fee$ 8 DBPR$*;L- O k-3 Notary$ Technology Fee$ 9 Training/Education Fee$ ®• Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 72- (Revised02/24/2014) r 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. Signatur . Ck" Signature OWNER or AGENT 0 CTOR The forego] nstrument was acknowledged before me this The foregoing instrument was acknowledged before me this �l�t day o Y y —�� 20 �- by f --�� 20 !� b � da of �/U(=4 ( o is rsonally known to DANIEL ESSIG who,is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. _ �01r6111111lB/j� NOTARY PUBLIC:- t1611illiil�j voit /� NOTARY PUBLIC: %X �•1�� Q�.'q+ii EVONDF �i .•••....,• s`i ;� e�`••N••, �• Gni �• �S0tZ7,2�1A�9 EXP `rte?°� �� �?y • op VO- �j�N�* S Print: Print: S Se UB�1G�,'�,.P°® �H!la4Q9.! qJ/5PIans APPROVED BY Examiner Zoning Structural Review Clerk (Revised02/24/2014)