PL-15-2059 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-241432 Permit Number: PL-8-15-2059
Scheduled Inspection Date: January 14, 2016 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: LUCA, CORNELIU Work Classification: Pool - Private
Job Address:1065 NE 97 Street
Miami Shores, FL Phone Number (305)321-3919
Parcel Number 1132050170090
Project: <NONE>
Contractor: ESSIG POOLS INC Phone: 305-949-0000
Building Department Comments
PLUMBING FOR NEW POOL AND EQUIPMENT Infractio Passed comments
INSTALLATION INSPECTOR COMMENTS False
spector Comments
Passed E�'
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
January 13,2016 For Inspections please call: (305)762-4949 Page 3 of 21
P� �t NO. PL-$- 6.2059
Miami Shores Village P mlt Type.Plullrtbing_Residenfla
10050 N.E.2nd Avenue NE ',� �� t+1 O&clas0ca��+t?o(l-Prii>gate
",• ""'� Miami Shores,FL 33138-0000
y y PatmitStait�,'APPROVED
Phone: (305)795-2204
'�LOR1°AP�
Ex iration: 3/14/2016
Isasa�s; 9J1'6/2016 3
Project Address Parcel Number Applicant
1065 NE 97 Street 1132050170090 j
CORNELIU LUCA
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
CORNELIU LUCA 1065 97 Street (305)321-3919
MIAMI SHORES FL 33138-
1065 97 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,500.00
ESSIG POOLS INC 305-949-0000 Total Sq Feet: 848
Type of Work:PLUMBING FOR NEW POOL AND EQUIPMENT Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Main Drain
Bond Return: Final
Classification:Residential Scanning:3 Rough
Review Plumbing
Review Planning
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-8-15-56720
DBPR Fee $3.38 09/16/2015 Check#:300002 $ 193.96 $50.00
DCA Fee $3.38
Education Surcharge $0.40 08/14/2015 Check#:99778 $50.00 $0.00
Permit Fee $225.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $243.96
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.
-- September 16, 2015
A thorize�_e: A licant / Contractor / Agent Date
BuildingCo y
September 16,2015 1
Miami Shores Village Nib
Building Department E
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
BUILDING Master Permit No/ / Z!� — 2Z)6--,-F
PERMIT APPLICATION Sub Permit Nopl-
BUILDING [--� ELECTRIC ROOFING ❑ REVISION EXTENSION RENEWAL
OPLUMBING F-1 MECHANICAL [-]PUBLICWORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ' Com 4S:5T
City: Miami Shores County: Miami Dade Zip: �� (� 45
Folio/Parcel#: I I C:'� 0`�1 ®is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER:Name(Fee Simple Titleholder):C®/�G I �y —'�e==a Phone#.n' �-3z " 3-7 i
Address:
City: �°�1 as rs-�9fl �-+�+9 S State: 1--1--" zip: 3 3 13S
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: 331625
Qualifier Name: DANIEL ESSIG Phone#: 305-949-0000
State Certification or Registration#: CPC052505 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 91 5J® Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration 0 New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$_ FCC $ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ e -
(Rev1sed02/24/2014)
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 a ch ent. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occ rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv d a d a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONT
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of -J—i= 20 `'S ,by _day of ,20 LS ,by
J ' -'e---i ,who is personally known to DANIEL ESSIG who is personally known to
me or who has produced I as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTA Y PUBLIC:
r
Sig Sign-
Print: Print:
YORIENYPA.H NANGF—��
Seal: =�: Y COMMISSION it FF 022 i o8 Seal: =+? :; YO NY PA.HERNANDEZ
p; Pi IRES:September 2%,2017 E Y O MISSION#FF 022108
Bonded Thru Notary Publu;Unrie u;ite s RES:September 27,2017
Bondad Thru Notary Public Underwrders
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(ReVIsed02/24/2014)