RC-16-2329 Miami Shores Village '
Building Department i A Nib
� 10050 N.E.2nd Avenue,
Miami Shores, Florida 33138
I��h1ctI� Tel:(305)795-2204 Fax:(305)756-8972
C32 127.
12b% INSPECTION LINE PHONE NUMBER:(305)762-4949 SJ�4
FBc ioH
BUILDING Master Permit No.�gc-S(0
PERMIT APPLICATION sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: 10&X6 titr jlt� Cr
City: Miami Shores County: Miami Dade Zip: 33)39,
Folio/Parcel#: I1a2.3a:oa.S 02430 Is the Building Historically Designated:Yes NO `✓
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ANN SS�enlfy Phone#: 305 35`-1 0100
Address: 106,Z•G 41E 116' Ct
City: IOU", ��re S State: F%'L Zip: 13-313y
Tenant/Lessee Name: Phone#:
Email: F
CONTRACTOR:Company Name: Ci2i�°fle(' Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: -State: Zip:
Value of Work for this Permit:$ 5aS®O Square/Linear Footage of Work: p®®
Type of Work: ❑ Addition ❑ Alteration ❑ ppNew �Repair/Replace ❑ Demolition
Description of Work: 2e a+ov l xi nct cit!+u ri p�^fJ� �t"U r
t -h csori! 4 irk Si�l�r►�uEl ^R-w
V\ fi
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ � �S-(Z CCF$ _� CO/CC$
Scanning Fee$ - Radon Fee$ 9" DBPR$ Notary$ ,C�
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ gg
TOTAL FEE NOW DUE$ I S�
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State ,,11 Zip
Mortgage Lender's Name(if applicable) ()rl%-ye GAe(Q sa)e /''I",AAe
Mortgage Lender's Address ALPIC ('KD
City T State /11 Zip 4819 83
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.
Signature �� Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged beforemethis The foregoing instrument was acknowledged before me this
d"6 day of 20 by day of ,20 , by
-�S H lr�J5Q'14k-C+ho is personally known to who is personally known to
me or who has produced — ate as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: 0\��111111111111%fir NOTARY PUBLIC:
�ddlOh/
s O.00 /�• j
Sign: Sign:
Print: . rry Print:
Seal: m . tfldX�
�9��•�. sa OZ ��°5�� Seal:
s��9<o E!!l1114111►������``
APPROVED BY d Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
I lillll!!Ill dill lllil lilil!Illi hili Ili!Ili!
GFN 2016RO4 58522
OR eY. 30181 Fes 4558-4560 (3fes)
RECORDED 08/05/2016 15:53:59
DEED DOC TAX $2r610.00
HARVEY RUVINr CLERK OF COURT
�Y� MIAMI-DADE COUNTY► FLORIDA
Prodded
JeBCymaaa,
LAW omals of hff P.�+P.A.
3M SwvuW-Fust Stet
M1mi FL33141 �
393•S354192
File Number: 16604M IMaaley
wSl Cap No.: i1�
Pavel Idendficiak►No.1 t �e c"�• �- 3313 4
3 b S 3g�.g8oc�
tse.ee,�bMe't�St.tneFa.Rooa�diat)rut ,
Warranty Deed
WA7V MY FORM- W.0%F.S.)
Tw Mat=tuade ab 4 dy► 2016 bet-ees F.dwa Gv ht"I a��.loeep6iae A.Mw fto ko*@d
sad wiifo whose post wfioa address is t County
of, nilaw, .State of .~,sad Mw
Soaoalto as its"INJOW"Soaaoa`e4 lmabaad and wee whose post olSoe oft=is 16626 ML If Court,Mind
Mom n 33f31h2123 offt Camty ofMhatWadk State of Fforida,gra W0.
WIhNISSM do MW VOW,for end is consl&Wou of ft no of M AND NW100 WUAM(3100)sad other
pod as vdueble Qoasideratiaaa to acid pastor In hand paid by acid gnmt k the t WO wbaUf is hweby s9luwerk4p4
bas is I-1 ej bergabte' and add to the said graatoe,sad Sratnae's heirs sad assla forever,tits fdlowbt dowribed had,
Avoftj bft sad belt is Mies""coal►,Fbri ft to
Lot 13,Block 3,M MIAMI SRO=BATES,ao to the Pia BtNvK as reeorded in Pod
Bosh 47 a Poe 58 of*o Pttblle Raor+ds of Mi mi.Dade County,Florida.
Subject to ftw far ft year 2916 sad sabsequea years eovmtas% eoadkioas, ratrklioo4
aae�.eaH, tnd of r�seon' if any.
The 6raaats bft wwnud that dw pnopway deaatW kwds was segahed by than darbg dm
nwrbp end they bare r odo d aatrried wftboa htownodos tbrargp the doe of this eotn►eyaaee.
and said gaaa- does hereby W waarow the title to Bald had.and wW dekad dta same spho larfid ebb=of all peraaois
•Moot 'ad'Qmoe=wWIbrsksaWapwed,aCOMMfto*m
b Wituea WbwnZ grantor bas bw mtto set grataars band sad nd the day std year first above wrktas.
Daibh►Ttau�
Si�od,aealad and
'Nan�c
swof FW"
Comy of I -kx*
The fwegft boomem was admw~bef"nye*b G.Manley and JMPWN
A.Menlgr,wro[J sn pmondly boom or[Xj hm a as�On.
IN"Y SUI Notwy"!�b,
h.
r p` MLDINA
ftbmd Nm w
No�rY Pum State of Florida
$ Commis6ltu�Fr i94333
My comm.expires Mar.23.2019 MY CSO
WormWD tdomiwyFdm#-hp2 DonM�lslUn�p
ORES Miami Shores Village
.,, Building Department
10050 N.E.2nd Avenue
� m Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: k6k—Ir &5s" DATE: 7
ADDRESS: 331°7
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have
read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner
must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption
allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the
construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a
cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or
lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built
for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make
sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on
your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and
with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all
applicable laws,ordinances,buildings codes and zoning regulations.
Please read and initial each paragraph.
1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an
exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain
restrictions even though I do not have a license.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial_
3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the
contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts.
Initial_
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial
building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy. It may not be built or substantially
improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the
construction is complete,the law will presume that I built or substantially improved it for sale or lease,which violates the exemption.
Initial _
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
Initial,_
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It
is my responsibility to ensure that the persons whom I employ have the license required by law andby county or municipal ordinance.
I&
Initial °!W
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously
implies that the property owner is providing his or her own labor and materials.I,as an owner-builder,may be held liable and subjected to
serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property.My homeowner's
insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance
coverage for injuries to workers on my property.
Initial_
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the
work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by
me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the
Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow
these may subject to serious financial risk.
Initial
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and
requirement that govern owner-builders as well as employers.I also understand that the
Construction must comply with all applicable laws,ordinances,building codes, and zoning regulations.
Initial_
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States
Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry
Licensing Board at 850.487.1395 or htto://www.mvfloridalicense.com/dbpr/pro/cilb/index.html
Initial_
11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
1 A&11'd^ C ;( wl; Skcc i l 9 V�_ 5 313 f
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on
this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public.if you contract with a person who does not have a license,the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial
loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or
employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder
permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of
the contractor's workers compensation coverage.
Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local
permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property
owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued.
Was acknowledged before me this �� day of 20
By Ni ��S0''3W-�L3 who was personally known to me or who has
Produced there License or �S id ` i�tr
� ,�s`(-� s •ti`�9 y��eW `�o•ire
OWNER NCP
w � Miami Shores Village
Building Department MAN _2 2017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 1`°1 5,
FBC 2 f
BUILDING master Permit
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION [5d EXTENSION ❑RENEWAL
F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10 dc�— G
City: Miami Shores County: Miami Dade Zia: 33/32
Folio/Parcel#:- 11) J3xo�', 80'(30 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): A S�y Phone#:
Address: 0(n�G, ME l l i�" (-a'
City: �'!C State: Zip: x$13
Tenant/Lessee Name: Phone#: '3®S o1cou
Email:
s
CONTRACTOR:Company Name: Phone#:
Address:
City: State Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 3Ln'L S c .
Specify color of color thru tile:
Submittal Fee$ (J C7 Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ 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 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.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z— day of Mar C-, 20 « by day of ,20 by
�3-5 L—QQ0 S-q-Q5& h i personally known to ,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.
NOTARY PUBLNOTARY PUBLIC:
=o1�•w MAMM K.GONZALEZ
•i My COMMISSION#GG 044602
EXPIRES:November 2,2020
$Ign: P Public underwriters Sign:
Print: Print:
Seal: Seal:
APPROVED BY I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
MAR 2 2017
By
, .�Lc- S51s �,I-� e r .e9� a q6® Y &It-1
r ��s
k4x-
(06).-6
1 l e- ct .
Permit.NO.
Miami Shores Village M Pemit'Type:R99tia1C<mstrll6ffon`�
10050 N.E.2nd Avenue NE Cl
5,ssi#c5tioir Aft
Miami Shores,FL 33138-0000
APPRO
ED
Phone: (305)795-2204 5�8� -V
tss riate,91612016. Expiration: 03/06/2017
Project Address Parcel Number Applicant
10626 NE 11 Court 1122320280430 ASHER SOSSONKO j
Miami Shores, FL Block: Lot:
Owner information Address Phone Cell
ASHER SOSSONKO 10626 NE 11 Court (305)354-0100
MIAM SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 5,500.00
HOME OWNER
Total Sq Feet: 800
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Window Door Attachment
Date Denied: Framing
Type of Construction:REMOVING EXISTING TILE AND PP Occupancy:Single Family Insulation
Stories: Exterior: Drywall Screw
Front Setback: Rear Setback: Final PE Certification
Left Setback: Right Setback: Window and Door Buck
Bedrooms: Bathrooms: Fill Cells Columns
Plans Submitted:Yes Certificate Status: Review Building
Certificate Date: Additional Info:
Review Building
Review Planning
Bond Return: Classification:Residential Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Plumbing
CCF $3.60 Review Structural
DBPR Fee $2.48 Invoice# RC-8-16-61035 Review Mechanical
DCA Fee $2.48 09/06/2016 Credit Card $ 143.56 $50.00
Education Surcharge $1.20 08/18/2016 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee $165.00
Scanning Fee $9.00
Technology Fee $4.80
Total: $193.56
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 cerfilly that�all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zqiAing. Fuermo¢,I authorize the above-named contractor to do the work stated.
17 ._— September 06, 2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 06,2016 1
:icy' k/V Ck f,
F n
August 29, 2016
Village of Miami Shores LC
Building and Zoning Department
10050 NE 2nd Avenue
Miami Shores, Florida
Attn: Building Official
Re: Special inspection
Project: Residence Permit# 1(f - -2399
10626 NE 11th Court
Miami Shores, Florida 33138
Dear Sir;
This letter is to advise that we inspected the existing floor system at the above referenced
residence. We observed 2"x10"joists at 16" on center with wood sheathing. The floor joists
were in good condition and would support the weight of a standard porcelain tile system as a
finished flooring system. The weight of the tile would not adversely affect the structural integrity
of the wood framing system. All work would conform to the requirements of the Village of
Miami Shores as well as the 2014 Florida Building Code.
Please call if we can provide anyj
qqWppal information.
��dO�p,Rp A.A L44,
Very trul ou
NO 38398
and A. n rs, P.E=-
0 STATE OF
0
1-0RIDN
'**;zNAL 66 so oo:ooe
*Soo**
o
so so o
0
:*eoo:
s000 eoo:oo :see*:
so
7850 N'W 146TH STREET, SUITE 509 MIAMI LAKES FL 33016 PHN: (305)823-3938 FAX: (305)823-9355
Ll
�
Les 15T-
FY:—
Qo
8 2010
C c�s�
,JiNiNG
I,I VI N