RC-18-1748Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel: 305-795-2204 Fax: 305-756-8972
Inspection Number: INSP-001154-2018
Permit Number: RC-6-18-1748
Scheduled Inspection Date: October 30, 2018
Inspector: Naranjo, Ismael
Owner: ERIC BANCROFT
Address: 195 NW 91 ST
Project:
Miami Shores, FL 33138
Contractor: HOME OWNER
HOMEOWNER
Permit Type: Building (Residential)
Inspection Type: Building Final
Work Classification: •Alteration
Phone Number: 3057133344
Parcel Number: 1131010000190
Phone Number:
Building Department Comments
ALTER EXISTING MASTER BATH AND HALL BATH AS REQUIRED FOR PROPOSED LAYOUT AFTER EXISTING KITCHEN AS
REQUIRED FOR PROPOSED LAYOUT.
Checklist Item
General Comments
Passed
False
Comments
Inspector Comments
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 29, 2018 For inspections please calf: 305-762-4949
Page 37 of 42
Address
195 NW 91 Street
MIAMI SHORES FL 33150-
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
ermit
PermitNO. RC-6-18-1748
Permit Type: 'Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 7/16/2018
Expiration: 01/12/2019
Parcel Number
195 NW 91 Street
Miami Shores, FL 33138-
1131010000190
Block: Lot:
Applicant
DANELLE BANCROFT
Owner Information
Contractor(s)
HOME OWNER
Phone
Cell
Valuation:
Total Sq Feet:
$ 10,000.00
250
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: ALTER
Stories: 1
Front Setback:
Left Setback:
Bedrooms: 3
Plans Submitted: Yes
Certificate Date:
Bond Return :
EXISTING MASTER BATH A
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms: 3
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
P&Z Review Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$6.00
$4.50
$3.00
$2.00
$5.00
$0.00
$300.00
$39.00
$8.00
$867.50
Pay Date Pay Type
Invoice # RC-6-18-68050
06/26/2018 Credit Card
07/16/2018 Credit Card
Bond #: 3828
Amt Paid Amt Due
$ 50.00 $ 817.50
$ 817.50 $ 0.00
Available Inspections:
Inspection Type:
Final PE Certification
Window Door Attachment
Framing
Insulation
Drywall Screw
Fill Cells Columns
Window and Door Buck
Review Planning
Review Plumbing
Review Electrical
Review Electrical
Review Building
Review Mechanical
Review Structural
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 certi
construction and
Authorized
ing.
uth
at all the foregoing information is accurate and that all work will be done in
ore, I authorize the above -named contractor to do the work stated.
ature: Owner / Applicant / Contractor
/ Agent
compliance with all applicable laws regulating
July 16, 2018
Date
Building Department Copy
July 16, 2018
1
w
Miami Shores Village
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
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
�cETVEn
J N 20 2018
BY.
FBC 20 1-mk
Master Permit No. 7..e.(g 1-; 9
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City:
Folio/Parcel#:
115 NW 4) Si
Miami Shores County:
(I'IO1•0000110
Occupancy Type: r.e5 Load: Construction Type:
Miami Dade Zip: 531 S0'0 lq0
Is the Building Historically Designated: Yes NO
Flood Zone: X BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 77A Vle I\ e V A p1 G(D f
Address: IcfS NW q l ST
City: MI,.,AAr , Sy1Ore State: F L
Tenant/Lessee Name: N ( A
01.n a l l e A. /I c4-0 ae 2 ma; 1. Chin
Email:
Phone#: 30 9 / 7 ' ) IS
Zip: 3315o O 110
Phone#: N (
CONTRACTOR: Company Name: 4\ ME • Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of. Competency #:
DESIGNER: Architect/Engineer: Am i ciat �. . U ►et e rd e , Phone#: 75G • 5(L• 2'S77
Address: 140'I SW G7 AYE 1 STE 102- City:
Value of Work for this Permit: $ f 0 j 000 Square/Linear Footage of Work: 2.rO SF •
Type of Work: ❑ Addition jg Alteration ❑ New fEl Repair/Replace ❑ Demolition
DescriptionofWork: Alter
J_GXistihal /i5}) �er 8A-an) HMI[jAri c c'eUirea
for nr- prnp'i 16'7 Q+. Al -ter e.(i(}In.j Ki,1-0,,ev► as (el•v;red for )roFo,e)
Nt lat. $A: State: F L- Zip: 33 I a `�
Specify color of color thru tile: „ '
Submittal Fee $ LD • Permit Fee $ 20 0 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ .• Notary $ 5
Technology Fee $ Training/Education Fee $ - Double Fee $
Structural Reviews $ Bond $ ,c00
TOTAL FEE NOW DUE $ O t" b
(Revised02/24/20141
it i4,74Ni r9 Ar V
Bonding Company's Name (if applicable) a
Bonding Company s Address
City, _____. _ _ J,. _ f:.i State Zip
Mortgage Lender's Name (if applicable) `
Mortgage Lender's Address
F .4
City I 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
RESULTIN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY: -'IF YOU INTEND
TO OBTAIN FINANCING,, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORtRECORDING
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 theSrecorded 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. a , '
OWNER or. AGENT
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z 6 day of Wl\. ", 20 (9 , by day of , 20 , by
-12-1 "Ur�who ids per o•—naliy known to , who is personally known to
me or who has produced `FL -L ER CLN 5 me or who has produced as
— 's 1 1,.. ..1 , ,..1 .. I tt., •,, { '*• '--
identification and who did take an oath. identification and who did take an oath.
a f
o f
NOTARY PUBLIC:
Sign: F .. ^x i'' r`` ►►,l t : P. Sign:
•
Print: S1� `PNWPrint' .�
j.. 4. .. .
Seal: r c rn Seal:
y os Note'
Notary Public State of Florida
k ? Sindia Alvarez
) My Commission FF 156750
) or Expires 09/03/2018 1 . 't
**********************'********************************************************
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: Van -el k I ncrcf DATE: CO 2l� ` I S
ADDRESS: `"ICJ NW ci I st--e-ef, rylictml S(nore.S, f (. 3'7I cb
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 taw. Your construction must comply with all
applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I 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 1, as the owner of the property listed, may act as my own contractor with certain
restrictions even though I do not have a license.
2. I 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. I 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 1.)1-/
4. I 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. t understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
6. I 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 and by county or municipal ordinance.
Initial
7. I 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 0127
9. I 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. I 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. 1 also understand that I may contact the Florida Construction Industry
Licensing Board at 850.487.1395 or http://www.myfloridalicense.com/dbpr/pro/cilb/index.html
Initial 4)
11. I 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:
Initial
12. I 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 2(0 day of 3s-- , 20 1
ByD\
who was personally known to me or who has
Produced there License or 'FL-- ►JR l � us_ E NSA as identification.
patlook_
QOt1E-clAtl
NOTARY
}•-''he�YYv vr v
"rr-r!-^vv"-r,r • rwY""' -
). Pee Notary Public State of Florida
>•?� �:
Sindia Alvarez
p 'A is My Commission FF 156750
i. 140,0,04" Expires 09/0312018
Prepared by:
Eric van der Vlugt, Esq.
1111 Kane Concourse Suite 209
Bay Harbor Islands, FL 33154
305-865-5718
File Number: 18-0339 Piriana
Return To:
Laura Bourne Burkhalter P.A.
Laura Bourne Burkhalter, Esq.
1508 East LasOlas Blvd, Ste B
Ft. Lauderdale, FL 33301
CFN: 20180326086 BOOK 30999 PAGE 1065
DATE:06/04/2018 01:33:19 PM
DEED DOC 2,700.00
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
[Space Above This Line For Recording Data]
Warranty Deed
This Warranty Deed made this 25th day of May, 2018 between David Piriano, a single man whose post office
address is 1831 NE 38th Street, Unit 401, Fort Lauderdale, FL 33308, grantor, and Eric Bancroft and Danelle Bancroft,
husband and wife, and Edward Jackson and Kim Jackson, husband and wife, as Tenants in Common whose post office
address is 195 NW 91st Street, Miami Shores, FL 33150, grantees:
(Whenever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives, and assigns of
individuals, and the successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS ($10.00) and other
good and valuable considerations to said grantor in hand paid by said grantees, the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantees, and grantee's' heirs and assigns forever, the following described land,
situate, lying and being in Miami -Dade County, Florida to -wit:
The West 135 Feet of the South 1/2 if the Southwest 1/4 of the Northwest 1/4 of the Southeast 1/4 in
Section 1, Township 53 South, Range 41 East, Less the North 169.25 feet thereof, and less the West 35
feet and the South 35 feet thereof, of the Public Records of Miami -Dade County, Florida.
Property Address: 195 NW 92st Street, Miami Shores, FL 33150
Parcel Identification Number: 11-3101-000-0190
SUBJECT TO:
1) Taxes for the year 2018 and subsequent years and all applicable zoning ordinances and
governmental regulations.
2) Conditions, restrictions, limitations, and easements of record, if any, but without the intention of
reimposing same._.
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantees that the grantor is lawfully seized of said land in fee simple; that the
grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all
encumbrances, except taxes accruing subsequent to December 31, 2017.
CFN: 20180326086 BOOK 30999 PAGE 1066
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed, seal
sN
State of Florida
County of Miami -Dade
red in our presence:
L
The foregoing instrument was acknowledged before
personally known or [X] has produced a driver's license
[Notary Seal]
David ' iriano
(Seal)
me this A4 day of - : 018 by David Piriano, who [__] is
as identificationrW/1/
/ rin•
y Commission Expires:
CFN: 20180326086 BOOK 30999 PAGE 1067
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores FI, 33138
Tel: 305-795-2204. Fax: 305-756-8972
Permit No. REOC-5-18-1397
Certificate of Re -Occupancy
Address: 195 NW 91 Street
City: Miami Shores
State: FL
Zip: 33138-.
This certificate verifies that the reference property has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining solely to the requirement that each
one -family dwelling is used and intended to be used for a one -family dwelling purpose
only; however, this certificate.does not constitute any representation or warranty as to the
condition of the dwelling or other structures on the premises described herein, or any
aspect of such condition, and interested persons are advised and encouraged to make
their own inspections of the premises in order to determine the condition thereof.
Building Approval:
%Si1/w�L At/ 'e 7 A -0