RC-18-308Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
mit
Permit NO. RC-2-18-308
Permit Type: Residential Construction
Work Classification: Alteration
Pennit Status: APPROVED
Issue Date: 4/12/2018
Expiration: 10/09/2018
Parcel Number
Applicant
221 NE 104 Street
Miami Shores, FL
1121360130560
Block: Lot:
FELIPE AND OLGA GODINEZ
Owner Information
Address
Phone
CeII
FELIPE AND OLGA GODINEZ
221 NE 104 ST
MIAMI SHORES FL 33138-2015
(305)751-1771
Valuation:
Total Sq Feet:
$ 5,660.00
530
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: REPLACING BATH TUB WITH SHO
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: Yes
Certificate Date:
Bond Return :
Occupancy:
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info: REPLACING BATH TUB WITH SHOV
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$2.55
$2.00
$1.20
$5.00
$169.80
$9.00
$4.80
$197.95
Pay Date Pay Type
Invoice # RC-2-18-66368
04/12/2018 Credit Card
02/07/2018 Credit Card
Amt Paid Amt Due
$ 147.95 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Fill Cells Columns
Final PE Certification
Window Door Attachment
Framing
Insulation
Drywall Screw
Window and Door Buck
Review Planning
Review Structural
Review Mechanical
Review Electrical
Review Electrical
Review Electrical
Review Building
Review Building
Review Plumbing
Review Plumbing
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 t
t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction ac4,zopjng. Futher e, I authorize the above -named contractor to do the work stated.
Authorizedignat re: Owner / Applic / Contractor / Agent
April 12, 2018
Date
Building Department Copy
April 12, 2018
1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel:. 305-795-2204 Fax: 305-756-8972
Inspection Number. INSP-000240-2018 Permit Number. RC-2-18-308
Scheduled Inspection Date: September 27, 2018
Inspector: Naranjo, Ismael
Owner: FELIPE AND OLGA GODINEZ
Address: 221 NE 104 ST
Project:
MIAMI SHORES, FL 331382
Contractor: HOME OWNER
HOME OWNER
Permit Type: Building (Residential)
Inspection Type: Building Final
Work Classification: Alteration
Phone Number. 3057511771
Parcel Number: 1121360130550
Phone Number:
Building Department Comments
REPLACING BATH TUB WITH SHOWER
REPLACING TILE WITH PAINT , REPLACE TOILET & SINK
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.
September 28, 2018
For Inspections please call: 305-762-4949
Page 8 of 42
1;6'2\9)3\
,(6) ,.
09
'BUILDING
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
RECF V [)i
FEB Q; 2018
BY: \
FBC 201101
Master Permit NoRC $ — I a _ 30 8
PERMIT APPLICATION Sub Permit No.
❑BUILDING
❑ PLUMBING
JOB ADDRESS:
City:
❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ARENEWAL
❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Shores County:
Folio/Parcel#: 1 — d 1 3 o 013 0 &6 0
Occupancy Type: Ord ll_ Load: Construction Type: C,'F.S Flood Zone:
Miami Dade
Is the Building Historically Designated: Yes
BFE:
Zip: 33 /,32
NO 1 '
FFE:
OWNER: Name (Fee Simple Titleholder): OG 6/1- /1/C . Phone#: 305-- 1 7 3 _ / Y 1r
Address: -.-) / lU L 1 U y £eii e.t:
City: /flf ft I?1 r S /4-61 Cr-
State: rL Zip: 23 / -
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:-H-prr\"e Own'e r 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: $ '� (� (� /� • G / Square/Linear Footage of Work: 3.S0
Type of Work: ❑ Addition
D cription of Work:
Alteration
❑ New
Repair/Replace
❑ Demolition
Specify color of color thru
H- r.nl-i'/ /2EFL i4c(
tile: %Z E /' /4 N GA- 41-fE
Submittal Fee $ So
C Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education
Structural Reviews $
CCF $ CO/CC $
DBPR $ . Notary $
Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ I ' .
IS
(Revised02/24/2014)
• Sign:
Print:
Seal:
**********
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 instru ent was acknowledged before me this 1 day of Cif 20 by The foregoing instrument was acknowledged before me this
day of , 20 , by
Not, a V'M Z. , w is personally known to , who is personally known to
me or 4ho has produced r i \ e ( L) CQ1(tc-5& as me or who has produced as
identification d who did to
1110
NOTARY P :
an oath.
YANADY PRIETO
'� MY COMMISSION # FF 214031
uiur
a•,,r��.: � EXPIRES: March 25, 2019
Bonded Thru Notary Public UnderwMere
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
****************************************************************
'(")
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: Ot C f� � 6�5 W & z - DATE: �01 U7/.0%.p
ADDRESS: 4 of (V& / 0q L go)? 3 /3 cr
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 1 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. 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 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.
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
I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that 1 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
Cl;
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. I understand that, as the owner -builder, 1 must provide direct, onsite supervision of the construction.
Initial
6. I understand that 1 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
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. 1 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. I 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
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:
a (N io y it) n4i frow
Initial -,••4
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 thef 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 0-7 day of ' +♦ Vnv 20 1 R
By Dr sOCy1Y1-e
Produced there License or 1 COI - as identification.
al6 Q,
OWN
ER
ER
who was personally known to me or who has
CA
NOTARY
is _; YANADYPRIETO
MY COMMISSION # FF214031
jo EXPIRES: March 25, 2019
'q . Bonded Thru Notary Public Underwriters
Property Search Application - Miami -Dade County
Page 1 of 2
Summary Report
Property Information
Folio:
11-2136-013-0560
Property Address:
221 NE 104 ST
Miami Shores, FL 33138-2015
Owner
OLGA GODINEZ
OLGA GODINEZ
Mailing Address
221 NE 104 ST
MIAMI SHORES, FL 33138-2015
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY : 1 UNIT
Beds / Baths / Half
3/3/0
Floors
1
Living Units
1
Actual Area
2,041 Sq.Ft
Living Area
1,801 Sq.Ft
Adjusted Area
1,921 Sq.Ft
Lot Size
9,300 Sq.Ft
Year Built
1950
Assessment Information
Year
2017
2016
2015
Land Value
$232,690
$199,874
$164,822
Building Value
$133,702
$133,702
$133,702
XF Value
$5,740
$5,782
$4,279
Market Value
$372,132
$339,358
$302,803
Assessed Value
$144,383
$141,414
$140,431
Benefits Information
Benefit
Type
2017
2016
2015
Save Our Homes
Cap
Assessment
Reduction
$227,749
$197,944
$162,372
Homestead
Exemption
$25,000
$25,000
$25,000
Second
Homestead
Exemption
$25,000
$25,000
$25,000
Widow
Exemption
$500
$500
$500
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
36 52 41 31 52 42
MIAMI SHORES SEC 5 PB 10-47
LOT 15 & W1/2 LOT 16 BLK 120
LOT SIZE 75.000 X 124
nR 17aac_nnnn nao7 1
http://www.miamidade.gov/propertysearch/
Generated On : 2/7/
Taxable Value Information
2017
2016
2
County
Exemption Value
$50,500
$50,500
$50
Taxable Value
$93,883
$90,914
$89
School Board
Exemption Value
$25,500
$25,500
$25.
Taxable Value
$118,883
$115,914
$114.
City
Exemption Value
$50,500
$50,500
$50.
Taxable Value
$93,883
$90,914
$89
Regional
Exemption Value
$50,500
$50,500
$50
Taxable Value
$93,883
$90,914
$89.
Sales Information
Previous
Sale
Price
OR Book -
Pa a
9
Qualification Description
06/01/1997
$142,500
17695
0800
Sales which are qualified
09/01/1992
$0
15655-
0271
Sales which are disqualified as a res'
of examination of the deed
08/01/1992
$130,900
15649
1574
Sales which are qualified
07/01/1990
$102,500
14637
3255
Sales which are qualified
2/7/2018
0
r
BATHROOM RECEPTACLE ON 20 AMP CKT
AND G.F.I PROTECTED
• •••
: . . .•. . • ••
•• • • •• ;o • • •. I
s• •
•• ••• •• •• • ' .
I
• •••
• ..• .
.•. •••.
•
• •.
• • • • •
• • • • • • • • •
• • • •
• •• •• • • • • • • • •
•• •• • • ••• • • • •• ••
{PERMIT #: 3_018
Miami Shcre3 village
BLDG DEPT
SUBJECT CO COMPLIANCE WCPH ALL FEDERAL
STATE AN C(UNi°f (ULiS AND REGULATIONS
fL6 ie >1R'
RECEIVE
FB0.,018
Juandyman
Estimate
221 ne 104 th st.
FL 33138
Name / Address
221 Ne 104th St.
Miami Shore,FI 33138
Date
Estimate #
1/23/2018
25
Project
.•1•
•
•
. •
....
• °
Description
Qty
Rate • .
• °:'
.. , Total
. .•
•••••.
70
••e.oe•
•
Demo
...450.00
$3,QQ.
• •
fix bathroom walls and door framing
...4810.00
• • •
• •480.00•
Install new insulation
�j0.00
••..•
• • • •
•94:0!0 0
Install drywall, finish and painting
• • • 1.,�40.00
•"• • 11240!00
Install shower and floor
.. • i,J 40.00
' • 2,1'0040
Install new toilet, bidet, and sink
• 4-0.00
' 450!a0
•
• • ••••••
• • •
•• •
• . •
•• • ••••••
• • • • •
•• •
a
'', ft-,
Total • • $5,660.00