RC-18-160�stjO1S L,� Miami Shores Village
10050 N.E. 2nd Avenue NE
" Miami Shores, FL 33138-0000
Phone: (305)795-2204
IORIDA
Permit No. RC-1-18-160
Permit Type: Residential Construction
Pen 'I Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 218/2018 1 Expiration: 08/07/2018
Project Address Parcel Number Applicant
1321 NE 103 Street 1132050300120
ADRIA I SILVERMAN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ADRIA I SILVERMAN 1321 NE 103 Street (305)542-0908
MAMI SHORES FL 33138-
1321 NE 103 Street
MAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
HOME OWNER
Valuation: $ 21,070.00
Total Sq Feet: 0
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Construction: BATHROOM REMODEL 3 BATHRO
Occupancy: Single Family
Stories:
Exterior:
Front Setback:
Rear Setback:
Left Setback:
Right Setback:
Bedrooms:
Bathrooms:
Plans Submitted: Yes
Certificate Status:
Certificate Date:
Additional Info: BATHROOM REMODEL 3 BATHROC
Bond Return :
Classification: Residential
Fees Due
Amount
Bond Type - Owners Bond
$500.00
CCF
$13.20
CO/CC Fee
$50.00
DBPR Fee
$9.49
DCA Fee
$6.32
Education Surcharge
$4.40
Notary Fee
$5.00
Permit Fee
$632.10
Scanning Fee
$9.00
Technology Fee
$17.60
Total:
$1,247.11
Pay Date Pay Type Amt Paid Amt Due
Invoice # RC-1-18-66188
02/08/2018 Credit Card $ 1,197.11 $ 50.00
01/22/2018 Cash $ 50.00 $ 0.00
Bond #: 3647
Available Inspections:
Inspection Type:
Final PE Certification
Drywall
Miscellaneous
Window Door Attachment
Tie Beam
Final
Framing
Insulation
Truss Insp
Columns
Foundation
Window and Door Buck
Fill Cells Columns
Wire Lathe
Review Electrical
Review Building
Review Plumbing
F. Termite Letter
F. Elevation Certificate
Review Planning
Review Structural
Review Mechanical
Declaration of Use
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. I authorize the above -named contractor to do the work stated.
� �J February 08, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
February 08, 2018 1
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
RECEIVED
JAN 2 2 1018
to
FBC 201—+
Master Permit No. F-C [ ra— 1 w
\PERMIT APPLICATION Sub Permit No.
O BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 13 � Iy 0 3 'It 5N-C-e C. t
City: Miami Shores County: Miami Dade Zip: 33139
Folio/Parcel#:- 3a-0_5"_ o3 o " o (ZO Is the Building Historically Designated: Yes o NO i-
�
Occupancy Type: Load: (Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ady' a- St k\f-e e-e I Gt/n Phone#: 3 OS - S74 Z' Q 3 O
Address: l 31( /Je— (0 3 (d STye-ei—
City: 1)) 1 acryl l 4,ot-e S State: Fz_ Zip: 3 3 (3 W
Tenant/Lessee AName: N I � Phone#: N f/,4
Email: a-0� 6a-6i I \fe'-M an-dd) 0 N � ' Ga'1
CONTRACTOR: Company Name: A 0\'C1 C& Phone#:-305--S-q -2-- 030 D
Address3 � : `-( (\f�
& ( Q3
M�e r�
City: I ' 1K (),. (Ym l 5+\ D(iS State: l_ Zip: 3 3(3 g
Qualifier Name: Phone#:
State Certification or Registration #: n Certificate of Competency #:
DESIGNER: Arch itect/Engineer:�old QaAja)(ffve— �eSCjGM'SY j—.L.C.Phone#: Cj_, - �8
Address: 42 23 1y Lt/ ep, City: 1 State: FL Zip: 333 q
Value of Work for this Permit: $ 21, 0'PIO'Sgquuare/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace emolition
Description of Work: ��Tonm r21_'1-lo 61c 3 - b.� arVo�S \\ ,J
Specify color of color thru tile: r�
Submittal Fee $Q 'M Permit Fee $ `((ww �32' 10 CCF $ 1 3 • 2-0 CO/CC $ 93• Q
Scanning Fee $ ` ' 00 Radon Fee $ G ' 3 2 DBPR $ , 1 • 1 Notary $ S
Technology Fee $ 60 `
Training/Education Fee $ '-/ Q Double Fee $
Structural Reviews $ Bond $ 5-00 . 00
TOTAL FEE NOW DUE $ -_
(Revised02/24/2014) t
Bonding Company's Name (if applicable) t I Pr
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
c a
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
The foregoing instrument was acknowledged before me this
22 day of 20 by
CA hoYis pe�r�s�onarl y known to
me or who has produced X!::� 1l�bs
identification and who did take an oath.
NOTARY
MAHARAI K. GONZALEZ
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 by
. who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
"' °2, EXPIRES: November 2, 2020
Print: =�: Print:
'-'F'! I�q',� Bonded Thru o ry
Seal: Seal:
�1j
**********�*ssrs*srsssssss*•rs* *s**s*s]`*�*s*+es*rrs********r*s*'sss:sssssss*ss::*:�sas:#:s:.*******ss**.***
APPROVED BY 666 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: Imo( "-iGi S I ,e,(- -h a yl DATE:
ADDRESS: d 2 e-f- (" l o4yv- SP)o reS `F� 3 3
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 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.
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 a cts.
Initial 0 &_-)
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, w ' violates the exemption.
Initial
S. I 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
Is my responsibility to ensure that the persons whom I employ have the license required by law and b coun or municipal ordinance.
Init�
41
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. 1, 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.
Initi�
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 1 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.
i
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��`-� c�
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 http://www.myfloridalicense.com/dbpr/pro/cilb/index.html
Initi6�—o
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 prop I
sed construction activity at the following address:
mI Ctmi 'ShoreS, �3Initia
l3� l[
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.
Ini al_�
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 day of 20
6y A 640. S W EV nm.woo was personally known to me or who has
Produced ther License as identification.
OWNER
6 C
2 lllm!!!!
0 CA
gZcn�
zi)
C N �
9�o
N
a
1/22/2018 Property Search Application - Miami -Dade County
il A
f FFICE OF
PROPERTY
Summary Report
Property Information
Folio: ��
11-3205-030-0120
Property Address:
1321 NE 103 ST
Miami Shores, FL 33138-2623
Owner
SCOTT J SILVERMAN
ADRIA I SILVERMAN
Mailing Address
1321 NE 103 ST
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1100 SGL FAMILY - 2301-2500 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/3/0
Floors
1
Living Units
1
Actual Area
3,346 Sq.Ft
Living Area
2,239 Sq.Ft
Adjusted Area
2,695 Sq.Ft
Lot Size
9,720 Sq.Ft
Year Built
1963
Assessment Information
Year
_-�-2017
...�_.. 2016
2015
Land Value
$350,309
$325,982
$296,789
Building Value
$214,145
$215,708
$217,271
XF Value
$20,363
$20,378
$15,471
Market Value
$584,817
$562,068
$529,531
Assessed Value
$455,307
$445,943
$442,844
Benefits Information
Benefit
Type
2017
2016
2015
Save Our Homes Cap
Assessment Reduction
$129,510
$116,125
$86,687
Homestead
Exemption
$25,000
$25,000
$25,000
Second Homestead
Exemption
$25,000
$25,000
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
(Short Legal Description
REPLAT OF TR B MIAMI SHORES BAY
PARK ESTS PB 63-17 1
LOT 3 BLK 6
LOT SIZE 90.000 X 108
OR 15939-3320 0593 1
Generated On : 1/22/2018
Taxable Value Information
2017 2016
2015
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
1 $405,3071
$395,9431
$392,844
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
$430,307
$420,9431
$417,844
City
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$405,307
$395,943
$392,844
Regional
Exemption Value $50,000
$50,000
$50,000
Taxable Value $405,307
$395,9431
$392,844
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Description
05/31/2013
$700,000
28662-3674
Qua[ by exam of deed
07/01/2005
$710,000
23564-2061
Sales which are qualified
06/01/2004
$570,000
22444-0448
Sales which are qualified
05/01/1993
$220,000
15939-3320
Sales which are qualified
The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property
Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disciaimer.asp
Version
/Jja�Gt P� 4111U-11 v `�
'ECTION RECORD
ICJ(O— 7UU wz-u "-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Permit NO RC-1-18-160
.Permit T)pe:. Kest entlial L:t' mtruttion
-- ,� 4, Wo*C/ass&atiorr_ Addition/Alzerariort
Issue Date: 2/8/2018
Expires: 08/07/2018
INSPECTION REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.comlcap
REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY.
Requests must be received by 3 pm for following day inspections.
Residential Construction Parcel #:1132050300120
Owner's Name: ADRIA I SILVERMAN is Phone: (305)542-0908
Job Address: 1321 NE 103 Street T BET uare Feet: 0
Bond Number: 3647 T b Valuation: $ 21,070.00
Contractor S Phone Prima ffirf
HOME OWNER Yes
jg� ley w�
s k
p �>
JMHROUGH FRIDAY, 8:OOAM - 7:OOPM.
8:OOAM - 6:OOPM.
J
S ALLOWED ON SUNDAY OR HOLIDAYS.
BUILDING AND ROOFING INSPECTIONS ARE DONE
MONDAY THROUGH FRIDAY.
.t 61--7' ' h1�541V
;T7/
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READILY AVAILABLE. IT IS
THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL
REQUIRED TO ALLOW INSPECTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
INSPECTION RECORD
Foundation
Stemwall
Slab
Columns (1st Lift)
Columns (2nd Lift)
Tie Beam
Truss/Rafters
Roof Sheathing
Bucks
Interior Framing
Insulation
Ceiling Grid
Drywall
Firewall
Wire Lath
Pool Steel
Pool Deck
Final Pool
Final Fence
Screen Enclosure
Driveway
Driveway Base
Tin Cap
Roof in Progress
Mop in Progress
Final Roof
Shutters Attachment
Final Shutters
Rails and Guardrails
ADA compliance
DOCUMENTS
lation
ringCerttment Certvation Surveyit Mas Certn Certificate
veyveyon
STRUCTURAL COMMENTS
Attachment
INSP
INSPECTION DATE IIVco
Excavation
INSPECTION DATE
INSP
Temporary Pole
30 Day Temporary
Pool Bonding
Pool Deck Bonding
Pool Wet Niche
Underground
Footer Ground
Slab
Wall Rough
Ceiling Ro
Rough Z
Telephone Rough
Telephone Final
TV Rough
TV Final
Cable Rough
Cable Final
Intercom Rough
Intercom Final
Alarm Rough
Alarm Final
Fire Alarm Rough
Fire Alarm Final
Service Work Wit
A
a
ELECTRICAL COMMENTS
DATE�!Sp
Fina�Sprink�ler
Fina
i LFECTION DATE
Rough��',.
Water Service J
2"d Rough
Top Out
Fire Sprinklers
Septic Tank
Sewer Hook-up
Roof Drains
Gas
LP Tank
Well
Lawn Sprinklers
Main Drain
Pool Piping
Backflow Preventor
Interceptor
CatcCatcBasins
Condensate Drains
HRS Final
a _
PLUMBING COMMENTS
INSPECTION DATE INSP
Underground Pipe
Rough
Ventilation Rough
Hood Rough
Pressure Test
Final Hood
Final Ventilation
Final Pool Heater
Final Vacuum
MECHANICAL COMMENTS