RC-18-2221Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
Permit No. IBC-8-18-2221
Permit Type: residential Construction
tWork Classification: Alteration
Permit Staters: APPROVED
issue Date: 812812018 1 Expiration: 02/24/2019
Applicant
1223 NE 102 Street 1132050250140
Miami Shores, FL 33138- Block: Lot: LEMAY & ALEJANDRA SANCHE
Phone Cell
LEMAY & ALEJANDRA SANCHEZ 1223 NE 102 Street (786)514-0776
MIAMI SHORES FL 33138-
1223 NE 102 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
HOME OWNER
Valuation: $ 5,200.00
Total Scl Feet: 66
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Construction: MASTER BATHROOM REMODELIN
Occupancy:
Stories:
Exterior:
Front Setback:
Rear Setback:
Left Setback:
Right Setback:
Bedrooms:
Bathrooms:
Plans Submitted:
Certificate Status:
Certificate Date:
Additional Info: MASTER BATHROOM REMODELIN(
Bond Return :
Classification: Residential
Fees Due
Amount
CCF
$3.60
DBPR Fee
$2.34
DCA Fee
$2.00
Education Surcharge
$1.20
PU Review Fee
$0.00
Penalty Fee
$100.00
Permit Fee
$156.00
Scanning Fee
$9.00
Technology Fee
$4.80
Work without Permit Fee
$156.00
Total:
$434.94
Pay Date Pay Type Amt Paid Amt Due
Invoice # RC-8-18-68615
08/28/2018 Credit Card $ 384.94 $ 50.00
08/21/2018 Credit Card $ 50.00 $ 0.00
Avaname i
Inspection Type:
Final PE Certification
Window Door Attachment
Insulation
Drywall Screw
Window and Door Buck
Fill Cells Columns
Review Plumbing
Review Planning
Review Electrical
Review Electrical
Review Building
Review Structural
Review Mechanical
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 respo ibili for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,,f"NMBIN , ME HANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ert' that al foregoing information is accurate and
that
construction and zoning. F er o , I a ho a ab e-named contractor/o " the
V,,rA/►Ynj Y�/��"��/�j
ork will be done in compliance with all applicable laws regulating
stated.
August 28, 2018
Authorized Sign tuKDwner / Applicant / Contract oj / Agent Date
Building Department Copy 1
August 28, 2018 1
" Miami Shores Village rT=�
``� Building Department AUG 21 018
J�
\^ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
I �f Tel: (305) 795-2204 Fax: (305) 756-8972
�� INSPECTION LINE PHONE NUMBER: (305) 762-4949
BC200b'
BUILDING Master Permit No. V ' L2� ,
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: f 2 2 3 �—E I b2-
Cit : Miami Shores County: Miami Dade Zip:
Folio/Parcel#: j( Q Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address:. 1-a3 NI 1'1-2Sl
City: rk- k
J'2
State: Zip:
33i ��(
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of C)mpetency #:
DESIGNER: Architect/Engineer:
Address: City: State: Zip:
Value of Work for this Permit: $_ Square/Linear Footage of Work: 66
Type of Work: ❑ Addition ❑ Alteration ❑ New epair/Replace ❑ Demolition
►A _ 1 r _ u \
Description of Work:
Specify color of color t—h1 ru tile:
Submittal Fee $ 5O VQ 1 G Permit Fee $ ) CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CO/CC $
Notary $ —1—
Double Fee $ k 'S l �v
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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..... Q A- 0 ( r c �/ tl�^ Y6 It
E
�-{. ,-L 1,z S C,0 M -e,, .� P nW -t t � 1�-v -4 'D �- A e11L-� Y`�t�1f 1(0 X%4 �e
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 seve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be opp�d and a rflfn'sj1ection fee will be charged.
!/ Signature
OWNER or AGENT
The^f going instru nt was ack owledged before me this
LEJ day of (� ! 20 �by
-S ^ who is personally known to
me or who has produced as
identification and
NOTARY PUBLIC: ANY
Sign:
Print:
Seal:
Signatu
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
E GA ,CUI
;ON #GG207279 NOTARY PUBLIC:
April
2022
rYo,
15,
nderwriters
Sign:_
Print:
Seal:
as
APPROVED BY 9 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: tam Q DATE: W( p
ADDRESS: 1-2- iV _ L dZ S�E�� '
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 C_. 15
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is re orisible 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, ich 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 Nave the license required by law and by y co y or municipal ordinance.
Initial
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. L )
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 U
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 http://www.myfloridalicense.com/dbpr/pro/ciIb/index.htmI
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:
(2z3 N�_ c 02 s—t,
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. L
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 worker's 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 Z da,
By I m G vC n0"`-, w o wa
Produc t ere Lic or
OWNER
.0
me or who has
s identification
d�k NOTARY
201 SEVILLA AVENUE, #301
0. Coral Gables, FL 33134
Our File No.: A1819124
RETURN TO:
RICHARD L. BARBARA, ESQ.
CORAL GABLES TITLE & ESCROW LLC
224 PALERMO AVENUE
Coral Gables, FL 33134
Property Appraisers Parcel Identification (Folio) Number: 11-3205-025-0140
Florida Documentary Stamps in the amount of $4,656.00 have been paid hereon.
ABOVE THIS LINE FOR RECORDING DAT
i
Fltaf'�'F t RIP,�.I'a 1.1�.5.r. t.)r C:[iilf:l�
'`iTAi9I-�GiaC+F i�:�iL1p1jY� 'tl+:?F):GA
THIS WARRANTY DEED, made the 23 day of July, 2018 by DANIEL J. DAMMRICH and MARYANNE
DAMMRICH, HIS WIFE, whose post office address is 7915 LOREL AVENUE, SKOKIE, IL 60077 herein called
the Grantors, to ALEJANDRA SANCHEZ and LEMAY SANCHEZ, wife and husband whose post office address
is 1223 NE 102 St, Miami Shores, FL 33138, hereinafter called the Grantees:
ffherever 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)
W I T N E S S E T H: That the Grantors, for and in consideration of the sum of TEN AND 00/100'S (S I0:00) Dollars
and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens,
remises, releases, conveys and confirms unto the Grantee all that certain land situate in MIAMI-DADE County, State
of Florida, viz.:
Lot 6, Block 186, Bay Breeze Section Miami Shores, according to the Plat thereof as recorded in Plat
Book 42, Page 25, of the Public Records of Miami -Dade County, Florida.
Also known as: 1223 NE 102 St., Miami Shores, FL 33138
Subject to easements, restrictions and reservations of record and taxes for the year 2018 and thereafter.
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 Grantors hereby covenant with said Grantees that the Grantors are lawfully seized of said land in fee simple;
that the Grantors have good right and lawful authority to sell and convey said land, and hereby warrant 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 al?
encumbrances, except taxes accruing subsequent to December 31, 2017.
IN WITNESS WHEREOF, the said Grantors have signed and sealed these presents the day and year first above
written.
collli4
P
Sim ed, sealed and eliver in th�presen�ceQf.
i ess #I Signature
Witness # I Printed Name
Witness #2 $ignatu e
�1 "/P P,i Ud rn 1'0'e e e6?
Witness #2 Printed Nanie
STATE OF ILLINOIS
COUNTY OF COOK
The foregoing instrument was acknowledged before me this2`3day of July, 2018, by DANIEL J. DAMMRICH and
MARYANNE DAMMRICH who are personally known to me or have produceds'�,�f1auGGt�st� as
identification and 6Zdid El did not take an oath. -
SE KAY OVERPACK+
Official Seal
Notary Public • State of Illinois
My Commission Expires Apr 12, 202001
My commission expires:
04-I-j--2J
i/
Notary Pbblic
Printed Notary Notary Name
STATE ()IF FLORIM COUNTY OF
I HerayCE"Fy 1sal th
an file in this -
HARVEY RtNtN
Miami Shuns Village
r-
APPRO'ED _.� __—BY
ZONING DEFT
BLDG 11EPT
DATE
SUBJECT i'O C(',Nj'L-jf NCE WI Fri ALL FEDERAL
STATE AN,) l:(.UN iY HL L_S AND P.ECULJArIONS
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BATHROOM RECEPTACLE ON 20 AMP CKT
AND G.F.I PROTECTED
or` ADD SMOKE/CARBON MONOXIDE DETECTORS.
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPLACED,
rAPPR70VE.)
ALR EW Zl lf�f /g
J DATE
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