RC-1-18-247, 1284 NE 94 St�sKO1SL,�
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
�'tonioA
Phone: (305)795-2204
Project Address
1284 NE 94 Street
Miami Shores, FL
Owner Information
SUZANNEJACOBS
Permit NO., RC-1-18-247
r itPermit Type: Residential Construction
Work Classification: Addition/Alteration►
Penni€ Statgs ED
Issue Date: 2/16/2018 Expiration: 08/15/201
Parcel Number
1132050100140
Block: Lot:
1284 NE 94 ST
MIAMI SHORES FL 33138-2947
Contractor(s) Phone Cell Phone
HOME OWNER
In Review
Applicant
SUZANNEJACOBS
I � ®00
Valuation: $ 3,500
Total Sq Feet: 700 1
wm
Comments:
Date Approved:: In Review
Date Denied:
Type of Construction: REPLACE DRYWALL, REMOVE SW
Occupancy: Single Family
Stories:
Exterior:
Front Setback:
Rear Setback:
Left Setback:
Right Setback:
Bedrooms:
Bathrooms:
Plans Submitted:
Certificate Status:
Certificate Date:
Additional Info: REPLACE DRYWALL, REMOVE SW
Bond Return :
Classification: Residential
Fees Due
Amount
CCF
$2.40
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$150.00
Scanning Fee
$9.00
Technology Fee
$3.20
Total:
$169.65
Pay Date
Pay Type Amt Paid Amt Due
Invoice #
RC-1-18-66290
02/16/2018
Credit Card $ 119.65 $ 50.00
01/31/2018
Credit Card $ 50.00 $ 0.00
Avauaoie ins
Inspection Type:
Final PE Certification
Miscellaneous
Window Door Attachment
Tie Beam
Final
Insulation
Truss Insp
Columns
Foundation
Window and Door Buck
Fill Cells Columns
Wire Lathe
Review Electrical
Review Electrical
Review Plumbing
F. Termite Letter
Review Planning
Review Mechanical
Review Building
Declaration of Use
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:
construction and zoning.
Authorized Sici
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
FuthermQre, I authori4e the abovernan)ed contractor to do the work stated.
/ AppR"EanY / Contractor / Agent
February 16, 2018
Building Department Copy
February 16, 2018 1
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
Miami Shores Village
Building Department JAN312018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �„� 1
Tel: (305) 795-2204 Fax: (305) 756-8972 '
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 14
Master Permit No. IC.(— ( _ --L(44
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1284 NE. 94th St.
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-3205-010-0140 Is the Building Historically Designated: Yes NO
Occupancy Type: SFR Load: Construction Type: CBS Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Suzanne J. Giller f/k/a Suzanne Jacobs
Address: 1284 NE. 94th St.
City: Miami Shores State: FL
Tenant/Lessee Name:
Email
N/A
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Owner
State:
Phone#:305-754-4482
3o5- t-73 - 9z.i�
Zip: 33138
Phone#:_
Phone#:
Zip:
Phone#:
Certificate of Competency #:
e#:
Address: City: State: Zip:
Value of Work for this Permit: $ ��� Square/Linear Footage of Work: �� Q
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Replace drywall, remove swing doors and replace with pocket doors, add closets,
Des ri tion of Workk:
refoc - -- water he e r p with Ix , and misc.
Dnteriff alter-atiens. See Plan.
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $ /3"G>` �'O CCF $
Radon Fee $ 2- ^ CA DBPR $ Z ZS
Training/Education Fee $
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ 11 a -
Bonding Company's Name (if applicable)
N/A
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) N/A
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.
11
X
Signature Wh"v
OWNER or AG
The foregoing instrument was acknowledged before me this
day of TO , 20 � by
Suzanne J. Giller who is personally known to
me or who has produced FL Driver's License as
identification and who did take an oath.
NOTARY PUBLIC:
MAHARAI K. GONZALEZ
Si
_' � `-
MY COMMISSION # GO 044602
EXPIRES: Novemer
Print:
-:FOF.�4" `
Bonded Thru Notary Public Underwriters
Seal:
Signature
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.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
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
NAME: Suzanne J
OWNER BUILDER DISCLOSURE STATEMENT
Giller DATE: 3
ADDRESS: 1284 NE. 94th St., Miami Shores, FL 33138
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. 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 a n ts.
Initial
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. 1 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 le h" 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
is my responsibility to ensure that the persons whom I employ have the license required by law and c u or municipal ordinance.
initial
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. l 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 andjmust 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.
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
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 prop% ed consWttion activity t the following address:
�'[ , Lr/. Initial
�,
I Chi m t' �Y ! �S /7 ( 3� 3
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the inf9f mation 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 -�31
By Suzanne J. Giller
Produced theyCL�ice�nsr
day of _ _, 20�
who was personally known to me or who has
as identification.
OWN I` NOTARY
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1/31/2018 Property Search Application- Miami -Dade County
'A OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3205-010-0140
Property Address:
1284 NE 94 ST
Miami Shores, FL 33138-2947
Owner
SUZANNE J JACOBS
Mailing Address
1284 NE 94 ST
MIAMI, FL 33138 USA
PA Primary Zone
1400 SG FAMILY - 3001-3250 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
4/4/0
Floors
1
Living Units
1
Actual Area
3,294 Sq.Ft
Living Area
2,316 Sq.Ft
Adjusted Area
2,805 Sq.Ft
Lot Size
9,675 Sq.Ft
Year Built
1957
Assessment Information
Year
2017
2016
2015
Land Value
$348,312
$324,082
$295,308
Building Value
$195,228
$195,228
$196,855
XF Value
$1,296
$1,316
$1,061
Market Value
$544,836
$520,626
$493,224
Assessed Value
$273,041
$267,426
$265,568
Benefits Information
Benefit
Type
2017
2016
2015
Save Our Homes
Cap
Assessment
Reduction
$271,795
$253,200
$227,656
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
MIAMI SHORES BAY VIEW PB 40-16
LOT 16
LOT SIZE 75.000 X 129
OR 20340-3470 02 2002 4
Generated On : 1/31/2018
Taxable Value Information
20172016 2015
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$223,041
$217,426
$215,568
School Board
Exemption Value
1 $25,000
$25,000
$25,000
Taxable Value
$248,041
$242,426
$240,568
City
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$223,0411
$217,426
$215,568
Regional
Exemption Value 1
$50,000
$50,000 $50,000
Taxable Value
$223,041
$217,426 $215,568
Sales Information
Previous
OR
Price
Book-
Qualification Description
Sale
Page
j
02/01/2002
$0
20340-
Sales which are disqualified as a result of
3470
examination of the deed
05/01/1986
$140,000
12883
Sales which are qualified
0417
10/01/1979
$105,000
10557-
Sales which are qualified
1843
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://w\&w.miamidade.gov/info/disclaimer.asp
Version
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MIAMI SHORES 'VILLAGE
ZT;77Ft
ZONING
--ter
STRUCTURAL
ELECTRICAE `r
07z I8
PLUMBING
BATHROOM RECEPTACLE ON 20 AMP CKT
AND G,FI PROTECTED
ADD SMOKE/CARBON MONOXIDE DETEC
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPI e
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LOUN Y RULES AND REGijWjo S � � � � � J � UV
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r wACTURAL
DATE
INSP
Columns (1st Lift)
'`J
R
Columns (2nd Lift)
t
Tie Beam
Truss/Rafters
Roof Sheathing
Bucks
Interior Framing
Insulation
Ceiling Grad
Drywall
Firewall u
Wire Lath
Pool Steel
j
Pool Deck
Final Pool
Final Fence
Screen Enclosure
Driveway
Driveway Base
Tin Cap
Roof in Progress
Map in Progress
final Roof
Shutters Attachment
F'nal Shutters
Rails and Guardrails
1ADA compliance
DOCuMENT / Y
Soil Bearing Cert
Soil Treatment Cert j
Floor Elevation Survey j
Reinf Unit Mas Cert
Insulation Certificate
Spot Survey
Final Survey
Truss Certification
STRUCTURAL COMMENTS
� ` c
WINDOWS &'�DOORS
INSPECTION I !?ATR I !?ATil JINSP
Attachment
PUBLIC WORKS
INSPECTION DATE INSP
Excavation
ELECTRICAL
INSPECTION
DATE
INSP
Temporary Pole
30 Day Temporary
Pool Bonding
Pool Deck Bonding
j
Pool Wet Niche
Underground
Footer Ground
Slab
Wall Rough
Ceiling Rough - -
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 With
E �
ELECTRICAL COMMENTS
INSPECTION (DATE INSP
Final Sprinkler
Final Alarm
INSPECTION
DATE
INSP
Rough
J
Water Service
T .
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
Catch Basins
Condensate Drains
HRS Final
9121-1
PLUMBING COMMENTS
�-
INSPECTION
DATE
INSP
'Underground Pipe
Rough
Ventilation Rough
Hood Rough
Pressure Test
Final Hood
Final Ventilation
Final Pool Hcater
Final Vacuum
MECHANICAL COMMENTS