RC-08-20-2219, 162 NW 108th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
162 NW 108TH ST, Miami Shores, FL 33168 1121360100060
Contacts
Jovens Degage Owner HOME OWNER Contractor
162 NW 108 ST, Miami Shores, 33168 HOME OWNER
Mobile: 3058499102 JOVENS.DEGAGE@YAHOO.COM
Description: 410 sq ft addition to the side and rear of the Valuation: $ 41,000.00 Inspection Requests:
home, the space will be used for a new master bedroom,
bath and closet . Total Sq Feet: 410.00:
Fees
Amount
Application Fee - Other
$200.00
CCF
$24.60
Certificte of Completion for Single Fam
$50.00
and Duplex
DBPR Fee
$18.45
DCA Fee
$12.30
Education Surcharge
$8.20
Permit Fee
$1,030.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$36.00
Structural Review ($45)
$60.00
Structural Review ($90)
$90.00
Structural Review ($90)
$90.00
Technology Fee
$30.75
Total:
$1,685.30
Payments
Date Paid Amt Paid
Total Fees
$1,685.30
Credit Card
03/31/2021 $1,485.30
Cash
09/30/2020 $200.00
Amount Due:
$0.00
Building Department Copy
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
regulatingeopstruction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
nature: dw- V / Applicant / Contractor / Agent
Date
31, 2021 Page 2 of 2
Miami Shores Villages
Building Department SEP 3 0 2020
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
F BC 20 t+
BUILDING Master Permit No. RC' OGl - 20 - ��19
PERMIT APPLICATION Sub Permit No.
E,(UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: hO'� A G✓ 10 2TA . , �i / J
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: //r 1?I31(. _010 — 00 6y Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):aOy-ekZ :�,?g «U:P Phone#: �J n�(� 9V
Address: l6a�Y�✓S
/d Tti T
City: I `� l C�( r ` . S4-rt.s State: 61— Zip: 3 316
Tenant/Lessee Name: Phone#:
Email
A a 0
CONTRACTOR: Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name:
hone#:
State Certification or Registration #: Certificate of Competency #: _
DESIGNER: Architect/Engineer:Phone#:
Address: 1// S IV 45 71 z OF —City: Stat
Value of Work for thris ermit: $T� 000 -y d Square/Linear Footage of Work: _
Type of Work: 2' Addition ❑ Alteration — ❑ New ❑ Repair/Replace
Specify color of color thru tile:
Submittal Fee $ ' o _() V Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF
DBPR $
7796-2 - 0.344,
Zip:
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 5
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Zip
Mortgage Lender's Name (if applicable) Y��1� �t 0' /?. P JI)ri4 Ser 1 uJ
Mortgage Lender's Addressy 13 OZ( > c3 C�
City C State i fi, Zip y C�
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
OWNER or AGE eT
The foregoing instrument was acknowledged before me this
C' day of ) 'r 20 ZO by
iu2 r2ufAJ O eUac n<, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
r'
Sign: 4,7
g
Print: '4dl ", Z Lff 0
Signature
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:
Print:
Seal: _ Seal:
as
;''tea tis•. ADNERLAPLANTE
°•1-1 ` ': NotryPublic - State ofrlorida
* Commission a GG 0 f r o
a*v*1�2********************************** **************** *************
APPROVED BY �) Plans Examiner 1 `J Zoning
siv Itml Structural Review Clerk
(Revised02/24/2014
NAME:
ADDRESS:
OWNER BUILDER DISCLOSURE STATEMENT
DATE:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
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. 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, which 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 have the license required by law and by county or municipal ordinance.
Initial TQ_
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. 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. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial a�
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 proposed construction activity at the following address:
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.
Initial--n—
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 '3L3 day of _ f 20 r,2 0
By C Qe Gc who was personally known to me or who has
Produced there License or T)r'Ne .'S LiC-e d1SC as identification.
pill I
waitmPun o9gnd'WN ru41 P"
ZOZ'ZZ LIPMUSUMM
OWNER NOTARY11 901U6M#NOISS►wW00An
VONM VN313S
Prepnd ¢y and return to.
Gentle Bari&94 Esq.
Attorney at Law
Law Office Of G. Barnett, LLC.
17794 SW tad Street
Pembroke Pines, FL 33029
954-639-7287
File Number 20-09-312
9✓ill Call No.:
ISpm* Above This Lint for Retarding Data)
Warranty Deed
CFN: 20200591195 BOOK 32148 PAGE 1704
DATE:10/19/2020 08:30:11 AM
DEED DOC 5,220.00
HARVEY RLNIN, CLERK OF COURT, MIA -DADS CTY
This Warranty Deed made this 9th day of October, 2020 between Richard Raymond and Elaine Roskos, husband
and wife whose post office address is 109 Harnish Drive, Willow Street, PA 17584. grantor, and Crbdaa Campetlo and
Boris Arsage, wife and husband whose post office address is 970 NE tooth Stree4 Miami Shores, FL 33131, grantee:
(Whenever we0 herein am terms •grantor and •smite ioch+de ail on patios to fhb immanent and the heim, Ito mpreseelaives, and a signs of
indn idwts, and the sueonsws and wigm of ampotadon; euris and wasa sl
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND 1,101100 DOLLARS ($10.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is haft acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate, lying and being in Miami -Dade County, Florida to -wit
Lot 3 and 4, Block 170, Miami Shores Section No. 3, according to the map or plat thereof; as
recorded in Plat Book 14, Page(s) 33, of the Pubtk Records of Miami -Dade County, Florida.
Parcel Identification Number: 11-3206-034-0190
Together with all the tenements, heraditaments and appurtenances thaoto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee 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 five of all
eneumbanw, except taxes accruing subsequent to December 31, 2019.
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day end year Hat above wrUten
Signed, sealed and delivered in our
v Witt
j lt,e'i
/ri� w:ti
Richard Raymond
Elaine Roskos
CFN: 20200591195 BOOK 32148 PAGE 1705
State of Florida
County of Miami, -Dade - L
IU roregoinrttitstruntent was acknowledged before me this day of October, 2020 by Richard Ra Elaine
by VVVVVV_ Aysical presences or by _online notarization, who U art persona or v odueed a
driver's license as identification. -
fg Y— +i CHARLES 14. KLUCK
�)) Notary public . State of Florida otary Public
�pj Commission M HN 18871if
„or „• My Comm. Expires Oct 31, 2024 Printed Name L �.1 Q1 • tom►'
Bonded through National Notary Assn,
My Commission Expires: /
W.m" Dmd- Pqe 2 Double11nre.
Department of Regulatory and Economic Resources
MIAMFDADE
Impact Fee Assessment
Process Number: M2020018798-0
Batch: Collection Number:
Folio: 1121360100060
Site Address: 162 NW 108 ST
CP": N
Assessment Date:10/07/2020
Fee Payer:
Disclaimer Note: ROAD/FIRE(POUPKS impact fees
will increase on 101112019
Online Payment available at:
CP": Exempt from Public Records 119.071 Florida Statues https://www8.miamidade.gov/apps/redlmpactFeesPayments/default.aspx
Y: Exempt
N: No Exempt Payment can be made by Credit Card, Cash, Check or Cashiers's Check
Blank: No info Payable to Miami Dade County
Fee Type Dist Id Category I Cat I Category Description Units Fee Extended Amount
Code ; Sufix
................ __ .. J
(AREA
1.0 15002 00 UNIT SIZE (SQ FT) 422 i $0 9180 $387.40 j
Assessment Total Amount: $387.40
••••••
• ••
• •
•
••••••
•• ••
•• ••
•
Deferral Amount: $0.00
Current Balance Due: $387.40
Dta& Candy of R@qftfty And Eromumic R=i; - Jab C.oW
1120018799-12/22J2020 5=11.24 PM
IliM20200187Npff
FwaninIr Dde Timie o - T=& amw malme
U=Wma Gonzalez IWW2020 2:21=19 PJd A FW1 F Impact fee a= ed
Report run on: October 07, 2020 10:41 AM Page 1 of 1
MIAMI-DADE COUNTY
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
http://www.miamidade.gov/building/home.asp
12/22/2020 5:11:24 PM
[Tracking #
1process #
JPermit #
1120018798
IM2020018798
12021018223
THIS COPY OF PLANS MUST BE AVAILABLE ON BUILDING SITE OR AN INSPECTION WILL NOT BE
MADE.
Process #
Review
Disposition
Reviewer
Date
M2020018798
UPFRONT FEES
A
WEB APPLICATION
ID
10/6/2020
M2020018798
DERM CORE
A
MOYA GRACE
10/8/2020
M2020018798
IMPACT FEES
A
INTERNET IMPACT
FEES IFS
10/9/2020
M2020018798
DERM TREES
A
HARRIS JENNIFER
10/9/2020
M2020018798
HRS
A
PERERA ERICK
12/22/2020
M2020018798
DERM PAVING &
DRAINAGE
A
DE TORRES, MAYRA
11/24/2020
M2020018798
WASA
A
CORTES OZZY
12/11/2020
•••
DiscjAimar.0.
0
Subjervtto co .Ice with all Federal, State, and County Laws, rules and regulations.
Miary�-Rzjde Cougt•y.issumes no responsibility for accuracy of or results of these plans.
• • • • •
NOTICE: In addition to the requirements of this permit, there may be additional
restriQ��ons applicable to the property that may be found in the public records of
this jounty, and there may be additional permits required from other governmental
entities -such as water management districts, state agencies or federal agencies.
Stamp Name
Trade
Disposit
Stamp Description
ion
Paving and
DERM
A
Approved for P&D
Drainage
Approved
HRS
A
Approved
Impact fee
PWIF
A
Impact fee assessed by Miami -Dade County
assessed
Approved
DERM
A
Approved
12/22/2020 Miami -Dade County - pay_success
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You can print this page or record your Permit, Process and Authorization number.
Date
12/22/2020
Time
17:11:19
[Authorization NumberI1084444
Process Number
IM20200187§8
Permit Number
12021018223
Transaction Number
221220AD2-83F461C4-A373-4BFE-A642-786DC22C2480
Name IPOVENS
DEGAGE
Job Address 11162
NW 108 ST
CardType
ISA
ExpDate
08/2022
mount
295.63
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