RC-16-3334Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit -NO. RC -12-16-3334
Permit Type: Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 12/9/2016
Expiration: 06/07/2017
Parcel Number
Applicant
362 NE 92 Street
Miami Shores, FL 33138 -
Owner Information
Address
1132060136440
Block: Lot:
2XM Miffik AGSM OM IV Mt Ste 161€
Phone
FRANCISCO PLAZA
Cell
[tractor(s)
FRANCISCO PLAZA
362 NE 92 Street
MIAMI SHORES FL 33138-
Phone CeII Phone
HOME OWNER
Approved. in Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Ccnstru .tion: CHANGE FLOOR IN A SECTION OF
Stories:
Front Setback:
Left Setback:
Bedrooms.
Plans Submitted: No
Certificate Date:
Bond Return :
(305)781-7666
Valuation:
Total Sq Feet:
$ 3,500.00
550
Occupancy: Single Family
Exterior.
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due Amount
CCF $2.40
DBPR Fee $2.00
DCA Fee $2.00
Education Surcharge $0.80
Permit Fee $105.00
Scanning Fee $9.00
Technology Fe? $3.20
Total: $124.40
Pay Date Pay Type Amt Paid Amt Due
Invoice # RC -12-16-62308
12/09/2016 Credit Card $ 124.40 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Framing
Insulation
Drywall Screw
Final PE Certification
Window and Door Buck
Fill Cells Columns
Review Planning
Review Electrical
Review Building
Review Plumbing
Review Structural
Review Mechanical
In consideration of the issuance to me of this perrr it, I agree to perform the work covered hereunder in compli ince wth all ordinances and regulations
pertaining thereto and in strict conformity with the plan s, drawings, statements or specifications submitted to the pro! ar authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all A'ork don_ e':!:er m;zelf, m; pert, sc:.a.i:_, J. : ya_ I understand that separate permits are
required for ELECTRICAL PLUMBING, MECHANICA _, WINDOWS, DOORS, ROOFING and SWIMMING POOL wor <.
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 an zoni g—F ermore I - thorize the above-named contractor to do the work stated.
/ AJ r' December 09, 2016
A thorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
December 09, 2016
'date
1
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
BUILDING
PERMIT APPLICATION
110‘UILDING ❑ ELECTRIC ❑ ROOFING
Dge 09 2018
FBC 20I' 11
Master Permit No.G� 6 —3334
Sub Permit No.
❑ REVISION ❑ EXTENSION E RENEWAL
PLUMBING ❑ MECHANICAL 0PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: N) z- Ai 2—1 c ST
City: Miami Shores County: Miami Dade Zip: 3'JI '6'6
Folio/Parcel#: Is the Building Historically Designated: Yes NO w'
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): RN (. SCO `PL,/\2.A Phone#: 3os- 7,1 71'064'
Address: 3(27-- N G AZ/to( sal
City: M(AMt &IIo>zCS State: FL—
zip: 3 3 138
Tenant/Lessee Name: l { Phone#:
Email:-kkavICCSC,O� 1WA o �1D ('' `611. cow,
CONTRACTOR: Company Name: 0-01‘1\60 ,1J1`) Phone#: )6 57o q 0090
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: $ 3 ST -DO Square/Linear Footage of Work: �.TO S3g-t
Type of Work: ❑ Addition IT Alteration ❑ NewRepair/Replace ❑ Demolition
Description of Work:
Chetn$e •QkOOr ' n c. ,se 613^ ok 11 • �pl4(C"
�h';1Ao w. '(/) CefCArAI G • l c--en'i.eA on G&6f..ko0f e,ui kV ,,
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ ' CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 ins.e .. ..' occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspectiill not be approved and a -' • ction fee will be charged.
Signature
OWNEAGENT111111111.111111.
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of T x iem bc% ,20 1 (0 , by day of , 20 , by
•raY�(SCS:L_170whtis peFcXXoncally known to , who is personally known to
me or who has produced?
u Z-1- 253 --4 -,31-C) me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
Seal:
goJG {c r*O7 ?0(C.-
***********
•,;n+P� MAHARAI K. GONZALEZ
ria' •...,,
�, . MY COMMISSION # GG 044602
,, 1,71 EXPIRES: November 2, 2020
��-'mac
**°** ***�*IUnd
****** i****
APPROVED BY
(Revised02/24/2014)
a
Sign:
Print:
Seal:
Plans Examiner
Zoning
Structural Review Clerk
OWNER BUILDER DISCLOSURE STATEMENT
NAME: -P1/414C SC.O 1.--PcLA
ADDRESS: %2- NG 92.4 4.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: -7966.01A1)6--t?.... , ZO 16
Do hereby petition the Village cf 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. 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.
Initial "(---?
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 "r
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 and contracts.
Initial 1::
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, I must provide direct, onsite supervision of the construction.
Initial
6. I 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 ��
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 u
8. I 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. I 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. 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.myfioridalicense.com/dbpr/pro/cilb/index.html
Initial
11. I 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:
g(02, ciez_
Initial
12. I agree to notify Miami Shores tillage immediately of any additions, deletions, or changes to any of the information that I have provided on
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 9. day of , 20 1
this disclosure.
By ,r rfv1` iSclJ
TL -A -2 -4 -
who was personally known to me or who has
Produced there License or Dal as identif t�'r��•. .,9.
mE-:
o� Gjy: Z
it p1, per: co
•
ti
NOTARY '�9oi• s3dlaX\\ �.
'1111111i11111N
Prepared by :
Andrew E. Feldman
Clear Title Services, Inc.
1111 Kane Concourse Suite 209
Bay Harbor Islands, FL 33154
305-865-5718
File Number. 16-0477 Escobar
111111111111111111111111111111111111111111111
CFN 2016R0695460
OR BK 30331 Pss 3682-3684 (3Pss)
RECORDED 12/05/2016 15:28:15
DEED DOC TAX $3,543.60
HARVEY RUM, CLERK OF COURT
MIAMI-DADE COUNTY, FLORIDA
Return To:
Peter M. Lopez PA
1911 NW 150th Ave
Suite 201
Pembroke Pines, FL 33028
[Space Above This Line For Recording Data]
Warranty Deed
This Warranty Deed made this 2qday of November, 2016 between Carlos Escobar, a single man and Renata
Fernandes Santeli f/k/a Renata Santeli f/k/a Renata Santeli-Escobar, a single woman whose post office address is 1003
N 17th Ave, Hollywood, FL 33020, grantor, and Francisco Plaza and Katitza Gloria Mandakovic, husband and wife
and Tomislav Mandakovic, a single man, as joint tenants with full rights of survivorship whose post office address is
362 NE 92nd Street, Miami Shores, FL 33138, grantee:
(Whenever used herein the term "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, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS ($10.00) and other
good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby 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:
The West 15 feet of Lot 4, all of Lot 5, the East 20 feet of Lot 6, Block 48, of AN AMENDED PLAT
OF MIAMI SHORES SECTION 1, according to Plat thereof, recorded in Plat Book 10, Page 70, of
the Public records of Miami -Dade County, Florida.
Parcel Identification Number: 11-3206-013-6440
SUBJECT TO:
1) Taxesfor the year 2016 and subsequent years and all applicable zoning ordinances and
governmental regulations.
2) Conditions, restrictions, limitations, and easements of record, if any, but without the intention of
reimposing same.
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 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 free of all
encumbrances, except taxes accruing subsequent to December 31, 2015.
DoubleTimee
Book30331/Page3682 CFN#20160695460 Page 1 of 3
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed, sealed : ' delivered in our presence as to both grantors:
State of Florida
County of
The foregoing instrument was acknowledged before me this 2 d4Y of Oc = . r, 2016 by Carlos Escobar, who 1 is
(Seal)
Carlos Escobar
Fernandes Santeli
(Seal)
personally known or [X] has produced a driver's license as iden ' , tion.
[Notary Seal]
40,4N woE1.YN
MY COMMISSION FF 1+ wo
EXPIRES: Ferry 21, 2019
or aordroarbkolikwygonto
Notary ' bite
Printed Name:
My Commission Expires:
State of Florida
County of /[/lr'uwd - 15at
The foregoing instrument was acknowledged before me this 2r day of October, 2016 by Renata Fernandes Santeli, who
u is personally known or [X] has produced a driver's license as identification.
[Notary Seal]
Notary Public
Printed Name: 14v4, A if /c1,40,,
My Commission Expires:
ANDREWFaDMAN
f,7 . UY COMMISSION t FF 930907
= EXPIRES: December 6, 2019
ewa.d rnn Por n Pubic Ikdr.dwt
Warranty Deed - Page 2 DoubleTlme.
Book30331/Page3683 CFN#20160695460 Page 2 of 3
ORBKP30331 PG 3684
LAST
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores FI, 33138
TeL 305-795-2204• Fax: 305-756-8972
Permit No. REOC-8-16-2254
Certificate of Re -Occupancy
Address: 362 NE 92 Street
City: Miami Shores
State: FL
Zip: 33138 -
This certificate verifies that the reference property has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining solely to the requirement that each
one -family dwelling is used and intended to be used for a one -family dwelling purpose
only; however, this certificate does not constitute any representation or warranty as to the
condition of the dwelling or other structures on the premises described herein, or any
aspect of such condition, and interested persons are advised and encouraged to make
their own inspections of the premises in order to determine the condition thereof.
Building Approval:
aff/i/AL
Book30331/Page3684 CFN#20160695460 Page 3 of 3
12'-4"
FLORIDA ROOM
1(1,3 C(uw
kITCHEN
13'-9"
10'-0"
DINING ROOM
Du
CLOSET
LIVING ROOM
BEDROOM
14'-10"
26'-8' 19'