RF-16-3473 Permit No. RF-12-161-3473
,SDORES Miami Shores Village Permit Type:Roof
10050 N.E.2nd Avenue NE
Work Classification:Flat
" Miami Shores,FL 33138-0000 Per
' Permit Status:APPROVED
,� Phone: (305)795-2204
FLOR1Dp`
Issue Date: 1/1212017 Expiration: 07/11/2017
Project Address Parcel Number Applicant
1238 NE 96 Street 1132060143920
Miami Shores, FL Block: Lot: ALBERTO MARTIN EZ-ARIZALA
Owner Information Address Phone Cell
ALBERTO MARTIN EZ-ARIZALA 1238 NE 96 ST (305)751-3853
MIAMI SHORES FL 33138-2554
Contractor(s) Phone Cell Phone
Valuation: $ 30,000.00
DECKTITE ROOFING AND WATERPR( (786)308-7657
Total Sq Feet: 6000
Type of Work:Re Roof Available Inspections:
Additional Info:RE ROOF OF FLAT ROOF Inspection Type:
Classification:Residential Tin Cap
Scanning:3 Final Roof
Roof in Progress
Renailing Affidavit
Review Roof
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $18.00
DBPR Fee Invoice# RF-12-16-62473
$5.63
DCA Fee $5.63 01/12/2017 Check#: 1535 $443.26 $0.00
Education Surcharge $6.00
Permit Fee-New Roof $375.00
Scanning Fee $9.00
Technology Fee $24.00
Total: $443.26
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. Futhermore, I authorize the above-named contractor to do the work stated.
January 12, 2017
Authorized Signature:Owner / Applicant / Contract / Agent ate
Building Department Copy
January 12,2017 1
/'X ' Miami Shores Village
BuildingDepartment
p
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 f
Tel:(305)795-2204 Fax:(305)756-8972 7BY:7
INSPECTION LINE PHONE NUMBER:(305)762-4949 _�T^
FBC 204 -1
BUILDING Master Permit No
PERMIT APPLICATION Sub Permit No.A=((o - (39-7
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL '
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I Z-3 N Ct 110-1�
City: Miami Shores County: Miami Dade Zip: 1 3
Folio/Parcel#: b122 20 66 1 31 Z b Is the Building Historically Designated:Yes NO
Occupancy Type: Load: aa Construction Type: Flood Zone: BFE:: FIFE:
OWNER: Name(Fee Simple Titleholder): fi/ /� W N��"7`K(�(2#4�-Phone#: l•��•S—����' �.3�
fA3 S AV t 15 6 S T
Address: q
City: Jy 4 j'0,4 '1 State: Zip: I3 a
Tenant/Lessee Name: AItA- Phone#:
Email: 49t �� romCA-j7`•JYe t i
CONTRACTOR:Company Name:_ i,QV�C�'D"�l �� "� Phone#: 7K 36 '�6, /
Address:j b l b �C t VV-1, ,(/W�,�--- �2_
City: 0t.1-in, , L G S State: �F-L' zip: � D` f
Qualifier Name: 2�i Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ � Square/Linear Footage of Work: d
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
V
Description of Work: 2fz
�f✓LP_,..:.�1:..\'1.'t, 4st/y./V� ..rr.V':N'1/\J�r\•1 i`.. ..I 2V;Il.^1'V".'�J'1
Specify color of color thru tiler`
Submittal Fee$ `Permiifee'$ CCF$ ' �•. ..» ,,,CO%CC'$`w''' ¢ "`'"
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ �^
TOTAL FEE NOW DU LA 1�J
(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.,- r,
Notice to Applicant: As a condition to the issuance of a building permit with on estimated value`exceeding$2500,<the'bpplicant 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 comi►1°encement 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 CONTRACIPIR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ��L L P►'�!2A-A— ,20 % , by Z G day of 20 19,0 by
who is personally known to )4 V(L-r- Zc-) d who' personally kno to
me or who has produced -D12 LIC, as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sig . Sign:
Print: \VI Print:
Seal: '' IVIS REY Seal:
)g� IVIS REY
MY COMMISSION Y FF147325 MY COMMISSION#FF147325
'�'i7 EXPIRES:AUV9 03,201 B ° EXPIRES:August 03,2018
********* * ******�e*************************************************************************
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)