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RF-16-1996Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit IsSue Date: 12/16/2016 Permit NO. RF -7-16-1996 Permit Type: Roof Work Classification: Tile/Flat Permit Status: APPROVED Expiration: 06/14/2017 Parcel Number Applicant 445 NE 94 Street Miami Shores, FL 1132060140520 Block: Lot: Darren Ockert Owner Information Address Phone Cell Darren Ockert 445 NE 94th Street , Miami Shores FL 33138 917 573-9022 Contractor(s) Phone TRI STATE ROOFING & GENERAL CO (561)337-7718 Cell Phone Valuation: Total Sq Feet: $ 41,000.00 5000 Type of Work: Re Roof Additional Info: RE -ROOF OF EXISTING HOUSE AND NEW R Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $24.60 $5.25 $5.25 $8.20 $5.00 $350.00 $9.00 $32.80 $440.10 Pay Date Pay Type Invoice # RF -7-16-60628 07/18/2016 Credit Card 12/16/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 390.10 $ 390.10 $ 0.00 Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Roof in Progress Renailing Affidavit Review Roof Review Roof Cap Sheet 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. December 16, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date December 16, 2016 1