RF-18-1808 Permit NQ. RF-7-1$-1,808
�sKO1 s i,� Miami Shores Village Permit Type:Roof
10050 N.E.2nd Avenue NE ' s
r .� Work Ctassifrcatjon:Tile
Miami Shores, FL 33138-0000 Per
Permit Status:APPROVE
y` Phone: (305)795-2204
FLORIDA
Issue Date:713/2018 Expiration: 12/30/2018
Project Address Parcel Number Applicant
74 NE 111 Street 1121360040070
Miami Shores, FL 33161-7047 Block: Lot: JOHN TISDELL
Owner Information Address Phone Cell
JOHN TISDELL 74 NE 111 Street
MIAMI SHORES FL 33161-7047
Contractor(s) Phone Cell Phone Valuation: $ 1,300.00
JJ QUALITY BUILDERS INC (305)300-3937
��....... �.._ m. . _._ Total Sq Feet: 15
Type of Work:Repair Available Inspections:
Additional Info:REPAIR OF 1 SMALL ROOF LEAK ON FRON Inspection Type:
Classification:Residential Up Lift Report
Scanning:3
Tin Cap
Final Roof
Tile In Progress
Renailing Affidavit
Review Roof
Cap Sheet
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $120 Invoice# RF-7-18-68120
DBPR Fee $2.00
DCA Fee $2.00 07/03/2018 Credit Card $ 121.20 $0.00
Education Surcharge $0.40
Notary Fee $5.00
Permit Fee-New Roof $100.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $121.20
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 EL ICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS FFIDA IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructi n and ni FuuthleppAwe-,tthe above-named contractor to do the work stated.
H I July 03, 2018
Auth6rizecl Signatur Owner Applicant / Contractor / Agent Date
Building Department Copy
July 03, 2018 1
MiIami Shores Village 0.6((t ���
g
Building Department tt�
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �l �
��•tl Tel:(305)795-2204 Fax:(305)756-8972 1 + 08
INSPECTION LINE PHONE NUMBER:(305)762-4949 i �
J 2b1--�W �1'
BUILDING _ Master Permit No. 12jp
k
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC C( ROOFING ❑ REVISION ,❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
L CONTRACTOR DRAWINGS
JOB ADDRESS: -7 L/ IJ
City: Miami Shores � County: Miami Dade zip: 3316 /
Folio/Parcel#: I I Z!3�o 0b Llao~I 0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load:' Construction Type: Flood Zone:�FE: FFE:
I 7�
OWNER:Name, (Fee Simple Titleholder): V a�V1 !� iS�E.c-L-- Phone#: J"S y7a 6S/7 Z
Address:
City: State: Zip:2�Z6
� F
Tenant/Lessee Name: N ei Phone#:
Email: -----' 1,
'CONTRACTOR:Company-Name: I Phone#:(1,:�CG—i
Address:2 t
City: iA m `� X j State: -1(1 Zip: FZ�Z
Qualifier Name:�Sesc�S YYI�_�(1P Phone#:VUS—
State Certification or Registration#:�WO, ( 2 qq Certificate of Competency#: q74 2-3
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ U
KL Square/Linear Footage of Work: •.. 2
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: Qk )� �- DA3 20,x, oFc r1
Specify color of color thrii tile:
Submittal Fee$ tPermit Fee$ CCF$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$" 0
TOTAL FEE NOW DUE$'
(Revised02/24/2014)
Y _
Bonding Company's Name(if applicable)
Bonding Company's Address '
City State Zip
44
Mortgage Lender's Name(if applicable)
Mortgage'Lender's,Address
City " ! State Zip
1
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
i
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."
• 7
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 pproved and a reinspection fee will be charged. -
Signature Signa tre
OWNER or AGENT i4f NTRACTOR
4
Fi
The f6rrjgoing instrum`e t was acknowledged before me this The foregoing instrument was acknowledged before me this
day
,i of J� `~< 20 1(7 by b ,2 day of ��LJ 20 [ by
to h n �t.TIS t/►L'�1' who is personally known to J �� J �`rnie-ne-'-t;who is personally known to
me or who has produced DG FL*T2�q—y�0�'-7�as"0 me or who has produced as
identification and who did take an oath. identification and who did take an oath.
0 ,, \ _ j C, I
NOTARY PUBLIC: C~NOTARY PUBLIC:
Sign. r f t -/� Sign: '
Print: LQU SI'S'� Prin .
Seal: o� JENWLEDESMA Sea I: REYNAAMATEO
}2t; MYCOMMfSSIONtFF821lTT oaY.pq'iG
'= EXPIRES'September MY COMMISSION#GG176896
eondedThmPb ryPv*Wdenw�n EXPIRES:JAN 18,2022
�4-r' Bonded through 1st State Insurance
APPROVED BY Plans Examiner Zoning
Y
q N.
Structural Review Clerk
(Revised02/24/2014) ,
i
Property Search Application - Miami-Dade County Page 1 of 1
.ga OFFIC&E OF THE PROPP"AERT'T"' APPRAISER
Summary Report
Generated On:7/2/2018
Property Information
, �.
Folio: 11-2136-004-0070 --.
*�rert.
Property Address: 74 NE 111 ST
Miami Shores,FL 33161-7047
Owner JOHN TISDELL
74 NE 111 ST
Mailing Address MIAMI SHORES,FL 33161-7047
PA Primary Zone 0800 SGL FAMILY-1701-1900 SQ
0101 RESIDENTIAL-SINGLE
Primary Land Use FAMILY: 1 UNIT
Beds/Baths I Half 2/1 /0
Floors 1
Living Units 1 ,a
Actual Area 2,279 Sq.Ft
Living Area 1,503 Sq.Ft
Adjusted Area 1,897 Sq.Ft Taxable Value Information
Lot Size 9,225 Sq.Ft
2018 2017 2016
Year Built 1942
County
Assessment Information Exemption Value $50,000 $50,000 $50,000
Year 2018 2017 2016 Taxable Value $184,563 $179,7391 $175,014
Land Value $230,638 $230,638 $198,007 School Board
Building Value $132,031 $132,031 $132,031 Exemption Value $25,000 $25,000 $25,000
XF Value $2,491 $2,526 $2,561 Taxable Value $209,563 $204,739 $200,014
_..._.._.._........__. _ . .. _._...............____.. ...._....
Market Value $365,160 $365,195 $332,599 City
Assessed Value $234,563 $229,739 $225,0141 Exemption Value $50,000 $50,000 $50,000
Taxable Value $184,563 $179,739 $175,014
Benefits Information Regional
Benefit Type 2018 2017 2016 Exemption Value $50,000 $50,000 $50,000
Save Our Homes Assessment Taxable Value $184,563 $179.7391 $175,014
Cap Reduction $130,597 $135,456 $107,585
Homestead Exemption $25,000 $25,000 $25,000 Sales Information
Second Previous OR Book-
Homestead Exemption $25,000 $25,000 $25,000 Sale Price Qualification Description
Page
Note:Not all benefits are applicable to all Taxable Values(i.e.County, 12/01/2003 $0 21943- Sales which are disqualified as a result
School Board,City,Regional). 1204 of examination of the deed
12/01/2003 $250,000 21943- Sales which are qualified
Short Legal Description 1203
36 52 41 02/01/2003 $0 21529- Sales which are disqualified as a result
COLLEGE HEIGHTS PB 42-8 4717 of examination of the deed
LOT 7 BLK 1 10/01/1996 $110,000 17416- Sales which are qualified
LOT SIZE 75.000 X 123 2106
OR 17416-2106 1096 1
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 hftp://www.miamidade.gov/info/disclaimer.asp
https://www.miamidade.gov/propertysearch/ 7/2/2018
• �5N�R9� Li
Miami shores Village
"" ""'?" Building Department
10050 N.E.2nd Avenue
�lORIDp` Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees,including the owner,must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State,Division of Corporations;and s
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
Owner
State of Flori a
County of Miami-Dade
The foregoing was acknowledge
bbefore me this2, day of (J ,20_J E?.
By� -St-1Ewho is personally known to me or has produced
as identification.
Notary:
SEAL: y
r
mar r Notary Public State of Florida
my CoMmiRt;iQn FF 15675 {
�, mad' FXpi,9a00)0312018��'��
'f
JJ QUALITY BUILDERS INC
Contractor: JJ Quality Builders Inc# CGC 1520532 J,0. ,,def
CCC-1329998 HI 6634
Address: 27541 S W 139 PI Homestead F133032
Date: 07/02/2018
f
State of Florida
County of Miami-Dade
Before me this day personally appeared Jesus Jimenez who, being duly sworn, deposes and says:
That he or she will be the only person working on the project located at : 74 NE 111 ST Miami Fl
33161.
qrn to (or affir ) and subscribed before me this 02 day of,2018, by Jesus Jimenez.
l
t
1 ier ame
Personally know
Or Produced Identification DL
Type of Identification Produced PL�
REYEAMATEOMY COMMIG176896
EXPIRE2 222 1
°� onded throuInsurance
AME OF N TAR , PRINT OR TYPE {
Pg. 1 of 3
JJ Quality Builders, Inc.
ROOF ASSEMBLI T S
!
AUL 3 10 Florida Building Code 5th Edition (2014)
1
I 11FAigh-Velocity Hurricane Zone Uniform Permit Application rm. 1
I I
1
` Section A(General.Information) -•• {, 1
i Master Permit No. Process No. 1
Contractor's Name
_ C 1
Job Address—'7 �frei�1JfL a��o/ 1
1
ROOF CATEGORY 1
❑ Low Slope ❑ Mechanically Fastened Tile X Mortar/Adhesive Set Tiles
❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes 1
r ❑ Prescriptive BUR-RAS 150
ROOF TYPE
❑ New roof X Repair ❑ Maintenance ❑ Reroofing ❑ Recovering 1
-ROOF SYSTEM INFORMATION1
r Low Slope Roof Area(SF) ar Steep Sloped Roof AREA(SSFJNotal(SF)A 1
Section B(Roof Plan) •••••• ***too
Sketch Roof Plan: Illustrate all levels and sections, roof drains,scuppers,overflow scuppers and oaeh;r drains elndude dimen-
sions of sections and levels,clearly identify dimensions of elevated pressure zones and location gjgg Vts.
9,"A/ •
•.•.•
Z •� •
Q •••• • • • ••• •
0 W F .. • .. .. ••.4.•
E•
c0 r • 1
�1 co W 1
" •t rc 1
C: •�
" ! LLJ D 2 O 1
5 C, U QI 1
G_
U- 0( m Q I 1
I Q
1
1
1
� t4 NQ,
FLORIDA BUILDING CODE—BUILDING,5th EDITION(2014) 15.37
Copyright to,or licensed by,ICC(ALL RIGHTS RESERVED):accessed by Eliezer Palacio on Jun 8,2015 10:32:12 AM pursuant to License
Agreement.No further reproductions authorized.
i
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code 5th Edition(2014)
1 High-Velocity Hurricane Zone Uniform Permit Application Form.
I 1 � '
Section C(L ow S Application) ! Top Ply Fastener/Bonding Material:
1 Fill in specific roof assembl components and identify
1 manufacturer
Surfacing: 1
(If a component is not used,i ntify as"NA") Fastener Spacing for Anchor/Base Sheet Attachment:
1 System Manufacturer: i
1 Field:_"oc @Lap,#Rows_@_"oc 1
I _ I 1
Product Approval No.: Perimeter: "oc @ Lap,#Rows_@ oc
1 i
Design Wind Pressures, From RAS 128 Calculations: Corner:_"oc @Lap,#Rows_@_"oc 1
P1: P2: P3 Number of Fasteners Per Insulation Board:
1 Field Perimeter Corner
Max.Design Pressure,from the specific produc 1
1 approval system: Illustrate Components Noted and Details as Applicable: 1
1 Deck: Woodblocking, Gutter, Edge Termination,Stripping, Flashing, 1
1 Continuous Cleat,Cant Strip,Base Flashing,Counterflashing, 1
1 Type: _ Coping, Etc.
Indicate: Mean Roof Height, Parapet Height, Height of Base 1
1 Gauge/Thickness: Flashing, Component Material, Material Thickness, Fastener
1
Slope: Type, Fastener Spacing or Submit Manufacturers Qqjji�that
1 p Comply with RAS 111 and Chapter 6. • ,•••••• 1••••••
1 I ••
Anchor/Base Sheet&No.of Ply(s): •• 0 000
1 •
0000. .. I......
1Anchor/Base Sheet Fastener/Bonding Material: 0000. i0 1'
000000
1 0000 0000 1.
1 •fi , 000• 00000
Insulation Base Layer. • •
1
0000. 1.....
0 0
•• 1000000Pa '
ra e �
1 Base Insulation Size and Thickness: \ ••••• p 1 •
1 Height
• 1000000
Base Insulation Fastener/Bonding Material:. \� 0 0 0 0 0
I 0
1'
1 ` 0.0 : 0• • 10.0000
1 Top Insulation Layer: FT. " '
I .� 1
1 Top Insulation Size and Thickness: Mean 1
1 Top Insulation Fastener/Bonding Material: Roof 1
1 Height
1
iBase Sheet(s)&No.of Ply(s): 1
1
1 Base Sheet Fastener/Bonding Material: 1
I , 1
1 Ply Sheet(s)&No.of Ply(s): 4\ 1
x 1
1 Ply Sheet Fastener/Bonding Material:
1
Top Ply:
+ 1
. 1
15.38 FLORIDA BUILDING CODE—BUILDING,5th EDITION(2014)
t t t 1 I I Copyright to,or licensed by,ICC(ALL RIGHTS RESERVED);accessed by Elie=Palacio on Jun 8,2015 10:32:12 AM pursuant to license
Agreement.No funkier reproductions authorized.
r
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code 5th Edition(2014)
High-Velocity Hurricane Zone Uniform Permit Application Form ' 1
� 1
Section D(Stee `Slo ed Roof System)-
1
. 1
Roof System Manufacturer: 1
Notice of Acceptance Number: 1
Minimum Design Wind Pressures,If Applicable(From RAS 127 or Calculations): 1
P1:�34. I P1: PI: - IDO- �' 1
1
1
peckeType: �i 1
g C-_4 1
1
Type1Und&rlayment: �j. IC� `-'v 1
R Slope: 1
l 12 Insulation:
+ Fire Barrier: 1
1
1
Ridge Ventilation? Frastener Type,&Spacing ? Q •h P �
-_�
Adhesive=Type: .Z GVl j� •••' ( 1 •
�d
Type Cap Sheet: �— •••• ....
t Mean Roof Height: Roof Covering: ••T.— •• •• �.....
......
1 •
Type&Size Drip
Edge: ....:
1
FLORIDA BUILDING CODE—BUILDING,5th EDITION(2014) 15.39
11 kill I"I t ' t I 1 ' Copyright to,or licensed by,ICC(ALL RIGHTS RESERVED);accessed by Eliezer Palacio on Jun 8,2015 10:32:12 AM pursuant to license
Agreement.No further reproductions authorized.
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code 5th Edition(2014)
1 High-Velocity Hurricane Zone Uniform Permit Application Form.
1
1 - 4
1" Section E(Tile Calculations)
1 For Moment ba d the systems,choose either Method 1 or 2. Compare the values for M,with the values from M,. If the M,values
are greater than r equal to the M,values,for each area of the roof,then the tile attachment method is acceptable.
1
1 Method 1 "Moment Based Tile Calculations Per RAS 127"
x X_= -Mg:_=Mr; Product Approval M,
1 (P xa = _)-Mg: =Mrz- Product Approval M,
(P3: XX Mg: =Mr,_ Product Approval Mf:
Method 2"Simplified Tile Calculations Per Table Below"
Required Moment of Resistan M)From Table Below Product Approval M,
M,required Moment Resistance'
Mean Roof Height
1 Roof Slope 15' '20' 25' 30' 40'
1 2:12 4.4 36.5 38.2 39.7 42.2
3:12 3 34.4 36.0 37.4 39.8
1 4:12 30.4 32.2 33.8 35.1 37.3 1
1 5:12 28.4 30.1 31.6 32.8 j 34.9
1 6:12 26.4 28.0 29.4 30.5 32.4 ....
1 7:12 24.4 25.9 27.1 28.2 90.0 ••••� 0000••
'Must be used in conjunction with a list of momentb sed tile systems endorsed by the Broward County board of f�t+ie;and •
1. Appeals. ...�.. 00 00000•
For Uplift based tile systems use Method 3.Compared the alues for F'with the values for Fr. If the F';;I;gs are gre�t�Li Ian or ••••••
equal to the Fr values,for each area of the roof,then the tile ttachment method is acceptable. • 0 •
Method 3"Uplift Based Til Calculations Per RAS 127" •••••• • • •• ••
(P1:_xL_=_xw:=_)-W:_xCosg_- Product Approval F' " '• •• •• 0000••
1 (P2:_x L__-x w:=_)-W:_x Cos 8 = Product Approval F :":': ' ••
1 (P3:_xL_= xw:=_)-W:-x Cos a-=Fr3 Product Approval F' ' ' ;..•;• 009009
1 Where to Obtain Infor ation • • •
1 Description Symbol Where to find
1 Design Pressure P1 or P2 or P3 F;bNS 127 Table 1 or by an engineering analysis pre-
paled by PE based on ASCE 7
t
1 , Mean Roof Height H Job Site
i
Roof Slope (3 Job Site
Aerodynamic Multiplier x Product A proval
1 Restoring Moment due to Gravity M9 Product Apprbval
Attachment Resistance M, Product Approv l
1 Required Moment Resistance M9 Calculated
1 Minimum Attachment Resistance F' Product Approval
1 Required Uplift Resistance Fr Calculated
1 Average Tile Weight W Product Approval
1 Tile Dimensions L =length W=width Product Approval
1 All calculations must be submitted to the building official at the time of permit application.
1
15.40 FLORIDA BUILDING CODE-BUILDING,5th EDITION(2014)
t ' I 1 1 Copyright to,or licensed by,ICC(ALL RIGHTS RESERVED);accessed by Eliezer Palacio on Jun 8,2015 10:32:12 AM pursuant to License
Agreement No further reproductions authorized.
f
SNORES GIS
Miami shores Village
Ilium will?" Building Department
10050 N.E.2nd Avenue
pjijpA Miami Shores, Florida 33138
Tel: (305) 795.2204
' Fax: (305) 756.8972
OWNERS'S AFFIDAVIT OF EXEMPTION
ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE-
BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES
PERSUANT TO SECTION 553.844 F.S.
t
To: Miami Shores Village Building Department Date: Zai
10050 NE 2nd Ave
Miami Shores, FI 33138
r Re: Owner's Name:
Property Address: —7 L/ NF_
Roofing Permit Number:
6666
Dear Building Official: ••••• ••••••
1 SGS certify that I am not required to retrofit the rooTtd Wd11 connectioht of mY""'
64,.40.. 4,
6666..
building because: 40.4,40•• •6666. •
00*0
he just valuation for the structure for purpose of ad valorem taxation is less than $300,000.40Fk(;lease plta�hproof e4d-
valorem taxation. " " " '
6
666 .. ,..
00
❑The building was constructed in compliance with the provisions of the Florida Building Codg (FB.C)or w9ht112provisions
of 19 ition of the South Florida Building Code (1994 SFBC) so ' '
0
Signat re Print Name
t
State of Florida
County of Dade
The undersigned, being the first duly swom, deposes and says that he/she is the owner for the above property mentioned.
t _
Sworn to and subscribed before me this )nGl day of .j
MY COM.:.tc:,L-T, 921971
NotaryPublic, Sate of Florida at Large ' EXPIHEs:September 27.2019 i
t • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than$300,000.00,a the bulding was not constructed with FBC nor a 1994
SFBC.Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation.
Revised on 5/21/2009
t
;L F
t
SNoREs G
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
FLORIDA Tel: (305) 795.2204
Fax: (305) 756.8972
AF DAVIT OF COMPLIANCE WITH ROOF TO WALL CONNECTION HURRICANE MITIGATION
RETRO T FOR EXISTING SITE-BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT
TO SECTION 553.844 F.S.
To: Mia\2nd
e Building Department Date: Cp he
100Mia138
Re: Owner's Name: iSCu it �
Property Address:
Roofing Permit Number:
Dear Building Official: ••••••
.. 0000
t I 000. 00.
ce ify that I have improved the roof to wall�jn0ions of the.referen. �0ea
property as required by the Manual of Hurricane Miti tion Retrofits for Existing Site-Built Si jjIVF.amily;FZ�lde0000..
ntial ' '
.. 0000 0000.
tru tures as adopted by the Florida Building Commissio by Rule 96-3.047 F.A.C. •••••• •• •••
�- .• •. .. .. 0000..
•
0 Goo***
V� 0000..
. .0900.
Sig ature P t Name • • • '
99 9
State of Florida
County of Dade
The undersigned, being the first duly swom,deposes and says that he/she is the own for the above property mentioned.
Sworn to and subscribed before me this day of
Notary Public,Sate`of Florida at Large
4
(SEAL)
FINAL COMPLIANCE
Revised on 5/21/2009
4
4�
5NoR�s "
'"1-932
Miami shores V
all Budding Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�ORIDp' Tel: (305) 795.2204
"
Fax: (305) 756.8972
RE: Permit# DATE:—q4�1�5
INSPECTION AFFIDAVIT
Iy S r n-,n licensed as a ( Contractor Engineer/Architect,
" (Print name and circle License Type) FS 468 Building Inspector
ILicense-#: C tZ G q GT$
On or about I did personally inspect the roof deck'IT�iRr�g
(Date 8 time) • • • •
work at �'"�-1 p.�- Ill �A- Mj QjM i S hors
(Complete Job Site Address) ••••••
Based upon that examination I have determined the installation was done according to the HMirfcane Mitigation Retrofit
......
anu Based on 5 . .S) •
. . . . ......
rnature
State of Florida
t
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is`th c contractor for the above property
mentioned.
Sworn to and subscribed before me this 2 day of
,fttary'Public,Sate of Florida at Large - REYNAAMATEO
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4�� MY COMMISSION#GG176R96 R
EXPIRES:JAN 18 ''02?
Bonded through 1st State insu�x-e
'General,Building,Residential,or Roofing Contractors or any individual certified under 468 F.S.to make such an inspection.Include photographs of each plane of the roof with
permit#and address#dearly shown marked on the deck for each inspection
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SECTION 1524
HIGH VELOCITY HURRICANE ZONES—REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
1524.1 Scope.As it pertains to the section,it is the responsibility of roofing contractor to provide the owner with
the required roofing permit,and to explain to the owner the content of the section.The provisions of Section R4402
govern the minimum requirements and standards of the industry for roofing system installations.Additionally, the
following items should be addressed as part of the agreement between the owner ant the contractor.The owner's
initial in the designated space indicates that the item has been explained.
2. _Renailing wood decks:When replacing roofing,the existing wood roof deck'may have to
be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually
concealed prior to removing the existing roof system).
I 4. Exposed Ceiling: Exposed,open beam ceilings are where the underside of the roof decking
can be viewed from below. The owner may wish to maintain the architectural appearance;therefore,
roofing nail penetration of the underside of the decking may not be acceptable. This provides ft"Qption of
maintaining the appearance. •
i 6. Overflow scuppers(wall outlets): It is required that rainwater fIMMI#So that the toof is
) q :•...:
i not overloaded from a buildup of water. Perimeter/edge wall or other roof exteggMfwy blorlMl.?• •
discharge if overflow scuppers(wall outlets)are not provided. It may be nec5 install overflow •:•
scuppers in accordance-with the requirements of Sections 02, R440 ands •••••
y� �� . .
Owner/Agent's SignatureAD to ontractor Sig Lire a :"•':
Prop rty Address �,� , Permit Number
Revised on 7/9/2009 LD;07/01/2015;
^
` STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
i
CONSTRUCTION INDUSTRY LICENSING BOARD (85U) 487-1395
2601BLA|R STONE ROAD
TALLAHASSEE FL 32399-0783
. .
JJ
� QUALITY BUILDERS INC.
27541SVV13QTHPLACE
HOMESTEAD FL 33032
i
------------ _ - - ------�-- ' — — — — - - — —--- - —1' --^ -
Congratulations! With this license you become one vfthe nearly
one million Floridians"licensed~'the Department"' "='^~~~~^~ | � OFLORIDA
Professional R 0u range | �/ ^'
restaurants,from architects to yacht brokers,from boxers to barbeque DEPARTMENT,'OF-BUSINESS AND
onumovxo�p�mnoanocnnnmyonong '
� ( �`��, rxu ,
' Every day we work to improve the do business in order u~C/
o°=,"'"""""". For.~information,about our services, �
lo onto www.myfloridalicense.com. There you ran find moreCERTIFIED ROOFINGrCON
information about our divisions and the regulations that impact � '
you,subscribe mdepartment newsletters and learn more about '
'
the Department's initiatives. ' -
Our mission at the Department is: License Efficiently,
Ro9ubm
Fairly. �
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oemeyour ouommnm Thank hv�n�sam�o�ua. ' '�� '~ C~^ '^'~ ` ' ' `
- '- - —'" 1 �m o us�n�m',m
and uong��|oUonaonyour new hoense! ~ -
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- •�;-.`.w..".,.4Y "ca'°'-.e"'rk"""` - ,- --ter se-+---a, _
it -
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I'. amiaDa'deCounty,-State .o , d
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IS,
NOT A BILL'-DO NOT PAY
7175429
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BUSINESS NA11[IEIL00AT10Nr - EXPIRES;
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QUALITY BUILDERS INC n RENEWALO-S�P.TE �ER � ��7 :
r` 27541 •SlfU 1'39 PL _ _� `.7454944 - '
1 I - - .. -
' t Must be displayed at place of'business
! HOMESTEAD FL 33032 Pursuant to County Code
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Chapter 8A - Art. 9.,&'10
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j SEC. TYPE OF-BUSINESS d
OWNER'' - PAYMENT RECEIVED
' JJ QUALITY BUILDERS INC + 1.96 SPECIALTY-BUILDING CONTRACTOR
i t r y CCC.1329998 ' BY TAX 60LLECTQR
"C10 JESUS- JIME,NEZ QUALIFIER
,. . ` $7,5.00_.q9/R9/`V 17
Worked(-�J r' 2
CREDITC�4 X1:7-0:66 9., -
- .. �` }' _ � - .• ...�-... ,. .. 7 rim�yy'''I�'L
-- cal Business�Tax Ri;ceipt only°confirms paymead the Local Business Tax. The 860,10. , 11a��, e.
:�`• This,lo
permit, or a certifiication-vf the holder s qualifications,to do business Holder-must comply jbvt t ntal
t r i .l a4 -
• ay4 3 J4,
e �of nongovernmental regulatory laws end_requuements which,.apply to the;business -
s
x �' The RECEIPT NO.above must be'displayed-on,all commercial vehicles- M
y - Colrmation,visit www miamidade.gov/tax 'r
J. Foy more f
3 � -
'°' f CERTIFICATE OF LIABILITY INSURANCE DATE /YYYY)
077/02//02/18
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the'policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT MARTA ALONSO
NAME:
Florida Bankers Insurance PHo N (305)266-6493 AC No): (305)262-0679
6874 SW 8 ST E[JIAIL maria@floridabankersinsurance.com
Miami,FL 33144 INSURERS AFFORDING COVERAGE NAIC#
Phone (305)266-6493 Fax (305)262-0679 INSURER A: AIX SPECIALTY INSURANCE COMPANY
INSURED INSURER B:
JJ QUALITY BUILDERS INC INSURER C: r
27541 SW 139 PI INSURER D:
HOMESTEAD,FL 33032- INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
t EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL UBR POLICY NUMBER MMIDD YYYY MM/DD/YYYY LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00
DAMAGE TO RENTED 50���.��
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $
A
❑ ❑ CLAIMS-MADE R] N N 04/19/2018 04/19/2019 OCCUR SIZGL1003A202182 MED EXP(Any one person) $ 5,000.00
❑
t PERSONAL&ADV INJURY $ 1,000,000.00
❑ GENERAL AGGREGATE $ 1,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000.00
POLICY ❑ PRO- ❑ LOC $
AUTOMOBILE LIABILITY COEaBINED SINGLE LIMIT Mac
❑ ANY AUTO BODILY INJURY(Per person) $
❑ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ❑ AUTOS
NON-OWNED PROPERTY DAMAGE $
❑ HIRED AUTOS ❑ AUTOS Per accident
❑ ❑ $
❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $
❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $
t ❑ DED ❑ RETENTION$
WORKERS COMPENSATION ❑TW
C STATULIMI- El EOR
TH-
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑ N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
i
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
CCC-1329998 ROOFING CONTRACTOR
I
CERTIFICATE HOLDER CANCELLATION
i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village Building Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
10050 N.E.2nd Avenue
Miami Shores,Florida 33138 AUTHORIZED REPRESENTATIVE
@ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105)QF The ACORD name and logo are registered marks of ACORD
i
f KIiE 3
wR F%
JEFF ATWATER
CHIEF FINANICAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
k
**CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
r
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 4/2/2017 EXPIRATION DATE: 4/2/2019
PERSON: JIMENEZ JESUS M
FEIN: 454707016
BUSINESS NAME AND ADDRESS:
1 JJ QUALITY BUILDERS INC
27541 SW 139 PLACE
HOMESTEAD FL 33032
SCOPE OF BUSINESS OR TRADE:
r
Licensed General Contractor Licensed Roofing Contractor
IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply
only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the
person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609
r
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♦5ORES
t
i soon _ googol Miami hoses Village
08 � Building Np artment
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY:OF QUALIFIER'S STATE LICENCES
B. Z_COPY OF LOCAL BUSINESS TAX RECEIPT
C. d COPY OF LIABILITYINSURANCE*
D. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
3
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT,
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
k 10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
■■�s��sbraa���ee�e�na��ssaao�soseoa��ma0000aon�ee�eoeaoome�o��a��eeo�sseemeamn�o�oasoe®®��
BUSINESS NAME:
1 _
BUSINESS ADDRESS'- Z 1 s:W CITY +Ip we TATE 1'-C ZIP_S
BUSINESS PHONE: FAX NUMBER( �AD Z
CELLPHONE( QUALIFIER'S NAME:
QUALIFIER'S LIC NUMBER: l__ LgQQ g