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RF-18-2062Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Parcel Number Issue Date: 8/6/2018 Permit NO. RF-8-18-2062. Permit Type: Roof Work Classification: Tile/Flat Permit Status: APPROVED Expiration: 02/02/2019 Applicant 148 NW 96 Street Miami Shores, FL 33150- 1131010240290 Block: Lot: OCA CORP TRS Owner Information Address Phone Cell OCA CORP TRS 148 NW 96 Street MIAMI SHORES FL 33150- 148 NW 96 Street MIAMI SHORES FL 33150- Contractor(s) Phone A & E BROTHERS ROOFING, INC (305)229-0471 CeII Phone Valuation: Total Sq Feet: $ 18,700.00 2695 Type of Work: Re Roof Additional Info: RE -ROOF TILE AND FLAT TILE IS SPAN! Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $o.00 $0.00 $o.00 $o.00 $150.00 $0.00 $0.00 $150.00 Pay Date Pay Type Invoice # RF-8-18-68413 08/06/2018 Cash 08/01/2018 Cash Amt Paid Amt Due $ 100.00 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Roof in Progress Renailing Affidavit 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: (rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonjr g.l, Fu hermore, I authorize the abo e-nam contras to do t a work stated. 15sa I c��+ OF7 Aut zed Signature: Owner / Applicant Contractor / Agent August 06, 2018 Date Building Department Copy August 06, 2018 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 ❑ BUILDING ❑ ELECTRIC ROOFING ❑ REVISION Master Permit No ❑PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: /Q 5 City: Miami Shores County: Sub Permit No. RECEIVED AUG 011018 COL-\\ F C O1� e_f \a- - zap 2 ❑ EXTENSION ❑ CANCELLATION Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: RENEWAL ❑ SHOP DRAWINGS NO FFE: OWNER: Name (Fee Simple Titleholder): ()COI CO ►r� Phone#: If— ��iror F' S State: Pr Address: City: Tenant/Lessee Name: Phone#: Email: Zip: CONTRACTOR:�vCompany Name: 4 .87,�%Ti"I e:'s�O-' ,' CPhone#: �5as) f / - ^ )-Z 0 k ?S Address: 4'©i' $GzJ 3 ?- s% / (/ City: _,..C.CDCQ-LC-C.c e' State: /V Zip: 3 3 / , Qualifier Name: /�G( e'i/ S it-'- s !2. Ojti Phone#: State Certification or Registration #: .?-' / S33 0 . $'Certificate of Competency #: Phone#: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ City: State: Zip: Type of Work: ❑ Addition ❑ Alteration Description of Work: Square/Linear Footage of Work: 2 (001_5 ❑ New ❑ Repair/Replace IT Demolition Specify color of color thru tile: �Jr Permit Fee $ L5 o CCF $ CO/CC $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 0 '� Submittal Fee $ Scanning Fee $ (Revised02/24/2014) Bonding -Company's Name (if applicable) 1 1 i Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lendes Address 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature (' "; Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of A ✓%f!S 7 , 20 %I , by ( day of Av V S T , 20 1 g , by 94L.1',rs "S"'LUaYi i , who is personally known to Ortic E. trljno5ok, who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: NOTARY PUBLIC: COS ek Sign: J 1` WS1'A REIIJE,-OSTA MY COMMISSION # GG000692 ?. EXPIRES June 09, 2020 (407) 393-U153 Floridallotary$ervice.com /2 APPROVED BY Seal: Plans Examiner Print: C'kREINALDOACOS'I..A _;` :`` MY COMMISSION # GG000692 „OF''EXPIRES June 09, 2020 (407( 393-0153 FloddallotaryServlcetom Zoning Structural Review Clerk (Revised02/24/2014)