RF-18-3376BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
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
® ROOFING
El PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 125 NE 107th ST
CQ-h
FBC 20f
Master Permit No. RF-11-18-3376
RECEIVED
DEC 12 2018
C4441
Sub Permit No.
❑ REVISION ❑ EXTENSION
[] CHANGE OF ® CANCELLATION
CONTRACTOR
El RENEWAL
❑ SHOP
DRAWINGS
City: Miami Shores
Folio/Parcel#:11-2136-007-0270
Occupancy Type: Load:
County:
Miami Dade Zia:
Is the Building Historically Designated: Yes NO X
Construction Type: Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder); TERRELL J. WALTER TRUST, GEORDIE EBERT TRUSTEE Phone#• 559-786-5180, 760-687-6418
Address:3415 W. MONTE VISTA CT (^ � x 2 Zq - IZZ.
City: VISALIA State: CA Zip: 93277
Tenant/Lessee Name: N/A Phone#:
Email: GEORDIE.EBERT@HOTMAIL.COM OR JASON.EBERT@GMAIL.COM
CONTRACTOR: Company Name: AKG INSPECTION SERVICES Phone#: 305-235-5511
Address: 14376 SW 19 CT, BAY 10
City: MIAMI State: FL zip: 33186
Qualifier Name: JOSE A. HERNANDEZ Phone#: 305-235-5511
State Certification or Registration #: CCC042809 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 16,300 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of work: CANCEL PERMIT APPLICATION. NO WORK HAS BEEN DONE AT PROPER
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 perrrnit 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 CONDfTIONERS, 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certed copy of the recorded notice of commencement must be posted at the job site
for the' first Inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
1 day of L72e,erv‘U.:.r , 20 t8 , by
day of , 20 , by
, who is personally known to , who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBUC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
Seal: Seal:
•***********************************************S***********************$******* ********************4******
APPROVED BY Plans Examiner Zoning
(Revised02/24/2O14)
Structural Review Clerk
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that
document.
STATE OF CALIFORNIA
COUNTY OF Tulare
}
}
On D .c 4, before me , Patricia Miller Notary
Public,
Date
(bare insert name and title of the officer)
personally appeared �¢� ► i (� tC—
who proved to me on the basis of satisfactory evidence to be the persons) whose narne($'is/are-
subscribed to the within instrument and acknowledged to me that-lie/she/they executed the same
i s/her/their authorized capadty(ies), and that by bis/her/their signature fg on the instrument
the personO, or the entity upon behalf of which the person(,ls) acted, executed the instrument
I certify under PENALTY OF PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
PATRICIA MILLER
Notary Public -California
Tulare County
Commission M 2261 a7a
My Comm. Expires Oct 3, 2022
Signa
OPTIONAL
Description of Attached Document nn
Title or Type of Document Py.-Lt t r A" Y 2rn i r h.OPu C4.T1i-Number of Pages: 02
Document Date: Other
7015 Apostille service. 707-992-5551 www Califom aApostille.us California Mobile Nolan, Newark crwwv.CAMP N.mm
3415 W. Monte Vista Ct.
Visalia, CA 93277
December 11, 2018
Miami Shores Building Department
10050 N.E. 2"d Avenue
Miami Shores Village, FL 33138
RE: Roofing Permit
125 N, E. 107th Street
Miami Shores, FL 33161
RF-11-18-3376
To Whom It May Concern;
You are processing a permit on the above -mentioned property, and I am requesting you to
this permit application. Due to issues that came up with the contractor and in obtaining this
have suffered an extreme delay that has affected the sale of our home. In order to close the
home by December 20, we need this permit canceled so the buyer can hire the roofing cant
their choice to put on the new roof after closing.
I understand you will need to do an inspection to verify that no work has been done to repl:
Can you please do this as quickly as possible so we can close our sale on or before DecembE
If you have any questions or need access to the property, please call our real estate agent, N
of Coldwell Banker, at 954-732-5308. We greatly appreciate your prompt response to this rr
Sincerely,
Geordie Ebert
INSPECTION SERVICES
CERTIFIED INSPECTORS IN SOUTH FLORIDA SINCE 1981
November 29'', 2018
Miami Shores Building Department
10050 N.E. 2"d Avenue
Miami Shores Village, FL 33138
Re: Roofing Permit
125 N.E. 107d' Street
Miami Shores, FL 33161
To Whom It May Concern,
Please be advised there is a permit being processed on the above mentioned property, however due to the
issues that came up with obtaining this permit it has caused an extreme delay in which has affected the
sale of the home. The homeowner is requesting to cancel this permit and issue a credit to the new
potential buyer at closing so they can hire a roofmg contractor of their choice to install a new roof.
I was told by your building department that you must conduct an inspection to verify that indeed the roof
is not being replaced. This needs to be done as quickly as possible in order to avoid default of his contact.
Please let us know what day the inspection will be done so we can advise Mr. Jason Ebert, the current
homeowner, to give access to the inspector.
Your prompt response to this matter is greatly appreciated. If you have any questions, please feel free to
contact our office at k305)235-5511.
R spectfull Sub itted
A. Hernandez
dent
Inspection Services, Inc. D • A G Roofing
42809 — Licensed, Insured : Bo i ' ed
14376 S.W. 139 Court, Bay #10 • Miami, Florida 33186
Telephone: (305) 235-5511 • Fax: (305) 969-1469 • E-mail. akghome@grnailcom
Address
j:✓�I��/�ME 107 n SMELT
r `ORLL S City: ' - I' t . ` I yState:
At3C2)
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 Master Permit No.
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC
RECEIVED
NOV 0 6 2018
Crh
BC20I P-
ix ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING 0 MECHANICAL PUBLIC WORKS
JOB ADDRESS: 175 NE ID 7
CHANGE OF El CANCELLATION El SHOP
CONTRACTOR DRAWINGS
City: Miami ShoresSh
Folio/Parcel#: I I2 134 0070270
Occupancy Type:
County: Miami Dade
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): ' 1
Zip: 331 fo I
Is the Building Historically Designated: Yes
Flood Zone:
FL
BFE:
NO
FFE:
Phone#: 7(00 t t C/'4I ZS
Zip: L ?I 6.1
Tenant/Lessee N me: Phon
1
Email:
NA
e#:
30nattonc Nhc-, sty \Acts .( 0
CONTRACTOR: Company Name: A n 7 IINJ C `-'r 'D• I Sz A as
Address: I (SW 1•39 coma, , to
City: M litiVI State:
h�� ^ �n'n w,�y Zip:
Qualifier Name: w A . J_1 VAi ilJ Phone#:
/'�
State Certification or Registration #: /� �Cci2T Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $ 110 3 oco
Type of Work: ❑ Addition�❑ Alteration
}
Description of Work: J (LE E- pcc*
Phone#:3S236 55I 1
33181n
Square/Linear Footage of VOork:
State: Zip:
;045
❑ New ❑ Repair/Replace
❑ Demolition
Specify color of color thru tile: l� r1'+e5ro LEA Neva c1�. _ C o
Submittal Fee $ i-4 Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ `JOO ` .3
TOTAL FEE NOW DUE $ 281 • 600
(Revised02/24/2014)
�-�`CO
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. FINANCIN.i, 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 per
promise in good faith that a copy of the notice of commencement and con
whose property is subject to attachment. Also, a certified copy of the recorded notice o
for the first inspection which occurs seven (7) days after the building permit is', issued.
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before
me this
day of Oc 1 asWE , 20 1 b , by
arie-DE Pi • Egger , who is personally known to
me or wh
identifica
NOTARY
Sign:
Print:
Seal:
ced J/V-� E L1 CENCE
o did take an oath.
of Commission # GG 214178
�oF r`` My Comm. Expires Aug 28, 2022
Bonded through National Notary Assn.
**************************
APPROVED BY
as
Sign . ture
CONTRACTOR
The for'egoing instrument was acknowledged -- before me
t B 1Z ,20 (OQ
value exceeding $2500, the applicant must
chure will be delivered to th• •ers.'n
cement - ust be posted at a jobs e
the absen e of such poste
me or who h
identification
NOTARY PU
Sign:
Print: _ti_w"a�'. DAISHAZANETTI
d'�' NotaryPublic - State of Florida
\• •
Seal: • 1 Commission k GG 214178
orv'° My Comm. Expires Aug 28, 2022
Bonded through National Notary Assn.
—do- �__--
Gt-7-vetto is personally know
ho did take an oath.
f\i
as
***********;e***********************************************************
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk