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RF-19-1646� _ Rf Y i �' M i Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 07/22/2029 Parcel Number 280 NE 95TH ST, Miami Shores, FL 33138 1132060133710 Contacts Permit No.: RF -07 -19 -IMS Permit Type: Work Classi affon: Repalr..Roof Permit Status: Approved Expiration: 01/20/2020 ARIANNA RIVERO Owner THREE BROTHERS ROOFING CORP Contractor 110 SW 12 ST 1607, MIAMI, FL 33130 LUIS ROCA 570 91 ST, MIAMI, FL 33150 Business: 3053704088 Description: REMOVE AND REPLACE APROX 45 BROKEN TILES Valuation: $ 750.00 Inspection Recuests: ^^f^^ THROUGHOUT THE ROOF. 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $0.20 Roofing Fee $50.00 Scanning Fee $9.00 Technology Fee $6.25 Total: $122.30 Payments Date Paid Amt Paid Total Fees $122.30 Credit Card 07/22/2019 $122.30 Amount Due: $0.00 Building Department Copy 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 abc)ve name"ontractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor Agent Date July 22, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION BUILDING 7 ELECTRIC Miami Shores Village Building Department JUL 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC20n?-r-01�j� Master Permit No. ——� l ROOFING Sub Permit No. REVISION F-] EXTENSION [-] RENEWAL PLUMBING F-] MECHANICAL PUBLIC WORKS F_� CHANGE OF 0 CANCELLATION [:] SHOP /�j CONTRACTOR DRAWINGS p JOB ADDRESS: Do /V c--.:," / M Folio/Parcel#: It " 37-06 - 0 13 - 32 10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): i r'1Qilf� U�I�►,�i� Phone#: 303 202 Address: ;;_� 3 0 & Qj ` +1 - city: ("' r j Tenant/Lessee Name: State EL Zip: 3 3 13 a Phone#: CONTRACTOR: Company Name: 16re(. SmlLers RaQfin4 Coro Phone#: (3o0370- yDsK Address: 5 --in N W ql ST City: MI CUM j State: EL Zip: 33/90 Qualifier Name: N. ne#: State Certification or Registration #: CCG II Certificate of Competency #: _ DESIGNER: Architect/Engineer: I N ZA Phone#: _ Address: N / A City: 'N % A State: Value of Work for this Permit: $ 7L 5-o . 06 Square/Linear Footage of Work: N/A / Zip: / Type of Work: ❑ Addition ❑ Alteration ❑ New [Repair/Replace ❑ Demolition Description of Work: RGrhoof, and re ola re, a L�DroX1 rhh^1 .I,y 4S brO kt4-1 7 � L I �� � � l e. s 1t f-15 4� o(A �.4_ m0 f . Specify color of color thru tile: P.r_Gc% Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee $, Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary Double Fee $ Bond $ TOTAL FEE NOW DUE $ Z L ` �1) Bonding Company's Name (if applicable) N /A Bonding Company's Address N JA _ City / State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 occ 0Sr ven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved anspection fee will be charged. Signatu OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 / i by fL j?rLy:s Gtc��yS E who is personally known to me or who has produced Ari yad W Ogi ✓gra as X/&6 -000 -7y -84S -//E o9-zs-zoLl identification and who did �ake an ath. BLIC: "—" HENRY ALBERTO State of Flo ' -Notary PuYI =* •' om i n GG 192842 -,+ m ion Expires Print: Seal Signature CONTRACTOR The foregoing instrument was acknowledged before me this L day of \T4 /V 20 If , by A -a-144 �iio�,.+ , who is personally known to me or who has produced Lars IQ . ,&,0- as identification and who did take an oath. NOT Pri HENRY ALBERTO State of Florida -Notary Public Commission # GG 182842 My Commission Expires APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) M5 0 1 (pl D— Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 notice to uwner — worKers, compensation insurance txemwion 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: 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; The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 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 BELO)Y_�OU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this / 7 day of Y. ly , 20 By i% r r cE nna Lei yr, -0> who is personally known to me or has produced as identification. HFNFiyALBERTO 4,= id State of Flora -Notary Public * *c Commission N GG 182842 ';teaMy Commission Expires 'p�III0, February 05, 2022 July 15, 2019 State of Florida Miami -Dade County THREE BROTHERS ROOFING CORP. 570 NW 91St STREET Miami, FL 33150 CCC1330211 Before me this day personally appeared Walter Barrientos who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 280 NE 95th ST Miami Shores, Fk-} 3138 Contractor Signature Sworn to (or affirmed) and subscribed before me this 17 day of 3N /y 20 /21 by VVirl-ler Personally knowA OR Produced Identification Type of Identificon P duced HENRY ALBERTO ;State of Florida -Notary Public =' Commission M GG 1 OTS32 My Commission Expires February 05, 2022 of Notary Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form Section A (General Information) I c� Master Permit Number Process Number �r+ 9 Contractor's Name Three. Bj-ot4e�5 �ootl ►')4 Cor P Job Address 2460 N6 CIS' ST ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile ❑ Asphalt Shingles ❑ Metal Panels/Shingles Is there an existing Roof Top Solar System? (- Yes (0 No Are there gas vents on the roof? (' Yes No ROOF TYPE ffrmortar/Adhesive Set Tile ❑ Wood Shingles/Shakes . . 6666 6666.. Will it be reinstalled{ (: Yes..G` No . • 696.00 .6 6666.. Type? ❑ NatdfdP E LPGX ;0�••; 6666 6666.. 6666 . 6666. ❑.New Roof Repair Maintenance Reroofing • • RbtoverincJ. 6690 6 • • ROOF SYSTEM ROOF INFORMATION • 6666.. . 6666.. Low Slope Roof Area (ft2) ZI Steep Slope Roof Area (f2) Tbtal'(ft2) . •'� • TTS Section B (Roof Plan) Sketch the Roof Plan: Illustrate all levels and sections, roof drain, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and locations of parapets. 123 01-48 4/19 PAGE 2 s^T TO CON"PLI, ;CE VJ', I H ALL FEDERAL j111�1T' %N� 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 itFn .... govern the minimum requirements and standards of the industry for roofing system installsfions. Add�tionajly, khe..� • following items should be addressed as part of the agreement between the owner anti;QBtractor. TM%Owner's • • .; initial in the designated space indicates that the item has been explained. • • • • • 2. Renailing wood decks: When replacing roofing, the existing Mod R*f declt Mai 4ave to be renailed in accordance with the current provisions of Section R4403. (ThErPooleeck is usually' concealed prior to removing the existing roof system). ;";'; •. . . . . ...... ...... 4. Gelling: Exposed, open beam ceilings are where the underside of tL;9* *decking •*—Exposed 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 the option of maintaining the appearance. 6• /V ---Overflow scuppers (wail outlets): It is required that rainwater flows off so that the roof is not overloa d from a buildup of water. Perimeter/edge wall or other roof extension may block this discharg if erflow scuppers (wall outlets) are not provided. it may be necessary to install overflow scu sin accordance with the requirements of Sections R4402, R4403 and R4413. /1� � (ol,'20 Owner/Agent's Signature to Contracto i nature Date 290 NE -9s- s -r Property Address Permit Number Revised on 7/9/2009 LD;07/01/2015;