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RF-09-23-2392Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1440 NE 3015T ST, Miami Shores, FL 33138 Contacts George E & Alice P Burch Owner 1440 NE 101 ST, Miami Shores, FL 33138-2613 aliceburch@aol.com SUPPLY CO. INC JAMES OBENOUR 9822 NE 2 AVE SUITE 9, MIAMI SHORES, FL 33138 Business: 3057572612 OBENOURROOFING@AOL.COM Mobile: 3054696896 Issue Date:09/29/2023 Parcel Number 1132050240030 Obenourroofi ne@aol.co m Permit NO.: RF-09-23-2392 Permit Type: Roof Work Classification: Repair Roof Permitstatus: Approved Expiration: 03/25/2024 Sandy Hart 9822 ne 6avenue 9, Miami shores, FL 33138 Business: 3057572612 harttwohart5@aol.com Mobile: 9548022965 Home: 3057577861 Other: 3053311200 Description: REPAIR LEAK IN THE TILE ROOF. PER ROOF PLAN, Valuation: $ 1,000.00 ins ection Requests: 15TORY, OWNER TO SUPPLYTILE FROM PREVIOUS WORK - �05-762-4949 WHITE FLAT 9" Total Sq Feet: 56.00 111 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.30 Permit Fee (Manual) $80.00 Scanning Fee (Manual) $9.00 Technology Fee (Manual) $13.00 Total: $156.90 Payments Date Paid Amt Paid Total Fees $156.90 Check# 11978 09/29/2023 $106.90 Check# 11977 09/27/2023 $50.00 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 above named contractor to do the work stated. &4� Owner Applicant / Contractor / Agent Date September 29, 2023 Page 2 of 2 Miami Shores Village RECEIVED 39P 2 7 2993 Building Department 13Y, 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 -- - �- Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ' FBC 20Za BUILDING Master Permit No. PF-ol-Z3-23yZ PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC C2400FING ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ,t /COONTRACTOR DRAWINGS ly JOB ADDRESS: / / �d L -`j k- / L I `s Folio/Parcel#: // _ 3.-2 OS-- Dal - 0 (93 U Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee b 4 Titleholder): a r Address: � � `1 o c l O / -5 City: k s /9 cur• S h o r e5 Tenant/Lessee Name: Email: Name: V b e 1l State: Address: y� l Y as lV L Z ASP IV V / M- S h oy Email: �i( ,hpa %[ • C eL Qualifier Name: /la /i {toy ���/9 ,'L'k'/" zror Phone State Certification or Registration #: lee r)5-1' T Y Certificate of Competency #: DESIGNER: Architect/Engineer: Phone Value of Work for this Permit: « Square/Linear Type of Work: ❑ AdditiLo� ❑ Alteration ) ❑ New Description of Work: ',2a' / � / P ,4 k /U mY af' 331 .3W i30 3©cY7s-7a61Z State: Zip: of Work: -)Replace ❑ Demolition , mpt w S io v Specify color of color thru tile: Lu Ile (�GA-i) 1 /' Submittal Fee $ J� Permit Fee $ &�' CCF $ /00 CO/CC $ Scanning Fee $ a • oo DCA Fee $ DBPR $ Notary $ Technology Fee $ ( 3 - 00 Training/Education Fee $ ' 30 Double Fee $ Structural Reviews $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ ) O/o • �10 Aa/;- (Revised04/05/2022( Bonding Company's Name (if applicable) Bonding Company's Address City State 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 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. Signatu Signatu�< OWNER or AGENT The foregoing instrument was acknowledged before me this ��+_ day of 20 Z 3 by /60 POi S•/ V h�---.who is person own to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: ^^ ,,/ Print:) t°!'-/ +" Seal: .....11, CATHERINEA.DUFFIN • My COMMISSION# HH 089522 EXPIRES: May 14,206 .P?....:' SO&Ad Thru = Public s�ses APPROVED BY CONTRACTOR The foregoing instrument was acknowledged before me this dayof 20oc73 by .yi4rt ( eS 1i D •heMX rd ,6ho is personal) wn to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: IA" MY COMMISSEXPIRES: IMay 114, 2025522 I� as sss Plans Examiner Zoning (Revised04/05/2022) Structural Review Clerk Florida Building Code 7th Edition (2020) RECEIVED High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -Delia@ 1tc5LQW INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS BELOW: Roof System Required Sections of the Permit Application Form Attachments Required See List Below Low Slope Application A,B,C 1,2,3,4,5,6,7 Asphaltic Shingles A,B,D 1,2,4,5,6,7 Concrete or Clay Tile A,B,D,E 1,2,3,4,5,6,7 Metal Roofs A,B,D 1,2,3,4,5,6,7 Wood Shingles and Shakes A,B,D 1,2,4,5,6,7 Other , Q- 4,EA.e As Applicable 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED: CITY COPY 1. Fire Directory Listing Page 2. From Product Approval: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design calculations per Chapter 16, or if applicable, RAS 127 or RAS 128 4. Other Component Product Approval 5. Municipal Permit Application 6. Owner's Notification for Roofing Considerations (Reroofing Only) 7. Any Required Roof Testing / Calculation Documentation Miami Shores Village B 'ding Dep t Zoning Dept. Date Building Dept. Date Subject to compliance with all Federal, State and C,qunty r les an regular ns. Permit# IC `1 L ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code7th Edition (2020) High -Velocity Hurricane Zone Uniform Permit Application Form N Section A (General Information) Master Permit re-ra Job Process No. ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile Mortar/Adhesive Set Tiles ❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes ❑ Prescriptive BUR-RAS 150 ROOFTYPE ❑ New roof Repair ❑ Maintenance ❑ Reroofing ❑ Recovering ROOF SYSTEM INFORMATION Low Slope Roof Area (SFj Steep Sloped Roof Area (SF) S0 r��' Total (SF) Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimen- sions of sections and levels, clearly Identify dimensions of elevated pressure zones and location of parapets. `- 474 FLORIDA BUILDING CODE - BUILDING, 7th EDITION (2020) Miami Shores Village - BUILDING DEPARTM�(VL�,EIVEE 10050 NE 2 Ave Miami Shores, FL 3313 305-795-2204 www.msvfl.gov SEP 2 7 2023 � � SECTION R4402.13 HIGH VEL CITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 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. 1. � Vb Aesthetics -Workmanship: the workmanship provisions of Section R4402 are for the purpose of providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2�3d� 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). 3� Common roofs: Common roofs are those which have no visible delineation between neighboring units (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of Cadjacent units of roofing to be performed. 4. �J_ 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 the option of maintaining the appearance. 5.c� �P-� Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low-lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. RevOI 142021 Owners roofing consideration Page 1 of 2 Miami Shores Village - BUILDING DEPARTITCEIVED 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov SEP 2 7 2023 BY: —4�— rflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water. Perimeter/edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. 7L-��Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. �9%z ziz-3 Owner/Agent's Signature Date Contractor Signature / Date For Forms and Applications click here: http://bidg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia mi5horesVillage U y7 Rev01 142021 Owners roofing consideration Page 2 of 2 Ron DeSands, Governor Melanie S. Griffin, Secretary Florida db r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE ROOFING CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES 1k I OBENOUR, JAMES D'ONALD JR OBENOUR ROOFING SHEET METAL & SUl.PPLYCO 9822 N.E. 21ND AVE NO.9 MIAMI SHORES FL 33138 l J LICENSE NUMBER. CCCOS2462� EXPIRATION DATE: AUGUST 31, 2024 Always verify licenses online at MYRoridal-icense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. 000403 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT BILL -DO NOT PAY 261107 LBT BUSINESS NMIE/LOCATON RECEIPTNO. EXPIRES OBENOUR ROOFING SHEET METAL a SUPPLY GONEWAL SEPTEMBER 30, 2024 12050 NE 14TH AVE UNIT 3A 261107 Must be displayed at place of business MIAMI FL 33161-6585 Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEGTYPE OF BUS WFSS PAYMENT RECENEO OBENOUR ROORNG SHEET METAL& 196 SPECIALTY BUILDING CONTRACTOR BYrAx COLLECTOR C/O JAMES D OBENOUR PRES CCC052462 $100.00 09/01 /2023 Worker(s) 15 INT-23-440497 This Local Business Tax Receipt only confirms Payment of the Lout Business Tax. The Receipt is not a license, Permit Ora cehificafion of the holdersqualificahons, to do business. Holdarmust comply with any governmental or nongovernmental regulatory laws and requirements Which apply to the business. The RECEIPT NO. above must he displayed on all commercial vehicles- Miami -Dade Code Sec Ba-276. For more information, visit ••^•^•' miamidade govftaxcollector ACORV CERTIFICATE OF LIABILITY INSURANCE DATE DIYYYY) 05/30/30/2023 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 have ADDITIONAL INSURED provisions or 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 Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. BOX 1927 Pompano Beach FL 33061 NAME: Regina Bunker PHONE (954) 943-5050 (954) 942-6310 INC,No Ext : AfC No ADDREss: regina@furinaninsurance.com INSURER(S) AFFORDING COVERAGE NAIC p 1NSURERA: Ironshore Specialty Ins 25445 INSURED Obenour Roofing Sheet Metal & Supply Co 9822 NE 2nd Ave Suite 9 Miami Shores FL 33138 INSURER B : Bridgefield Employers Ins Co 10701 INSURER C : INSURER D : INSURER E : INSURER F : r_nvGlaer:l:c CERTIFICATE NUMBER: 23-24 GL/WC 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSDOULr POLICY NUMBER MfuDCQ F POLICY EXP MMfQQ LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE © OCCUR DAMAGE To 1719TI117- PREMISES Ea occurrence $ 0,000 MED EXP (Any one person) $ 5,000 A RCS0046607 06/0112023 06/01/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY � EC LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITYaccident) COMBINED SINGLE LIMIT Ea axident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ a UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIvE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N f A 83036966 10/06/2022 10/06/2023 TARIUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yea, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Roofing and Sheet Metal Contractor, Classification 5551 Roofing, Classification 5535 Sheet Metal SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores FL 33153 1 ju;'_ V 178�-LV7�7A�.VRu VVRrVRNIwf♦. Mir rl�naii rvav�vau. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD