RF-09-206Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
asPeot
i
Scheduled Inspection Date: April 03, 2009
Inspector: Rodriguez, Jorge
Owner: SAMMONS, EILEEN
Job Address: 600 NE 98 Street
Miami Shores, FL 33138 -2472
Project: <NONE>
Contractor: SEGARRA ROOFING INC
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number
Parcel Number 1132060171840
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP - 106259. NOT READY 03/16/09
JR
April 02, 2009
Page 9 of 14
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores,. Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 200 �'
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder) ( �i v�B Mart 5__Phone # DS —151 5q70(1-'
Owner's Addre�sss� UGC') e � q t
City 1 Vtq S State% Zip J tD,I
Tenant/Lessee Name 1 fl" Phone #
PIECENSO
FED 1 U L
dlaDl09 App.
Permit No. R O 1 Z1d�
Master Permit No.
Job Address (where the work is being done) l.Q OQ M
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # k\ r 2. - r,1
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address `1
City `l-1 ,o.,1 Pc, L�
Qualifier Name MO !O Vt,
L.Ou <
State
State Certificate or Registration No. Pr 0 .3 33
Architect/Engineer's Name (if applicable)
co r i
Zip
Phone# �,COb) 'd - �i5 i 1
Zip
Phone #
5614-
(�c)
Certificate of Competency No. 0000 1 Lis c�
Value of Work For this Permit $ } t) C)
T fW k ❑ ❑
Phone #
❑ Demolition
Square / Linear Footage Of Work:
❑New
• \f a air/Re lace
yp� o Work: ['Addition Alteration � �4 p p
Describe Work: iu ak,, ��< _ •_ a _ -i 1 S' t" __
ri I cL -li ire ! L■ — .►
l it 1 r 4 fit' lir��:t ►��� �� "�1��, i��►r� �i�/V �!
Sub6iitttal Fee $ Permit Fee $
Not0ry $
Scanning $ 3 `ill,! Radon $
Training/Education Fee $
* * ** *Fees * * **
V•60
DPBR $
Bon$ Code Enforcement $
Structural Review. $
CCF $ I ' CO/CC ,,�c
Technology Fee $ 2 50
Zoning $
Double Fee $
Total Fee Now Due $.%•0p9
See Reverse side ->
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
Zip
Application is hereby made to obtain a permit to do th =:r 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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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.
Signa
The fore
day of
who is person
\ir'; (\(« , G ( W 16 Signature
Owner or Agent
oing instrument was acknowledged before me this
, 2OO 4 , by 5 f jW ,U 5
ANIL S.
actbr
The foregoing instrument was acknowledged before me this
, 20, by ili1 IAet,
to me or who has produced
, day of
known to me or who has produced who is p
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:.
°e'`rP% SALVATORE JOHN FEDERICO
c' ! gON ;1 DDa66773
^or;
APPLICATION APPROVED BY:
(Revised 07/10/07)
rsona
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Exp
* * * * * * * * * * * * * * * * * * * * * **
MY COMMISSION 0 DD466773
EXPIRES: Aug. 29,2039
Plans Examiner
Engineer
Zoning
OOFASSEMBLIES AND ROOFTOP STRUCTURES
• • ••• • • • •••
•• •• • • • •• •• •
• • • • • • • • • •
• • • ••• • • •
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lo l,:lcDrig Cotes dditioo 2004
n ican4zone t nitorm Permit Application Form.
n A (Caere�rai 1�rlfoirri6{iop)
1 •
• Process No.
Master Perm t
Contractor'st
Job Address
RECEIVED
FEB 1 O Ja i
❑ Low Slope
❑ Asphaltic
Shingles
ROOF CATEGORY
❑ Mechanically Fastened Tile
❑ Metal Panel/Shingles
❑ Prescriptive BUR -RAS 150
❑ New Roof ❑ Reroofing
Low Slope Roof Area (SF)
ROOF TYPE
❑ Mortar /Adhesive Set Tile
❑ Wood ShingleslShakes
❑ Recovering (14 Repair 0 Maintenance
ROOF SYSTEM Y/;5 5 r
INFORMATION
f Plan �o
tch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains.
ide dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of
pets.
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HURRICANE ONES
• • 4100 • • •
00 *0 • • • 00 ••
• • • • •0 • • • •
• • • 0,0 • •
• • • • • • • • • •
• • •08 • • • • •00
• • •
•
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His
Florida .Building Code Edition 2004
Hur ne2 P irpsubrWorrii:
9•4tio..ns Mte,4tivi-13e
•
414300
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0 2dge
Roof Systein.Menuficturer
II
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........
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Product Approval Number:
• . • ... ..
Minimum Destan WitgisProsgures, itApPlicebte (0.0111:R0:10brdAteilt40040):
P.It :P2: Pal.
Maximare Des:ttp Pressure
Product Approval Specific System:
Metheit'el tie attachment f)
P.piggp yvt,F,N valet- Piki)Dt
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Roof Slope:
:12
•Steqp_41•40.e, .11Got *System OespliOtion
Deck
5
.ype Underlay
Tient:
Insulation.
k
BaFhe nor:
•a5tener Type & -S p a r M
•Adhesive Type,:
Ridge Ventitatien?
1Q\
Mean Roof Height: rZ-I
ype .cap Sheet:
opf Gpvertrig::
AioNez,
Type 4.Size Drip
dg:
G-ki,voitqr9
c.A/vit
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