RF-12-633r.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 172663 Permit Number: RF -4 -12 -633
Scheduled Inspection Date: April 23, 2012
Inspector: Bruhn, Norman
Owner: EDMISTON, SUE
Job Address: 790 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: PONTIFEX CONSTRUCTION GROUP INC
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number
Parcel Number 1132060141860
Phone: (305)218 -9425
Building Department Comments
REPAIR FLASHING AND PERIMETER EXTERIOR WALL
CHIMNEY. REAPIR ROOF FLASHING
Passe
Failed
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 172248. PROVIDE CLOSURE
AT TILE ENDS.
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 20, 2012
For Inspections please call: (305)762 -4949
Page 32 of 33
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
IMMEEVIEill
111 APR 1 1 2012
BY: �—
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: �ke., e4 vivid WO egg-sr-1-J � 7�-7 --Erb Z
City: Miami Shores County: Miami Dade Zip: �.�/ 3 81-'
Folio/Parcel #:
Is the Building Historically Designated: Yes NO X Flood Zone:
OWNER: Name (Fee Simple Titleholder): & k j Phone #: 36c- 757 -S-SeZ
City:U -1///4/e-.5, PL State: Zip: �3! 3 cf-
Address:
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name CGS t 1 4 ycs -'4- Phone #:ES 24 7'1 %
Address:
City:
Qualifier Name:
The 5 753 •
`M State:
l 4- 6vC-4..-
State Certification or Registration #: Cet,, 13 '` C'9
Contact Phone #: t 9Y 7iS
3i�' ) p: ``�3/%'�
Phone #: � u 8 9v z
Certificate of Competency #:
Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this
Permit: $ I , y00
Type of Work: OAddition
Description of Work:
OAIt ration
et/
Square/Linear Foota
ONew
e of Work:
lace
(®0 55/ frr
ODemolition
******** * * * * * * * * * * * * * * * * * * * * *** * ** * * * ** Fees************* ** * * * * * * * * * * * * * ** * * * * * * * * * * ** **
Submittal Fee $ Permit Fee $ AOCJ at)
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ coo. 2.4.0
Bonding Conic any'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 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 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.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this t i't" The fore ing instrument was acknowledged before me this YY'
day of ` 94 6R. ,20 a, by X1t sDo,tt >°io4l , day of 20 7' by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
Signature
Contractor.
NOTARY PUBLIC:
Sign:
Print:
lW> 1 .�aG,�s}
My Commission Expires:
••�i" • LUIS I RODRIGUEZ
1 , MY COMMISSION # DD978164
•:��,�;;� EXPIRES April 01, 2014
(407) 398 0163 FlotidalloleryServbe.com
NOTARY
Sign:
Print:
•
1610144. No =ry Public State of Florida
$ 4d' ; r na Hernandez
e,.
? M I or7lmiQgivn EE007535
09/13/2014
f.►:1;
My Commission Expires:
ogi3lW 10-
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APPROVED BY ` r 102— Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
0
� ,�R CERTIFICATE OF LIABILITY INSURANCE
DATE
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 pollcy(tes) must be endorsed. If SUBROGATION 15 WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on thls certificate does not confer rights to the
certificate holder In Iteu of such endorsement(s).
PRODUCER -693-0003
305 - 693 -0003 305 - 691 -4381
Emmanuel Insurance & Associates, Inc.
2370 East 8th Ave
Hialeah. FL 33013
NAME: Emmanuel Insurance & Associates., Inc.
P,u"J o.Extp 305- 693 -0003 [idre.NO�:
305 - 691
-4381
NAIC S
Ap AMPS: saral @emmanuelinsurance.com
INSURER(S) AFFORDING COVERAGE
wsuRERA• Scottsdale Ins Ca
41297
INSURED
Pontifex Construction Group, Inc
8720 SW 83rd St
Miami, FL 33173 -4136
INSURER B : Travelers Indemnity Co.
25658
INSURER G: Bridgefield Emplo e.ry s Ins
10701
INSURER D:
EACH OCCURRENCE
INSURER E:
OtEaa ce nce1
INSURER F :
I CLAIMS -MACE
E
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
INSR
LTR
TYPE OF *ENHANCE
ADDL
ASR
SUBR
4WD
POLICY NUMBER
pp LIC�OLr
IMMIDD
Y EXP
► M1p JYYYYI
LIMITS
A
DENERAL
✓
LABILITY
COMMERCIAL GENERAL
-Cantr
LABU.ITY
"% OCCUR
CPS1322133
08/02/2011
06/02/2012
EACH OCCURRENCE
$ 1.000:000
$ 100.000
OtEaa ce nce1
I CLAIMS -MACE
MEOW (Any one person)
$ 5.000
✓
Primary Nan
Blanket Waiver
PERSONAL RADVINJURY •
$1.000.000
$2,000.000
$2.000.000
✓
GENERALAGGREOATE
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS •COMPIOPAGG
POLICY I N ( I& 1 I LOC
$
B
B
AUTOMOBILE
Y
✓
LABIUTY
ANY AUTO
AU. OWNED
AUTOS
HIRED AUTOS '
SCHEDULED
AUTOS
AUTO ED
BA 1 A96265A -11 SEL
BA 1 A96265A -11 S EL
BA- 1A96265A -11SEL
5/20/2011
5/20/ 2011
5no/2011
5/20/2012
5/20/2012
5/20/2012
(g eaoctdennn LIMIT
$ 1.000,000
BODILY INJURY (Pet person)
S
BODILY INJURY (Per accrdent)
$
Pl enet oq 'IardE
e
UMBRELLA LUAB F-I OCCUR
EXCESS LAB CLAIMS -MADE
EAH OCCURRENCE
S
AGGREGATE
$
OED I I RETENT ON $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LABILITY
ANY FICCEPIM SBE6 EREX�CLUDED? ""`E LJ
(Mandatory In NH)
Iles, describe ureter
DESCRIPTION OF OPERATIONS baler
N/A
m
. 0830 -48121
05/17/2011
05/17 /2012
WC STAW-
✓ I TORYLIA5T 1 I 0 ER
51.000.000
E.L. .EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
S 1.000,000
E.L DISEASE. POLICY LIMIT
$ 1.000.000
DESCRIPTION OF OPERATIONS t LOSATIONS /VEHICLES (AUach ACORD 101, AddWanal Rern+rka Schadula, If mcra.apa.EO !!UUsdy_._ .,
•
CERTIFICATE HOLDER
Miami Shores Village
10050 NE 2nd Ave
Miami Shores, FL 33138
ACORD 25 (2010/05)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POUCY PROVISIONS.
AUTHORIZED REPRESENTATIVE
®1988.2010 ACORD CORPORATION, All rights reserved.
The ACORD name and logo are registered marks of ACORD
.<<,:: I`. , RENEWAL
710
TION GROUP INC STAT ffi °T 1` 29640
SW 83 ST
UNIN DADE COUNTY
OM &TIFEX CONSTRUCTION GROUP INC
se"'TY BUILDING CONTRACTOR
Taal IS OMY A Lor,AJ.
BUSINESS TAX RECEIPT. PP
DOES ItOT RER T THE
ROM ER TO VIOLATE ANY
Exfl1a P OULATQRY OR
MEM WRVS- OP THE
COW N OR CMS. *OR
ODES MOLDER FROM AM OMR
REMOREb. OW TIOS
UOT A il'taPIDATroca OP
S OUALIPfCA-
DO NOT FORWARD
PONTIFEX CONSTRUCTION GROUP INC
LUIS I RODRIGUEZ PRES
8720 SW 83 ST
o MIAMI FL 33173
TA2I
010004001
0075.00
SEE OTHER SIDE
laailaaaj7aaaailiaaa►aalEa+Iu Jaar�tatJJuIfareaItfllai? II
STATE OF FLORIDA
DEPARTMENT Qr BUSINESS AND monggioNAL REGULATION
CONSTRUCTION INDUSTRY LIcRNSING BOARD SEC lit L110323007!
DATE BATCH NUMBER - C54 ,FE
03 23:2011
100094045
CCC1329690
The ROOFING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2012
RODRIGUEZu LUIS ISRAEL
PONTIFEX CONSTRUCTION GROUP INC
8720 SW 83R0 ST
MIAMI FL 33173-4136
RICK SCOTT
GOVERNOR
DISPLAY AS REQUIRED BY LAW
STATE Of ALCSOOA ACF
DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
CCC1329690 03/23/11 100094045
CERTIFI ROOFING CONTRACTOR
RODRXGUES, LUIS ISRAEL
PONTIFEX CONSTRUCTION GROUP INC
18 CERTIFIED under the provision o Cb,489
expiration data AUG 31, 2012 L11032300752
CHARLIE LIEM
SECRETARY
Master Permit No:
APR 1 I ZCI2
Contractor's Name:
Job Address:
Section A (General I
Process No:
Pontifex Construction Group Inc.
a'
i2. - 3
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
BLDG. DEPT
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
,1 A rr AND COUNTY RULES AND REGULATIONS
790 NE 95 Street Miami Shores, F
Asphaltic Shingles
❑ Sprayed Polyurethane Foam
❑ Mechanically Fastened Tile
❑ Metal Panel /Shingles
❑ Other:
oof Type
g1
Morta s'wd Se1- e
❑ Wood Shingles /Shakes
❑ New Roof ❑ Re- Roofing ❑ Recovering 4 Repair ❑ Maintenance
Are there Gas Vent Stacks located on the roof? ❑ Yes ❑ No
Roof System Information
Low slope roof area (ft.2)
0:50 sq /ft
Steep Sloped area (ft.2)
If yes, what type? ❑ Natural ❑ LPGX
ection B (Roof
Total (ft.2)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include
dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets.
Perimeter Width (a'): Corner Size (a' x a'):
r, fib° rt.
1
al AP 1 1 c5 i2 JJ
B Y:
_ SECTION 1524
HIGH VELOCITY HURRICANE ZONES— REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS
1524.1 Scope. As it pertains to this section, it is the responsibility of the roofmg contractor to provide the owner
with the required roofing permit, and to explain to the owner the content of this section. The provisions of
Chapter 15 of the Florida Building Code, Building 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 and the contractor. The owner's initial in the designated space indicates that the
item has been explained. ,
Js.
1. Aesthetics - workmanship: The workmanship provisions of Chapter 15 (High Veld ' Hurricane
Zone) are for the purpose of providing that the roofmg system meets the wind resistance and watertrusion
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.
I'
2. Renailing wood decks :. When replacing roofing, the existing wood roof deck may have to be
renailed in accordance with the current provisions. ,of Chapter 16 (High Velocity Hurricane Zones) of the Florida
Building Code. (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.). Inbuildings.with common roofs, the roofmg contractor and/or
owner should notify the occupants of adjacent units'ofroofing work to be performed.
4. Exposed ceilings: 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
penetrations of the underside of the decking may mit be acceptable. The owner provides the option of
maintaining this appearance.
5. Ponding water: The current roof system and/or deck of the building may not drain well and may
use water to pond (accumulate) in low- lying . areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original
roofing system is removed. Ponding conditions should be corrected.
6. Overflow scuppers (wall outlets): ' It is required that rainwater flow off so that the roof is not
o erloaded from a build up of water. Perimeter/edge walls or Other roof extensions 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: Chapter 15 and 16 herein and the Flora Building Code, Plumbing.
7. Ventilation:. Most roof structures should have some ability to vent natural airflow through the
interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be
reduced. Exception: Attic spaces, designed by a Florida- licensed engineer or registered architect to eliminate
the attic venting, venting shall not be required.
Owner's /Agent's Signature: — Date: D Y /
Contractor's Signature:
Property Address:
Permit Number: